Abstract
An analysis of surveillance data was performed to assess treatment outcomes of patients belonging to selected calendar year cohorts. Twenty-two countries in the European Union (EU) and European Economic Area (EEA) reported treatment outcome monitoring data for culture-confirmed pulmonary tuberculosis (TB) cases reported in 2007. The overall treatment success rate was 73.8% for all culture-confirmed pulmonary cases and 79.5% for new culture-confirmed pulmonary cases. For the cohort of new culture-confirmed TB cases, only three countries achieved the target of 85% success rate. This underachievement appears to be a result of relative high defaulting and unknown outcome information. Case fatality remains high particularly among cases of national origin. This factor appears attributable to advanced age of the national cohort. Treatment outcomes for multidrug-resistant tuberculosis were reported by 15 countries, with a range of 19.8% to 100% treatment success at 24 months. The data underline the urgent need for strengthening treatment outcome monitoring in the EU and EEA in order to ensure an effective programme implementation and case management that will ultimately contribute to TB elimination.
Highlights
Tuberculosis (TB) remains a global emergency with estimates of 1.8 millions deaths worldwide in 2008 and over nine million cases
Overall treatment success rates below 75% were associated with a high loss to follow-up ranging from 6.6% to 25.7%
It is a matter of concern that there has been only a marginal improvement in the number of countries reporting treatment outcomes to the European Union (EU)-wide database, which increased by only one Member State compared with the 2006 cohort reporting (22 versus 21 countries)
Summary
Tuberculosis (TB) remains a global emergency with estimates of 1.8 millions deaths worldwide in 2008 and over nine million cases. In 2008, the estimated global incidence rate fell to 139 cases per 100,000 population after reaching its peak in 2004 at 143 per 100,000. This decline was not homogeneous throughout the World Health Organization (WHO) regions, with Europe failing to record a substantial decline, but rather appearing to have reached a stabilisation of rates [1]. Three broad epidemiological areas are distinguished within the borders of the EU/EEA: low incidence countries Attention to TB control in the EU and EEA has been raised in recent years through a number of initiatives, including the launching of a Framework Action Plan to Fight Tuberculosis in the EU [5]. Among the key issues underlined in the Action Plan is the need to achieve and sustain acceptable levels of treatment success among all TB patients
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