TB situation in the EU and EEA countries, 2014
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Transcript of TB situation in the EU and EEA countries, 2014
World Tuberculosis Day 2016
TB situation in the EU/EEA, in 2014Findings from the joint TB surveillance and monitoring report by ECDC and WHO Regional Office for Europe
ECDC TB TeamEuropean Centre for Disease Prevention and ControlStockholm, 24 March 2016
TB Surveillance data, EU/EEA, 2014
2
TB notifications, EU/EEA, 201458 008 TB cases notified in 29 EU/EEA countries Notification rate of 12.8 per 100 000 population(range 2.5–79.7)
3
Not reporting
20 to 49 per 100 000
10 to 19 per 100 000
5 to 9 per 100 000
< 5 per 100 000
≥ 50 per 100 000
Source: European Centre for Disease Prevention and Control.
TB surveillance and monitoring in Europe, 2016.
Reported TB cases, EU/EEA, 2005 – 2014
Steady decline between 2005 and 2014:• number of TB cases decreased by
35% • notification rate decreased by 36%
4
2005 2006 2007 2008 2009 2010 2011 2012 2013 2014
10 000 20 000 30 000 40 000 50 000 60 000 70 000 80 000 90 000
0.02.04.06.08.010.012.014.016.018.020.0
TB cases TB cases/100 000
Year of reporting
TB c
ases
TB c
ases
/100
000
Source: European Centre for Disease Prevention and Control.
TB surveillance and monitoring in Europe, 2016.
Confirmed TB cases*, EU/EEA, 2014
5
70 to 79%≥ 80%
60 to 69%< 60%
Not reporting* Confirmation identified by culture or by both sputum microscopy and Mycobacterium tuberculosis nucleic acid amplification test
Source: European Centre for Disease Prevention and Control.
TB surveillance and monitoring in Europe, 2016.
65.3% of the reported TB cases were laboratory confirmed (range 39.2–88.2%)
Notified previously treated TB cases, EU/EEA, 2014
6
10 to 14.9%
≥ 15%
5 to 9.9%
< 5%
Not reportingSource: European Centre for Disease Prevention and Control.
TB surveillance and monitoring in Europe, 2016.
11.5% of reported cases had been previously treated (range 2.2–21.4%)
TB notification rate by age group, EU/EEA, 2005 – 2014
7
2005 2006 2007 2008 2009 2010 2011 2012 2013 20140.0
5.0
10.0
15.0
20.0
25.00-4 5-14 15-24 25-44 45-64 65+
Year of reporting
TB c
ases
/100
000
Source: European Centre for Disease Prevention and Control.
TB surveillance and monitoring in Europe, 2016.
Decreased by > 25% in all age groups over the period
Notified TB in children under 15, EU/EEA, 2014
8
Not reporting
4 to 9.9 per 100 000 child population
2 to 3.9 per 100 000 child population
≥ 10 per 100 000 child population
< 2 per 100 000 child population
Source: European Centre for Disease Prevention and Control.
TB surveillance and monitoring in Europe, 2016.
2 258 TB cases reported in children under 15 years. That is 3.9% of all TB cases (range 0-13.7%) and2.8 notifications per 100 000 child population (range 0–20.7).
Notified TB cases in persons of foreign origin, EU/EEA, 2014
9
10 to 39.9%
≥ 75%
1 to 9.9%
40 to 74.9%
< 1%
Not reporting
Source: European Centre for Disease Prevention and Control.
TB surveillance and monitoring in Europe, 2016.
26.8% of TB cases occurred in persons of foreign origin (range 0.3–100.0%)
Notified TB cases in persons of foreign origin, EU/EEA, 2005 – 2014
10* Slight decrease in the proportion of cases in persons of foreign-origin in 2014, probably due to missing data from Italy
2005 2006 2007 2008 2009 2010 2011 2012 2013 20140
5
10
15
20
25
30
0
2
4
6
8
10
Year of reporting
Perc
enta
ge
Case
s/100
000
Source: European Centre for Disease Prevention and Control.
TB surveillance and monitoring in Europe, 2016.
Percentage of cases in persons of foreign origin increased from 19% in 2005 to 27% in 2014. Rate per 100 000 total population stable* between 3.4 and 3.8
Notified extrapulmonary TB cases, EU/EEA, 2014
11
10 to 19.9%
≥ 30%
0 to 9.9%
20 to 29.9%
Not reporting
Source: European Centre for Disease Prevention and Control.
TB surveillance and monitoring in Europe, 2016.
21.8% of TB cases were extrapulmonary TB (range 3.2–46.0%)
Multidrug-resistant TB, EU/EEA, 2014
12
2 to 4.9%
≥ 10%
1 to 1.9%
5 to 9.9%
< 1%
Not reporting
* DST – drug susceptibility results reported for at least isoniazid and rifampicin
Source: European Centre for Disease Prevention and Control.
TB surveillance and monitoring in Europe, 2016.
4.0% of TB cases with DST* results were multidrug-resistant (range 0–25.8%)
Multidrug-resistant TB notification rate, EU/EEA, 2010 – 2014
13
2010 2011 2012 2013 20140
0.1
0.2
0.3
0.4
0.5
Year of reporting
MDR
TB c
ases
/100
000
Source: European Centre for Disease Prevention and Control.
TB surveillance and monitoring in Europe, 2016.
Rate was stable at 0.3 per 100 000 population between 2010 and 2014
Multidrug resistance among new pulmonary TB cases, EU/EEA, 2014
14
2 to 4.9%
≥ 10%
1 to 1.9%
5 to 9.9%
< 1%
Not reporting
Source: European Centre for Disease Prevention and Control.
TB surveillance and monitoring in Europe, 2016.
• DST – drug susceptibility test. (Results reported for at least isoniazid and rifampicin)
2.4% of new pulmonary TB cases with DST* results had multidrug-resistant TB (range 0–19.5%)
Multidrug resistance among previously treated pulmonary TB cases, EU/EEA, 2014
15
5 to 14.9%
≥ 25%
1 to 4.9%
15 to 24.9%
< 1%
Not reporting
Source: European Centre for Disease Prevention and Control.
TB surveillance and monitoring in Europe, 2016.* DST – drug susceptibility test results for isoniazid and rifampicin
17.7% (range 0–62.1%) of previously treated pulmonary TB cases with DST* results had multidrug-resistant TB
Extensively drug-resistant TB (XDR TB), EU/EEA, 2014
16
10 to 14.9%
≥ 25%
1 to 9.9%
15 to 24.9%
< 1%
Not reporting
Source: European Centre for Disease Prevention and Control.
TB surveillance and monitoring in Europe, 2016.* DST – drug susceptibility test
17.5% of MDR TB cases with 2nd line DST* were extensively drug-resistant (range 0–50.0% and 5.7–26.1% for countries reporting more than one case)
Notified TB/HIV co-infection, EU/EEA, 2014
17
10 to 14.9%
≥ 15%
1 to 9.9%
< 1%
Not reporting
* Among countries with at least 50% reporting completeness for HIV status
Source: European Centre for Disease Prevention and Control.
TB surveillance and monitoring in Europe, 2016.
4.9% of TB cases with known HIV status* were HIV positive (range 0–22.6%)
Treatment success of all TB cases, EU/EEA, 2014
18* Four EU/EEA Member States did not report treatment outcome data
EU/EEALuxembourg
CroatiaCyprusFinland
DenmarkIrelandPoland
GermanyLithuania
Czech RepublicAustriaEstonia
PortugalHungary
MaltaSpainLatvia
SloveniaBelgiumRomania
United KingdomBulgariaNorway
NetherlandsSwedenIceland
Slovakia
0 10 20 30 40 50 60 70 80 90 100Treatment success (%)
Source: European Centre for Disease Prevention and Control.
TB surveillance and monitoring in Europe, 2016.
74.0% of all TB cases* had a successful treatment outcome after 12 months (range 0.0–92.8%)
Treatment success, EU/EEA, 2014
19* Four EU/EEA Member States did not report treatment outcome data
≥ 85%
60 to 84.9%
< 60%
Not reportingSource: European Centre for Disease Prevention and Control.
TB surveillance and monitoring in Europe, 2016.
Treatment success rate for all TB cases has been stable at 75% over the past five years
Treatment success in new confirmed pulmonary TB cases and relapses, started on treatment in 2013*, EU/EEA, 2014
20* Cases started on second line treatment are excluded
EU/EEACyprus
FinlandePolandIreland
DenmarkGermanyPortugal
Czech RepublicSpainMalta
HungaryAustria
LithuaniaBelgiumSlovenia
United KingdomLatvia
RomaniaBulgaria
NetherlandsNorwaySwedenEstonia
SlovakiaIceland
0 20 40 60 80 100 120Treatment success (%)
Source: European Centre for Disease Prevention and Control.
TB surveillance and monitoring in Europe, 2016.
77.6% of new confirmed pulmonary cases and relapses had a successful treatment outcome (range 50.0–100.0%)
21* Four EU/EEA Member States did not report treatment outcome data
≥ 85%
60 to 84.9%
< 60%
Not reportingSource: European Centre for Disease Prevention and Control.
TB surveillance and monitoring in Europe, 2016.
77.6% of new confirmed pulmonary TB cases and relapses had a successful treatment outcome (range 50.0-100.0%).
Treatment success in new confirmed pulmonary TB cases and relapses started on treatment in 2013*, EU/EEA, 2014
Treatment success in multidrug-resistant TB*, EU/EEA, 2014
22* Cyprus, Luxembourg, Malta and Slovenia reported zero MDR TB cases in 2012, nine Member States did not report treatment outcome data for MDR TB cases
EU/EEASlovakia
PolandCzech Republic
RomaniaNorway
LithuaniaHungary
GermanyPortugal
AustriaUnited Kingdom
BulgariaLatvia
EstoniaBelgium
NetherlandsIreland
Sweden
0 10 20 30 40 50 60 70 80 90Treatment success (%)
Source: European Centre for Disease Prevention and Control.
TB surveillance and monitoring in Europe, 2016.
40.3% was the success rate for all multidrug-resistant TB cases notified in 2012 (range 0–85.7%)
Treatment success in all cases with multidrug-resistant TB*, EU/EEA, 2014
23
≥ 70%
40 to 69.9%
< 40%
Not reporting* Cyprus, Luxembourg, Malta and Slovenia reported zero MDR TB cases in 2012. Nine Member States did not report treatment outcome data for MDR TB cases.
Source: European Centre for Disease Prevention and Control.
TB surveillance and monitoring in Europe, 2016.
40.3% was the success rate for all multidrug-resistant TB cases notified in 2012 (range 0–85.7%)
Treatment outcomes in MDR TB notified in 2010-2012, EU/EEA, 2014
24
Success Died Failed Defaulted or unknown
Still on treatment
0
10
20
30
40
50
MDR TB cohort 2010 MDR TB cohort 2011 MDR TB cohort 2012
Perc
enta
ge
Source: European Centre for Disease Prevention and Control.
TB surveillance and monitoring in Europe, 2016.
Treatment success rates increased from 32% to 40% in the 2010, 2011 and 2012 cohorts
25
Treatment success in extensively drug-resistant TB (XDR TB) cases, EU/EEA, 2014
25* Bulgaria, Cyprus, Denmark, Slovakia and Slovenia reported zero XDR TB cases in 2011. 13 countriesdid not report second line drug susceptibility testing results or XDR TB treatment outcome data.
EU/EEA
Poland
Lithuania
United Kingdom
Latvia
Belgium
0 20 40 60 80 100Treatment success (%)
Source: European Centre for Disease Prevention and Control.
TB surveillance and monitoring in Europe, 2016.
33.8% was the success rate in extensively drug-resistant TB cases notified in 2011 (range 0–100.0%)