Assessment of tuberculosis surveillance in Romania

1
(No Transcript)
2
TB notification, EU West, 2006 Level of
ascertainment by Laboratory criteria alone, all
TB cases notified
Confirmed
Probable
Not classified
100
80
60
40
20
0
Italy
Malta
Poland
Finland
Cyprus
Latvia
Austria
France
Greece
Portugal
Romania
Iceland
Belgium
Estonia
Hungary
Sweden
Norway
Lithuania
Denmark
Andorra
Ireland
Germany
Slovakia
Slovenia
Netherlands
Luxembourg
Switzerland
Czech Republic
United Kingdom
Classification as per revised European TB case
definition (publication pending see also EuroTB
report 2006 Table 16 on www.eurotb.org). Probable
if in a clinical specimen there is detection of
either (i) acid-fast bacilli (AFB) or equivalent
fluorescent staining bacilli on light microscopy,
or (ii) M. tb complex nucleic acid, or (iii)
histological appearance of granulomata. Confirmed
if in a clinical specimen there is either (i)
isolation of M.tb complex (excluding
M.bovis-BCG), or (ii) detection of M.tb complex
nucleic acid AND AFB or equivalent fluorescent
staining bacilli on light microscopy. All
countries report data of varying completeness on
culture and AFB in sputum countries denoted by
() also report data on M.tb complex nucleic acid
and those with () report data on histological
appearance of granulomata.
3
TB notification rates, EU West, 1995-2006 (1)
Countries joining the EU since 2004
4
TB notification rates, EU West, 1995-2006 (2)
Countries with rate lt 8 per 100,000 in 2006
Excluding new EU countries (in previous slide)
and Monaco San Marino (0-3 cases/yr no
reporting since 2005)
5
TB notification rates, EU West, 1995-2006 (3)
Countries with rate gt 7 per 100,000 in 2006
Excluding new EU countries (in slide before
previous)
6
TB notification rates, European UnionBy country
group, 1996-2006
Including countries with data by age-group EU
pre-2004 Austria, Belgium, Denmark, Finland,
France, Germany, Italy, Luxembourg, The
Netherlands, Portugal, Sweden, United Kingdom EU
accession 2004 Czech Republic, Hungary, Malta,
Poland, Slovakia, Slovenia (excluding Baltic
States) Baltic States Estonia, Latvia, Lithuania
(EU Member States since 2004) based on WHO
World Population Standard, 2000-2025 average
(Ahmad OA, Boschi-Pinto C, Lopez AD et al.)
7
TB notification rates, EU West, 2002-2006Mean
annual percentage change
Sweden
Norway
Greece
United Kingdom
Ireland
Italy
Bulgaria
Spain
Lithuania
Denmark
Belgium
Romania
Poland
France
Czech Republic
Austria
Switzerland
Portugal
Latvia
Slovakia
Netherlands
Israel
Germany
Hungary
Estonia
Finland
Slovenia
-12
-10
-8
-6
-4
-2
0
2
4
6
change
Excluding countries without data or with lt60
cases in 2006 (Andorra, Cyprus, Iceland,
Luxembourg, Malta, Monaco, San Marino)
8
TB notification rates by age-group, sex and
origin, EU West, 2004
Pooled data from countries reporting population
data by geographic origin Austria, Belgium,
Denmark, Finland, France, Germany, Iceland,
Netherlands, Norway, Slovenia, Sweden,
Switzerland, United Kingdom
9
TB notifications by age-group and geographic
origin, EU West, 2006
Excluding countries with missing data (Monaco,
San Marino)
10
Foreign TB cases by area of origin,EU West,
2006 (N13,478)
Cases native or citizens of a country other
than the one of report. Former Soviet Union does
not include Baltic States. Pooled for countries
with case-based data on country of origin,
excluding Bulgaria, France, Israel, Monaco,
Norway, San Marino, Spain.
11
TB cases by geographic origin,EU West,
2000-2006
Excluding countries with incomplete data for
any one year or change in criterion of origin
Andorra, Bulgaria, Cyprus, Greece, Luxembourg,
Monaco, Poland, San Marino, Spain. Cases from
Romania (gt25,000 yearly lt0.1 foreign) are not
included.
12
HIV infection among TB casesEU West, 2000-2006
TB cases
18
Portugal
16
14
12
10
8
Estonia
United Kingdom
6
4
Latvia
2
0
2000
2001
2002
2003
2004
2005
2006
Completeness of information differs between
countries. Including only countries with gt50 TB
cases / year.
13
Multidrug resistance (MDR), EU West, 2006
(1)Primary MDR, cases and prevalence
140
130
120
110
Cases
100
1ary MDR
90
80
70
60
50
40
30
20
10
0
Malta
Israel
Latvia
Cyprus
Iceland
Austria
France
Norway
Finland
Estonia
Andorra
Belgium
Slovenia
Sweden
Denmark
Slovakia
Germany
Lithuania
Netherlands
Switzerland
Luxembourg
Czech Republic
United Kingdom
Presence of MDR among previously untreated
cases in countries with nationwide representative
data in 2006 (sentinel surveillance data in
France) proportion MDR calculated as a
percentage of new cases with results of initial
testing for isoniazid and rifampicin.
14
Multidrug resistance (MDR), EU West, 2006
(2)Combined MDR, by area of origin
Countries with case-based data (excluding
Baltic States - Estonia, Latvia, Lithuania)
Andorra, Austria, Belgium, Cyprus, Czech
Republic, Denmark, Finland, Germany, Hungary,
Iceland, Ireland, Luxembourg, Malta, Netherlands,
Portugal, Slovakia, Slovenia, Sweden,
Switzerland, United Kingdom. The 12 countries
in the East, and the Baltic States
15
Treatment outcome, EU West, 2005 (1) New
pulmonary culture positive TB cases, by country
Died
Failed
Still on treatment
Other
Including only countries with nationwide,
complete data (Bulgaria smear or culture
positive). Defaulted, Transferred and Unknown.
16
Treatment outcome, EU West, 2005 (2) New
pulmonary culture positive TB cases, by age group
Success
Died
Other
100
80
60
40
20
0
0-14
15-44
45-64
gt64
Pooled case-based records (N30,074 excluding
12 cases with age unknown) from countries with
complete, nationwide cohorts Andorra, Austria,
Belgium, Cyprus, Czech Republic, Denmark,
Estonia, Germany, Hungary, Iceland, Ireland,
Latvia, Lithuania, Malta, Netherlands, Norway,
Poland, Portugal, Romania, Slovakia, Slovenia,
Sweden, United Kingdom. Failed, Defaulted,
Transferred, Still on treatment and Unknown.
17
Treatment outcome, EU West, 2005 (3) All
pulmonary TB cases, by geographic origin
Success
Died
Still on treatment
Other
100
80
60
40
20
0
National
Foreign
Origin unknown
Pooled case-based records (N56,708) from
countries with complete, nationwide data
Andorra, Austria, Belgium (culture positive cases
only), Cyprus, Czech Republic, Denmark, Estonia,
Germany, Hungary, Iceland, Ireland, Latvia,
Lithuania, Malta, Netherlands, Norway, Poland,
Portugal, Romania, Slovakia, Slovenia, Sweden,
United Kingdom. Failed, Defaulted, Transferred
and Unknown.
18
Treatment outcome, EU West, 2005 (4) All TB
cases, by site of disease
Success
Died
Still on treatment
Other
100
80
60
40
20
0
Pulmonary
Extrapulmonary
Pooled case-based records (N59,487 excluding
213 cases with site unknown) from countries with
complete, nationwide data Andorra, Austria,
Cyprus, Czech Republic, Denmark, Estonia,
Germany, Hungary, Iceland, Ireland, Latvia,
Lithuania, Malta, Netherlands, Norway, Portugal,
Romania, Slovakia, Slovenia, Sweden, United
Kingdom. Poland excluded as outcome of
extrapulmonary cases is not reported. Failed,
Defaulted, Transferred and Unknown.
19
TB mortality rates, EU West (1)Total rates,
selected countries, 2000-2005
TB deaths / 100 000 pop
15
10
Romania
Lithuania
Latvia
Bulgaria
5
Poland
Portugal
United Kingdom
Finland
Switzerland
0
2000
2001
2002
2003
2004
2005
Source WHO Mortality Database, October 2007
update. Including codes ICD-9 010-018 or ICD-10
A15-19.
20
TB mortality rates, EU West (2)Age-group
specific rates, selected countries, 2004
TB deaths / 100 000 pop
25
20
15
Romania
Latvia
Bulgaria
10
Poland
Portugal (2003)
5
United Kingdom
Finland
0
0-4
5-14
15-24
25-34
35-44
45-54
55-64
65
Source WHO Mortality Database, October 2007
update. Including codes ICD-9 010-018 or ICD-10
A15-19.