In 2019, 1,848 tuberculosis cases were reported, 38 less than the 1,886 in 2018, equivalent to a notification rate of 18 per 100 thousand inhabitants in 2019 and 18.4 per 100 thousand inhabitants in 2018.
As for new cases, 2019 registered 1,696, in addition to 152 retreatments; while in 2018 there were 1,740 new cases and 146 retreatments. The incidence rate (number of new cases) also followed the downward trend, with 17 cases per 100 thousand inhabitants in 2018 and 16.5 in 2019.
In regional terms, Lisbon and the Tagus Valley, with 22.9 cases per 100 thousand inhabitants in 2019 (884 cases), and the North, with a notification rate of 19.8 (707 cases), remain as the regions with the highest incidence of the disease in the country.
In the distribution by sex, there is a greater impact on men, with 66.9% of the cases being male in 2019.
At the age level, there is a clear prevalence of tuberculosis in adulthood. Only 3% of the total cases of 2019 appeared in children and young people up to the age of 15. The median age recorded in 2019 was 49 years, one more than the estimated 48 years for 2018.
Regarding the clinical and bacteriological characterization of the cases, the majority continue to have the pulmonary form, with 74.1% of the total cases in 2019. On the other hand, severe forms of disseminated, meningeal or nervous system tuberculosis were found in only 92 cases in 2019 (87 in the previous year), representing 5% of the total cases.
At the same time, 79.9% of the cases reported in 2019 were also tested for HIV (88.1% in 2018), with 9% having tuberculosis / HIV co-infection.
According to the indicators, the success of the treatments was 83%, while the lethality of the disease did not exceed 7.1%.
The report warns of the long time of diagnosis and the risks that this poses in terms of social dissemination. “The median delay between the onset of symptoms and the diagnosis has been increasing in the last decade, which is related to a lower index of suspicion of tuberculosis by professionals and the population itself and which justifies the need to improve literacy in tuberculosis".
Among the explanations, the document indicates that the “delay in diagnosis is related in two thirds of the cases to the delay of the user in valuing the symptoms and seeking health care and in one third of the cases with the health care response”. At the national level, the time between the onset of symptoms and the diagnosis was 74 days in 2019, which translates into a positive evolution compared to the 79 days of 2018, but is well below the 60 days that occurred in 2010, the year with the lowest value in the last decade.
"The current results mean the need to optimize the surveillance tools for greater accuracy of the results and the planning of future strategies for improving tuberculosis literacy by the population and professionals", says the Director-General of Health, Graça Freitas, in the report .
In defining the prospects for 2021 and 2022, the National Tuberculosis Program “defines as a priority the reorganization of the assistance response to tuberculosis, the optimization of notification platforms and the improvement of tuberculosis literacy in the general population and health professionals and finally, the interconnection between the various health and social structures, allowing an integrated response ”.
The impact of the covid-19 pandemic is not overlooked in the document, which recalls that the financial investment made to halt the spread of the SARS-CoV-2 virus “will have a predictable impact” in the control of diseases such as tuberculosis. "Access to health care may be more difficult, requiring strategies to adjust the health care response, keeping the response centered on the patient and involving the community", he concludes.