Monitoring predictors of mortality: A necessary action to reach TB elimination
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"apellidos" => "Migliori" "email" => array:1 [ 0 => "giovannibattista.migliori@fsm.it" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "affb" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor1" ] ] ] ] "afiliaciones" => array:3 [ 0 => array:3 [ "entidad" => "Department of Infectious Diseases – Galliera Hospital, Genoa, Italy" "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "affa" ] 1 => array:3 [ "entidad" => "WHO Collaborating Centre for Tuberculosis & Lung Diseases, Fondazione S. Maugeri, IRCCS, Tradate, Italy" "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "affb" ] 2 => array:3 [ "entidad" => "Public Health Consulting Group, Lugano, Switzerland" "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "affc" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor1" "etiqueta" => "<span class="elsevierStyleSup">*</span>" "correspondencia" => "Corresponding author. giovannibattista.migliori@fsm.it" ] ] ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:8 [ "identificador" => "fig1" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "copyright" => "Elsevier España" "figura" => array:1 [ 0 => array:4 [ "imagen" => "320v21n06-90445966fig1.jpg" "Alto" => 1044 "Ancho" => 2667 "Tamanyo" => 399348 ] ] "descripcion" => array:1 [ "en" => "Definitions of elimination and pre-elimination." ] ] ] "textoCompleto" => "<p class="elsevierStylePara">In this issue of the Revista Portuguesa de Pneumologia – Portuguese Journal of Pulmonology Spinola and colleagues report about the predictors of mortality during tuberculosis (TB) treatment identified in Northern Portugal.<a href="#bib18" class="elsevierStyleCrossRefs"><span class="elsevierStyleSup">1</span></a></p><p class="elsevierStylePara">Although the paper deals with a limited geographical area of a relatively small European country, the data reported raise some interesting issues for discussion. The study findings are of particular interest as Portugal remains a country with intermediate TB incidence rates (in a way close to those of Eastern Europe), but with an in-country variability depicting a country in-between persistence of intermediate TB incidence/transmission and shift towards low incidence/pre-Elimination dynamics.</p><p class="elsevierStylePara">Aim of the present manuscript is to discuss the importance of looking carefully at TB treatment outcomes, and in particular to TB mortality death rates, in the perspective of TB Elimination.</p><p class="elsevierStylePara">The findings of the study by Spinola et al.<a href="#bib18" class="elsevierStyleCrossRefs"><span class="elsevierStyleSup">1</span></a> are discussed having in mind the treatment outcomes achieved in Europe and in the different WHO Regions. Data have been retrieved through the WHO and ECDC last annual reports and other relevant published figures and relevant documents.<a href="#bib19" class="elsevierStyleCrossRefs"><span class="elsevierStyleSup">2</span></a><span class="elsevierStyleSup">, </span><a href="#bib20" class="elsevierStyleCrossRefs"><span class="elsevierStyleSup">3</span></a><span class="elsevierStyleSup">, </span><a href="#bib21" class="elsevierStyleCrossRefs"><span class="elsevierStyleSup">4</span></a><span class="elsevierStyleSup">, </span><a href="#bib22" class="elsevierStyleCrossRefs"><span class="elsevierStyleSup">5</span></a><span class="elsevierStyleSup">, </span><a href="#bib23" class="elsevierStyleCrossRefs"><span class="elsevierStyleSup">6</span></a><span class="elsevierStyleSup">, </span><a href="#bib24" class="elsevierStyleCrossRefs"><span class="elsevierStyleSup">7</span></a><span class="elsevierStyleSup">, </span><a href="#bib25" class="elsevierStyleCrossRefs"><span class="elsevierStyleSup">8</span></a></p><p class="elsevierStylePara">The World Health Organization (WHO) has recently launched the End TB Strategy,<a href="#bib19" class="elsevierStyleCrossRefs"><span class="elsevierStyleSup">2</span></a><span class="elsevierStyleSup">, </span><a href="#bib20" class="elsevierStyleCrossRefs"><span class="elsevierStyleSup">3</span></a> which contains, among lines, several elements supporting TB elimination.</p><p class="elsevierStylePara">The definitions of TB elimination and pre-elimination are summarized in <a href="#f0005" class="elsevierStyleCrossRefs">Figure 1</a>.<a href="#bib21" class="elsevierStyleCrossRefs"><span class="elsevierStyleSup">4</span></a></p><a name="f0005" class="elsevierStyleCrossRefs"></a><p class="elsevierStylePara"><img src="320v21n06-90445966fig1.jpg" alt="Definitions of elimination and pre-elimination."></img></p><p class="elsevierStylePara">Figure 1. Definitions of elimination and pre-elimination.</p><p class="elsevierStylePara">The key elements to achieve TB elimination are represented by diagnosis and treatment of latent TB infection (LTBI), on top of the basic TB control interventions, which constituted the basis for the WHO DOTS strategy before and the Stop TB Strategy afterwards.<a href="#bib22" class="elsevierStyleCrossRefs"><span class="elsevierStyleSup">5</span></a><span class="elsevierStyleSup">, </span><a href="#bib23" class="elsevierStyleCrossRefs"><span class="elsevierStyleSup">6</span></a><span class="elsevierStyleSup">, </span><a href="#bib24" class="elsevierStyleCrossRefs"><span class="elsevierStyleSup">7</span></a></p><p class="elsevierStylePara">Presently the End TB Strategy is composed of 3 pillars (<a href="#t0005" class="elsevierStyleCrossRefs">Table 1</a>). Pillar one includes the technical elements, diagnosis and treatment, and – for the first time – TB prevention, which are usually coordinated by a national TB programme (NTP) or equivalent body at the Ministry of Health level.</p><p class="elsevierStylePara">Table 1. End TB strategy.</p><a name="t0005" class="elsevierStyleCrossRefs"></a><p class="elsevierStylePara"></p><table><tr align="left"><td colspan="5">The End TB Strategy</td></tr><tr align="left"><td>Vision</td><td colspan="4">A world free of TB<br></br><span class="elsevierStyleItalic">Zero TB deaths, Zero TB disease, and Zero TB suffering</span></td></tr><tr align="left"><td>Goal</td><td colspan="4">End the Global TB epidemic (<10 cases per 100,000 population)</td></tr><tr align="left"><td colspan="5"> </td></tr><tr align="left"><td>Indicators</td><td colspan="2"><span class="elsevierStyleBold">Milestones</span></td><td colspan="2"><span class="elsevierStyleBold">Targets</span></td></tr><tr align="left"><td> </td><td>2020</td><td>2025</td><td><span class="elsevierStyleItalic">SDG</span> 2030</td><td><span class="elsevierStyleItalic">End TB</span> 2035</td></tr><tr align="left"><td>Reduction in number of TB deaths compared with 2015 (%)</td><td>35%</td><td>75%</td><td>90%</td><td>95%</td></tr><tr align="left"><td>Reduction in TB incidence rate compared with 2015 (%)</td><td>20% (<85/100,000)</td><td>50% (<55/100,000)</td><td>80% (<20/100,000)</td><td>90% (<10/100,000)</td></tr><tr align="left"><td>TB-affected families facing catastrophic costs due to TB (%)</td><td>Zero</td><td>Zero</td><td>Zero</td><td>Zero</td></tr><tr align="left"><td colspan="5"> </td></tr><tr align="left"><td>Pillars</td><td colspan="4"><span class="elsevierStyleBold">Components</span></td></tr><tr align="left"><td>1. Integrated, patient-centred care and prevention</td><td colspan="4">A. Early diagnosis of tuberculosis including universal drug-susceptibility testing, and systematic screening of contacts and high-risk groups<br></br>B. Treatment of all people with tuberculosis including drug-resistant tuberculosis, and patient support<br></br>C. Collaborative tuberculosis/HIV activities, and management of co-morbidities<br></br>D. Preventive treatment of persons at high risk, and vaccination against tuberculosis</td></tr><tr align="left"><td>2. Bold policies and supportive systems</td><td colspan="4">A. Political commitment with adequate resources for tuberculosis care and prevention<br></br>B. Engagement of communities, civil society organizations, and public and private care providers<br></br>C. Universal health coverage policy, and regulatory frameworks for case notification, vital registration, quality and rational use of medicines, and infection control<br></br>D. Social protection, poverty alleviation and actions on other determinants of tuberculosis</td></tr><tr align="left"><td>3. Intensified research and innovation</td><td colspan="4">A. Discovery, development and rapid uptake of new tools, interventions and strategies<br></br>B. Research to optimize implementation and impact, and promote innovations</td></tr></table><p class="elsevierStylePara">TB: tuberculosis; SDG: sustainable development goal.<br></br></p><p class="elsevierStylePara">TB prevention includes both vaccination (a new vaccine is expected by 2025) and the above mentioned diagnosis and treatment of LTBI.<a href="#bib25" class="elsevierStyleCrossRefs"><span class="elsevierStyleSup">8</span></a></p><p class="elsevierStylePara">The second pillar includes all the different interventions that are necessary as a result of a coordinated action at different ministerial levels, as several ministries are likely to be involved: interior, finance, social affairs or equivalent, on top of ministry of health. Interventions like social protection, universal health coverage, or high quality vital registrations ideally require fine tuning of the legal framework by low TB incidence countries (initially called for action and defined as having a notification rate below 10 cases per 100,000 population, <a href="#t0005" class="elsevierStyleCrossRefs">Table 1</a>).</p><p class="elsevierStylePara">The third pillar emphasizes the importance of both developing new tools (prevention, diagnostic and treatment) and rationally introducing them at the programmatic level.<a href="#bib26" class="elsevierStyleCrossRefs"><span class="elsevierStyleSup">9</span></a></p><p class="elsevierStylePara">It is clear that although difficult to achieve, TB elimination is epidemiologically plausible, as shown in the recently published WHO Elimination framework: all the low TB incidence countries are estimated to reach TB pre-elimination by 2035, as a preliminary step towards TB elimination, which is forecasted for 2050.<a href="#bib21" class="elsevierStyleCrossRefs"><span class="elsevierStyleSup">4</span></a></p><p class="elsevierStylePara">Among the requirements of a good TB programme, and with the aim of controlling TB by early diagnosing infectious TB cases and rendering them rapidly non-infectious, case-finding and treatment outcomes are considered the core indicators and are constantly monitored.</p><p class="elsevierStylePara">The outcomes expected by a successful programme, together with those achieved in 2013 in the EU as well as in the different WHO Regions are summarized in <a href="#t0010" class="elsevierStyleCrossRefs">Table 2</a>.<a href="#bib27" class="elsevierStyleCrossRefs"><span class="elsevierStyleSup">10</span></a></p><p class="elsevierStylePara">Table 2. Treatment outcomes for new and relapse cases, 2012 for the six WHO regions <span class="elsevierStyleSup">a</span> and EU/EEA countries <span class="elsevierStyleSup">a</span> .</p><a name="t0010" class="elsevierStyleCrossRefs"></a><p class="elsevierStylePara"></p><table><tr align="left"><td>Outcome <span class="elsevierStyleSup">b</span></td><td>Theoretical good programme performances (%)</td><td>EU/EEA <span class="elsevierStyleSup">c</span> (%)</td><td>WHO European <span class="elsevierStyleSup">d</span> Region (%)</td><td>WHO African Region (%)</td><td>WHO/PAHO Region of the Americas (%)</td><td>WHO South-East Asia Region (%)</td><td>WHO Eastern Mediterranean Region (%)</td><td>WHO Western Pacific Region (%)</td></tr><tr align="left"><td>Treatment success</td><td>>85</td><td>77.1</td><td>75.51</td><td>81.31</td><td>74.61</td><td>87.81</td><td>87.31</td><td>92.21</td></tr><tr align="left"><td>Death</td><td><5</td><td>6.5</td><td>7.3</td><td>6.5</td><td>6.4</td><td>3.7</td><td>2.4</td><td>2.0</td></tr><tr align="left"><td>Default</td><td><5</td><td>4.8</td><td>6.2</td><td>5.7</td><td>7.7</td><td>5.1</td><td>4.6</td><td>1.5</td></tr><tr align="left"><td>Failure</td><td><2</td><td>0.9</td><td>5.1</td><td>0.9</td><td>0.8</td><td>1.2</td><td>0.8</td><td>0.5</td></tr></table><p class="elsevierStylePara">a (<span class="elsevierStyleItalic">WHO Regions</span>: data extracted from WHO's global TB database. Available at: http://www.who.int/tb/country/data/download/en/ . Date last accessed: October 13, 2015. <span class="elsevierStyleItalic">EU/EEA</span>: data from European Centre for Disease Prevention and Control/WHO Regional Office for Europe. Tuberculosis surveillance and monitoring in Europe 2015. Stockholm: European Centre for Disease Prevention and Control, 2015. Available at: http://ecdc.europa.eu/en/publications/Publications/tuberculosis-surveillance-monitoring-Europe-2015.pdf ).<br></br>b New TB cases and relapse treatment outcome (%).<br></br>c <span class="elsevierStyleItalic">EU/EEA</span> (European Union/European Economic Area) comprises 31 Countries: 28 EU Member States (Austria, Belgium, Bulgaria, Croatia, Cyprus, Czech Republic, Denmark, Estonia, Finland, France, Germany, Greece, Hungary, Ireland, Italy, Latvia, Lithuania, Luxembourg, Malta, Netherlands, Poland, Portugal, Romania, Slovakia, Slovenia, Spain, Sweden and the United Kingdom) and 3 EEA countries (Iceland, Liechtenstein and Norway).<br></br>d <span class="elsevierStyleItalic">WHO European Region</span> comprises the 53 countries: 28 EU Member States, 2 EEA countries (Liechtenstein not included), 23 non-EU/EEA countries (Albania, Andorra, Armenia, Azerbaijan, Belarus, Bosnia and Herzegovina, Georgia, Israel, Kazakhstan, Kyrgyzstan, the former Yugoslav Republic of Macedonia, Moldova, Monaco, Montenegro, Russia, San Marino, Serbia, Switzerland, Tajikistan, Turkey, Turkmenistan, Ukraine and Uzbekistan).<br></br></p><p class="elsevierStylePara">A core treatment outcome to be monitored is the death rate. Although this outcome has been initially conceived as death for any cause (TB being the most plausible cause, particularly in high TB incidence countries), the introduction of electronic, nominal databases has allowed to differentiate deaths for TB from deaths for other reasons.<a href="#bib28" class="elsevierStyleCrossRefs"><span class="elsevierStyleSup">11</span></a></p><p class="elsevierStylePara">The paper by A.C. Franco Spinola et al. published in the present issue of the Journal<a href="#bib18" class="elsevierStyleCrossRefs"><span class="elsevierStyleSup">1</span></a> merits special attention because of its choice of dealing with TB mortality in a region that can be considered a hot-spot for TB.</p><p class="elsevierStylePara">In particular, mortality during TB treatment in the evaluated cohort is in line with what reported in the EU/EEA countries and in WHO-EURO Region, i.e. 7.3% in this study vs. 6.5% and 7.3% in the two groups of countries (see <a href="#t0010" class="elsevierStyleCrossRefs">Table 2</a> for details). This outcome is actually more in line with Eastern European NTP performances (all included in the WHO-EURO report) rather than Western European ones (only some Eastern countries are included in the EU/EEA report).<a href="#bib27" class="elsevierStyleCrossRefs"><span class="elsevierStyleSup">10</span></a><span class="elsevierStyleSup">, </span><a href="#bib29" class="elsevierStyleCrossRefs"><span class="elsevierStyleSup">12</span></a></p><p class="elsevierStylePara">Notwithstanding that TB mortality is the hardest end-point of TB treatment, it has been till recent years a “neglected area” of interest in the evaluation of NTP performance or in the international TB literature, with the exception of settings with high HIV and/or MDR/XDR-TB prevalence. Actually, only in the last few years a few reports on predictors of TB mortality started to be published.<a href="#bib30" class="elsevierStyleCrossRefs"><span class="elsevierStyleSup">13</span></a><span class="elsevierStyleSup">, </span><a href="#bib31" class="elsevierStyleCrossRefs"><span class="elsevierStyleSup">14</span></a><span class="elsevierStyleSup">, </span><a href="#bib32" class="elsevierStyleCrossRefs"><span class="elsevierStyleSup">15</span></a><span class="elsevierStyleSup">, </span><a href="#bib33" class="elsevierStyleCrossRefs"><span class="elsevierStyleSup">16</span></a><span class="elsevierStyleSup">, </span><a href="#bib34" class="elsevierStyleCrossRefs"><span class="elsevierStyleSup">17</span></a></p><p class="elsevierStylePara">Among the different TB treatment outcomes, mortality is the most important one to identify what went deadly wrong among patients enrolled in TB programmes. Identifying and evaluating patients’ characteristics associated to mortality during TB treatment may help to highlight the existing programmatic weaknesses where to invest for improvements.</p><p class="elsevierStylePara">In particular, the Authors of the report published in this issue of the Journal identified male TB patients over 45 years of age with prior cancer and with disseminated diseases as those at higher risk of death during TB treatment. This is in part similar, but not identical, to what reported by other Authors (<a href="#t0015" class="elsevierStyleCrossRefs">Table 3</a>).</p><p class="elsevierStylePara">Table 3. Predictors of mortality during tuberculosis (TB) treatment.</p><a name="t0015" class="elsevierStyleCrossRefs"></a><p class="elsevierStylePara"></p><table><tr align="left"><td>Authors</td><td>Year of publication</td><td>Country</td><td>Predictors of mortality</td></tr><tr align="left"><td>Kourbatova et al. <span class="elsevierStyleSup">13</span></td><td>2006</td><td>Russia</td><td>Advanced TB; intravenous drug use</td></tr><tr align="left"><td>Lin et al. <span class="elsevierStyleSup">14</span></td><td>2014</td><td>Taiwan</td><td>Disseminated TB <span class="elsevierStyleSup">a</span> ; malignancy <span class="elsevierStyleSup">a</span> ; liver cirrhosis; renal failure</td></tr><tr align="left"><td>Alobu et al. <span class="elsevierStyleSup">15</span></td><td>2014</td><td>Nigeria</td><td>Extrapulmonary TB; smear-negative TB cases; rural residents; human immunodeficiency virus (HIV) co-infection; not receiving antiretroviral therapy; not receiving cotrimoxazole prophylaxis.</td></tr><tr align="left"><td>Pepper et al. <span class="elsevierStyleSup">16</span></td><td>2015</td><td>South Africa</td><td>Advancing age <span class="elsevierStyleSup">a</span> , co-infection with HIV; prior history of TB; disseminated TB <span class="elsevierStyleSup">a</span></td></tr><tr align="left"><td>Liew et al. <span class="elsevierStyleSup">17</span></td><td>2015</td><td>Malaysia</td><td>Older age <span class="elsevierStyleSup">a</span> ; male sex <span class="elsevierStyleSup">a</span> ; foreign citizenship; lower Education; no bacille Calmette-Guérin (BCG) vaccination scar; rural residence; treatment in tertiary settings; HIV infection; not receiving directly observed treatment (DOT); advanced chest radiography findings; multidrug-resistant TB (MDR-TB); extra-pulmonary TB.</td></tr></table><p class="elsevierStylePara">a Same predictors of mortality as reported by Spinola et al. <span class="elsevierStyleSup">1</span><br></br></p><p class="elsevierStylePara">In Spinola's paper<a href="#bib18" class="elsevierStyleCrossRefs"><span class="elsevierStyleSup">1</span></a> lung cancer emerged as the most important co-morbidity associated to mortality. Such results may prompt initiatives to develop programmes of screening of those patients at higher mortality risk (e.g. lung cancer).</p><p class="elsevierStylePara">In different settings different predictors of mortality (see <a href="#t0015" class="elsevierStyleCrossRefs">Table 3</a>) can be observed during TB treatment, even within the same country. Nevertheless, once such predictors are identified, a strategy to confront with them need to be developed, tested and – if proven effective – implemented. Otherwise, the simple identification of mortality predictors would remain a mere “academic exercise” without a significant impact on programme performance and, most importantly, on TB patients’ health.</p><p class="elsevierStylePara">The important exercise of analysing systematically (and into details) the TB treatment outcomes (and, particularly, death rates), identifying programmatic drawbacks and tackling them with appropriate public health actions are part of the well-known TB managerial cycle.</p><p class="elsevierStylePara">If we want to push the paradigm shift from TB Control to Elimination forward, we need to start (or re-start) to perform systematically this as well as the other exercises aimed at monitoring case-finding and treatment results, which NTPs in several European countries have unfortunately started to forget.</p><p class="elsevierStylePara">Corresponding author. giovannibattista.migliori@fsm.it</p>" "pdfFichero" => "320v21n06a90445966pdf001.pdf" "tienePdf" => true "multimedia" => array:2 [ 0 => array:8 [ "identificador" => "fig1" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "copyright" => "Elsevier España" "figura" => array:1 [ 0 => array:4 [ "imagen" => "320v21n06-90445966fig1.jpg" "Alto" => 1044 "Ancho" => 2667 "Tamanyo" => 399348 ] ] "descripcion" => array:1 [ "en" => "Definitions of elimination and pre-elimination." ] ] 1 => array:6 [ "identificador" => "fig2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "copyright" => "Elsevier España" "descripcion" => array:1 [ "en" => "Definitions of elimination and pre-elimination." ] ] ] "bibliografia" => array:2 [ "titulo" => "Bibliography" "seccion" => array:1 [ 0 => array:1 [ "bibliografiaReferencia" => array:17 [ 0 => array:3 [ "identificador" => "bib18" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "Tuberculosis deaths in Northern Portugal Predictors of mortality during TB treatment – a five-year analysis (2008–2012). Rev Port Pneumol. 2015; 6:304-10." "contribucion" => array:1 [ 0 => array:3 [ "titulo" => "Tuberculosis deaths in Northern Portugal Predictors of mortality during TB treatment – a five-year analysis (2008–2012)." "idioma" => "en" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:7 [ 0 => "Franco Spinola AC" 1 => "Campos M" 2 => "Rita Gaio A" 3 => "Maria Correi A" 4 => "Gomes M" 5 => "Duarte R" 6 => "et-al." ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Rev Port Pneumol. " "fecha" => "2015" "volumen" => "6" "paginaInicial" => "304" "paginaFinal" => "310" ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib19" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "WHO's new end TB strategy. Lancet. 2015; 385:1799-801." "contribucion" => array:1 [ 0 => array:3 [ "titulo" => "WHO's new end TB strategy." "idioma" => "en" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:7 [ 0 => "Uplekar M" 1 => "Weil D" 2 => "Lonnroth K" 3 => "Jaramillo E" 4 => "Lienhardt C" 5 => "Dias HM" 6 => "et-al." ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/S0140-6736(15)60570-0" "Revista" => array:6 [ "tituloSerie" => "Lancet. " "fecha" => "2015" "volumen" => "385" "paginaInicial" => "1799" "paginaFinal" => "1801" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25814376" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib20" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "Evidence-based, agreed-upon health priorities to remedy the tuberculosis patient's economic disaster. Eur Respir J. 2014; 43:1563-6." "contribucion" => array:1 [ 0 => array:3 [ "titulo" => "Evidence-based, agreed-upon health priorities to remedy the tuberculosis patient's economic disaster." "idioma" => "en" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "Sotgiu G" 1 => "Mauch V" 2 => "Migliori GB" 3 => "Benedetti A." ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1183/09031936.00064314" "Revista" => array:6 [ "tituloSerie" => "Eur Respir J. " "fecha" => "2014" "volumen" => "43" "paginaInicial" => "1563" "paginaFinal" => "1566" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24881058" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib21" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "Towards tuberculosis elimination: an action framework for low-incidence countries. Eur Respir J. 2015; 45:928-52." "contribucion" => array:1 [ 0 => array:3 [ "titulo" => "Towards tuberculosis elimination: an action framework for low-incidence countries." "idioma" => "en" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:7 [ 0 => "Lönnroth K" 1 => "Migliori GB" 2 => "Abubakar I" 3 => "D’Ambrosio L" 4 => "de Vries G" 5 => "Diel R" 6 => "et-al." ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1183/09031936.00214014" "Revista" => array:6 [ "tituloSerie" => "Eur Respir J. " "fecha" => "2015" "volumen" => "45" "paginaInicial" => "928" "paginaFinal" => "952" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25792630" "web" => "Medline" ] ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib22" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "European Forum for TB Innovation Old ideas to innovate tuberculosis control: preventive treatment to achieve elimination. Eur Respir J. 2013; 42:785-801." "contribucion" => array:1 [ 0 => array:3 [ "titulo" => "European Forum for TB Innovation Old ideas to innovate tuberculosis control: preventive treatment to achieve elimination." "idioma" => "en" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:7 [ 0 => "Diel R" 1 => "Loddenkemper R" 2 => "Zellweger JP" 3 => "Sotgiu G" 4 => "D’Ambrosio L" 5 => "Centis R" 6 => "et-al." ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1183/09031936.00205512" "Revista" => array:6 [ "tituloSerie" => "Eur Respir J. " "fecha" => "2013" "volumen" => "42" "paginaInicial" => "785" "paginaFinal" => "801" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23397299" "web" => "Medline" ] ] ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib23" "etiqueta" => "6" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "TB Elimination: theory and practice in Europe. Eur Respir J. 2014; 43:1410-20." "contribucion" => array:1 [ 0 => array:3 [ "titulo" => "TB Elimination: theory and practice in Europe." "idioma" => "en" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:7 [ 0 => "D’Ambrosio L" 1 => "Dara M" 2 => "Tadolini M" 3 => "Centis R" 4 => "Sotgiu G" 5 => "van der Werf MJ" 6 => "et-al." ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1183/09031936.00198813" "Revista" => array:6 [ "tituloSerie" => "Eur Respir J. " "fecha" => "2014" "volumen" => "43" "paginaInicial" => "1410" "paginaFinal" => "1420" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24389868" "web" => "Medline" ] ] ] ] ] ] ] ] 6 => array:3 [ "identificador" => "bib24" "etiqueta" => "7" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "History of tuberculosis and drug resistance. N Engl J Med. 2013; 368:88-9." "contribucion" => array:1 [ 0 => array:3 [ "titulo" => "History of tuberculosis and drug resistance." "idioma" => "en" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "Sotgiu G" 1 => "Spanevello A" 2 => "Migliori GB." ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1056/NEJMc1212308#SA2" "Revista" => array:6 [ "tituloSerie" => "N Engl J Med. " "fecha" => "2013" "volumen" => "368" "paginaInicial" => "88" "paginaFinal" => "89" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23281997" "web" => "Medline" ] ] ] ] ] ] ] ] 7 => array:3 [ "identificador" => "bib25" "etiqueta" => "8" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "Management of latent <i>Mycobacterium tuberculosis</i> infection: WHO guidelines for low tuberculosis burden countries. Eur Respir J. 2015; 24:." "contribucion" => array:1 [ 0 => array:3 [ "titulo" => "Management of latent <span class="elsevierStyleItalic">Mycobacterium tuberculosis</span> infection: WHO guidelines for low tuberculosis burden countries." "idioma" => "en" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:7 [ 0 => "Getahun H" 1 => "Matteelli A" 2 => "Abubakar I" 3 => "Aziz MA" 4 => "Baddeley A" 5 => "Barreira D" 6 => "et-al." ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:3 [ "tituloSerie" => "Eur Respir J. " "fecha" => "2015" "volumen" => "24" ] ] ] ] ] ] 8 => array:3 [ "identificador" => "bib26" "etiqueta" => "9" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "Ensuring rational introduction and responsible use of new TB tools: outcome of an ERS multisector consultation. Eur Respir J. 2014; 44:1412-7." "contribucion" => array:1 [ 0 => array:3 [ "titulo" => "Ensuring rational introduction and responsible use of new TB tools: outcome of an ERS multisector consultation." "idioma" => "en" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "Migliori GB" 1 => "Lienhardt C" 2 => "Weyer K" 3 => "van der Werf MJ" 4 => "Blasi F" 5 => "Raviglione MC." ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1183/09031936.00132114" "Revista" => array:6 [ "tituloSerie" => "Eur Respir J. " "fecha" => "2014" "volumen" => "44" "paginaInicial" => "1412" "paginaFinal" => "1417" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25435528" "web" => "Medline" ] ] ] ] ] ] ] ] 9 => array:3 [ "identificador" => "bib27" "etiqueta" => "10" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "Global tuberculosis report 2014. WHO/HTM/TB2014.08. Geneva: World Health Organization; 2014." "contribucion" => array:1 [ 0 => array:3 [ "titulo" => "Global tuberculosis report 2014. WHO/HTM/TB2014.08." "idioma" => "es" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "World Health Organization." ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Libro" => array:2 [ "titulo" => "Global tuberculosis report 2014. WHO/HTM/TB2014.08." "fecha" => "2014" ] ] ] ] ] ] 10 => array:3 [ "identificador" => "bib28" "etiqueta" => "11" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "Comparison of tuberculosis surveillance systems in low-incidence industrialised countries. Eur Respir J. 2008; 32:1616-24." "contribucion" => array:1 [ 0 => array:3 [ "titulo" => "Comparison of tuberculosis surveillance systems in low-incidence industrialised countries." "idioma" => "en" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "Mor Z" 1 => "Migliori GB" 2 => "Althomsons SP" 3 => "Loddenkemper R" 4 => "Trnka L" 5 => "Iademarco MF." ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1183/09031936.00042908" "Revista" => array:6 [ "tituloSerie" => "Eur Respir J. " "fecha" => "2008" "volumen" => "32" "paginaInicial" => "1616" "paginaFinal" => "1624" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18684850" "web" => "Medline" ] ] ] ] ] ] ] ] 11 => array:3 [ "identificador" => "bib29" "etiqueta" => "12" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "Tuberculosis surveillance and monitoring in Europe 2015. Stockholm: European Centre for Disease Prevention and Control; 2015. Available at: <inter-ref>http://ecdc.europa.eu/en/publications/Publications/tuberculosis-surveillance-monitoring-Europe-2015.pdf</inter-ref>" "contribucion" => array:1 [ 0 => array:3 [ "titulo" => "Tuberculosis surveillance and monitoring in Europe 2015." "idioma" => "en" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "European Centre for Disease Prevention and Control/WHO Regional Office for Europe." ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Libro" => array:2 [ "titulo" => "Tuberculosis surveillance and monitoring in Europe 2015." "fecha" => "2015" ] ] ] ] ] ] 12 => array:3 [ "identificador" => "bib30" "etiqueta" => "13" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "Risk factors for mortality among adult patients with newly diagnosed tuberculosis in Samara, Russia. Int J Tuberc Lung Dis. 2006; 10:1224-30." "contribucion" => array:1 [ 0 => array:3 [ "titulo" => "Risk factors for mortality among adult patients with newly diagnosed tuberculosis in Samara, Russia." "idioma" => "en" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "Kourbatova EV" 1 => "Borodulin BE" 2 => "Borodulina EA" 3 => "del Rio C" 4 => "Blumberg HM" 5 => "Leonard MK." ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Int J Tuberc Lung Dis. " "fecha" => "2006" "volumen" => "10" "paginaInicial" => "1224" "paginaFinal" => "1230" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17131780" "web" => "Medline" ] ] ] ] ] ] ] ] 13 => array:3 [ "identificador" => "bib31" "etiqueta" => "14" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "Tuberculosis mortality: patient characteristics and causes. BMC Infect Dis. 2014; 14:5. PMID: <inter-ref>24387757</inter-ref>" "contribucion" => array:1 [ 0 => array:3 [ "titulo" => "Tuberculosis mortality: patient characteristics and causes." "idioma" => "en" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:7 [ 0 => "Lin CH" 1 => "Lin CJ" 2 => "Kuo YW" 3 => "Wang JY" 4 => "Hsu CL" 5 => "Chen JM" 6 => "et-al." ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1186/1471-2334-14-5" "Revista" => array:5 [ "tituloSerie" => "BMC Infect Dis. " "fecha" => "2014" "volumen" => "14" "paginaInicial" => "5" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24387757" "web" => "Medline" ] ] ] ] ] ] ] ] 14 => array:3 [ "identificador" => "bib32" "etiqueta" => "15" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "Risk factors of treatment default and death among tuberculosis patients in a resource-limited setting. Asian Pac J Trop Med. 2014; 7:977-84." "contribucion" => array:1 [ 0 => array:3 [ "titulo" => "Risk factors of treatment default and death among tuberculosis patients in a resource-limited setting." "idioma" => "en" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "Alobu I" 1 => "Oshi SN" 2 => "Oshi DC" 3 => "Ukwaja KN." ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/S1995-7645(14)60172-3" "Revista" => array:6 [ "tituloSerie" => "Asian Pac J Trop Med. " "fecha" => "2014" "volumen" => "7" "paginaInicial" => "977" "paginaFinal" => "984" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25479627" "web" => "Medline" ] ] ] ] ] ] ] ] 15 => array:3 [ "identificador" => "bib33" "etiqueta" => "16" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "Independent predictors of tuberculosis mortality in a high HIV prevalence setting: a retrospective cohort study. AIDS Res Ther. 2015; 12:35." "contribucion" => array:1 [ 0 => array:3 [ "titulo" => "Independent predictors of tuberculosis mortality in a high HIV prevalence setting: a retrospective cohort study." "idioma" => "en" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "Pepper DJ" 1 => "Schomaker M" 2 => "Wilkinson RJ" 3 => "de Azevedo V" 4 => "Maartens G." ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1186/s12981-015-0076-5" "Revista" => array:5 [ "tituloSerie" => "AIDS Res Ther. " "fecha" => "2015" "volumen" => "12" "paginaInicial" => "35" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26448780" "web" => "Medline" ] ] ] ] ] ] ] ] 16 => array:3 [ "identificador" => "bib34" "etiqueta" => "17" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "Tuberculosis in Malaysia: predictors of treatment outcomes in a national registry. Int J Tuberc Lung Dis. 2015; 19:764-71." 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| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 November | 7 | 8 | 15 |
| 2024 October | 32 | 31 | 63 |
| 2024 September | 18 | 12 | 30 |
| 2024 August | 24 | 22 | 46 |
| 2024 July | 69 | 43 | 112 |
| 2024 June | 54 | 30 | 84 |
| 2024 May | 72 | 43 | 115 |
| 2024 April | 63 | 34 | 97 |
| 2024 March | 44 | 27 | 71 |
| 2024 February | 38 | 27 | 65 |
| 2024 January | 32 | 18 | 50 |
| 2023 December | 24 | 29 | 53 |
| 2023 November | 35 | 36 | 71 |
| 2023 October | 24 | 32 | 56 |
| 2023 September | 35 | 37 | 72 |
| 2023 August | 29 | 16 | 45 |
| 2023 July | 28 | 31 | 59 |
| 2023 June | 26 | 14 | 40 |
| 2023 May | 46 | 22 | 68 |
| 2023 April | 31 | 30 | 61 |
| 2023 March | 62 | 16 | 78 |
| 2023 February | 43 | 25 | 68 |
| 2023 January | 27 | 20 | 47 |
| 2022 December | 57 | 19 | 76 |
| 2022 November | 79 | 39 | 118 |
| 2022 October | 82 | 29 | 111 |
| 2022 September | 74 | 31 | 105 |
| 2022 August | 67 | 37 | 104 |
| 2022 July | 36 | 43 | 79 |
| 2022 June | 37 | 38 | 75 |
| 2022 May | 42 | 46 | 88 |
| 2022 April | 32 | 34 | 66 |
| 2022 March | 36 | 40 | 76 |
| 2022 February | 45 | 32 | 77 |
| 2022 January | 32 | 37 | 69 |
| 2021 December | 28 | 38 | 66 |
| 2021 November | 39 | 37 | 76 |
| 2021 October | 32 | 41 | 73 |
| 2021 September | 25 | 32 | 57 |
| 2021 August | 32 | 22 | 54 |
| 2021 July | 23 | 14 | 37 |
| 2021 June | 26 | 25 | 51 |
| 2021 May | 32 | 26 | 58 |
| 2021 April | 110 | 94 | 204 |
| 2021 March | 95 | 28 | 123 |
| 2021 February | 64 | 13 | 77 |
| 2021 January | 53 | 17 | 70 |
| 2020 December | 41 | 14 | 55 |
| 2020 November | 59 | 24 | 83 |
| 2020 October | 48 | 14 | 62 |
| 2020 September | 53 | 27 | 80 |
| 2020 August | 80 | 24 | 104 |
| 2020 July | 102 | 20 | 122 |
| 2020 June | 92 | 23 | 115 |
| 2020 May | 86 | 21 | 107 |
| 2020 April | 110 | 33 | 143 |
| 2020 March | 115 | 14 | 129 |
| 2020 February | 81 | 44 | 125 |
| 2020 January | 96 | 15 | 111 |
| 2019 December | 80 | 18 | 98 |
| 2019 November | 68 | 11 | 79 |
| 2019 October | 60 | 18 | 78 |
| 2019 September | 54 | 15 | 69 |
| 2019 August | 103 | 13 | 116 |
| 2019 July | 144 | 14 | 158 |
| 2019 June | 135 | 11 | 146 |
| 2019 May | 112 | 14 | 126 |
| 2019 April | 145 | 41 | 186 |
| 2019 March | 182 | 13 | 195 |
| 2019 February | 112 | 7 | 119 |
| 2019 January | 147 | 38 | 185 |
| 2018 December | 99 | 11 | 110 |
| 2018 November | 39 | 3 | 42 |
| 2018 October | 33 | 9 | 42 |
| 2018 September | 12 | 4 | 16 |
| 2018 August | 51 | 30 | 81 |
| 2018 July | 28 | 20 | 48 |
| 2018 June | 37 | 12 | 49 |
| 2018 May | 43 | 23 | 66 |
| 2018 April | 54 | 19 | 73 |
| 2018 March | 103 | 18 | 121 |
| 2018 February | 42 | 20 | 62 |
| 2018 January | 75 | 13 | 88 |
| 2017 December | 118 | 26 | 144 |
| 2017 November | 51 | 16 | 67 |
| 2017 October | 22 | 12 | 34 |
| 2017 September | 19 | 14 | 33 |
| 2017 August | 23 | 17 | 40 |
| 2017 July | 12 | 14 | 26 |
| 2017 June | 20 | 12 | 32 |
| 2017 May | 21 | 21 | 42 |
| 2017 April | 15 | 13 | 28 |
| 2017 March | 13 | 14 | 27 |
| 2017 February | 8 | 7 | 15 |
| 2017 January | 11 | 6 | 17 |
| 2016 December | 34 | 14 | 48 |
| 2016 November | 22 | 13 | 35 |
| 2016 October | 26 | 11 | 37 |
| 2016 September | 22 | 18 | 40 |
| 2016 August | 17 | 24 | 41 |
| 2016 July | 26 | 72 | 98 |
| 2016 June | 1 | 0 | 1 |
| 2016 May | 2 | 0 | 2 |
| 2016 April | 16 | 1 | 17 |
| 2016 March | 28 | 12 | 40 |
| 2016 February | 41 | 26 | 67 |
| 2016 January | 73 | 48 | 121 |
| 2015 December | 74 | 53 | 127 |
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