The data, which appears in the tuberculosis surveillance and monitoring report in Portugal by the Directorate-General for Health (DGS), released on World Tuberculosis Day, indicate that of the 1,584 cases of tuberculosis reported, 1,461 were new cases and 123 were re treatments.

According to the document, the migrant population remained a population in a situation of greater vulnerability, with a notification rate 3.6 times higher than the national average (54.3 cases per 100,000 migrants in 2023), with an increase in the proportion of cases, compared to 2022 (35.8% in 2023 and 30% in 2022).

The Lisbon and Tagus Valley region and the North region remained the two regions with the highest incidence, with 18.2 and 16 cases per 100,000 inhabitants, respectively, highlights the report, which will be presented today, in Porto, at the meeting promoted by the DGS “Tuberculosis in Portugal: epidemiology and strategies”.

“There were 76 deaths, which corresponds to a fatality rate of 4.8% in all reported cases, and the deaths are associated with other comorbidities and also with an age group over 75 years old,” the director of the National Tuberculosis Program (PNT) of the DGS, Isabel Carvalho, told Lusa.

He noted that it is a disease that continues to predominate in men, corresponding to 68.3% of reported cases, adding that 2.8% of reported cases occurred in children and adolescents under the age of 15.

“Tuberculosis continues to be a disease that has a greater focus on populations in situations of greater vulnerability, whether in the migrant population, or also in its association with other social determinants, such as addictions, or other infections, such as HIV infection or other chronic diseases, such as poorly controlled diabetes or even oncological diseases”, he highlighted.

Isabel Carvalho noted that the most frequent form of the disease continues to be pulmonary (70.8% in 2023), with a higher level of contagiousness, highlighting that 51.4% of these pulmonary cases were contagious.

In this group, the delay until diagnosis showed, in 2023, a median of 78 days, representing a significant increase compared to 2022 (53 days), although lower than the national median (81 days), compared to 60 days in 2010.

The director argued that it is “extremely important that in pulmonary forms treatment begins early to control this contagiousness and bring benefits to the patient”.

“We are fully aware that health professionals are capable, but they need to think about tuberculosis earlier (…) to include tuberculosis on their list of diagnostic hypotheses, especially when there are respiratory symptoms, especially because the most frequent form of tuberculosis continues to be the pulmonary form, which is also inevitably the one most associated with transmission of the disease in the community”, he highlighted.

In 2023, the delay attributed to the patient (from the onset of symptoms to the first contact with health services) remained stable at around 43 days, while the delay attributed to health services was 13 days.

The doctor explained that the days allocated to the patient are related to other factors, “namely not knowing how to access tuberculosis healthcare, or not valuing symptoms, or not being able to access tuberculosis healthcare”.

He therefore argued that it is essential to work with all local partners with the most vulnerable populations, helping them to recognize the symptoms and go to specialized services.

The tuberculosis notification rate remained at 14.9 cases per 100,000 inhabitants in 2023, identical to 2022, stable since the years of the covid-19 pandemic.

“What we wanted was to continue to see a reduction in the rate, but that has not been achieved this year, which means that we really need to adapt our strategies,” said Isabel Carvalho.

“If we know that tuberculosis is more associated with some social risk factors or chronic diseases, we can and should focus our strategies on these groups to be more profitable, that is, identify within these groups who is infected, offer preventive treatment to reduce the 'boom' of future new cases of diseases”, he maintained.