Tuberculosis Warning: You are not logged in. Your IP address will be publicly visible if you make any edits. If you log in or create an account, your edits will be attributed to your username, along with other benefits.Anti-spam check. Do not fill this in! === Public health efforts === {{Further information|Tuberculosis elimination}} In 2014, the WHO adopted the "End TB" strategy which aims to reduce TB incidence by 80% and TB deaths by 90% by 2030.<ref name="who_end_tb">{{Cite web|url=https://www.who.int/teams/global-tuberculosis-programme/the-end-tb-strategy|title=The End TB Strategy|website=who.int|access-date=22 July 2021|archive-date=22 July 2021|archive-url=https://web.archive.org/web/20210722170507/https://www.who.int/teams/global-tuberculosis-programme/the-end-tb-strategy|url-status=live}}</ref> The strategy contains a milestone to reduce TB incidence by 20% and TB deaths by 35% by 2020.<ref name="2020_TB_report">{{Cite book |url=https://apps.who.int/iris/rest/bitstreams/1312164/retrieve |title=Global tuberculosis report 2020 |year=2020 | publisher = World Health Organization | isbn = 978-92-4-001313-1 |access-date=22 July 2021 |archive-date=22 July 2021 |archive-url= https://web.archive.org/web/20210722172009/https://apps.who.int/iris/rest/bitstreams/1312164/retrieve |url-status=live }}</ref> However, by 2020 only a 9% reduction in incidence per population was achieved globally, with the European region achieving 19% and the African region achieving 16% reductions.<ref name="2020_TB_report"/> Similarly, the number of deaths only fell by 14%, missing the 2020 milestone of a 35% reduction, with some regions making better progress (31% reduction in Europe and 19% in Africa).<ref name="2020_TB_report"/> Correspondingly, also treatment, prevention and funding milestones were missed in 2020, for example only 6.3 million people were started on TB prevention short of the target of 30 million.<ref name="2020_TB_report"/> The World Health Organization (WHO), the [[Bill and Melinda Gates Foundation]], and the U.S. government are subsidizing a fast-acting diagnostic tuberculosis test for use in low- and middle-income countries as of 2012.<ref name=PressRelease2012/><ref name=Xpert2011>{{cite journal | vauthors = Lawn SD, Nicol MP | title = Xpert® MTB/RIF assay: development, evaluation and implementation of a new rapid molecular diagnostic for tuberculosis and rifampicin resistance | journal = Future Microbiology | volume = 6 | issue = 9 | pages = 1067–82 | date = September 2011 | pmid = 21958145 | pmc = 3252681 | doi = 10.2217/fmb.11.84 }}</ref><ref>{{cite news |url=https://www.reuters.com/article/idUSTRE6B71RF20101208 |title=WHO says Cepheid rapid test will transform TB care |work=[[Reuters]] |date=8 December 2010 |url-status=live |archive-url=https://web.archive.org/web/20101211140847/http://www.reuters.com/article/idUSTRE6B71RF20101208 |archive-date=11 December 2010 }}</ref> In addition to being fast-acting, the test can determine if there is resistance to the antibiotic rifampicin which may indicate multi-drug resistant tuberculosis and is accurate in those who are also infected with HIV.<ref name=PressRelease2012>{{cite web|title=Public–Private Partnership Announces Immediate 40 Percent Cost Reduction for Rapid TB Test|url=https://www.who.int/tb/features_archive/GeneXpert_press_release_final.pdf|publisher=World Health Organization (WHO)|date=6 August 2012|url-status=live|archive-url=https://web.archive.org/web/20131029234310/http://www.who.int/tb/features_archive/GeneXpert_press_release_final.pdf|archive-date=29 October 2013}}</ref><ref>{{cite web|title=The Stop TB Partnership, which operates through a secretariat hosted by the World Health Organization (WHO) in Geneva, Switzerland|url=http://www.stoptb.org/wg/gli/assets/documents/map/XpertPublications.pdf|author=STOPTB|date=5 April 2013|url-status=live|archive-url=https://web.archive.org/web/20140124041952/http://www.stoptb.org/wg/gli/assets/documents/map/XpertPublications.pdf|archive-date=24 January 2014}}</ref> Many resource-poor places {{as of|2011|lc=yes}} have access to only sputum microscopy.<ref>{{cite journal | vauthors = Lienhardt C, Espinal M, Pai M, Maher D, Raviglione MC | title = What research is needed to stop TB? Introducing the TB Research Movement | journal = PLOS Medicine | volume = 8 | issue = 11 | pages = e1001135 | date = November 2011 | pmid = 22140369 | pmc = 3226454 | doi = 10.1371/journal.pmed.1001135 | doi-access = free }}</ref> India had the highest total number of TB cases worldwide in 2010, in part due to poor disease management within the private and public health care sector.<ref>{{Cite journal| vauthors = Sandhu GK |date=2011|title=Tuberculosis: Current Situation, Challenges and Overview of its Control Programs in India|journal=Journal of Global Infectious Diseases|volume=3|issue=2|pages=143–150|doi=10.4103/0974-777X.81691|issn=0974-777X|pmc=3125027|pmid=21731301 |doi-access=free }}</ref> Programs such as the [[Revised National Tuberculosis Control Program]] are working to reduce TB levels among people receiving public health care.<ref name="Bhargava">{{cite journal | vauthors = Bhargava A, Pinto L, Pai M |title=Mismanagement of tuberculosis in India: Causes, consequences, and the way forward |journal=Hypothesis |volume=9 |issue=1 |page=e7 |year=2011 |url=http://www.hypothesisjournal.com/wp-content/uploads/2011/09/vol9no1-hj009.pdf |archive-url=https://web.archive.org/web/20160314104924/http://www.hypothesisjournal.com/wp-content/uploads/2011/09/vol9no1-hj009.pdf |archive-date=14 March 2016 |url-status=unfit }}</ref><ref>{{cite journal | vauthors = Amdekar Y | s2cid = 41788291 | title = Changes in the management of tuberculosis | journal = Indian Journal of Pediatrics | volume = 76 | issue = 7 | pages = 739–42 | date = July 2009 | pmid = 19693453 | doi = 10.1007/s12098-009-0164-4 }}</ref> A 2014 [[Economist Intelligence Unit|EIU]]-healthcare report finds there is a need to address apathy and urges for increased funding. The report cites among others Lucica Ditui "[TB] is like an orphan. It has been neglected even in countries with a high burden and often forgotten by donors and those investing in health interventions."<ref name="EIU 2014"/> Slow progress has led to frustration, expressed by the executive director of the [[Global Fund to Fight AIDS, Tuberculosis and Malaria]] – Mark Dybul: "we have the tools to end TB as a pandemic and public health threat on the planet, but we are not doing it."<ref name="EIU 2014"/> Several international organizations are pushing for more transparency in treatment, and more countries are implementing mandatory reporting of cases to the government as of 2014, although adherence is often variable. Commercial treatment providers may at times overprescribe second-line drugs as well as supplementary treatment, promoting demands for further regulations.<ref name="EIU 2014"/> The government of Brazil provides universal TB care, which reduces this problem.<ref name="EIU 2014"/> Conversely, falling rates of TB infection may not relate to the number of programs directed at reducing infection rates but may be tied to an increased level of education, income, and health of the population.<ref name="EIU 2014"/> Costs of the disease, as calculated by the [[World Bank]] in 2009 may exceed US$150 billion per year in "high burden" countries.<ref name="EIU 2014"/> Lack of progress eradicating the disease may also be due to lack of patient follow-up – as among the 250 million [[migration in China|rural migrants in China]].<ref name="EIU 2014"/> There is insufficient data to show that active contact tracing helps to improve case detection rates for tuberculosis.<ref>{{cite journal | vauthors = Fox GJ, Dobler CC, Marks GB | title = Active case finding in contacts of people with tuberculosis | journal = The Cochrane Database of Systematic Reviews | issue = 9 | pages = CD008477 | date = September 2011 | volume = 2011 | pmid = 21901723 | pmc = 6532613 | doi = 10.1002/14651858.CD008477.pub2 }}</ref> Interventions such as house-to-house visits, educational leaflets, mass media strategies, educational sessions may increase tuberculosis detection rates in short-term.<ref>{{cite journal | vauthors = Mhimbira FA, Cuevas LE, Dacombe R, Mkopi A, Sinclair D | title = Interventions to increase tuberculosis case detection at primary healthcare or community-level services | journal = The Cochrane Database of Systematic Reviews | volume = 2017 | pages = CD011432 | date = November 2017 | issue = 11 | pmid = 29182800 | pmc = 5721626 | doi = 10.1002/14651858.CD011432.pub2 | collaboration = Cochrane Infectious Diseases Group }}</ref> There is no study that compares new methods of contact tracing such as social network analysis with existing contact tracing methods.<ref>{{cite journal | vauthors = Braganza Menezes D, Menezes B, Dedicoat M | title = Contact tracing strategies in household and congregate environments to identify cases of tuberculosis in low- and moderate-incidence populations | journal = The Cochrane Database of Systematic Reviews | volume = 2019 | pages = CD013077 | date = August 2019 | issue = 8 | pmid = 31461540 | pmc = 6713498 | doi = 10.1002/14651858.CD013077.pub2 | collaboration = Cochrane Infectious Diseases Group }}</ref> Summary: Please note that all contributions to Christianpedia may be edited, altered, or removed by other contributors. If you do not want your writing to be edited mercilessly, then do not submit it here. You are also promising us that you wrote this yourself, or copied it from a public domain or similar free resource (see Christianpedia:Copyrights for details). Do not submit copyrighted work without permission! Cancel Editing help (opens in new window) Discuss this page