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Tuberculosis
Tuberculosis is an infectious disease that mainly affects the lungs. It is spread when a person coughs or sneezes, which releases the Mycobacterium tuberculosis bacteria into the air (Mayo Clinic, 2023).
There are 3 main types of TB (Mayo Clinic, 2023) -
Latent TB Infection: Mycobacterium tuberculosis bacteria are present in the body but are inactive and do not cause symptoms.
Active TB Infection: Mycobacterium tuberculosis bacteria are actively multiplying and causing symptoms. It is highly contagious but can be treated with first-line antibiotics for approximately six months.
Drug-Resistant TB: TB bacteria have become resistant to first-line treatments when antibiotics are not taken properly. Treatment options for MDR-TB are much longer and more costly than primary treatment options.
Individuals with HIV/AIDS are 16 times more likely to catch tuberculosis than people with strong immune systems (World Health Organization, 2024) .
Tuberculosis in Peru
Burden of Disease
Tuberculosis claimed 1.25 million lives in 2023, including 161,000 people with HIV. Worldwide, TB has returned to being the world's leading cause of death from a single infectious agent and is the leading killer of people with HIV (World Health Organization, 2024). Peru has approximately 13% of the cases in the Americas, the highest TB cases after Brazil, and the highest number of multidrug-resistant (MDR-TB) cases (Partners in Health, 2023).
Populations Affected
Tuberculosis disproportionately impacts low-and middle-income countries. In those countries, the conditions that increase the risk of TB include (Mayo Clinic, 2023):
Living with someone with active TB disease
Living or traveling in a country where TB is common
Living or working in places where people live close together (prisons, nursing homes, and homeless shelters)
Living in a community identified as being at high risk of tuberculosis
Peru's economic landscape makes it a hotbed for highly contagious diseases. Roughly 27% of Peru's population lives in poverty, and a lack of proper housing confines many to dense slums in urban centers (Thelwell, 2021). This contributes to a lack of medical resources to prevent HIV cases among the Peruvian population.
Trends Over Time
Figure 1. The number of incidences of tuberculosis per 100,000 people in Peru from 2000 to 2022.
Figure 2. A comparison of the number of TB and MDR-TB cases in Peru from 2005 to 2010.
As shown in Figure 1, there were 151 cases of TB per 100,000 people in Peru in 2022, which is the highest it has been since 2005 (World Bank Open Data, 2022). Additionally, Figure 2 shows the rate of TB and MDR-TB cases in Peru from 2005 to 2010. These numbers have remained relatively stable in current years. Preventative measures have caused a decline in TB rates since the early 2000s, however current economic and political turmoil have contributed to a recent resurgence of cases, particularly MDR-TB cases.
Programs
endTB (endTB, 2024): Socios En Salud has managed to shorten the treatment of patients with multi-drug-resistant tuberculosis to nine months (from 18-24 months) without injectables. A consortium has tested five new shortened, all-oral, nine-month treatment regimens for MDR-TB over the past decade. While still in its early stages, regimens proposed by endTB can be applied in patients as young as 0 years of age, with comorbidities, and pregnant women. In 2024, they have 66 patients recruited and 112 have started treatment with shortened oral regimens. Due to the newness of these medications, no current data is available to prove their effectiveness.
TB Móvil (Partners in Health, 2021): A strategy by Socios En Salud, which partners with Peru's Ministry of Health. It uses campers known as "blue trucks" to bring TB testing to more than 210 people per day. These vehicles are set up in streets, squares, parks, markets, and health centers and offer free testing for TB.
Mochila TB (Partners in Health, 2021): A Socios En Salud that expanded upon the TB Móvil program. The intervention is compact and portable, can test as many as 80 people per day, and emits less radiation than a conventional X-ray machine. These backpacks can enter communities inaccessible by car such as prisons, human settlements, shelters, and rural hillside communities. They served over 3,491 people in less than a month with the Mochila TB program, helping the most impoverished communities in Peru.
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