Categorization as an Assessment Tool for Tuberculosis Control

Abstract

Introduction: Tuberculosis control requires renewed monitoring and evaluation processes.

Objective: To analyse tuberculosis notification and gaps in Latin American and Caribbean countries in 2021.

Methods: Application of a revamped control categorisation model using each country's case notification rates and gaps in relation to estimated rates. The simplified version contains seven categories and the detailed version includes subcategories. Percentages and median country rates were calculated for each simplified category, the lowest value being the reference for calculating absolute and relative differences. From the detection ratio, a rating scale was applied and the correlation between reporting rates was obtained. The categories of poor control were contrasted with the categories of near-satisfactory control, satisfactory control and ultracontrol.

Results: Of the 40 countries that reported tuberculosis cases to WHO in 2021, 15 (37.5%) were in the poor control category; 2 (5%) in pre-elimination and 4 (10%) in elimination. The absolute inequality ranged from 31.8 per 100,000 in insufficient control to 2.5 in ultra-control, higher than the baseline. The correlation performed was weak, as the points of the dispersion were far from the straight line and closer to zero. 

Conclusions: The categorisation can be applied across and within countries to assess ‘step-by-step’ progress in control towards elimination of tuberculosis as a public health problem.