Tuberculosis in Cuba, 2015-2021: progress towards elimination goals

Abstract

Introduction: The World Health Organization’s End Tuberculosis Strategy aims to end the tuberculosis epidemic.

Objective: To analyze the trends of tuberculosis cases reported between 2015 and 2021 in Cuba to achieve the 2025 milestone of reducing the incidence by 50% compared to 2015.

Methods: It was conducted a time series study of the reported rates. The percentage variation of the rates between 2015 and 2021, and between 2015-2019 and 2020-2021 by provinces were calculated. Differences between the estimated and reported incidence rates were compared; Pearson correlation was estimated between the reported cases and the respiratory symptoms identified and the bacilloscopies and cultures performed.

Results: The notification rate decreased from 6.2 in 2015 to 4.5 in 2021, with a total reduction of 26.6% and an average annual reduction of 4.4%. All provinces reduced their rates in 2021 compared to 2015, except Santiago de Cuba and Camagüey. Ciego de Avila, Mayabeque and Havana reported the highest rates (10.5, 9.8 and 8.8, respectively). Since 2019, a decrease in notifications is observed, although it was higher in 2021. The national notification rate decreased from 6.1 in 2015-2019 to 4.9 in 2020-2021 and the diagnosis gap doubles. A strong correlation (r ≥ 0.9; p≤0.005) was observed between the reduction in the number of reported cases and the respiratory symptomatic detected, and the bacilloscopies and cultures performed.

Conclusions: The decrease in tuberculosis case notifications in Cuba and their uneven variation in some provinces are probably related to the decrease in case finding, given the reduced attention of the health care services to tuberculosis control actions.