The document summarizes tuberculosis (TB) data from 2011 in the European Union and European Economic Area (EU/EEA). Some key findings include:
- 72,334 TB cases were reported in the EU/EEA in 2011, with notification rates ranging widely between countries.
- Overall notification rates have declined steadily between 2007-2011.
- Laboratory confirmation of TB cases varied between countries, from 28-95% of cases.
- Foreign-born individuals accounted for 25.8% of TB cases on average across EU/EEA countries.
In 2013, 64 844 cases of TB were reported in 30 EU/EEA countries, which was 6% less than in 2012, reflecting a decrease in 19 countries. The EU/EEA notification rate was 12.7 per 100 000 population, continuing a long-term decreasing trend. The seventh report launched jointly by ECDC and the WHO Regional Office for Europe indicates that, despite notable progress in the past decade, tuberculosis (TB) is still a public health concern in many countries across Europe.
- The number of TB cases in the EU/EEA decreased by 30% from 2006 to 2015 while the notification rate decreased by 37% over this period.
- The highest notification rate in 2015 was observed in the 25-44 year old age group. Males had higher notification rates than females in most age groups.
- Treatment success rates for TB cases remained stable around 72-75% from 2005-2014. The treatment success rate for MDR TB cases was lower at 40.4%.
Despite notable progress in the past decade, tuberculosis (TB) is still a public health concern in many countries across Europe. The high rates of TB and multidrug-resistant TB outside the European Union/European Economic Area (EU/EEA) are of particular concern, as are the significant number of TB cases among vulnerable populations within the EU/EEA.
1) 58,994 TB cases were notified in 30 EU/EEA countries in 2016, with a notification rate of 11.4 per 100,000 population. The number and rate of TB cases have declined continuously between 2007-2016.
2) The highest notification rates in 2016 were among those aged 25-44, and males had higher rates than females in all groups over 14. Rates have declined annually by 2-4% in all age groups between 2007-2016.
3) 32.7% of cases in 2016 were in persons of foreign origin, an increase from 21% in 2007. The rate of cases in foreign-born persons was stable between 2007-2016.
Presentation from the 3rd Joint Meeting of the Antimicrobial Resistance and Healthcare-Associated Infections (ARHAI) Networks, organised by the European Centre of Disease Prevention and Control - Stockholm, 11-13 February 2015
Informe sobre la situación del uso de antimicrobianos en EspañaSEMPSPH
El presidente de la Sociedad Española de Medicina Preventiva, Salud Pública e Higiene, el doctor Francisco Botía, y el doctor Ángel Asensio, miembro de la citada sociedad, han participado en reuniones con el ECDC, el Ministerio de Sanidad, Servicios Sociales e Igualdad y otras sociedades científicas, para valorar la situación actual del uso de antimicrobianos en España.
In 2013, 64 844 cases of TB were reported in 30 EU/EEA countries, which was 6% less than in 2012, reflecting a decrease in 19 countries. The EU/EEA notification rate was 12.7 per 100 000 population, continuing a long-term decreasing trend. The seventh report launched jointly by ECDC and the WHO Regional Office for Europe indicates that, despite notable progress in the past decade, tuberculosis (TB) is still a public health concern in many countries across Europe.
- The number of TB cases in the EU/EEA decreased by 30% from 2006 to 2015 while the notification rate decreased by 37% over this period.
- The highest notification rate in 2015 was observed in the 25-44 year old age group. Males had higher notification rates than females in most age groups.
- Treatment success rates for TB cases remained stable around 72-75% from 2005-2014. The treatment success rate for MDR TB cases was lower at 40.4%.
Despite notable progress in the past decade, tuberculosis (TB) is still a public health concern in many countries across Europe. The high rates of TB and multidrug-resistant TB outside the European Union/European Economic Area (EU/EEA) are of particular concern, as are the significant number of TB cases among vulnerable populations within the EU/EEA.
1) 58,994 TB cases were notified in 30 EU/EEA countries in 2016, with a notification rate of 11.4 per 100,000 population. The number and rate of TB cases have declined continuously between 2007-2016.
2) The highest notification rates in 2016 were among those aged 25-44, and males had higher rates than females in all groups over 14. Rates have declined annually by 2-4% in all age groups between 2007-2016.
3) 32.7% of cases in 2016 were in persons of foreign origin, an increase from 21% in 2007. The rate of cases in foreign-born persons was stable between 2007-2016.
Presentation from the 3rd Joint Meeting of the Antimicrobial Resistance and Healthcare-Associated Infections (ARHAI) Networks, organised by the European Centre of Disease Prevention and Control - Stockholm, 11-13 February 2015
Informe sobre la situación del uso de antimicrobianos en EspañaSEMPSPH
El presidente de la Sociedad Española de Medicina Preventiva, Salud Pública e Higiene, el doctor Francisco Botía, y el doctor Ángel Asensio, miembro de la citada sociedad, han participado en reuniones con el ECDC, el Ministerio de Sanidad, Servicios Sociales e Igualdad y otras sociedades científicas, para valorar la situación actual del uso de antimicrobianos en España.
This document summarizes information about tuberculosis (TB) in Italy and Europe in 2020. Some key points:
- In 2020, over 10 million people worldwide fell ill with TB and 1.5 million died from the disease. It is one of the top 10 causes of death globally.
- In Italy in 2020, there were 2,287 reported TB cases, down from 4,692 in 2010. The notification rate decreased from 8 cases per 100,000 people in 2010 to 3.8 cases per 100,000 in 2020.
- 55.7% of Italian TB cases in 2020 were in foreign-born individuals, up from 33% of cases in 2011. Monitoring TB rates in foreign-born populations
Simon stevens presentation - future nhs stage, 12.00, 2 september 2015NHS England
Expo is the most significant annual health and social care event in the calendar, uniting more NHS and care leaders, commissioners, clinicians, voluntary sector partners, innovators and media than any other health and care event.
Expo 15 returned to Manchester and was hosted once again by NHS England. Around 5000 people a day from health and care, the voluntary sector, local government, and industry joined together at Manchester Central Convention Centre for two packed days of speakers, workshops, exhibitions and professional development.
This year, Expo was more relevant and engaging than ever before, happening within the first 100 days of the new Government, and almost 12 months after the publication of the NHS Five Year Forward View. It was also a great opportunity to check on and learn from the progress of Greater Manchester as the area prepares to take over a £6 billion devolved health and social care budget, pledging to integrate hospital, community, primary and social care and vastly improve health and well-being.
More information is available online: www.expo.nhs.uk
Sickle Cell Disease: Newborn screening in France and the UK - Jacques ElionHuman Variome Project
This document discusses the comprehensive care programs for sickle cell disease (SCD) in the United Kingdom and France. It describes the establishment of newborn screening programs for SCD in both countries in the late 1980s/early 2000s. It also outlines national registries, specialized treatment centers, and clinical standards/guidelines that have been implemented to improve care for SCD patients. The document analyzes outcomes data from these programs, showing improvements in early diagnosis, treatment, and survival for children with SCD.
This report summarizes surveillance data on zoonoses (diseases transmitted between animals and humans), zoonotic agents, and foodborne outbreaks in the European Union in 2009. It finds that:
- Salmonellosis and campylobacteriosis were the most common zoonotic infections in humans. Salmonellosis cases decreased while campylobacteriosis cases increased slightly.
- Listeriosis cases in humans increased by 19.1% compared to 2008. Listeria was rarely found above safety limits in ready-to-eat foods.
- Over 5,500 foodborne outbreaks were reported causing nearly 49,000 illnesses, 4,356 hospitalizations and 46 deaths. The
Poster presentation at the AIDS 2018 conference in Amsterdam.
By: Marieke J. van der Werf and Csaba Ködmön, European Centre for Disease Prevention and Control, ECDC.
This document summarizes key information about tuberculosis (TB), including:
- TB remains a global health problem, infecting around one third of the world's population and killing millions each year. It is one of the top infectious disease killers worldwide.
- The largest number of TB cases occur in Asia, with India and China accounting for over half of all global cases. Sub-Saharan Africa has the highest rates of cases and deaths per capita.
- TB is closely linked to HIV/AIDS, with those coinfected being at much higher risk of falling ill from TB. Over 80% of TB cases among people living with HIV reside in Africa.
TB/HIV co-infections have risen sharply across Europe between 2011-2015, threatening progress made in reducing TB cases. While TB deaths and cases have decreased and treatment success has increased for most groups, TB/HIV deaths and cases are rising significantly. Drug-resistant TB also remains a major problem, with over half of cases in Europe being multi-drug resistant and about a quarter being extensively drug resistant. Increased efforts are needed across Europe to curb the rise of TB/HIV and improve diagnosis and treatment of drug resistant TB.
The document discusses evaluating the surveillance system for latent tuberculosis infection (LTBI) in children in France from 2010-2014. It finds that the number of reported LTBI cases increased during this period, possibly due to improved reporting or case investigation practices. However, the surveillance system has limitations like not including interferon-gamma release assay test results in the case definition and lacking data on LTBI treatment. It recommends evaluating the surveillance system and collecting more comprehensive data to better understand and detect LTBI cases.
- There were 49,752 TB cases notified in 29 EU/EEA countries in 2019, with a notification rate of 9.6 per 100,000 population. The number and rate of TB cases have declined steadily between 2010-2019.
- Males had higher notification rates than females across all age groups over 14. The highest rate was in those aged 25-44.
- 34.5% of cases were in persons of foreign origin, up from 25.3% in 2010.
- Treatment success rates after 12 months of treatment declined from 76.2% in 2009 to 63.7% in 2018.
Background: Circulation of influenza subtypes varies between influenza seasons. Little is known about patterns of circulation from one season to another. We studied the association of influenza virus subtypes detected in consecutive influenza seasons in EU/EEA countries to understand the possible predictive value of the previous season for the upcoming season.
Method: We analysed the sentinel (with systematic sampling) and non-sentinel (with convenience sampling) influenza virological surveillance data reported to the European Surveillance System from all EU/EEA countries during the seasons 2006/07-2013/14. Data were excluded if viruses were not subtyped, the number of detections exceeded the number of tested specimens or if less than 10 specimens were tested per week. Countries were excluded from analysis of any pair of consecutive seasons (cycle) if they reported for <50% of weeks in either season. We assessed the association of weekly A(H1), A(H1) pdm09, A(H3) and B virus-specific detection rates in cycles for sentinel and non-sentinel specimens. We used multilevel Poisson regression with 7 cycles as repeated measures, treated countries as cluster, and corrected for week of reporting. A sensitivity analysis was performed omitting the 2009 pandemic cycle. Associations were reported as incidence rate ratios (IRR) and 95% confidence intervals (CI).
Conclusion: Six-11 countries reported sentinel and 3-10 non-sentinel data per each cycle. The proportion of sentinel and non-sentinel influenza detections varied by (sub)type across seasons, being highest for the A(H1)pdm09 subtype during season 2009/10 (99.4%; 99.3%). The A(H3) detections were highest during 2006/07 (92.5; 91.1%). The highest proportion of influenza B was observed in 2012/13 in sentinel (64.2%) and 2007/08 in non-sentinel specimens (78.1%).
Significant associations between consecutive seasonal influenza rates were found for A(H1) (2.73;1.33-5.61, p=0.006), A(H1)pdm09 (4.31;1.92-9.67, p<0.001)><0.001) virus in the sentinel system and for A(H1) (2.70;1.00-7.30, p=0.049), A(H1)pdm09 (3.87;1.50-10.01, p=0.005) and B (0.7;0.51-0.98, p=0.039) in the non-sentinel system. When omitting the pandemic cycle, the association remained significant for A(H1) and A(H1)pdm09 in the sentinel system.
The virological influenza surveillance data suggest that influenza A(H1) and B virus circulation during any season is associated with the circulation in the forthcoming season. Vaccination coverage and vaccine effectiveness have probably an impact on the results and cause country variation as well, however, they were not within the scope of this study.
Presentation during the EU session "Eliminationm of hepatitis B and C in teh EU: challenges and opportunities", at the International Liver Congress (ILC) 2017 in Amsterdam.
Presenter: Erika Duffell, European Centre for Disease Prevention and Control (ECDC)
The document discusses HIV infection among children and adolescents in the European Union and European Economic Area (EU/EEA). It provides statistics on new HIV diagnoses from 2006-2015, showing an increase among adolescents ages 15-19. The majority of infections in children under 15 were due to mother-to-child transmission, while most adolescents were infected through heterosexual sex or sex between men. While mother-to-child transmission rates are declining in EU/EEA-born children, transmission remains high in children born outside the EU/EEA to migrant mothers. The document calls for targeted HIV prevention strategies focusing on at-risk groups.
Presentation from the 3rd Joint Meeting of the Antimicrobial Resistance and Healthcare-Associated Infections (ARHAI) Networks, organised by the European Centre of Disease Prevention and Control - Stockholm, 11-13 February 2015
The document analyzes whether the European Union reached the United Nations Millennium Declaration target of a 50% reduction in tuberculosis (TB) mortality between 1990 and 2015. It finds that between 1999 and 2014, the TB death rate in the EU decreased by 50%, meeting the target. The adjusted TB death rate, which accounts for incomplete reporting, decreased by 56%. Additionally, the annual average percentage decline in the adjusted death rate was 5.43%, higher than the 2.73% needed to reach the target. Thus, the EU achieved the Millennium Development Goal of reducing TB mortality by 50% by 2015.
Presentation by: Erika Duffell, European Centre for Disease Prevention and Control, Stockholm, Sweden
Presentad at: International Liver Congress, April 2018
Using #teledermatology effectively in rural #primarycare settingsJosep Vidal-Alaball
20th Wonca Europe Conference 2015. Wonca 2015 Istanbul.
New Ways for Dealing with Medical Conditions.
It has been known for the last 2 decades that telemedicine provides better access to users in addition to reducing the waiting time between diagnosis in primary care and hospital.
In the Catalonian central region, two counties, Bages and Berguedà, have developed a teledermatology programme, which have had considerable success in reducing waiting lists while having wide acceptance among patients. This service is especially useful in rural areas where has been able to attend thousands avoiding unnecessary trips.
I would like to share my experience first as a manager implementing the teledermatology programme in 2010 and now working as a rural GP and actively using this service in my day-to-day work.
PPT Rizzardini "HAART, sostenibilità di un miracolo"StopTb Italia
This document discusses the sustainability of highly active antiretroviral therapy (HAART) for HIV/AIDS treatment. It begins by recounting the history of HAART from initial hope to "miracle" outcomes. However, it notes the global economic crisis challenges sustainability of healthcare systems. Charts show rising healthcare costs as a percentage of GDP in many nations by 2030 and 2050. Italy faces a large national debt and rising healthcare spending. The document questions if the HAART miracle can continue given these economic pressures and need to control costs.
More Related Content
Similar to TB situation in 2011:Findings from the ECDC and WHO/EURO joint TB surveillance report
This document summarizes information about tuberculosis (TB) in Italy and Europe in 2020. Some key points:
- In 2020, over 10 million people worldwide fell ill with TB and 1.5 million died from the disease. It is one of the top 10 causes of death globally.
- In Italy in 2020, there were 2,287 reported TB cases, down from 4,692 in 2010. The notification rate decreased from 8 cases per 100,000 people in 2010 to 3.8 cases per 100,000 in 2020.
- 55.7% of Italian TB cases in 2020 were in foreign-born individuals, up from 33% of cases in 2011. Monitoring TB rates in foreign-born populations
Simon stevens presentation - future nhs stage, 12.00, 2 september 2015NHS England
Expo is the most significant annual health and social care event in the calendar, uniting more NHS and care leaders, commissioners, clinicians, voluntary sector partners, innovators and media than any other health and care event.
Expo 15 returned to Manchester and was hosted once again by NHS England. Around 5000 people a day from health and care, the voluntary sector, local government, and industry joined together at Manchester Central Convention Centre for two packed days of speakers, workshops, exhibitions and professional development.
This year, Expo was more relevant and engaging than ever before, happening within the first 100 days of the new Government, and almost 12 months after the publication of the NHS Five Year Forward View. It was also a great opportunity to check on and learn from the progress of Greater Manchester as the area prepares to take over a £6 billion devolved health and social care budget, pledging to integrate hospital, community, primary and social care and vastly improve health and well-being.
More information is available online: www.expo.nhs.uk
Sickle Cell Disease: Newborn screening in France and the UK - Jacques ElionHuman Variome Project
This document discusses the comprehensive care programs for sickle cell disease (SCD) in the United Kingdom and France. It describes the establishment of newborn screening programs for SCD in both countries in the late 1980s/early 2000s. It also outlines national registries, specialized treatment centers, and clinical standards/guidelines that have been implemented to improve care for SCD patients. The document analyzes outcomes data from these programs, showing improvements in early diagnosis, treatment, and survival for children with SCD.
This report summarizes surveillance data on zoonoses (diseases transmitted between animals and humans), zoonotic agents, and foodborne outbreaks in the European Union in 2009. It finds that:
- Salmonellosis and campylobacteriosis were the most common zoonotic infections in humans. Salmonellosis cases decreased while campylobacteriosis cases increased slightly.
- Listeriosis cases in humans increased by 19.1% compared to 2008. Listeria was rarely found above safety limits in ready-to-eat foods.
- Over 5,500 foodborne outbreaks were reported causing nearly 49,000 illnesses, 4,356 hospitalizations and 46 deaths. The
Poster presentation at the AIDS 2018 conference in Amsterdam.
By: Marieke J. van der Werf and Csaba Ködmön, European Centre for Disease Prevention and Control, ECDC.
This document summarizes key information about tuberculosis (TB), including:
- TB remains a global health problem, infecting around one third of the world's population and killing millions each year. It is one of the top infectious disease killers worldwide.
- The largest number of TB cases occur in Asia, with India and China accounting for over half of all global cases. Sub-Saharan Africa has the highest rates of cases and deaths per capita.
- TB is closely linked to HIV/AIDS, with those coinfected being at much higher risk of falling ill from TB. Over 80% of TB cases among people living with HIV reside in Africa.
TB/HIV co-infections have risen sharply across Europe between 2011-2015, threatening progress made in reducing TB cases. While TB deaths and cases have decreased and treatment success has increased for most groups, TB/HIV deaths and cases are rising significantly. Drug-resistant TB also remains a major problem, with over half of cases in Europe being multi-drug resistant and about a quarter being extensively drug resistant. Increased efforts are needed across Europe to curb the rise of TB/HIV and improve diagnosis and treatment of drug resistant TB.
The document discusses evaluating the surveillance system for latent tuberculosis infection (LTBI) in children in France from 2010-2014. It finds that the number of reported LTBI cases increased during this period, possibly due to improved reporting or case investigation practices. However, the surveillance system has limitations like not including interferon-gamma release assay test results in the case definition and lacking data on LTBI treatment. It recommends evaluating the surveillance system and collecting more comprehensive data to better understand and detect LTBI cases.
- There were 49,752 TB cases notified in 29 EU/EEA countries in 2019, with a notification rate of 9.6 per 100,000 population. The number and rate of TB cases have declined steadily between 2010-2019.
- Males had higher notification rates than females across all age groups over 14. The highest rate was in those aged 25-44.
- 34.5% of cases were in persons of foreign origin, up from 25.3% in 2010.
- Treatment success rates after 12 months of treatment declined from 76.2% in 2009 to 63.7% in 2018.
Background: Circulation of influenza subtypes varies between influenza seasons. Little is known about patterns of circulation from one season to another. We studied the association of influenza virus subtypes detected in consecutive influenza seasons in EU/EEA countries to understand the possible predictive value of the previous season for the upcoming season.
Method: We analysed the sentinel (with systematic sampling) and non-sentinel (with convenience sampling) influenza virological surveillance data reported to the European Surveillance System from all EU/EEA countries during the seasons 2006/07-2013/14. Data were excluded if viruses were not subtyped, the number of detections exceeded the number of tested specimens or if less than 10 specimens were tested per week. Countries were excluded from analysis of any pair of consecutive seasons (cycle) if they reported for <50% of weeks in either season. We assessed the association of weekly A(H1), A(H1) pdm09, A(H3) and B virus-specific detection rates in cycles for sentinel and non-sentinel specimens. We used multilevel Poisson regression with 7 cycles as repeated measures, treated countries as cluster, and corrected for week of reporting. A sensitivity analysis was performed omitting the 2009 pandemic cycle. Associations were reported as incidence rate ratios (IRR) and 95% confidence intervals (CI).
Conclusion: Six-11 countries reported sentinel and 3-10 non-sentinel data per each cycle. The proportion of sentinel and non-sentinel influenza detections varied by (sub)type across seasons, being highest for the A(H1)pdm09 subtype during season 2009/10 (99.4%; 99.3%). The A(H3) detections were highest during 2006/07 (92.5; 91.1%). The highest proportion of influenza B was observed in 2012/13 in sentinel (64.2%) and 2007/08 in non-sentinel specimens (78.1%).
Significant associations between consecutive seasonal influenza rates were found for A(H1) (2.73;1.33-5.61, p=0.006), A(H1)pdm09 (4.31;1.92-9.67, p<0.001)><0.001) virus in the sentinel system and for A(H1) (2.70;1.00-7.30, p=0.049), A(H1)pdm09 (3.87;1.50-10.01, p=0.005) and B (0.7;0.51-0.98, p=0.039) in the non-sentinel system. When omitting the pandemic cycle, the association remained significant for A(H1) and A(H1)pdm09 in the sentinel system.
The virological influenza surveillance data suggest that influenza A(H1) and B virus circulation during any season is associated with the circulation in the forthcoming season. Vaccination coverage and vaccine effectiveness have probably an impact on the results and cause country variation as well, however, they were not within the scope of this study.
Presentation during the EU session "Eliminationm of hepatitis B and C in teh EU: challenges and opportunities", at the International Liver Congress (ILC) 2017 in Amsterdam.
Presenter: Erika Duffell, European Centre for Disease Prevention and Control (ECDC)
The document discusses HIV infection among children and adolescents in the European Union and European Economic Area (EU/EEA). It provides statistics on new HIV diagnoses from 2006-2015, showing an increase among adolescents ages 15-19. The majority of infections in children under 15 were due to mother-to-child transmission, while most adolescents were infected through heterosexual sex or sex between men. While mother-to-child transmission rates are declining in EU/EEA-born children, transmission remains high in children born outside the EU/EEA to migrant mothers. The document calls for targeted HIV prevention strategies focusing on at-risk groups.
Presentation from the 3rd Joint Meeting of the Antimicrobial Resistance and Healthcare-Associated Infections (ARHAI) Networks, organised by the European Centre of Disease Prevention and Control - Stockholm, 11-13 February 2015
The document analyzes whether the European Union reached the United Nations Millennium Declaration target of a 50% reduction in tuberculosis (TB) mortality between 1990 and 2015. It finds that between 1999 and 2014, the TB death rate in the EU decreased by 50%, meeting the target. The adjusted TB death rate, which accounts for incomplete reporting, decreased by 56%. Additionally, the annual average percentage decline in the adjusted death rate was 5.43%, higher than the 2.73% needed to reach the target. Thus, the EU achieved the Millennium Development Goal of reducing TB mortality by 50% by 2015.
Presentation by: Erika Duffell, European Centre for Disease Prevention and Control, Stockholm, Sweden
Presentad at: International Liver Congress, April 2018
Using #teledermatology effectively in rural #primarycare settingsJosep Vidal-Alaball
20th Wonca Europe Conference 2015. Wonca 2015 Istanbul.
New Ways for Dealing with Medical Conditions.
It has been known for the last 2 decades that telemedicine provides better access to users in addition to reducing the waiting time between diagnosis in primary care and hospital.
In the Catalonian central region, two counties, Bages and Berguedà, have developed a teledermatology programme, which have had considerable success in reducing waiting lists while having wide acceptance among patients. This service is especially useful in rural areas where has been able to attend thousands avoiding unnecessary trips.
I would like to share my experience first as a manager implementing the teledermatology programme in 2010 and now working as a rural GP and actively using this service in my day-to-day work.
Similar to TB situation in 2011:Findings from the ECDC and WHO/EURO joint TB surveillance report (20)
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PPT Rusconi "Le multiresistenze dell'HIV/AIDS"StopTb Italia
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PPT Concia "Localizzazioni extrapolmonari nella coinfezione"StopTb Italia
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PPT Bonora "Clinica e terapia dell'HIV"StopTb Italia
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This document summarizes a presentation on immunological testing for tuberculosis (TB) and HIV co-infection. It discusses the clinical utility of interferon gamma release assays (IGRAs) for detecting latent TB infection (LTBI) in HIV-infected individuals. While IGRAs perform similarly to the tuberculin skin test (TST) in identifying those who could benefit from LTBI treatment, important questions remain about their use in HIV-positive populations with different CD4 counts. The document also examines the diagnostic value of IGRAs for active TB, finding no evidence they are more sensitive than the TST, especially in low- and middle-income countries.
PPT Castelli "Dall'HIV all'AIDS fino alla coinfezione: una diagnosi difficile?"StopTb Italia
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PPT Bocchino "Diagnosi dell'infezione tubercolare"StopTb Italia
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PPT Angarano "Storia naturale dell'HIV"StopTb Italia
The document summarizes the natural history of HIV/AIDS, beginning with its identification and description in 1981. It describes how HIV attacks and destroys CD4+ T cells, ultimately overwhelming the immune system. As the immune system is compromised, victims develop secondary infections and diseases that they are no longer able to fight off, leading to AIDS and death if left untreated. The introduction of antiretroviral therapy in the 1990s was able to control viral replication and boost CD4+ counts, reducing AIDS-related illnesses and death rates dramatically. However, even with treatment, chronic inflammation persists and contributes to accelerated aging effects and non-AIDS comorbidities over time.
The document discusses the genetic epidemiology of tuberculosis. It summarizes that analysis of TB epidemics in Europe from the 18th-19th centuries found mortality rates of up to 2% per year without chemotherapy. There was an initial spike in cases over the first 50-100 years, followed by a slow decline over the next 200-250 years. This supports the hypothesis that the initial phase eliminated the most susceptible 20% of the population.
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TB situation in 2011:Findings from the ECDC and WHO/EURO joint TB surveillance report
1. World Tuberculosis Day 2013
TB situation in 2011:
Findings from the ECDC and WHO/EURO
joint TB surveillance report
ECDC TB Team
European Centre for Disease Prevention and Control
Stockholm, 24 March 2013
2. TB notification rates in EU/EEA, 2011
In the EU/EEA, 72 334 TB cases were reported in 2011.
Notification rate 14.2 per 100 000 population (range 2.8–89.7).
Figure 1: Country-specific TB notification rates, 2011
< 10 per 100 000
10 to 19 per 100 000
20 to 49 per 100 000
50 to 99 per 100 000
Not included or not
reporting
2
3. TB notification rates in EU/EEA, 2007−2011
Overall in the EU/EEA, notification rates have steadily declined.
Figure 2: Trend in TB notification rate in the EU/EEA 2007−2011
20
Notification rate per 100 000 population
16,8 16,5
15 15,8
14,9
14,2
10
5
2007 2008 2009 2010 2011
Year of reporting
3
4. Proportion of confirmed* TB cases in the EU/
EEA, 2011
Overall 61.3% (range 27.9 – 94.8%) of TB cases reported in
the EU/EEA were laboratory-confirmed.
Figure 3: Country-specific
proportion of all confirmed TB
cases in 2011
< 60%
60 to 69%
70 to 79%
≥ 80%
Not included or
not reporting
* Confirmed by culture or both a positive sputum microscopy result and Mycobacterium tuberculosis nucleic acid identified in nucleic
acid amplification test. 4
5. TB notification rates in children <15 years
of age in EU/EEA, 2011
In 2011, 3 190 cases of TB in children were reported,
accounting for 4.4% of all notified TB cases
(range 0 – 11.1%) in the EU/EEA.
Figure 4: Country-specific childhood TB
notification rates among child population
(0–14 years), 2011
< 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
5
6. Proportion of foreign origin among notified
TB cases in EU/EEA, 2011
In 2011, the overall proportion of TB cases of foreign origin in
the EU/EEA was 25.8% (range 0.3 – 89.4%).
Figure 5: Country-specific
proportion of foreign origin cases
among all notified
TB cases, EU/EEA, 2011
< 1%
1 to 24%
25 to 49%
50 to 74%
≥ 75%
Not included or
not reporting
6
7. Proportion of notified extrapulmonary
TB cases in EU/EEA, 2011
In 2011, the overall proportion of extrapulmonary TB cases in
the EU/EEA was 22.3% (range 3.9 – 66.7%).
Figure 6: Country-specific proportion
of extrapulmonary TB of all notified
TB cases, EU/EEA, 2011
< 1%
1 to 19%
20 to 29%
30 to 49%
≥ 50%
Not included or
not reporting
7
8. Extrapulmonary TB notification rates in
EU/EEA, 2002−2011
Extrapulmonary TB notification rates have remained stable in the last 10 years.
Figure 7: Trend in extrapulmonary TB notification rate
in the EU/EEA, 2002−2011
5
Notification rate per 100 000 population
4
3 3,4 3,4 3,5 3,4 3,5 3,4
3,3 3,2 3,3
3,2
2
1
0
2002 2003 2004 2005 2006 2007 2008 2009 2010 2011
Year of reporting
8
9. Proportions of TB by site among all notified
TB cases in EU/EEA, 2002−2011
Percentage of extrapulmonary TB increased from 16.4% in 2002 to 22.4% in 2011.
Figure 8: Proportion of notified pulmonary and
extrapulmonary TB cases in the EU/EEA, 2002−2011
Number of cases
100000 Pulmonary TB Extrapulmonary TB
90000
80000
70000
60000
50000
40000
30000
20000
10000
0
2002 2003 2004 2005 2006 2007 2008 2009 2010 2011
Year of reporting
9
10. Proportion of culture-confirmed new
pulmonary TB cases in EU/EEA, 2011
61% of new pulmonary TB cases were culture-confirmed.
The proportion varied widely across countries (range 33 – 98%).
Figure 9: Proportion of new pulmonary TB cases confirmed by culture, 2011
100
90
80
70
Percentage
60
50
40
30
20
10
0
10
11. Proportion of notified TB cases with multi-
drug resistance among all confirmed TB
cases in EU/EEA, 2011
In 2011, the overall proportion of TB cases with multi-drug
resistance in the EU/EEA was 4.5% (range 0 – 29.8%).
Figure 10: Country-specific proportion
of multidrug resistance among all
confirmed TB cases,
EU/EEA, 2011
< 1%
1 to 1.9%
2 to 4.9%
5 to 9.9%
≥ 10%
Not included or
not reporting
11
12. Proportion of notified new TB cases with
multidrug resistance in EU/EEA, 2011
In 2011, the overall proportion of new TB cases with multi-
drug resistance in the EU/EEA was 2.4% (range 0 – 23.3%).
Figure 11: Country-specific
proportion of new TB cases with
multidrug resistance,
EU/EEA, 2011
< 1%
1 to 1.9%
2 to 4.9%
5 to 9.9%
≥ 10%
Not included or
not reporting
12
13. Notification rates of new cases with
multidrug resistant TB in EU/EEA, 2007−2011
The notification rate of multidrug resistant TB have remained stable at around
0.3 per 100 000 population.
Figure 12: Trends in multidrug resistant TB notification rate in the EU/EEA,
2007−2011
0,4
Notification rate per 100 000 population
0,3 0,33 0,35
0,33
0,30 0,30
0,2
0,1
0,0
2007 2008 2009 2010 2011
Year of reporting
13
14. Proportion of notified previously treated
TB cases with multidrug resistance in EU/
EEA, 2011
In 2011, the overall proportion of previously treated TB cases
with multidrug resistance in the EU/EEA was 16.8%
(range 0 – 57.7%).
Figure 13: Country-specific
proportion of previously
treated TB cases with
multi-drug resistance,
EU/EEA, 2011
< 1%
1 to 1.9%
2 to 4.9%
5 to 9.9%
≥ 10%
Not included or
not reporting
14
15. Proportion of TB cases with extensive drug
resistance among MDR-TB cases with SLD
ST* reported in EU/EEA, 2011
In 2011, the proportion of extensive drug resistant cases among
cases with multidrug resistance in EU/EEA was 13.4%
(range 0 – 40.0%).
Figure 14: Country-specific proportion of extensively
drug-resistant TB cases
among TB cases with
multi-drug resistance,
EU/EEA, 2011
< 1%
1 to 4%
5 to 9%
10 to 19%
≥ 20% or
Not included or
Not included
not reporting
not reporting
*SLD ST – second line drug susceptibility testing result 15
16. Proportion of HIV positive TB cases among
all TB cases with known HIV status in EU/
EEA, 2011
In 2011, the overall proportion of HIV positive TB cases
among TB cases with known HIV status in EU/EEA was 4.7%
(range 0 – 40%).
Figure 15: Country-specific proportion of
HIV positive TB cases
among TB cases with
known HIV status,
EU/EEA, 2011
< 1%
1 to 1.9%
2 to 4.9%
5 to 9.9%
≥ 10%
Not included or
not reporting
16
17. Treatment success rate for new pulmonary
TB cases in EU/EEA*, 2010
The treatment success rate for new culture-confirmed pulmonary TB cases notified in
2010 was 76.8% (range: 0 – 91.4%).
Figure 16: Treatment success rate for new culture-confirmed
pulmonary TB cases notified in 2010
100
Treatment success (%)
80
60
40
20
0
* Five EU/EEA Member States did not report treatment outcome data.
17
18. Treatment success rate for new
pulmonary TB cases by year of reporting
in EU/EEA, 2006−2010
The treatment success rate for new culture-confirmed pulmonary TB cases notified
between 2006 and 2010 has slightly decreased from 79.5% in 2006 to 76.8% in 2010.
Figure 17: Treatment success rate for new culture-confirmed pulmonary
TB cases notified in 2006−2010
100
80
Treatment success (%)
79,5 79,2 79,5 78,9 76,8
60
40
20
0
2006 2007 2008 2009 2010
Year of reporting
18
19. Treatment success rate for previously
treated pulmonary TB cases in EU/EEA*,
2010
The treatment success rate for previously treated culture-confirmed pulmonary
TB cases notified in 2010 was 53.7% (range 31.4 – 85.7%).
Figure 18: Treatment success rate for previously treated culture-confirmed pulmonary
TB cases notified in 2010
100
Treatment success (%)
80
60
40
20
0
* Iceland and Luxembourg reported zero previously treated TB cases in 2010. Seven EU/EEA Member States did not
report stratified treatment outcome data 19
20. Treatment success rate for all notified
pulmonary TB cases in EU/EEA*, 2010
The treatment success rate for all confirmed pulmonary TB cases notified
in 2010 was 74.3% (range 0 – 90.1%).
Figure 19: Treatment success rate for all confirmed pulmonary TB cases notified in
2010
100
80
Treatment success (%)
60
40
20
0
* Five EU/EEA Member States did not report treatment outcome data
20
21. Treatment success* rate for extra-
pulmonary TB cases in EU/EEA**, 2010
The treatment success rate for extrapulmonary TB cases notified in 2010 was
82.2% (range 21.1 – 100%).
Figure 20: Treatment success rate for extrapulmonary TB cases notified in 2010
100
80
Treatment success (%)
60
40
20
0
* Treatment success of extrapulmonary TB consists of cases reported as completed full course of anti-tuberculosis treatment
** Seven Member States did not report stratified treatment outcome data 21
22. Treatment success rate for notified
multidrug-resistant TB cases in EU/EEA*,
2009
The treatment success rate for all confirmed multidrug-resistant TB cases notified in
2009 was 31.6% (range 0 – 84.6%).
Figure 21: Treatment success rate for all confirmed multidrug-resistant TB
cases notified in 2009
100
80
Treatment success (%)
60
40
20
0
* Malta reported zero MDR TB cases in 2009, 11 Member States did not report treatment outcome data
22
23. Treatment outcome for multidrug-resistant
TB cases notified in 2007−2009
Treatment outcomes for multidrug-resistant TB cases did not improve between the
2007 and 2009 cohort, EU/EEA.
Figure 22: Treatment outcome at 24 months for multidrug-resistant TB cases
diagnosed in 2009, compared with cases diagnosed in 2007 and 2008
35
cohort 2009 (18 countries)
30
cohort 2008 (20 countries)
25
cohort 2007 (15 countries)
Percentage
20
15
10
5
0
Success Died Failed Defaulted Still on Transferred or
treatment unknown
23