Three key messages on tuberculosis control

World Tuberculosis Day 2010

ECDC TB TeamEuropean Centre for Disease Prevention and ControlStockholm, 24 March 2010

Message 1The treatment success rate in the EU/EEA is too low to meet global targets

1a. The treatment success rate in the EU/EEA is too low to meet global targetsReported treatment success rates in the EU/EEA are far below the 85% target set by the WHO World Health Assembly. Only three EU/EEA countries recorded a treatment success rate over 85% or more for new laboratory-confirmed pulmonary TB cases.

* Treatment success rate among not previously diagnosed cases. Source: ECDC

85% target set by the Stop TB Partnership.Only Iceland, Portugal and Slovakia meet the 85% target.

Figure 1a: Treatment success rate among new laboratory-confirmed pulmonary TB cases, 2007

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1b. The treatment success rate in the EU/EEA is too low to meet global targetsFigure 1b: Percentage success rate among laboratory-confirmed new pulmonary TB cases, EU/EEA, 2007

71 to 84%

≥ 85%

60 to 70%

< 60%

Not included or not reporting

Source: ECDC

1c. The treatment success rate in the EU/EEA is too low to meet global targetsTreatment success among previously untreated laboratory-confirmed pulmonary TB remains low in the EU/EEA and is below the 85% target. No changes in the trend were seen in the last five years. Figure 1c: EU/EEA treatment outcome among laboratory-confirmed pulmonary cases 2003–2007

0.0010.0020.0030.0040.0050.0060.0070.0080.0090.00

100.00

2003 2004 2005 2006 2007 2003 2004 2005 2006 2007 2003 2004 2005 2006 2007* Excluded: Austria, Bulgaria, Finland, France, Greece, Liechtenstein, Luxembourg, and Spain

Previously untreated Previously treated All pulmonary cases

Success

Died

Failed

Defaulted

Still on treatment

Transferred or unknown

* Excluded: Austria, Bulgaria, Cyprus, Finland, France, Greece, Italy, Liechtenstein and Spain

1009080706050403020100

Message 2Multidrug-resistant tuberculosis (MDR TB) remains a problem in the EU/EEA

2a. MDR TB* remains a problem in the EU/EEAFigure 2a: Proportion of notified TB cases with primary multidrug resistance, EU/EEA, 2008

2 to 5.9%

> 10%

1 to 1.9%

> 6-10%

< 1%

Not included or not reporting

* Multidrug-resistant tuberculosis (MDR TB) is defined as TB that is resistant at least to isoniazid (INH) and rifampicin (RMP), the two most powerful first-line anti-TB drugs.

2b. MDR TB remains a problem in the EU/EEA Treatment success rate among MDR TB cases is extremely low (31%).

78%

31%

7%

17%

3%

17%

6%13%

2%

17%

5% 5%0

10

20

30

40

50

60

70

80

90

MDR MDR MDR MDR MDR MDR

Success Died Failed Defaulted Still on treatment

Transferred or unknown

Figure 2b: Treatment outcome of all* MDR TB cases, compared to all non-MDR cases, EU/EEA, 2006**

* Pulmonary and extra-pulmonary ** Both groups are 2006 treatment cohorts

Non-MDR Non-MDR Non-MDR Non-MDR Non-MDRNon-MDR

Message 3The decline in tuberculosis has levelled off in the EU/EEA

3a. The decline in tuberculosis has levelled off in the EU/EEA

Figure 3a: TB notification rates by incidence grouping, 1995–2008 and 2002–2008

Source: ECDC

The decrease in TB notification rates has stagnated in the EU/EEA.The decline seen in countries with high and intermediate incidence rates contributes substantially to the average EU/EEA decline.

<20/100 000

EU/EEA

>20/100 000

Notifi

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3b. The decline in tuberculosis has levelled off in the EU/EEA

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19951996199719981999200020012002200320042005200620072008

19951996

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Notification rate (per 100 000 population)

Figure 3b: TB notification rates, 1995–2008, EU/EEA