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World Tuberculosis Day 2017
Tuberculosis situation in the EU/EEA, 2015
Findings from the joint Tuberculosis surveillance a...
TB notifications, EU/EEA, 2015
60 195 TB cases in 30 EU/EEA countries
Notification rate of 11.7 per 100 000
population (ra...
TB notifications, EU/EEA, 2006-2015
Steady decline between 2006 and 2015:
• number of TB cases decreased by 30%
• notifica...
TB notification rate by sex and age group,
EU/EEA, 2015
4
0
5
10
15
20
25
0-4 5-14 15-24 25-44 45-64 ≥ 65
TBcases/100000
A...
TB notification rate by age group, EU/EEA,
2006–2015
5
Decreased by 2-5% annually in all age groups
1
10
100
2006 2007 200...
TB in children under 15 years, EU/EEA, 2015
6
2 444 TB cases reported in children under 15 years
4.1% of all TB cases (ran...
Confirmed TB cases*, EU/EEA, 2015
7
* Confirmation by culture or by both sputum microscopy and
Mycobacterium tuberculosis ...
Previously treated TB cases, EU/EEA, 2015
8
Source: European Centre for Disease Prevention and Control/WHO Regional Office...
TB cases in persons of foreign origin,
EU/EEA, 2015
9
29.8% of TB cases occurred in persons of
foreign origin (range 0.2–8...
TB cases in persons of foreign origin,
EU/EEA, 2006–2015
10
0
2
4
6
8
10
0
5
10
15
20
25
30
35
2006 2007 2008 2009 2010 20...
TB notification rates by origin, EU/EEA,
2010–2015
11
3.7% annual decline of notification rate in foreign population
7.0% ...
Extrapulmonary TB cases, EU/EEA, 2015
12
22.2% of TB cases had extrapulmonary TB
(range 2.8–46.4%)
Not reporting
≥ 30%
20 ...
Multidrug-resistant TB (MDR TB), EU/EEA,
2015
13
* DST – drug susceptibility results reported for at least isoniazid and r...
MDR TB notification rate, EU/EEA, 2011–
2015
14
Rate was stable at 0.3 per 100 000 population between
2011 and 2015
0
0.1
...
Multidrug resistance among new
pulmonary TB cases, EU/EEA, 2015
15
Source: European Centre for Disease Prevention and Cont...
Multidrug resistance among previously
treated pulmonary TB cases, EU/EEA, 2015
16
Source: European Centre for Disease Prev...
Extensively drug-resistant TB (XDR TB),
EU/EEA, 2015
17
* DST – drug susceptibility test
19.7% of MDR TB cases with second...
TB/HIV co-infection, EU/EEA, 2015
18
* Among countries reporting HIV status for at least 50% of
TB cases
4.6% of TB cases ...
Treatment success of all TB cases notified
in 2014, EU/EEA, 2015
19
* Six EU/EEA Member States did not report treatment ou...
Treatment success of all notified TB cases,
2005–2014, EU/EEA
20
Proportion of successfully treated cases is stable (range...
Treatment success, EU/EEA, 2015*
21
72.0% of all TB cases* had a successful treatment
outcome after 12 months (range 43.3–...
Treatment success in new confirmed TB
cases and relapses, started on treatment in
2014*, EU/EEA, 2015
22
* Cases started o...
23
* Six EU/EEA Member States did not report treatment outcome dataSource: European Centre for Disease Prevention and Cont...
Treatment success in MDR TB*, EU/EEA,
2015
24
40.4% of all MDR TB cases notified in 2013 were successfully
treated (range ...
Treatment success in all cases with MDR
TB*, EU/EEA, 2015
25
* Croatia, Czech Republic, Iceland and Slovenia reported zero...
Treatment outcomes of MDR TB cases
notified in 2011–2013, EU/EEA, 2015
26
Source: European Centre for Disease Prevention a...
27
Treatment success in XDR TB cases,
EU/EEA, 2015
27
* Cyprus, Ireland, Netherlands, Norway and Slovakia reported zero XD...
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World Tuberculosis Day 2017 - Tuberculosis situation in the EU/EEA, 2015

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World Tuberculosis Day 2017 - Tuberculosis situation in the EU/EEA, 2015

  1. 1. World Tuberculosis Day 2017 Tuberculosis situation in the EU/EEA, 2015 Findings from the joint Tuberculosis surveillance and monitoring in Europe, 2017 report by ECDC and WHO Regional Office for Europe ECDC TB Team European Centre for Disease Prevention and Control Stockholm, 24 March 2017
  2. 2. TB notifications, EU/EEA, 2015 60 195 TB cases in 30 EU/EEA countries Notification rate of 11.7 per 100 000 population (range 2.1–76.5) 2 Not reporting 20 to 49 10 to 19 5 to 9 ≥ 50 Cases per 100 000 population < 5 Source: European Centre for Disease Prevention and Control/WHO Regional Office for Europe. Tuberculosis surveillance and monitoring in Europe 2017
  3. 3. TB notifications, EU/EEA, 2006-2015 Steady decline between 2006 and 2015: • number of TB cases decreased by 30% • notification rate decreased by 37% 3 Source: European Centre for Disease Prevention and Control/WHO Regional Office for Europe. TB surveillance and monitoring in Europe, 2017 0 4 8 12 16 20 20 000 40 000 60 000 80 000 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 TBcases/100000 TBcases Year of reporting TB cases Rate per 100 000 population
  4. 4. TB notification rate by sex and age group, EU/EEA, 2015 4 0 5 10 15 20 25 0-4 5-14 15-24 25-44 45-64 ≥ 65 TBcases/100000 Age group Male Female The highest notification rate was observed in the age group 25–44 years, (14.4 per 100 000). Males were over-represented in all age groups except children under 15 years. Source: European Centre for Disease Prevention and Control/WHO Regional Office for Europe. TB surveillance and monitoring in Europe, 2017
  5. 5. TB notification rate by age group, EU/EEA, 2006–2015 5 Decreased by 2-5% annually in all age groups 1 10 100 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 TBcases/100000 Year of reporting 0-4 5-14 15-24 25-44 45-64 65+ Source: European Centre for Disease Prevention and Control/WHO Regional Office for Europe. Tuberculosis surveillance and monitoring in Europe 2017
  6. 6. TB in children under 15 years, EU/EEA, 2015 6 2 444 TB cases reported in children under 15 years 4.1% of all TB cases (range 0-21.1%) 3.0 notifications per 100 000 child population (range 0–21.3) Not reporting 4 to 9.9 2 to 3.9 1 to 1.9 ≥ 10 Cases per 100 000 children < 1 Source: European Centre for Disease Prevention and Control/WHO Regional Office for Europe. Tuberculosis surveillance and monitoring in Europe 2017
  7. 7. Confirmed TB cases*, EU/EEA, 2015 7 * Confirmation by culture or by both sputum microscopy and Mycobacterium tuberculosis nucleic acid amplification test Source: European Centre for Disease Prevention and Control/WHO Regional Office for Europe. TB surveillance and monitoring in Europe, 2017 66.9% of TB cases were laboratory-confirmed (range 42.9–91.5%) Not reporting ≥ 80% 70 to 79% 60 to 69% Proportion of confirmed cases < 60%
  8. 8. Previously treated TB cases, EU/EEA, 2015 8 Source: European Centre for Disease Prevention and Control/WHO Regional Office for Europe. TB surveillance and monitoring in Europe, 2017 11.1% of reported cases had been previously treated (range 0–21.7%) Not reporting ≥ 15% 10 to 14.9% 5 to 9.9% Proportion of previously treated cases < 5%
  9. 9. TB cases in persons of foreign origin, EU/EEA, 2015 9 29.8% of TB cases occurred in persons of foreign origin (range 0.2–89.5%) Not reporting 50 to 74.9% 10 to 49.9% 1 to 9.9% ≥ 75% Proportion of cases < 1% Source: European Centre for Disease Prevention and Control/WHO Regional Office for Europe. Tuberculosis surveillance and monitoring in Europe 2017
  10. 10. TB cases in persons of foreign origin, EU/EEA, 2006–2015 10 0 2 4 6 8 10 0 5 10 15 20 25 30 35 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 Cases/100000 Percentage Year of reporting Percentage of cases in persons of foreign origin Rate per 100 000 of total population Percentage of cases in persons of foreign origin increased from 17.6% in 2006 to 29.8% in 2015 Rate per 100 000 total population stable between 3.1 and 3.5 Source: European Centre for Disease Prevention and Control/WHO Regional Office for Europe. TB surveillance and monitoring in Europe, 2017
  11. 11. TB notification rates by origin, EU/EEA, 2010–2015 11 3.7% annual decline of notification rate in foreign population 7.0% annual decline of notification rate in native population Source: Hollo V, Beauté J, Ködmön C, van der Werf MJ. TB notification rate decreases faster in residents of native origin than in residents of foreign origin in the EU/EEA. (Eurosurveillance, March 2017). 1.0 10.0 100.0 2010 2011 2012 2013 2014 2015 cases/100000 Year of reporting Rate per 100 000 in native population Rate per 100 000 in foreign population
  12. 12. Extrapulmonary TB cases, EU/EEA, 2015 12 22.2% of TB cases had extrapulmonary TB (range 2.8–46.4%) Not reporting ≥ 30% 20 to 29.9% 10 to 19.9% Proportion of extrapulmonary cases 0 to 9.9% Source: European Centre for Disease Prevention and Control/WHO Regional Office for Europe. Tuberculosis surveillance and monitoring in Europe 2017
  13. 13. Multidrug-resistant TB (MDR TB), EU/EEA, 2015 13 * DST – drug susceptibility results reported for at least isoniazid and rifampicinSource: European Centre for Disease Prevention and Control/WHO Regional Office for Europe. TB surveillance and monitoring in Europe, 2017 4.1% of TB cases with DST* results were multidrug-resistant (range 0–21.2%) Not reporting 5 to 9.9% 2 to 4.9% 1 to 1.9% ≥ 10% Proportion of cases < 1%
  14. 14. MDR TB notification rate, EU/EEA, 2011– 2015 14 Rate was stable at 0.3 per 100 000 population between 2011 and 2015 0 0.1 0.2 0.3 0.4 0.5 2011 2012 2013 2014 2015 cases/100000 Year of reporting Source: European Centre for Disease Prevention and Control/WHO Regional Office for Europe. Tuberculosis surveillance and monitoring in Europe 2017
  15. 15. Multidrug resistance among new pulmonary TB cases, EU/EEA, 2015 15 Source: European Centre for Disease Prevention and Control/WHO Regional Office for Europe. TB surveillance and monitoring in Europe, 2017 2.2% of new pulmonary TB cases with DST* results had MDR TB (range 0–13.5%) * DST – drug susceptibility results reported for at least isoniazid and rifampicin Not reporting 5 to 9.9% 2 to 4.9% 1 to 1.9% ≥ 10% Proportion of cases < 1%
  16. 16. Multidrug resistance among previously treated pulmonary TB cases, EU/EEA, 2015 16 Source: European Centre for Disease Prevention and Control/WHO Regional Office for Europe. TB surveillance and monitoring in Europe, 2017 17.2% (range 0–51.4%) of previously treated pulmonary TB cases with DST* results had MDR TB * DST – drug susceptibility results reported for at least isoniazid and rifampicin Not reporting 15 to 24.9% 5 to 14.9% 1 to 4.9% ≥ 25% Proportion of cases < 1%
  17. 17. Extensively drug-resistant TB (XDR TB), EU/EEA, 2015 17 * DST – drug susceptibility test 19.7% of MDR TB cases with second line DST* were extensively drug-resistant (range 0–30.0% and 13.0– 25.4% for countries reporting more than five cases) Not reporting 15 to 24.9% 10 to 14.9% 1 to 9.9% ≥ 25% Proportion of cases < 1% Source: European Centre for Disease Prevention and Control/WHO Regional Office for Europe. Tuberculosis surveillance and monitoring in Europe 2017
  18. 18. TB/HIV co-infection, EU/EEA, 2015 18 * Among countries reporting HIV status for at least 50% of TB cases 4.6% of TB cases with known HIV status* were HIV positive (range 0–17.4%) Not reporting ≥ 15% 10 to 14.9% 1 to 9.9% Proportion of confirmed cases < 1% Source: European Centre for Disease Prevention and Control/WHO Regional Office for Europe. Tuberculosis surveillance and monitoring in Europe 2017
  19. 19. Treatment success of all TB cases notified in 2014, EU/EEA, 2015 19 * Six EU/EEA Member States did not report treatment outcome dataSource: European Centre for Disease Prevention and Control/WHO Regional Office for Europe. TB surveillance and monitoring in Europe, 2017 72.0% of all TB cases* had a successful treatment outcome after 12 months (range 43.3–88.9%) 0 10 20 30 40 50 60 70 80 90 100 EU/EEA Finland Denmark Ireland Spain Poland Cyprus Germany Croatia Portugal Hungary Austria Czech Republic Slovenia Lithuania Belgium United Kingdom Latvia Estonia Norway Romania Netherlands Bulgaria Sweden Slovakia Iceland Treatment success (%)
  20. 20. Treatment success of all notified TB cases, 2005–2014, EU/EEA 20 Proportion of successfully treated cases is stable (range 72–75%) 0% 20% 40% 60% 80% 100% 0 10 000 20 000 30 000 40 000 50 000 60 000 70 000 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 Year of notification Totalnumber Total number Total number of successfully treated cases Treatment success % Source: European Centre for Disease Prevention and Control/WHO Regional Office for Europe. Tuberculosis surveillance and monitoring in Europe 2017
  21. 21. Treatment success, EU/EEA, 2015* 21 72.0% of all TB cases* had a successful treatment outcome after 12 months (range 43.3–88.9%) Not reporting ≥ 85% 60 to 84.9% Proportion of treatment success < 60% * Six EU/EEA Member States did not report treatment outcome dataSource: European Centre for Disease Prevention and Control/WHO Regional Office for Europe. Tuberculosis surveillance and monitoring in Europe 2017
  22. 22. Treatment success in new confirmed TB cases and relapses, started on treatment in 2014*, EU/EEA, 2015 22 * Cases started on second line treatment are excludedSource: European Centre for Disease Prevention and Control/WHO Regional Office for Europe. TB surveillance and monitoring in Europe, 2017 74.4% of new confirmed cases and relapses had a successful treatment outcome (range 44.8–88.9%) 0 10 20 30 40 50 60 70 80 90 100 EU/EEA Finland Denmark Ireland Spain Poland Cyprus Germany Croatia Portugal Hungary Austria Czech Republic Slovenia Lithuania Belgium United Kingdom Latvia Estonia Norway Romania Netherlands Bulgaria Sweden Slovakia Iceland Treatment success (%)
  23. 23. 23 * Six EU/EEA Member States did not report treatment outcome dataSource: European Centre for Disease Prevention and Control/WHO Regional Office for Europe. TB surveillance and monitoring in Europe, 2017 74.4% of new confirmed TB cases and relapses had a successful treatment outcome (range 44.8–88.9%) Treatment success in new confirmed TB cases and relapses notified in 2014*, EU/EEA, 2015 Not reporting ≥ 85% 60 to 84.9% Proportion of treatment success < 60%
  24. 24. Treatment success in MDR TB*, EU/EEA, 2015 24 40.4% of all MDR TB cases notified in 2013 were successfully treated (range 0–93.8%) 0 10 20 30 40 50 60 70 80 90 100 EU/EEA Slovakia Poland Ireland Lithuania Hungary Romania Germany Bulgaria Denmark Portugal United Kingdom Estonia Norway Latvia Sweden Austria Belgium Netherlands Treatment success (%) * Croatia, Czech Republic, Iceland and Slovenia reported zero MDR TB cases in 2013 Source: European Centre for Disease Prevention and Control/WHO Regional Office for Europe. Tuberculosis surveillance and monitoring in Europe 2017
  25. 25. Treatment success in all cases with MDR TB*, EU/EEA, 2015 25 * Croatia, Czech Republic, Iceland and Slovenia reported zero MDR TB cases in 2013, nine Member States did not report treatment outcome data for MDR TB cases Source: European Centre for Disease Prevention and Control/WHO Regional Office for Europe. TB surveillance and monitoring in Europe, 2017 40.4% of all MDR TB cases notified in 2013 was successfully treated (range 0–93.8%) Not reporting ≥ 70% 40 to 69.9% Proportion of treatment success < 40%
  26. 26. Treatment outcomes of MDR TB cases notified in 2011–2013, EU/EEA, 2015 26 Source: European Centre for Disease Prevention and Control/WHO Regional Office for Europe. TB surveillance and monitoring in Europe, 2017 Treatment success rates remained stable at 38-40% in the 2011, 2012 and 2013 cohorts 0 10 20 30 40 50 Success Died Failed Defaulted or unknown Still on treatment Percentage MDR TB cohort 2011 MDR TB cohort 2012 MDR TB cohort 2013
  27. 27. 27 Treatment success in XDR TB cases, EU/EEA, 2015 27 * Cyprus, Ireland, Netherlands, Norway and Slovakia reported zero XDR TB cases in 2012. 13 countries did not report second line drug susceptibility testing results or XDR TB treatment outcome data Source: European Centre for Disease Prevention and Control/WHO Regional Office for Europe. TB surveillance and monitoring in Europe, 2017 24.3% of the XDR TB cases notified in 2012 were treated successfully (range 0–100%) 0 20 40 60 80 100 120 EU/EEA Germany Czech Republic Lithuania Romania Bulgaria Estonia Austria United Kingdom Hungary Latvia Sweden Portugal Belgium Treatment success (%)

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