Tuberculosis Cases Surge in Argentina: Rising Concerns & Diagnostic Delays

Argentina is facing a “very worrying” public health trend as new tuberculosis (TB) cases appear to be accelerating, health professionals warn. Official data shows more than 17,000 cases were detected in 2024, compared to just under 10,000 a decade prior. The increase is attributed to a combination of factors, including delays in diagnosis, socioeconomic difficulties hindering access to care, and insufficient clinical suspicion leading to misdiagnosis as other respiratory infections like influenza, pneumonia, or bronchitis.

“The scenario is very worrying,” said Alejandra Gaiano, pediatric infectious disease specialist and pro-secretary of the Infectiology Committee of the Argentine Society of Pediatrics (SAP). “There is a real increase in cases of tuberculosis in the population in recent years, and this is happening in all age groups. The mycobacterium that causes the disease has humans as its exclusive reservoir, but its elimination and control are very complex given that it sometimes presents with few, but prolonged symptoms – a cough lasting 14 days or more, fever, fatigue, and weight loss – which are confused with other problems. And when the patient does consult, diagnostic delays are a limitation.”

Gerardo Leube, professor of Microbiology and Infectiology at the Barceló Foundation, echoed this concern, stating the epidemiological situation remains troubling and has not reversed in over a decade. “The biggest worry, from the patient’s perspective, is that diagnoses are often late, especially in adolescents, who only seek medical attention when they have bloody respiratory secretions and severe lung involvement, making recovery difficult,” he noted.

According to the latest update from the Ministry of Health, prior to World Tuberculosis Day on March 24th, new diagnoses and relapses – whether or not treatment was completed – are concentrated in individuals aged 15 to 40. Annual notifications to the national health surveillance system from the provinces ranged between 9,000 and just under 12,000 cases until 2018. In 2019, the figure nearly reached 13,000, but with the onset of the COVID-19 pandemic, official notifications decreased by an estimated 18%. However, the situation subsequently deteriorated.

“Notification rates increased until 2024 with an average annual variation of 11%, representing the highest number of cases, the highest rate, and the most pronounced rate of increase in a 16-year period analyzed,” the Ministry of Health reported. The negative impact affected both the detection and treatment of the disease, with a “generalized” increase across all ages, particularly among adolescents and young adults.

Last week, the Ministry of Health updated its technical criteria for TB detection and treatment – a revision not undertaken in 13 years – officially highlighting the need to strengthen “the capacities of health teams through clear guidelines for the detection, diagnosis, treatment and follow-up of cases and contacts.” Juan Carlos Beltramino, former Director of Teaching and Research at the Dr. Orlando Alassia Children’s Hospital in Santa Fe, emphasized this point, noting the effects of the disease visible in pulmonary radiological images.

Santa Fe province is one of 11 regions where tuberculosis has grown significantly over the past decade (more than 12%), alongside the city and province of Buenos Aires, Córdoba, Salta, Chaco, Jujuy, Entre Ríos, Tucumán, Corrientes, and Tierra del Fuego, according to the official report. “After the pandemic, Santa Fe is accompanying the marked increase in TB cases observed throughout the country. Hospitals are on alert, and doctors are using rapid molecular diagnostics,” Beltramino described. However, he expressed alarm at seeing “tuberculous caverns in the lungs of young people, as was the case 50 years ago,” stressing the need to reinforce surveillance and follow-up of patients and contacts.

Sandra Inwentarz, coordinator of the Tuberculosis Section of the Argentine Association of Respiratory Medicine (AAMR) and a professor at the Faculty of Medicine of the University of Buenos Aires (UBA), identified a “major problem” as the loss of a specific national program following the reorganization of the health portfolio. “We closed 2024 with more than 17,000 cases, and we grasp that there are cases that are not reported for various reasons, such as lack of internet access or computers, and lack of time. In the interior of the country, one person often handles patient care, medication dispensing, and adverse reaction monitoring. After the pandemic, cases increased by 60% in the population between 14 and 35 years old, groups in which we are seeing six out of ten diagnoses,” she indicated, adding that she was a member of the advisory committee of the former national tuberculosis program and former head of the department at the Dr. Raúl Vaccarezza Institute of Tisioneumonology at the UBA.

Another issue raised concerns the procurement of medications through the Pan American Health Organization (PAHO). “In the last two years, there were no purchases until a few months ago when orders were signed for the country,” Inwentarz stated. Treatment typically involves four drugs for two months (first-line therapies for drug-sensitive tuberculosis), followed by two drugs for another four, six, or more months, depending on the patient. “There are provinces without medication,” she added.

Both first- and second-line therapies, when administered promptly, can shorten and improve treatment effectiveness. Gaiano concurred, noting that cases are particularly occurring in adolescents and young adults, while socioeconomic vulnerability and inadequate housing increase risk. “Transmission often occurs within the family, but can also occur in schools or workplaces,” she explained. By law, treatment is free once tuberculosis is diagnosed, but the drugs used “require patient adherence,” along with controls and follow-up of contacts by the health system. “Raising awareness among the population and, especially, among healthcare personnel, both in the public and private sectors, is a constant challenge from a teaching and care perspective to continue thinking that tuberculosis is present. A disease is not diagnosed if it is not known or suspected,” Leube concluded.