Transcript tuberculosis-surveillance-findings-2015

World Tuberculosis Day 2015
The TB situation in 2013: Findings from the joint
TB surveillance and monitoring report by
ECDC and the WHO Regional Office for Europe
ECDC TB Team
European Centre for Disease Prevention and Control
Stockholm, 24 March 2015
TB notifications by country
In 2013, 64 844 TB cases were reported in the EU/EEA.
The notification rate was 12.7 per 100 000 population (range 3.4–83.5).
Figure 1: TB
notification rate
per 100 000
population by
country, EU/EEA,
2013
< 5 per 100 000
5 to 9 per 100 000
10 to 19 per 100 000
20 to 49 per 100 000
≥ 50 per 100 000
Not included or not
reporting
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TB notification rate over time
The TB notification rate has decreased from 19.3 per 100 000
population in 2004 to 12.7 in 2013.
Figure 2: TB notification rate per 100 000 population in EU/EEA
2004−2013
25
cases/100 000
20
15
10
5
0
2004
2005
2006
2007
2008
2009
Year of reporting
2010
2011
2012
2013
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EU definition: confirmed TB cases*
In 2013, 62.1% (range 21.4–94.3%) of TB cases reported
in the EU/EEA were laboratory confirmed.
Figure 3:
Percentage of
laboratoryconfirmed TB
cases by country,
EU/EEA, 2013
< 60%
60 to 69%
70 to 79%
≥ 80%
Not included or
not reporting
* Confirmed by culture or by both a positive sputum microscopy result and Mycobacterium tuberculosis nucleic acid identified in
nucleic acid amplification test.
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Previously treated TB cases
In 2013, the proportion of all previously treated TB cases in
the EU/EEA was 11.7% (range 0.0–23.0%).
Figure 4:
Percentage of
previously
treated TB cases
by country,
EU/EEA, 2013
< 5%
5 to 9.9%
10 to 14.9%
≥ 15%
Not included or
not reporting
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TB in children
In 2013, 2 655 TB cases in children were reported, accounting
for 4.1% of all notified TB cases (range 0–9.5%) in the EU/EEA.
Figure 5: TB
notification rate in
children under 15
years of age per
100 000 child
population, by
country, EU/EEA, 2013
< 2 per
100 000 child population
2 to 3.9 per
100 000 child population
4 to 9.9 per
100 000 child population
≥ 10 per
100 000 child population
Not included or not
reporting
6
TB cases of foreign origin
In 2013, the proportion of TB cases of foreign origin
in the EU/EEA was 28.0% (range 0.3–94.7%).
Figure 6:
Percentage of TB
cases of foreign
origin by country,
EU/EEA, 2013
< 1%
1 to 24.9%
25 to 49.9%
50 to 74.9%
≥ 75%
Not included or not
reporting
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TB cases of foreign origin over time
The percentage of foreign TB cases increased from 18.2% in 2004
to 28.0% in 2013. The notification rate of foreign-origin TB cases
has remained stable since 2004 (between 3.4 and 3.8 per 100 000
population).
Figure 7: Percentage of TB cases with foreign origin, EU/EEA,
2004−2013
30
25
Percentage
20
15
10
5
0
2004
2005
2006
2007
2008
2009
Year of reporting
2010
2011
2012
2013
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Extrapulmonary TB cases
In 2013, the proportion of extrapulmonary TB cases
in the EU/EEA was 22.3% (range 4.7–63.6%).
Figure 8:
Percentage of
extrapulmonary
TB cases by
country, EU/EEA,
2013
< 10%
10 to 19.9%
20 to 29.9%
30 to 39.9%
≥ 40%
Not included or
not reporting
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Multidrug-resistant TB among all TB cases
In 2013, the proportion of TB cases with multidrugresistance in the EU/EEA was 4.1% (range 0–22.7%).
Figure 9:
Percentage of
MDR TB among
all confirmed TB
cases by country,
EU/EEA, 2013
< 1%
1 to 1.9%
2 to 4.9%
5 to 9.9%
≥ 10%
Not included or
not reporting
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Multidrug-resistant TB case notification
rate over time
The rate of notified MDR TB cases has remained stable over the past
five years at 0.3 per 100 000 population.
Figure 10: MDR TB notification rate per 100 000 population in EU/EEA
2009−2013
0.5
cases/100 000
0.4
0.3
0.2
0.1
0.0
2009
2010
2011
2012
2013
Year of reporting
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Multidrug-resistance among new
pulmonary TB cases
In 2013, the percentage of new pulmonary TB cases with multidrugresistance in the EU/EEA was 2.6% (range 0–17.3%).
Figure 11:
Percentage of
new pulmonary
TB cases with
MDR TB by
country, EU/EEA,
2013
< 1%
1 to 1.9%
2 to 4.9%
≥ 5%
Not reporting
12
Multidrug-resistance among previously
treated pulmonary TB cases
In 2013, the proportion of previously treated pulmonary TB cases with
multidrug-resistance in the EU/EEA was 17.0% (range 0–100.0%).
Figure 12:
Percentage of
previously treated
pulmonary TB
cases with MDR TB
by country,
EU/EEA, 2013
< 1%
1 to 9.9%
10 to 19.9%
≥ 20%
Not reporting
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Extensively drug-resistant TB (XDR TB)
In 2013, the proportion of extensively drug-resistant TB cases among
multidrug-resistant cases in the EU/EEA was 17.5% (range 0–100.0%
and 4.2–36.4% for countries reporting more than one case).
Figure 13:
Percentage of XDR
TB cases among
MDR TB cases
tested for secondline drug
susceptibility, by
country, EU/EEA,
2013
< 10%
10 to 19.9%
20 to 29.9%
≥30%
Not reporting
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TB/HIV co-infection
In 2013, the proportion HIV positive among TB cases
with known HIV status in EU/EEA was 4.9% (range 0–22.6%).
Figure 14:
Percentage of HIVpositive cases
among TB cases
with known HIV
status, by country,
EU/EEA, 2013
< 1%
1 to 4.9%
5 to 9.9%
≥10%
Not reporting
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Treatment success after 12 months in all
TB cases*
The treatment success rate for all TB cases notified in 2012 was 73.5%
(range: 10.3–87.8%) and has remained stable over the past five years.
Figure 15: Treatment success rate of TB cases notified in 2012, by
country, EU/EEA, 2013
Slovakia
Bulgaria
Netherlands
Iceland
Slovenia
Sweden
Romania
United Kingdom
Norway
Latvia
Portugal
Belgium
Czech Republic
Germany
Spain
Hungary
Lithuania
Austria
Denmark
Poland
Ireland
Estonia
Finland
Cyprus
Malta
Croatia
EU/EEA
0
20
40
60
Treatment success (%)
* Four EU/EEA Member States did not report treatment outcome data
80
100
16
Treatment success in new confirmed
pulmonary TB cases and relapses started
on treatment in 2012*
The treatment success rate for confirmed new pulmonary TB cases and
relapses notified in 2012 was 77.1% (range: 9.3–90.0%).
Figure 16: Treatment success rate in confirmed new pulmonary TB cases and
relapses started on treatment in 2012, by country, EU/EEA, 2013
Iceland
Slovakia
Latvia
Bulgaria
Slovenia
Netherlands
Romania
Sweden
Estonia
United Kingdom
Norway
Belgium
Czech Republic
Portugal
Germany
Austria
Hungary
Spain
Denmark
Ireland
Poland
Finland
Cyprus
Malta
Croatia
EU/EEA
0
20
* Cases started on second line treatment are excluded
40
60
Treatment success (%)
80
100
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Treatment success rate in
multidrug-resistant TB*
The treatment success rate for all multidrug-resistant TB cases notified in
2011 was 37.8% (range 0–75.0%).
Figure 17: 24-month treatment success rate in multidrug-resistant TB
cases notified in 2011, by country, EU/EEA, 2013
Norway
Belgium
Sweden
Austria
Netherlands
Bulgaria
Latvia
Germany
Portugal
Estonia
United Kingdom
Hungary
Lithuania
Poland
Slovakia
Ireland
Czech Republic
Romania
Denmark
EU/EEA
0
20
40
Treatment success (%)
60
80
* Malta and Slovenia reported zero MDR TB cases in 2011, 9 Member States did not report treatment outcome data for MDR TB cases
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Treatment outcome in
multidrug-resistant TB over time
The treatment outcomes for multidrug-resistant TB cases improved slightly
between the 2009 and 2011 cohort, EU/EEA.
Figure 18: 24-month treatment outcome in multidrug-resistant TB cases
notified from 2009 to 2011, by year of initial case reporting, EU/EEA
40
Treatment outcome (%)
MDR TB cohort 2009
MDR TB cohort 2010
MDR TB cohort 2011
30
20
10
0
Success
Died
Failed
Defaulted or
unknown
Still on treatment
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Treatment success in
extensively drug-resistant TB*
The treatment success rate in extensively drug-resistant TB cases notified in
2010 was 25.9% (range 0–100.0%).
Figure 19: 36-month treatment success rate in extensively drug-resistant
TB cases notified in 2010, by country, EU/EEA, 2013
100
Treatment success (%)
80
60
40
20
0
* Cyprus, Denmark, Italy, Norway, Slovakia and Slovenia reported zero XDR TB cases in 2010, 12 countries did not report SLD
DST results or XDR TB treatment outcome data
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