Clinical FeaturesRespiratory

How Ending Tuberculosis (TB) in Ireland Could Be Approached

Quality Management – How Ending Tuberculosis in Ireland Could Be Approached – World Tuberculosis Day 2022. Written by James O’Connell, MSc, MD – Specialist Registrar Public Health Medicine, Department of Public Health, Health Service Executive West, Galway

59-61 – HPN January 2022 Digital

The 2015 Sustainable Development Goals (SDGs) set out a shared global vision for a better, more sustainable future through 17 interlinked goals. In addition, goal three is to ensure healthy lives and promote well-being for all and includes targets to end tuberculosis. Despite being preventable and treatable, TB is a leading cause of global morbidity and mortality, with 10 million infected and 1.5 million TB-related deaths in 2020.

Therefore to achieve the SDG and World Health Organisation End TB Strategy targets (Table 1), greater progress must be made. In 2020, only 59% of TB cases globally were detected and treated, 13% less than in 2019. Finding the “missing millions”, most of whom are in 16 high-burden countries, is a major challenge to addressing TB. So too are drug-resistant TB and human immunodeficiency virus (HIV)-TB co-infection which, although comprising only a minority of infections globally, can be difficult to diagnose and treat.

This article has sought to describe how quality management could be a beneficial approach to addressing TB in Ireland, consistent with the vision of the SDGs and the End TB Strategy. So, according to Dr Tedros Adhanom Ghebreyesus, Director General of the WHO, “Quality is not a given” and takes “vision, planning, investment, compassion, meticulous execution, and rigorous monitoring, from the national level to the smallest, remotest clinic”. in Ireland, efforts to ensure TB care is of high-quality should not end with the border given the importance of migration to the national burden of TB. Instead, Ireland must collaborate internationally, particularly with countries with a high burden of TB, to improve care quality and end tuberculosis.

Useful Resources:

McGill, Quality of Tuberculosis Care ebook

Podcast: High-quality Care for Tuberculosis Elimination with Dr. Hannah Alsdurf

O’Connell, J., de Barra, E. & McConkey, S. Systematic review of latent tuberculosis infection research to inform programmatic management in Ireland. Ir J Med Sci (2021).

O’Connell, J., de Barra, E., McNally, C., & McConkey, S. (2021). A Survey of Latent Tuberculosis Screening and Treatment Practices in a Tertiary Centre. Irish medical journal, 114(7), 406.

Dorman, S. E., Nahid, P., Kurbatova, E. V., et al.,Tuberculosis Trials Consortium (2021). Four-Month Rifapentine Regimens with or without Moxifloxacin for Tuberculosis. The New England journal of medicine, 384(18), 1705–1718.

Reza, T.F., Nalugwa, T., Farr, K. et al. Study protocol: a cluster randomized trial to evaluate the effectiveness and implementation of onsite GeneXpert testing at community health centers in Uganda (XPELTB). Implementation Sci 15, 24 (2020). 

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