2019, Number 4
The challenge of eliminating childhood tuberculosis in Cuba
Language: English
References: 39
Page: 59-63
PDF size: 69.84 Kb.
ABSTRACT
WHO’s 2015 End Tuberculosis Strategy can succeed only through universal health coverage, social protection, poverty alleviation and effective multisector actions to tackle social determinants in general. The pediatric age group is particularly vulnerable to tuberculosis and historically neglected worldwide. However, this group is a priority within Cuba’s National Tuberculosis Control Program that has functioned since 1970, and Cuba is considered a low-incidence country with rates <7 per 100,000 population since 2011. Tuberculosis incidence in children aged <15 years is <1 per 100,000, similar to that reported in high-income countries and representing less than 2% of total cases in Cuba. Since 1999, no deaths from tuberculosis, coinfection with HIV or resistance to the two first-line TB drugs have been reported in affected children, and most diagnosed cases correspond to early, primary forms of the disease. These results place Cuba among the countries on track to eliminate TB by 2050. This article reviews the pillars and components of the 2015 End TB Strategy and the strategies developed by the National Tuberculosis Control Program that enabled Cuba to bring incidence below the 2035 targets of WHO’s End TB strategy. The article also proposes other actions Cuba can take, despite limited resources, to eliminate TB, particularly in the pediatric age group.REFERENCES
Ministry of Public Health (CU). Resolución Ministerial 277/2014. Programa Nacional de Control de la Tuberculosis. Manual de normas y procedimientos [Internet]. Havana: Editorial Ciencias Médicas; 2014 [cited 2018 Oct 27]. 201 p. Available from: http://www.sld.cu/galerias/pdf/sitios/ tuberculosis/programa_2015.pdf. Spanish.
González E, Díaz R, Suárez L, Abreu G, Armas L, Beldarraín E, et al. Eliminación de la tuberculosis en Cuba: contribuciones recientes, resultados y desafíos. Rev Cubana Med Trop [Internet]. 2017 [cited 2018 Nov 20];69(3). Available from: http://www.revmedtropical.sld .cu/index.php/medtropical/article/view/260/174. Spanish.
Mellado Peña MJ, Santiago García B, Baquero- Artigaoa F, Moreno Pérez D, Piñeiro Pérez R, Méndez Echevarría A, et al. Actualización del tratamiento de la tuberculosis en niños. An Pediatr (Barc) [Internet]. 2018 [cited 2018 Oct 27];88(1):52.e1–52.e12. Available from: https:// doi.org/10.1016/j.anpedi.2017.05.013. Spanish.
National Health Statistics and Medical Records Division (CU). Anuario Estadístico de Salud 2018 [Internet]. Havana: Ministry of Public Health (CU); 2019 [cited 2019 May 27]. 206 p. Available from: http:// les.sld.cu/bvscuba/ les/2019/04/Anuario -Electr%C3%B3nico-Espa%C3%B1ol-2018 -ed-2019-compressed.pdf. Spanish.
Erkens CG, de Vries G, Keizer ST, Slump E, van den Hof S. The epidemiology of childhood tuberculosis in the Netherlands: still room for prevention. BMC Infect Dis [Internet]. 2014 May 31 [cited 2019 Feb 20];14:295. Available from: https://bmcinfectdis.biomedcentral.com/articles/ 10.1186/1471-2334-14-295
Abreu G, González JA, González E, Bouza I, Velázquez A, Pérez T, et al. Cuba’s strategy for childhood tuberculosis control, 1995–2005. MEDICC Rev [Internet]. 2011 Jul [cited 2018 Sep 20];13(3):29–34. Available from: http:// www.scielosp.org/scielo.php?script=sci_arttext &pid=S1555-79602011000300007&lng=en
Monteiro de Andrade LO, Pellegrini Fhilo A, Solar O, Rígoli F, Malagón de Salazar L, Castell- Florit Serrate P, et al. Determinantes sociales de salud, cobertura universal de salud y desarrollo sostenible: estudios de caso en países latinoamericanos. MEDICC Rev [Internet]. 2015 [cited 2018 Sep 20];17(Suppl):S53–61. Available from: http://mediccreview.org/determi nantes-sociales-de-salud-cobertura-universal -de-salud-y-desarrollo-sostenible-estudios-de -caso-en-paises-latinoamericanos/. Spanish.
Verdasquera Corcho D, Ramos Valle I, Borroto Gutiérrez S, Rumbaut Castillo R, Pérez Ávila LJ, Alfonso Berrio L, et al. Capacidad de respuesta y desafíos del sistema de salud cubano frente a las enfermedades trasmisibles. Rev Panam Salud Publica [Internet]. 2018 [cited 2018 Oct 27];42:e30. Available from: http://doi .org/10.26633/RPSP.2018.30. Spanish.
Muñoz Peña R, Reynel PGE, Abreu Suárez G, González Valdés JA, Rodríguez Vargas LE. Control de foco de tuberculosis en menores de 15 años. Rev Cubana Pediatr [Internet]. 2014 [cited 2018 Sep 20];86(2). Available from: http:// scielo.sld.cu/scielo.php?script=sci_arttext&pid =S0034-75312014000200007. Spanish.
Abreu Suárez G, González Valdés JA, Muñoz Peña R, Solar Salaverri LA, Marchena Béquer JJ. La preparación del estudiante de Medicina para la eliminación de la tuberculosis. Educ Med Super [Internet]. 2013 [cited 2013 May 20];27(1). Available from: http://www.ems.sld.cu/index.php/ ems/article/view/113/68. Spanish.
World Medical Association [Internet]. Ferney- Voltaire (FR); c2019. Declaración de Helsinki de la AMM -Principios éticos para las investigaciones médicas en seres humanos; [updated 2015 May; cited 2019 Jan 15]. Available from: https:// www.wma.net/es/policies-post/declaracion-de -helsinki-de-la-amm-principios-eticos-para-las -investigaciones-medicas-en-seres-humanos/. Spanish.
Lemus D, Echemendía M, Díaz R, Llanes MJ, Suárez L, Marrero A. Antituberculosis drug resistance in pulmonary isolates of Mycobacterium tuberculosis, Cuba 2012-2014. MEDICC Rev [Internet]. 2017 Jan [cited 2018 Oct 27];19(1):10–5. Available from: http://mediccreview.org/antituber culosis-drug-resistance-in-pulmonary-isolates -of-mycobacterium-tuberculosis-cuba-2012-2014/
Morales Ojeda R, Mas Bermejo P, Castell-Florit P, Arocha Mariño C, Valdivia Onega NC, Druyet Castillo D, et al. Transformaciones en el sistema de salud en Cuba y estrategias actuales para su consolidación y sostenibilidad. Rev Panam Salud Publica [Internet]. 2018 Apr [cited 2018 Oct 22];42:e25. Available from: http://doi .org/10.26633/RPSP.2018.25. Spanish.
Gálvez González AM, González López R, Álvarez Muñiz M, Vidal Ledo MJ, Suárez Lugo NC, Vázquez Santiesteban M. Consideraciones económicas sobre la salud pública cubana y su relación con la salud universal. Rev Panam Salud Publica [Internet]. 2018 [cited 2018 Sep 20];42:e28. Available from: http://doi .org/10.26633/RPSP.2018.28. Spanish.
Atun R, Monteiro de Andrade LO, Almeida G, Cotlear D, Dmytraczenko T, Frenz P. La reforma de los sistemas de salud y la cobertura universal de salud en América Latina. MEDICC Rev [Internet]. 2015 [cited 2018 Sep 20];17(Suppl):S21–39. Available from: http://mediccreview.org/la-refor ma-de-los-sistemas-de-salud-y-la-cobertura -universal-de-salud-en-america-latina/. Spanish.
Rojo Pérez N, Valenti Pérez C, Martínez Trujillo N, Morales Suárez I, Martínez Torres E, Fleitas Estévez I, et al. Ciencia e innovación tecnológica en la salud en Cuba: resultados en problemas seleccionados. Rev Panam Salud Publica [Internet]. 2018 Apr [cited 2019 Feb 17];42:e32. Available from: http://doi.org/10.26633/RPSP.2018.32. Spanish.