“In Portugal, there was, in fact, a decrease in cases. There is no underreporting”, guaranteed Isabel Carvalho, director of the National Program for Tuberculosis, in statements to Lusa regarding the most recent report by the World Health Organization (WHO) on the infectious disease.
Portugal has "a very well set up notification system", she pointed out, considering that "it is necessary to understand the reason for the decrease, because there was a significant drop in the number of people who resorted to services and health care in the area of tuberculosis", namely by the “most vulnerable”, despite the Pneumological Diagnostic Centers (CDP) having remained open during the confinements imposed by covid-19.
“This is what has to be worked on and that we have been working on”, she stressed, noting that social isolation and the use of masks also reduced the spread of tuberculosis.
According to the Global Tuberculosis Report, Portugal dropped from “about 1,800” cases in 2019 to 1,445 in 2020. But, notes Isabel Carvalho, throughout 2020, "especially in the last quarter, number of cases was progressively increasing”.
The WHO also highlights in the report that “much fewer people were diagnosed” with the disease (from 7.1 million in 2019 to 5.8 million in 2020).
In Portugal, over the years, there has been “a progressive and sustained regression”, said Isabel Carvalho, noting that “Portugal even excels in very good practices in the area of tuberculosis, namely free treatment and easy access (…) to specialised consultations”.
However, it is necessary to “accelerate this downward trend”, she acknowledged, admitting that Portugal will still be at the tail end of Europe for some time.
The latest report by the European Center for Disease Prevention and Control (ECDC), released in 2018, attributed Portugal to the third highest rate of tuberculosis in Europe, only behind Romania and Lithuania.
“Although [Portugal] is doing a good job, we still haven't reached the level of being in the same line as countries like Spain or France”, stated Isabel Carvalho.
To do so, it is necessary to “act more directly” with the most vulnerable – namely homeless people, people with addictions, people with HIV/AIDS – and “pass the information to properly characterize each region, as each area has social determinants that demand adapted answers.” And also “increase the literacy” of everyone about the disease, stressed the director of the national program.
“Working with non-governmental organizations has been essential,” she said. “It's no use having the door to the CDP open if I don't have someone to take me there for some of the most vulnerable, who may not have the means to travel or are not sensitized to tuberculosis,” she said.