Tuberculosis: research estimates that Brazil will not meet WHO targets by 2030

Researchers from Fiocruz Bahia have identified the main predictors of tuberculosis incidence in Brazil by analyzing the disease records from January 2018 to December 2023, and have made projections from 2024 to 2030. The results suggest that, although valuable, current public policies are not enough to reduce the burden of tuberculosis, according to the World Health Organization (WHO) elimination plan.

The study, coordinated by Fiocruz Bahia researcher Bruno Bezerril, was published in The Lancet Regional Health - Americas to assess the possible impact of strategic public health interventions to reduce the incidence of the disease in the country. In 2023, the incidence of tuberculosis in Brazil was 39.8 cases per 100,000 inhabitants, well above the WHO target of 6.7 cases per 100,000. The study predicts that this rate will be even higher by 2030: 42.1 per 100,000 people per year.

The research identified incarceration and TB comorbidity with HIV and diabetes mellitus as the main predictors, as well as coverage of directly observed therapy (DOT), contact and completion of preventive treatment (TPT). The challenges to meeting the global targets for eliminating the disease were limited access to healthcare, non-adherence to treatment, the impact of the COVID-19 pandemic and limited resources for innovative actions to control the disease in the last decade.

Integrated strategies

The experts assessed that if there was an increase in DOT coverage, adherence to TPT and contact investigation, combined with efforts to reduce tuberculosis cases among vulnerable populations, the incidence could be reduced to 18.5 cases per 100,000, although this is still above the WHO targets. With these interventions, reductions of 25.1% in the projected incidence by 2025 and 56.1% by 2030 were observed, highlighting the potential of integrated strategies.

The article also highlighted the need to improve tuberculosis control programs in prison settings, by improving screening, access to TPT and completion of treatment, as well as better co-management of cases of co-infection with HIV and diabetes, with increased testing and initiation of treatment, in order to significantly reduce the national incidence rates of the disease.

The data used in the study was collected from the Information System for Notifiable Diseases (SINAN-TB), the Information System for Special Tuberculosis Treatments (Site-TB), and the Information System for Notifying People Undergoing Treatment for LTBI (IL-TB).