van den Boom M, Bennani K, Migliori G B, D'Ambrosio L, Centis R, Parvez Sayed A, Atta H Y, Hutin Y
World Health Organization, Regional Office for the Eastern Mediterranean Region, Cairo, Egypt.
Servizio di Epidemiologia Clinica delle Malattie Respiratorie, Istituti Clinici Scientifici Maugeri, Istituto di Ricovero e Cura a Carattere Scientifico, Tradate, Italy.
IJTLD Open. 2024 Jan 1;1(1):50-55. doi: 10.5588/ijtldopen.23.0470. eCollection 2024 Jan.
In 2022, 11 of 22 Member States of the WHO Eastern Mediterranean Region (EMR) had an estimated TB incidence of <20 cases per 100,000 population. We assessed preparedness for elimination and provided recommendations to pursue the process.
We surveyed 11 EMR national TB programme managers and collected information on eight TB elimination framework domains using a close-ended data collection tool. We compiled, consolidated and validated data, including a virtual consultation before triangulating data with other sources.
Implementation was sufficient (≥74%) for 5 of 8 domains, highest for TB infection management, TB preventive treatment, laboratory service, drug management, drug-resistant TB and TB-HIV collaboration (89%, 83% and 78%, respectively). Countries ranked lowest for commitment (73%), operational research and infection control (63%), and partnership/collaborations (41%). Five countries reached >80% when consolidating the responses, reaching sufficient from all domains. Two reached <50%.
Key identified obstacles to TB elimination in EMR were insufficient commitment/financing, sub-optimal partnerships/collaborations and operational research calling for 1) all-stakeholder-inclusive, sustainably funded TB elimination plans, 2) cost-effective tools to exchange strategic information and build operational research capacity, and 3) improved collaboration.
2022年，世界卫生组织东地中海区域（EMR）的22个成员国中有11个国家的结核病估计发病率低于每10万人口20例。我们评估了消除结核病的准备情况，并提出了推进该进程的建议。
我们对11位东地中海区域国家结核病项目管理人员进行了调查，并使用封闭式数据收集工具收集了关于八个结核病消除框架领域的信息。我们汇编、整合并验证了数据，包括在与其他来源的数据进行三角测量之前进行的一次虚拟咨询。
八个领域中有五个领域的实施情况良好（≥74%），结核病感染管理、结核病预防性治疗、实验室服务、药物管理、耐多药结核病和结核病与艾滋病病毒协作领域的实施情况最佳（分别为89%、83%和78%）。各国在承诺（73%）、运筹学和感染控制（63%）以及伙伴关系/合作（41%）方面得分最低。五个国家在汇总答复时达到了80%以上，所有领域均达到了良好水平。两个国家的得分低于50%。
确定的东地中海区域结核病消除的主要障碍是承诺/资金不足、伙伴关系/合作不理想以及运筹学方面的问题，这就需要1）制定所有利益攸关方都参与的、有可持续资金支持的结核病消除计划，2）采用具有成本效益的工具来交流战略信息并建设运筹学能力，以及3）加强合作。
