Ministry of Health expands treatment options for Tuberculosis — Português (Brasil)

Tuberculosis is a serious public health problem that for centuries has remained among the infectious diseases that kill the most in the world. Together with the World Health Organization (WHO), the Ministry of Health adhered to the goals of reducing the disease incidence rate by 90% and the number of deaths to 230 by 2035, when compared to 2015 data. annually, the folder warns of the importance of early detection and diagnosis in coping with the disease.

In the period between 2019 and 2022, five new drugs and five new diagnostic methods for sensitive tuberculosis, for drug-resistant tuberculosis (DRTB) and for latent Mycobacterium infection were incorporated into the Unified Health System (SUS), for acquisition and centralized distribution by the Folder. tuberculosis (ILTB). These tools represent an important advance for patient care, as it speeds up diagnosis, prevents disease and expands treatment options.

For the diagnosis of tuberculosis, access to standardized tests was expanded. Among them, a cartridge that offers higher quality rapid molecular testing; automated liquid culture, which speeds up the diagnosis of drug-resistant tuberculosis; and a test that also offers the quickest identification of resistance and optimizes the prescription of drug treatment based on laboratory results.

In addition, the incorporation of the lateral flow test for detection in urine was recommended, yet another alternative for the early diagnosis of TB for people living with HIV/AIDS. A test for diagnosing LTBI in people living with HIV/AIDS, children with contact with tuberculosis cases, people with immune-mediated inflammatory diseases and recipients of stem cell or solid organ transplants was also incorporated into the public health network. More recently, its target audience has been expanded, including people using immunobiologicals, immunosuppressants or pre-organ transplantation.

For children under 10 years of age, two new drugs were made available, in a fixed combined dose, in the pediatric presentation of dispersible tablets for the treatment of tuberculosis. It is important to highlight that the main way to prevent severe forms of tuberculosis in children is through immunization. The BCG vaccine is offered by SUS and should be applied to newborns or children up to 4 years, 11 months and 29 days old.

Regarding treatment, delamanid and bedaquiline were incorporated to treat cases in which patients showed resistance or intolerance to the treatment already available. With this incorporation, Brazil updates the therapeutic schemes for drug-resistant tuberculosis, in accordance with current WHO recommendations. There was also the incorporation of rifapentine, which favors adherence to the treatment of latent infection, an important disease prevention strategy.

There was also an improvement in the Rapid Molecular Tuberculosis Test Network (RTR-TB), with approximately 460,000 diagnostic exams performed, between January and October 2022, by the Rapid Molecular Tuberculosis Test (TRM-TB), the method considered to be of choice for the initial diagnosis of TB cases, which represents an increase of about 35% when evaluating the same period of the previous year.

In addition to the incorporation of new technologies, in 2019 Public Notice No. 01/2019 was launched for the qualification of national and regional reference laboratories for tuberculosis and microbacteria (NTM), within the scope of the National Network of Public Health Laboratories. On January 27, 2020, Ordinance No. 54/2019 was published, officializing the qualification of a national reference laboratory and four regional reference laboratories, thus composing the network of reference laboratories in TB and NTM.

The Ministry also submitted to public consultation the review of the National Plan to end Tuberculosis as a Public Health Problem, 2021-2025, material constructed with the participation of civil society and researchers. It is a strategic, operational and specific document that organizes efforts to control tuberculosis, linking national and international actions, in particular the Global Strategy to end the disease. The “Brazil free of TB” Plan was agreed upon at the Tripartite Intermanagers Commission and is formalized by Ordinance GM/MS No. 154 of February 10, 2022.

Ministry of Health

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