Table 1

A proposed framework for initial areas of research to understand and mitigate the recent increase of tuberculosis in Latin America

AreaQuestionsActors
TheoreticalWhat are the actions and pathways responsible for the recent increase of TB in Latin America?
  • To establish theoretical models aiming to explain the phenomenon, describe the complex interactions and support the analysis of causal research questions

DescriptiveWhen, where and how much is occurring the recent increase in TB incidence?
  • To describe the time series of TB cases/incidence stratified by demographic features such as age and sex, regions and groups of interest

  • To quantify the trend of the increased incidence in TB in relative (ie, growth rate) and absolute measures

EpidemiologyWhat are the main drivers of recent increase in TB incidence?
  • To evaluate factors associated with the recent increase in TB using ecological data

  • To quantify the contribution of factors on the relative increase of TB incidence using individual population data

  • To estimate the population attributable fraction (PAF) of each factor associated with the TB increase and the combined risk factors (intersectional approach)

ModellingIn a complex scenario, what parameters could explain and mitigate the recent increase in TB incidence?
  • To account for the several players and changes in the region, accounting for its heterogeneity, to explain the observed phenomena

  • To simulate scenarios of potential interventions to mitigate the recent increase and return to the phase of decreasing incidence

  • To evaluate cost-effective interventions in the short term and long term to mitigate the recent increase and return to the phase of decreasing incidence

Clinical trials and implementationDoes the intervention X could reduce incidence of TB in the region?
  • To evaluate better strategies to implement and optimise already known interventions to reduce incidence of TB, taking account the particularities of Latin America

  • To perform randomised interventions based on the main drivers aiming to reduce the incidence of TB, focusing on prevention of transmission, development of disease after infection and treatment

  • Health impact evaluation of new implementations

  • TB, tuberculosis.