Ref. :  000038694
Date :  2015-10-28
Language :  Spanish
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La mortalidad de la tuberculosis se ha reducido a cerca de la mitad desde 1990

Sin embargo, esta enfermedad sigue siendo, junto con el VIH, una de las principales causas mundiales de muerte

Author :  OMS / WHO


La lucha contra la tuberculosis (TB) está dando buenos resultados. La tasa de mortalidad de este año se ha reducido a cerca de la mitad de la de 1990. No obstante, en 2014 murieron de TB 1,5 millones de personas. Según el Informe mundial sobre la tuberculosis 2015 de la Organización Mundial de la Salud (OMS) que se presenta hoy en Washington, la mayoría de estas muertes podrían haberse evitado.

Según el informe, para reducir la carga mundial de TB es necesario corregir las deficiencias en materia de detección y tratamiento, cubrir los déficits de financiación y desarrollar nuevos productos diagnósticos, fármacos y vacunas.

La mayoría de los avances son posteriores al año 2000, en el que se establecieron los Objetivos de Desarrollo del Milenio. Según el informe, el vigésimo de una serie de evaluaciones anuales llevadas a cabo por la OMS, los diagnósticos y tratamientos eficaces han salvado 43 millones de vidas entre 2000 y 2015.

«El informe muestra que el control de la TB ha tenido un enorme impacto en términos de vidas salvadas y pacientes curados», ha dicho la Directora General de la OMS, Dra. Margaret Chan. «Estos avances son esperanzadores, pero para que el mundo pueda acabar con esta epidemia es necesario ampliar los servicios e invertir en la investigación».

Entre los logros se encuentra la consecución del Objetivo de Desarrollo del Milenio consistente en detener y comenzar a reducir la incidencia de la TB para 2015. Este objetivo se ha alcanzado a nivel mundial, así como en 16 de los 22 países con gran carga de TB, que en su conjunto sufren el 80% de los casos.

La incidencia mundial de la TB ha disminuido un 1,5% al año desde 2000, y un 18% en total.

«Pese a estos logros, los progresos realizados en materia de TB están lejos de ser suficientes», ha opinado Dr. Mario Raviglione, Director del Programa Mundial contra la Tuberculosis de la OMS. «Todavía nos enfrentamos a la carga que supone la muerte de 4400 personas al día, cifra inaceptable en una era en la que se pueden diagnosticar y curar prácticamente todas las personas con TB».

En 2014 la TB mató a 890 000 hombres, 480 000 mujeres y 140 000 niños. La TB constituye, junto con el VIH, una de las principales causas mundiales de muerte. De los 1,5 millones de personas muertas por TB en 2014, 400 000 eran VIH-positivas. Las muertes por VIH en 2014 se estiman en 1,2 millones, cifra que incluye las
400 000 muertes por TB en personas VIH-positivas.

En el informe de este año se registra un aumento de los nuevos casos de TB (9,6 millones) con respecto a años anteriores, pero estas cifras reflejan un aumento y una mejora de los datos nacionales y de los estudios en profundidad, más que un aumento de la propagación de la enfermedad. Más de la mitad de los casos mundiales de TB (54%) correspondieron a China, India, Indonesia, Nigeria y Pakistán. Entre los nuevos casos, se estima que el 3,3% presentaron TB multirresistente, porcentaje que se ha mantenido sin cambios en los últimos años.

Medidas necesarias para corregir las deficiencias en materia de diagnóstico y tratamiento

El informe destaca la necesidad de corregir las deficiencias en materia de detección y tratamiento, cubrir los déficits de financiación y desarrollar nuevos productos diagnósticos, fármacos y vacunas.

Las deficiencias con respecto a la detección son importantes. De los 9,6 millones de casos que enfermaron de TB en 2014, 6 millones (62,5%) fueron notificados a las autoridades nacionales. Eso significa que más de un tercio (37,5%) de los casos mundiales no se diagnosticaron o no se notificaron a las autoridades nacionales. Se desconoce la calidad de la atención prestada a las personas de este último grupo.

Las deficiencias con respecto a la detección y el tratamiento son especialmente graves entre los pacientes con TB multirresistente, que sigue constituyendo una crisis de salud pública. De los 480 000 casos que se estima que hubo en 2014, solo aproximadamente una cuarta parte (123 000) fueron detectados y notificados a las autoridades nacionales. Los tres países con mayor número de casos son China, India y la Federación de Rusia.

La administración de tratamiento a los casos diagnosticados de TB multirresistente ha aumentado considerablemente, y en 2014 se ha iniciado un tratamiento en casi todos los casos detectados. Cuarenta y tres países notificaron tasas de curación superiores al 75% en pacientes con TB multirresistente. No obstante, a nivel mundial, los datos muestran una tasa de curación de tan solo un 50% en los casos de TB multirresistente tratados.

El tratamiento está mejorando y el 77% de los casos conocidos de TB y coinfección por VIH han recibido antirretrovíricos en 2104.

El número de personas con VIH que recibieron profilaxis antituberculosa se acercó al millón en 2014, lo cual representa un aumento de cerca del 60% en comparación con 2013. Más de la mitad (59%) de esas personas eran de Sudáfrica.

Los déficits de financiación siguen siendo un obstáculo a la aceleración de los progresos

«Una de las principales causas de las deficiencias con respecto a la detección y el tratamiento es el gran déficit de financiación», ha dicho la Dra. Winnie Mpanju-Shumbusho, Subdirectora General de la OMS para VIH, Tuberculosis, Paludismo y Enfermedades Tropicales Desatendidas. Ese déficit ascendió este año a US$ 1400 millones de los US$ 8000 millones necesarios para aplicar plenamente las intervenciones. Además, hay que cubrir un déficit anual de al menos US$ 1300 millones para investigación, incluido el desarrollo de nuevos productos diagnósticos, fármacos y vacunas.

A partir de 2016, el objetivo mundial cambiará del control de la TB al fin de la epidemia mundial de esta enfermedad. La Estrategia para acabar con la TB, adoptada por todos los Estados Miembros de la OMS, sirve como plan de trabajo para que en 2030 los países hayan reducido la incidencia de la enfermedad en un 80% y su mortalidad en un 90% y para que hayan eliminado los costos catastróficos para las familias afectadas por la TB.

«Acabar con la epidemia de TB ahora forma parte de los Objetivos de Desarrollo Sostenible», ha dicho el Dr. Eric Goosby, Enviado Especial de las Naciones Unidas para la Tuberculosis. «Si queremos alcanzar este objetivo, tendremos que invertir mucho más, a un nivel apropiado para semejante amenaza mundial. También tendremos que avanzar en la cobertura sanitaria universal y el alivio de la pobreza. Queremos que las comunidades más vulnerables del mundo sean las primeras, y no las últimas, en beneficiarse de nuestros esfuerzos».


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