Towards tuberculosis elimination: an action framework for low-incidence countries.
Towards tuberculosis elimination: an action framework for low-incidence countries.
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DOI：
10.1183/09031936.00214014
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发表时间：
2015-04
期刊：
影响因子：
--
通讯作者：
Raviglione MC
中科院分区：
文献类型：
--
作者：
Lönnroth K;Migliori GB;Abubakar I;D'Ambrosio L;de Vries G;Diel R;Douglas P;Falzon D;Gaudreau MA;Goletti D;González Ochoa ER;LoBue P;Matteelli A;Njoo H;Solovic I;Story A;Tayeb T;van der Werf MJ;Weil D;Zellweger JP;Abdel Aziz M;Al Lawati MR;Aliberti S;Arrazola de Oñate W;Barreira D;Bhatia V;Blasi F;Bloom A;Bruchfeld J;Castelli F;Centis R;Chemtob D;Cirillo DM;Colorado A;Dadu A;Dahle UR;De Paoli L;Dias HM;Duarte R;Fattorini L;Gaga M;Getahun H;Glaziou P;Goguadze L;Del Granado M;Haas W;Järvinen A;Kwon GY;Mosca D;Nahid P;Nishikiori N;Noguer I;O'Donnell J;Pace-Asciak A;Pompa MG;Popescu GG;Robalo Cordeiro C;Rønning K;Ruhwald M;Sculier JP;Simunović A;Smith-Palmer A;Sotgiu G;Sulis G;Torres-Duque CA;Umeki K;Uplekar M;van Weezenbeek C;Vasankari T;Vitillo RJ;Voniatis C;Wanlin M;Raviglione MC
本文描述了结核病发病率低（每百万人口中结核病病例<100例）的国家努力消除结核病的行动框架。该框架规定了这些国家所需的优先干预措施，以首先实现“消灭前”（每百万人少于10例），并最终消除结核病这一公共卫生问题（每百万人少于1例）。在大多数低发病率国家，结核病流行病学的特点是一般人群中的传播率低，偶尔爆发，大多数结核病病例是由潜伏性结核感染（LTBI）的进展而不是本地传播产生的，集中于某些脆弱和难以接触的风险群体，以及跨境移民带来的挑战。卫生系统面临的共同挑战是，随着结核病发病率福尔斯的下降，政治承诺、资金、临床专业知识和对结核病的普遍认识都在减少。该框架针对这些挑战提出了有针对性的对策，分为八个优先行动领域：（1）确保规划和基本服务的政治承诺、资金和管理;（2）解决最脆弱和最难以接触的群体;（3）解决移民的特殊需要和跨界问题;（4）解决移民的特殊需要和跨界问题。4）在结核病接触者和选定的高危人群中筛查活动性结核病和LTBI，并提供适当的治疗; 5）优化耐药结核病的预防和护理; 6）确保持续监测、方案监测和评估以及基于病例的数据管理; 7）投资于研究和新工具; 8）支持全球结核病预防、护理和控制。总体方法需要是多部门的，重点是公平获得高质量的诊断和护理，并解决结核病的社会决定因素。由于全球化和人口流动性的增加，应对措施需要兼顾国家和全球层面。结核病发病率低的国家行动框架：消除结核病的一致办法http://ow.ly/H03ZZ
This paper describes an action framework for countries with low tuberculosis (TB) incidence (<100 TB cases per million population) that are striving for TB elimination. The framework sets out priority interventions required for these countries to progress first towards “pre-elimination” (<10 cases per million) and eventually the elimination of TB as a public health problem (less than one case per million). TB epidemiology in most low-incidence countries is characterised by a low rate of transmission in the general population, occasional outbreaks, a majority of TB cases generated from progression of latent TB infection (LTBI) rather than local transmission, concentration to certain vulnerable and hard-to-reach risk groups, and challenges posed by cross-border migration. Common health system challenges are that political commitment, funding, clinical expertise and general awareness of TB diminishes as TB incidence falls. The framework presents a tailored response to these challenges, grouped into eight priority action areas: 1) ensure political commitment, funding and stewardship for planning and essential services; 2) address the most vulnerable and hard-to-reach groups; 3) address special needs of migrants and cross-border issues; 4) undertake screening for active TB and LTBI in TB contacts and selected high-risk groups, and provide appropriate treatment; 5) optimise the prevention and care of drug-resistant TB; 6) ensure continued surveillance, programme monitoring and evaluation and case-based data management; 7) invest in research and new tools; and 8) support global TB prevention, care and control. The overall approach needs to be multisectorial, focusing on equitable access to high-quality diagnosis and care, and on addressing the social determinants of TB. Because of increasing globalisation and population mobility, the response needs to have both national and global dimensions. Action framework for countries with low tuberculosis incidence: a coherent approach for eliminating tuberculosis http://ow.ly/H03ZZ
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影响因子：
24.3
作者：
Broekmans, JF;Migliori, GB;Raviglione, MC
通讯作者：
Raviglione, MC
影响因子：
3.9
作者：
Cantini, Fabrizio;Niccoli, Laura;Goletti, Delia
通讯作者：
Goletti, Delia
影响因子：
6.4
作者：
Abubakar, Ibrahim;Stagg, Helen R.;Zumla, Alimuddin
通讯作者：
Zumla, Alimuddin
影响因子：
3.9
作者：
Arinaminpathy, Nimalan;Dye, Christopher
通讯作者：
Dye, Christopher
影响因子：
11.8
作者：
Borgdorff, MW;van der Werf, MJ;van Soolingen, D
通讯作者：
van Soolingen, D