The same report shows that, among immigrants, the rate is almost three times the national average.

The Report on Tuberculosis Surveillance and Monitoring in Portugal, published on World Tuberculosis Day, confirms a downward trend in the country, with a notification rate of 14.3 cases per 100,000 inhabitants.

Reduction in the incidence rate

“We have seen a reduction in the incidence rate of around 31.8% compared to 2015. However, this is still below the reduction required to reach the target of a 90% decrease in incidence by 2035,” said the deputy director of the DGS’s National Tuberculosis Programme to the Lusa news agency. The World Health Organization set this target.

Sofia Sousa also highlighted the positive trend in mortality. In 2024, there were 50 deaths from tuberculosis, almost a 70% drop compared to 2015. This brings Portugal closer to international targets.

Demographic data

According to the report, the highest incidence remained in Lisbon, the Tagus Valley, and the North, with 17.1 and 16.4 cases per 100,000 inhabitants, respectively.

She explained that this concentration is due to higher population density and the presence of vulnerable groups. Associated comorbidities and urban factors such as overcrowding also contribute to an increase in tuberculosis cases, a trend that has been evident for a long time.

Of the total number of cases, 1,418 were new cases, and 118 were re-diagnosed cases. Men remain the most affected group (64.4% of total cases), whilst children and adolescents aged 15 and under accounted for 2.4% of reported cases.

Migrant population

The migrant population remained the most vulnerable group, with a notification rate 2.7 times higher than the national average, accounting for 39.1% of cases in 2024, an increase compared to 2023 (35.7%).

Starting the treatment

According to the report, the time between the onset of symptoms and the start of treatment remained at 81 days in 2024, whilst the delay in patients accessing treatment decreased to 41 days (43 days in 2023), and the delay in healthcare provision increased to 14 days (13 days in 2023).

Sofia Sousa considered this interval “still very high”, emphasising that the delay in seeking medical help remains a main challenge and advocating for improved health literacy and greater access to services.

She noted that in 2024, a reorganisation of care was initiated, with tuberculosis consultations integrated into respiratory care consultations within the community, at local health centres, and the creation of referral centres in Lisbon and Porto for more complex cases, such as multidrug-resistant tuberculosis.

Multidrug-resistant

In 2024, 36 cases of multidrug-resistant tuberculosis were reported, an increase of 63.6% compared to 2023, with the majority concentrated in Lisbon and the Tagus Valley (63.9%).

Most cases occurred in men, and one involved a 4-year-old child of Angolan origin. Of the 36 cases, 24 occurred in migrants, mainly from Angola, Brazil and Guinea-Bissau.

Sofia Sousa said that various strategies have been implemented to improve surveillance of this type of case, including at the molecular level, to identify which strains are being introduced and where they are located.

Treatment success rate

The treatment success rate reached 82.1%, the highest figure in recent years, which, according to the DGS, reflects “the quality of clinical care in Portugal, but is still far from international targets”.

In 2024, 4,315 cases of latent infection were treated, the highest figure on record, highlighting the results of screening in high-risk groups.

“Worrying slowdown”

Despite this positive trend, the DGS warns of a “worrying slowdown” in the rate of decline in disease incidence between 2020 and 2024.

This trend, coupled with the rise in multidrug-resistant tuberculosis and the increasing concentration of the disease in vulnerable populations, requires “a strategic reorientation” to achieve the WHO’s targets, it argued.

He pointed out that tuberculosis is a curable and preventable disease, highlighting the role of preventive treatments in reducing the risk of developing active disease, particularly among people with risk factors, such as those who have been in contact with patients, people living with HIV, or those with a weakened immune system.

Raising awareness

He emphasised the importance of raising awareness of symptoms, such as a persistent cough and weight loss, encouraging the public to seek healthcare in good time.

On the other hand, he stressed that combating stigma remains a challenge, and it is essential to speak openly about the disease, “give a voice to those who are ill” and promote early diagnosis, helping to ensure that tuberculosis is no longer seen as a disease “that no longer exists or that should no longer exist”.