Ending tuberculosis in a post-COVID-19 world: a person-centred, equity-oriented approach.
Ending tuberculosis in a post-COVID-19 world: a person-centred, equity-oriented approach.
复制标题
在covid -19后的世界中消除结核病：以人为本、以公平为导向的方法。
DOI：
10.1016/s1473-3099(22)00500-x
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发表时间：
2023-03
影响因子：
56.3
通讯作者：
Dowdy, David W
中科院分区：
文献类型：
--
作者：
Ryckman, Theresa;Robsky, Katherine;Cilloni, Lucia;Zawedde-Muyanja, Stella;Ananthakrishnan, Ramya;Kendall, Emily A;Shrestha, Sourya;Turyahabwe, Stavia;Katamba, Achilles;Dowdy, David W
COVID-19大流行扰乱了包括结核病在内的传染病护理系统，并暴露了长期以来损害防治这些疾病努力的普遍不公平现象。由此产生的健康差距往往在个人和社区两级交织在一起，增加了感染结核病的可能性。对结核病（和其他传染病）的有效应对必须应对这些现实。遗憾的是，目前的结核病防治方案一般不是从受影响个人的角度设计的，未能解决健康差距的结构性决定因素。我们描述了一个以人为本，以公平为导向的反应，将确定和关注受差异影响的社区，量身定制的干预措施的机制，差距恶化结核病，并解决这些差距的上游决定因素。我们详细介绍了该方法的四个关键要素（数据收集，方案设计，实施和可持续性）。然后，我们说明了如何在多个层次的组织可能的合作伙伴和适应当前的做法，以纳入这些元素。这种方法可以在社区一级更大幅度、可持续和公平地减少结核病负担，突出表明以更加以人为本、以公平为导向的方式重建COVID-19后卫生系统的紧迫性。
The COVID-19 pandemic has disrupted systems of care for infectious diseases—including tuberculosis—and has exposed pervasive inequities that have long marred efforts to combat these diseases. The resulting health disparities often intersect at the individual and community levels in ways that heighten vulnerability to tuberculosis. Effective responses to tuberculosis (and other infectious diseases) must respond to these realities. Unfortunately, current tuberculosis programmes are generally not designed from the perspectives of affected individuals and fail to address structural determinants of health disparities. We describe a person-centred, equity-oriented response that would identify and focus on communities affected by disparities, tailor interventions to the mechanisms by which disparities worsen tuberculosis, and address upstream determinants of those disparities. We detail four key elements of the approach (data collection, programme design, implementation, and sustainability). We then illustrate how organisations at multiple levels might partner and adapt current practices to incorporate these elements. Such an approach could generate more substantial, sustainable, and equitable reductions in tuberculosis burden at the community level, highlighting the urgency of restructuring post-COVID-19 health systems in a more person-centred, equity-oriented way.