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Evaluación del control mundial de la tuberculosis. Proyecto de Vigilancia y Monitoreo Global de la OMS
M C Raviglione1, C Dye, S Schmidt
1Global Tuberculosis Programme, World Health Organization, Geneva, Switzerland. RaviglioneM@who.ch
Lancet (London, England)
|August 30, 1997
Resumen
Los programas nacionales de tuberculosis (TB) que utilizan la estrategia de control de la TB de la OMS muestran mejores tasas de curación. Sin embargo, una implementación más amplia es crucial para un impacto global significativo en el control de la TB.
Área de la Ciencia:
- Salud Pública La salud pública.
- Epidemiología La epidemiología.
- Control y Control de Enfermedades Infecciosas
Sus antecedentes:
- La Organización Mundial de la Salud (OMS) inició un proyecto de vigilancia mundial en 1995 para evaluar los esfuerzos de control de la tuberculosis (TB).
- Las evaluaciones anteriores del rendimiento mundial del control de la tuberculosis eran deficientes.
- El proyecto tuvo como objetivo evaluar los programas nacionales de TB y la adopción de la estrategia de control de TB de la OMS.
Objetivo del estudio:
- Evaluar el desempeño de los programas nacionales de TB a nivel mundial.
- Determinar el grado de implementación de la estrategia de control de la TB de la OMS.
- Comparar los resultados del control de la tuberculosis en regiones con y sin la estrategia de la OMS.
Principales métodos:
- Los formularios de recopilación de datos fueron enviados a 216 países/territorios en 1996.
- La información solicitada incluía las políticas de control de la TB, las notificaciones de casos de 1995 y los resultados del tratamiento de 1994.
- El rendimiento del programa se evaluó comparando las notificaciones de casos con la incidencia estimada y analizando los resultados del tratamiento.
Principales resultados:
- 180 países (83%) respondieron, lo que representa el 98% de la población mundial.
- La estrategia de control de la tuberculosis de la OMS se implementó en 75 países en 1995.
- Los países que utilizan la estrategia de la OMS informaron tasas más altas de casos de TB positivos por esputo y mancha (54% frente a 30%) y lograron tasas de éxito del tratamiento significativamente mejores (76% frente a 42%).
Conclusiones:
- Los programas nacionales de TB que adoptan la estrategia de la OMS demuestran tasas de curación más altas.
- El impacto mundial general de la estrategia de la OMS, basado en la cobertura actual, es modesto.
- La implementación amplia y continua de la estrategia de control de la tuberculosis de la OMS es esencial para un control efectivo de la tuberculosis a nivel mundial.
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