Tuberculosis: challenges in detection and treatment adherence

• DOI: https://doi.org/10.22533/at.ed.1595332520114

• Palavras-chave: Tuberculosis; Diagnosis; Treatment Adherence; Mycobacterium tuberculosis; Latent Infection; Preventive Therapy; Public Health.

• Keywords: Tuberculosis; Diagnosis; Treatment Adherence; Mycobacterium tuberculosis; Latent Infection; Preventive Therapy; Public Health.

• Abstract:

  Tuberculosis (TB) remains a critical global public health challenge, sustained by a vast reservoir of latent infection and high morbidity and mortality rates. This narrative review analyzes the main obstacles to controlling the disease, focusing on the difficulties of detection and adherence to treatment. Diagnosis is hampered by the limitation of current immunological tests (TST and IGRA) in differentiating latent infection from active disease, as well as the complexity of identifying paucibacillary forms in children and extrapulmonary presentations, such as spinal and miliary TB. In the therapeutic sphere, the long duration of traditional regimens is the main barrier to adherence. The study highlights the importance of transitioning to shorter and safer regimens (based on rifamycins) for the treatment of latent infection and the need for appropriate pediatric formulations. The analysis reinforces that overcoming these challenges requires diagnostic innovation and patient-centered therapeutic strategies.