Epidemiologia della tubercolosi · Estimated new TB cases (all forms) per 100 000 population Global...
Transcript of Epidemiologia della tubercolosi · Estimated new TB cases (all forms) per 100 000 population Global...
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Epidemiologia della tubercolosi
Sorveglianza della tubercolosi nelle strutture sanitarie e socio-assistenziali
Parma, 19 maggio 2006
Bianca Maria Borrini
Dipartimento Sanità Pubblica – AUSL di Parma
La tubercolosi nel mondo
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Tuberculosis notification rates, 2004
The boundaries and names shown and the designations used on this map do not imply the expression of any opinion whatsoever on the part of the World Health Organization concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries. Dotted lines on maps represent approximate border lines for which there may not yet be full agreement. © WHO 2005. All rights reserved
0 - 2425 - 4950 - 99100 or moreNo report
Notified TB cases (new and relapse) per 100 000 population
Estimated number of new TB cases, 2004
The boundaries and names shown and the designations used on this map do not imply the expression of any opinion whatsoever on the part of the World Health Organization concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries. Dotted lines on maps represent approximate border lines for which there may not yet be full agreement. © WHO 2005. All rights reserved
0 - 9991000 - 999910 000 – 99 999100 000 - 999 999
No estimate1 000 000 or more
Estimated number of new cases (all forms)
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Estimated TB incidence rates, 2004
The boundaries and names shown and the designations used on this map do not imply the expression of any opinion whatsoever on the part of the World Health Organization concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries. Dotted lines on maps represent approximate border lines for which there may not yet be full agreement. © WHO 2005. All rights reserved
0 - 2425 - 4950 - 99100 - 299
No estimate300 or more
Estimated new TB cases (all forms) per 100 000 population
Global Tuberculosis Control. WHO Report 2002. WHO/CDS/TB/2002.295
Russia
22 high-burden countries
CambodiaChinaPhilippinesVietnam
AfghanistanPakistan
EthiopiaDR CongoKenyaMozambique NigeriaS. AfricaTanzania UgandaZimbabwe
BangladeshIndiaIndonesia Myanmar Thailand
Brazil
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Estimated HIV prevalence in new adult TB cases
The boundaries and names shown and the designations used on this map do not imply the expression of any opinion whatsoever on the part of the World Health Organization concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries. Dotted lines on maps represent approximate border lines for which there may not yet be full agreement. © WHO 2005. All rights reserved
HIV prevalence in TB cases, 15-49 years (%)
0 - 45 - 1920 - 4950 or moreNo estimate
La tubercolosi in Europa
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Geographic areas, Europe
EuroTB
European Union (EU, solid blue)AustriaBelgiumCyprusCzech RepublicDenmarkEstoniaFinlandFranceGermanyGreeceHungaryIrelandItalyLatviaLithuaniaLuxembourgMaltaNetherlandsPolandPortugalSlovakiaSloveniaSpainSwedenUnited Kingdom
Non-EU (blue hatch)AndorraIcelandIsraelMonacoNorwaySan MarinoSwitzerland
AlbaniaBosnia & HerzegovinaBulgariaCroatiaMacedonia, F.Y.RRomaniaSerbia & MontenegroTurkey
ArmeniaAzerbaijanBelarusGeorgiaKazakhstanKyrgyzstanMoldova, Republic ofRussian FederationTajikistanTurkmenistanUkraineUzbekistan
TB notification rates per 100,000 population Europe, 2003
EuroTB
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TB notification rates by geographic area, Europe, 1996-2003
EuroTB* excluding Bosnia & Herzegovina
0
20
40
60
80
100
120
1996 1997 1998 1999 2000 2001 2002 2003
TB cases / 100,000
East
Centre
EU & West
Percentage change in TB notification rates, EU & West*, 1999-2003
EuroTB* Excluding countries with <60 cases notified in 2003 (Andorra, Cyprus, Iceland, Luxembourg, Malta, Monaco, San Marino)
SloveniaCzech Republic
HungaryGermany
DenmarkFinland
AustriaPortugalSlovakiaSwitzerland
SwedenPoland
NetherlandsIreland
EstoniaSpain
BelgiumLatvia
FranceIsrael
LithuaniaItaly
United KingdomNorway
Greece
-12% -10% -8% -6% -4% -2% 0% 2% 4% 6% 8% 10%% change
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Proportion of TB cases of foreign origin, Europe, 2003
EuroTB
TB cases by geographic origin, EU & West*, 1996-2003
EuroTB* Austria, Belgium, Denmark, Estonia, Finland, France, Germany, Iceland, Israel, Netherlands, Norway, Slovakia, Slovenia, Sweden and Switzerland
0
3 000
6 000
9 000
12 000
15 000
18 000
21 000
1996 1997 1998 1999 2000 2001 2002 2003
TB casesNationals
Foreigners
Unknown
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Proportion of pulmonary TB cases by geographic area, Europe, 2003*
EuroTB* Dots indicate mean for area, lines indicate country range. Excluding countries with respiratory classification: Belarus, Bulgaria, San Marino, Serbia & Montenegro, Spain, Tajikistan, Ukraine.
0%
20%
40%
60%
80%
100%
EU & West Centre East
% cases
Multi-drug resistance (MDR), new cases, 2003*
* countries with nationwide-representative data and with more than 60 new cases reported§ countrywide survey, 2001 EuroTB
02468
10121416
Estonia
Lithu
ania
Latvi
aIsr
ael
Switzerl
and
Sweden
Austria
German
y
Netherl
ands
Irelan
d
Slovak
ia
Finlan
d
United
Kingdo
m(ex
cl. Sco
tland
, 200
2)
Belgium
Croatia
Sloven
ia
Czech
Repub
lic
Bosnia
& Herz
egov
ina(F
ed.)
Denmark
Norway
% MDR
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La tubercolosi in Italia
10
< 4
4-6,9
7-9,9
Incidenza dei casi notificati di
tubercolosi polmonare
Anno 2002
Incidenza per 100.000 abitanti
Ministero della Salute
> 10
La tubercolosi in Emilia-Romagna
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Tassi di incidenza (x 100.000) di tubercolosi polmonare ed extrapolmonare.
Emilia-Romagna e Italia. Periodo 1990-2004
0,0
2,0
4,0
6,0
8,0
10,0
12,0
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000 20
0120
0220
0320
04
tass
o in
cide
nza
x 10
0000
abi
tant
i
TB extrapolmonare RER TB polmonare RERTB extrapolmonare ITA TB polmonare ITA
Casi di tubercolosi notificati. Emilia-Romagna. Periodo 1996-2004
0
50
100
150
200
250
300
350
400
1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004
TB polmonare TB extrapolmonare
12
Incidenza per
100.000 abitanti
5,5-6,9
7,0-8,5
>=10,0 Tasso medio annuo RER 7,4 – Casi totali 436; polmonari 296
Incidenza annuale di tubercolosi polmonare per AUSL. Emilia-Romagna. Periodo 2001–2002
8,6-9,9
Incidenza per
100.000 abitanti
5,5-6,9
7,0-8,5
>=10,0 Tasso medio annuo RER 7,9 – Casi totali 477; polmonari 321
Incidenza annuale di tubercolosi polmonare per AUSL. Emilia-Romagna. Periodo 2003–2004
8,6-9,9
13
Tassi di incidenza della tubercolosi per classi di età Emilia-Romagna. Periodo 1996-2004
0
5
10
15
20
25
30
1996 1997 1998 1999 2000 2001 2002 2003 2004
Casi n
otificat
i pe
r 10
0.00
0 ab
.
0-14 15-24 25-44 45-64 65+
Casi di tubercolosi distinti per luogo di nascita. Emilia-Romagna. Periodo 1996-2004
0
50
100
150
200
250
300
350
400
450
500
1996 1997 1998 1999 2000 2001 2002 2003 2004
N. ca
si
Italiani Non italiani
14
Casi di tubercolosi (%) notificati in cittadini nati all’estero Emilia-Romagna. Periodo 1996-2004.
10,014,0 13,0
19,323,0 21,3
28,230,3
40,737,9
45,246,4
05
101520253035404550
1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004Anno di notifica
%
Casi di tubercolosi notificati in cittadini nati all’estero per anni di residenza in Italia.
Emilia-Romagna. Anno 2004
0
10
20
30
40
50
60
70
<2 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 20 24
Anni di residenza in Italia
Casi
Not
ifica
ti
15
00,5
1
1,52
2,53
3,54
4,5
1996 1997 1998 1999 2000 2001 2002 2003 2004
Anno di notifica
Casi
per
100
.000
ab.
Casi notificati con esame diretto dell’espettorato positivo per 100.000 abitanti.
Emilia-Romagna. Periodo 1996-2004.
Respiratoria17%
Intestinale5%
Linfonodale29%
Osteo-Articolare
8%Meningi-SNC3%
Genito-Urinaria
17%
Altri organi21%
Proporzione delle sedi anatomiche nei casi di tubercolosi extrapolmonare. Emilia-Romagna.
Periodo 1996-2001
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0,0 2,0 4,0 6,0 8,0 10,0 12,0 14,0 16,0 18,0 20,0
Contatto con malato di TB
Esiti di TB
Grave immunodeficienza acquisita
Infezione recente
Operatore sanitario/sociale
Ospite/personale istituti di detenzione
Patologie
Tossicodipendenza/alcolismo
Totale
Non italiani
Italiani
Presenza di fattori di rischio nei casi di tubercolosi. Emilia-Romagna. Periodo 1996-2001.
La tubercolosi in Provincia di Parma
17
0
5
10
15
20
25
30
35
40
1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003
num
ero
casi
Polmonare Extrapolmonare
Casi notificati di TB polmonare ed extrapolmonare.Provincia di Parma. Periodo 1987-2003
0
2
4
6
8
10
12
14
1996 1997 1998 1999 2000 2001 2002 2003RER - Extra p o lmo nare RER - Po lmo nareRER - To tale Parma - Extra p o lmonareParma - Po lmo nare Parma - To tale
Incidenza della tubercolosi in Provincia di Parma e in Regione. Periodo 1996-2003
18
0
5
10
15
20
25
1996 1997 1998 1999 2000 2001 2002 2003
0-14 15-24 25-44 45-64 65+
Incidenza della tubercolosi per classi di età. Provincia di Parma. Anni 1996-2003.