Operational research towards TB elimination in the Americas

Research on tuberculosis

Tuberculosis (TB) is a major source of ill health, one of the top 10 causes of death worldwide and the leading cause of death from a single infectious agent, ranking above HIV/AIDS.  TB is preventable, treatable, and curable. The World Health Organization’s (WHO) End TB Strategy provides a framework for ending the TB epidemic by 2030 with a patient-centered approach and inter-programmatic and intersectoral interventions.

In the Region of the Americas, TB persists as a public health problem with an estimated 289 000 new and relapsed cases in 2018 and an incidence rate of 29 cases per 100 000 population. Countries in the Region have been working to implement the End TB Strategy and the Regional Action Plan for the Prevention and Control of Tuberculosis, along with their national strategic plans. The third of the three pillars of the End TB Strategy refers to research and innovation, and operational research has been recognized as a key instrument for developing major TB control strategies and vital to strengthening health programs. 

With the aim of contributing evidence and options towards TB elimination in the Region, the Pan American Journal of Public Health is publishing this special supplement on “Operational research in the context of advancing towards TB elimination in the Americas.” It includes studies carried out as part of the Structured Operational Research and Training Initiative (SORT IT), a global partnership led by the WHO Special Program for Research and Training in Tropical Diseases (TDR), which aims to train participants to conduct and publish operational research and influence policy and practice. The supplement comprises original peer-reviewed research articles that highlight strategies for addressing TB prevention, treatment, and care in three countries of the Region of the Americas: Ecuador, considering specific populations such as children, multidrug resistant patients, and prisoners; Paraguay, covering factors associated with failures to TB treatment, TB mortality, and TB and diabetes mellitus comorbidity; and Suriname, looking at determinants of sputum smear nonconversion and factors associated with TB/HIV mortality in co-infected persons. The results of these studies will provide policy makers and managers with evidence for improving quality, effectiveness, and coverage of national TB programs.

The Journal thanks Dr. Freddy Perez, Regional Advisor, Communicable Diseases and Environmental Determinants of Health Department, Pan American Health Organization, for the support to produce this thematic supplement, and the Sub-Regional Program for South America, Pan American Health Organization, for the financial support to implement the SORT IT course and the production of the supplement.

This supplement is dedicated to the memory of Dr. Edith Alarcón, contributor as a researcher and author of several papers in this supplement, who passed away on August 27, 2019.