04207nas a2200973   4500000000100000008004100001100001600042700001600058700001500074700001700089700001200106700001100118700001400129700001300143700001500156700001400171700002200185700001200207700001600219700001100235700001400246700001200260700001200272700001200284700001100296700001600307700001700323700001600340700001500356700002500371700001500396700001300411700001200424700001200436700001600448700001500464700001300479700001400492700001500506700001500521700001100536700001300547700001500560700001100575700001300586700001600599700001100615700001400626700001400640700001500654700001800669700001100687700001600698700001100714700001200725700001200737700001700749700001300766700001600779700001800795700001300813700001400826700002200840700001500862700001400877700001400891700001700905700001900922700001300941700001200954700002100966700001200987700001400999700001701013700001601030700001501046700001501061700001301076700001701089245008701106856008801193520193801281022001403219       2015                            d1 aLönnroth K1 aMigliori GB1 aAbubakar I1 aD'Ambrosio L1 aVries G1 aDiel R1 aDouglas P1 aFalzon D1 aGaudreau M1 aGoletti D1 aGonzález Ochoa E1 aLoBue P1 aMatteelli A1 aNjoo H1 aSolovic I1 aStory A1 aTayeb T1 aWerf MJ1 aWeil D1 aZellweger J1 aAbdel Aziz M1 aAl Lawati M1 aAliberti S1 aArrazola de Oñate W1 aBarreira D1 aBhatia V1 aBlasi F1 aBloom A1 aBruchfeld J1 aCastelli F1 aCentis R1 aChemtob D1 aCirillo DM1 aColorado A1 aDadu A1 aDahle UR1 aDe Paoli L1 aDias H1 aDuarte R1 aFattorini L1 aGaga M1 aGetahun H1 aGlaziou P1 aGoguadze L1 aDel Granado M1 aHaas W1 aJärvinen A1 aKwon G1 aMosca D1 aNahid P1 aNishikiori N1 aNoguer I1 aO'Donnell J1 aPace-Asciak A1 aPompa MG1 aPopescu G1 aRobalo Cordeiro C1 aRønning K1 aRuhwald M1 aSculier J1 aSimunović A1 aSmith-Palmer A1 aSotgiu G1 aSulis G1 aA Torres-Duque C1 aUmeki K1 aUplekar M1 aWeezenbeek C1 aVasankari T1 aVitillo RJ1 aVoniatis C1 aWanlin M1 aRaviglione M00aTowards tuberculosis elimination: an action framework for low-incidence countries.  uhttp://erj.ersjournals.com/content/early/2015/03/18/09031936.00214014.full.pdf+html3 a<p>This paper describes an action framework for countries with low tuberculosis (TB) incidence (&lt;100 TB cases per million population) that are striving for TB elimination. The framework sets out priority interventions required for these countries to progress first towards "pre-elimination" (&lt;10 cases per million) and eventually the elimination of TB as a public health problem (less than one case per million). TB epidemiology in most low-incidence countries is characterised by a low rate of transmission in the general population, occasional outbreaks, a majority of TB cases generated from progression of latent TB infection (LTBI) rather than local transmission, concentration to certain vulnerable and hard-to-reach risk groups, and challenges posed by cross-border migration. Common health system challenges are that political commitment, funding, clinical expertise and general awareness of TB diminishes as TB incidence falls. The framework presents a tailored response to these challenges, grouped into eight priority action areas: 1) ensure political commitment, funding and stewardship for planning and essential services; 2) address the most vulnerable and hard-to-reach groups; 3) address special needs of migrants and cross-border issues; 4) undertake screening for active TB and LTBI in TB contacts and selected high-risk groups, and provide appropriate treatment; 5) optimise the prevention and care of drug-resistant TB; 6) ensure continued surveillance, programme monitoring and evaluation and case-based data management; 7) invest in research and new tools; and 8) support global TB prevention, care and control. The overall approach needs to be multisectorial, focusing on equitable access to high-quality diagnosis and care, and on addressing the social determinants of TB. Because of increasing globalisation and population mobility, the response needs to have both national and global dimensions.</p>
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