The appearance of new cases of tuberculosis in the country, which seems to have accelerated since the Covid pandemic, it is showing a “very worrying” public health trend for professionals who have been following it at all ages and with more than 17,000 detections last year recorded, compared to just under 10,000 a decade earlier. Beyond the delays in diagnosis, which still persist, they also attribute it to a combination of other factors that range from the socioeconomic difficulties of the population in going to the doctor or sustaining treatment to the lack of sufficient clinical suspicion during the consultation and which leads to continuing to confuse it with other respiratory infections, such as flu, pneumonia or bronchitis.
“The scenario is very worrying,” he said. Alejandra Gaianopediatric infectious disease specialist, public health specialist and pro-secretary of the Infectology Committee of the Argentine Society of Pediatrics (SAP). “There is a real increase in cases of tuberculosis in the population in recent years and this is happening in all age groups. The mycobacteria (Koch bacillus) that causes the disease has an exclusive human reservoir, but its elimination and control is very complex because it sometimes presents with few but prolonged symptoms (cough for 14 days or more, fever, fatigue and weight loss), which are confused with other problems, and when the patient consults many times, the diagnostic delay It is a limitation,” he added.
Gerardo Leubeprofessor of Microbiology and Infectology at the Barceló Foundationagrees that “the epidemiological scenario continues to be worrying” and conveys this to his classes in the face of the number of cases that has not been reversed for more than a decade. “The biggest concern, from the patients’ point of view, is that diagnoses are usually late, especially in adolescents, who just arrive at the consultation when they have bloody respiratory secretions and the lung involvement is serious and usually makes recovery difficult,” said the infectious disease specialist.
According to the latest update released by the Ministry of Health of the Nation, prior to the World Day to Fight Tuberculosiswhich is commemorated this March 24, new diagnoses, as well as relapses – whether due to having completed treatment or not – are concentrating in the groups of between 15 and 40 years. Until 2018, between 9,000 and just under 12,000 cases were reported annually to the national health surveillance system from the provinces.
In 2019, the figure was almost 13,000, but with the appearance of the pandemic coronavirus, official notifications fell by what the national health portfolio estimated at 18%. But, as with many other diseases, the situation worsened. “Notification rates increased until 2024 with an average annual variation of 11%, which represents the highest number of cases, the highest rate and the most pronounced speed of increase in a 16-year period analyzed,” they described from the health portfolio when closing that survey. The negative impact fell, as they maintained, on both the detection and treatment of the disease, with a “generalized increase” in the disease at all ages, especially in adolescents and young adults.
Last week, when updating the technical criteria for the detection and treatment of tuberculosis in the health system 13 years after its last review, the need to strengthen “the capacities of health teams through clear guidelines for the detection, diagnosis, treatment and monitoring of cases and contacts” was officially noted. Something that also pointed out Juan Carlos Beltraminoformer director of Teaching and Research of the Hospital de Niños Dr. Orlando Alassiain Santa Fe, after pointing out the effects of the disease in lung radiological images.
The province is one of the 11 in which tuberculosis grew significantly in more than a decade (more than 12%), along with the city and province of Buenos Aires, Córdoba, Salta, Chaco, Jujuy, Entre Ríos, Tucumán, Corrientes and Tierra del Fuego, according to the official report.
“After the pandemic, Santa Fe is experiencing the marked increase in tuberculosis cases observed throughout the country. In hospitals, doctors are alert and use rapid molecular diagnoses,” described Beltramino. But he pointed out that “it is alarming to see, as 50 years ago, tuberculous caverns in the lungs of young people,” which is why he insisted in dialogue with THE NATION in that “it is key to reinforce surveillance and monitoring of patients and contacts.”
To Sandra Inventorycoordinator of the Tuberculosis Section of the Argentine Association of Respiratory Medicine (AAMR) and professor at the Faculty of Medical Sciences of the University of Buenos Aires (UBA), the “big problem” is, in this “worrying” context, the loss of a specific national program since the reorganization of the structure of the health portfolio. “We closed 2025 with more than 17,000 cases and we know that there are cases that are not reported for different reasons, such as lack of internet connection or computers, and time (in the interior of the country, the vast majority of the time a person is in charge of patient care, dispensing medications, controlling adverse reactions). After the pandemic, cases increased by 60% in the population between 14 and 35 years old, groups in which we are having six of every 10 diagnoses,” said the specialist, a member of the Advisory Committee of the former national tuberculosis program and who was also head of department of the Dr. Institute of Thysioneumology Raul Vaccarezzafrom the UBA.
Another problem that he pointed out for the management of tuberculosis is the problems with forecasting drug purchaseswhat the country does through the Pan American Health Organization (PAHO). “In the last two years, there were no purchases until a few months ago when the orders for the country’s acquisition were signed,” he said. Treatment includes four drugs for two months (first-line therapies for susceptible tuberculosis), followed by two drugs for another four, six or more months, depending on each patient. “There are provinces without medicines,” he added. Both first- and second-line therapies, administered on time, allow treatments to be shorter and more effective.
“There are certain access limitations because treatment is not 100% available“, agreed Gaiano, who insisted that cases are occurring especially in adolescents and young adults, while socioeconomic and housing vulnerability increase the risk. “Most of the time, the transmission of tuberculosis occurs within the family, but it can occur in schools or the workplace,” he reviewed.
By law, as Laube recalled, treatment is free of charge once tuberculosis is diagnosed and, due to the drugs used, “requires adherence on the part of patients,” plus controls and contact tracing by the health system.
“Raise awareness to the population and, above all, to health personnel, both in the public and private systems, it is a permanent challenge from teaching and healthcare to continue thinking that tuberculosis is present. A disease is not diagnosed if it is not known or suspected that it may occur,” he concluded.
