tb situation in 2011:findings from the ecdc and who/euro joint tb surveillance report
TRANSCRIPT
World Tuberculosis Day 2013 TB situation in 2011: Findings from the ECDC and WHO/EURO joint TB surveillance report ECDC TB Team European Centre for Disease Prevention and Control Stockholm, 24 March 2013
TB notification rates in EU/EEA, 2011
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Not included or not reporting
50 to 99 per 100 000
20 to 49 per 100 000
10 to 19 per 100 000
< 10 per 100 000
Figure 1: Country-specific TB notification rates, 2011
In the EU/EEA, 72 334 TB cases were reported in 2011. Notification rate 14.2 per 100 000 population (range 2.8–89.7).
TB notification rates in EU/EEA, 2007−2011 Overall in the EU/EEA, notification rates have steadily declined.
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Figure 2: Trend in TB notification rate in the EU/EEA 2007−2011
16,8 16,5 15,8
14,9 14,2
5
10
15
20
2007 2008 2009 2010 2011
Not
ifica
tion
rate
per
100
000
pop
ulat
ion
Year of reporting
Proportion of confirmed* TB cases in the EU/EEA, 2011 Overall 61.3% (range 27.9 – 94.8%) of TB cases reported in the EU/EEA were laboratory-confirmed.
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Figure 3: Country-specific proportion of all confirmed TB cases in 2011
70 to 79%
≥ 80%
60 to 69%
< 60%
Not included or not reporting
* Confirmed by culture or both a positive sputum microscopy result and Mycobacterium tuberculosis nucleic acid identified in nucleic acid amplification test.
TB notification rates in children <15 years of age in EU/EEA, 2011
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Figure 4: Country-specific childhood TB notification rates among child population (0–14 years), 2011
Not included or 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
In 2011, 3 190 cases of TB in children were reported, accounting for 4.4% of all notified TB cases (range 0 – 11.1%) in the EU/EEA.
Proportion of foreign origin among notified TB cases in EU/EEA, 2011
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In 2011, the overall proportion of TB cases of foreign origin in the EU/EEA was 25.8% (range 0.3 – 89.4%). Figure 5: Country-specific proportion of foreign origin cases among all notified TB cases, EU/EEA, 2011
25 to 49%
≥ 75%
1 to 24%
50 to 74%
< 1%
Not included or not reporting
Proportion of notified extrapulmonary TB cases in EU/EEA, 2011
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In 2011, the overall proportion of extrapulmonary TB cases in the EU/EEA was 22.3% (range 3.9 – 66.7%). Figure 6: Country-specific proportion of extrapulmonary TB of all notified TB cases, EU/EEA, 2011
20 to 29%
≥ 50%
1 to 19%
30 to 49%
< 1%
Not included or not reporting
Extrapulmonary TB notification rates in EU/EEA, 2002−2011 Extrapulmonary TB notification rates have remained stable in the last 10 years.
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Figure 7: Trend in extrapulmonary TB notification rate in the EU/EEA, 2002−2011
3,4 3,4 3,5 3,3 3,4 3,2
3,5 3,4 3,3 3,2
0
1
2
3
4
5
2002 2003 2004 2005 2006 2007 2008 2009 2010 2011
Not
ifica
tion
rate
per
100
000
pop
ulat
ion
Year of reporting
Proportions of TB by site among all notified TB cases in EU/EEA, 2002−2011 Percentage of extrapulmonary TB increased from 16.4% in 2002 to 22.4% in 2011.
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Figure 8: Proportion of notified pulmonary and extrapulmonary TB cases in the EU/EEA, 2002−2011
0
10000
20000
30000
40000
50000
60000
70000
80000
90000
100000
2002 2003 2004 2005 2006 2007 2008 2009 2010 2011
Number of cases
Year of reporting
Pulmonary TB Extrapulmonary TB
Proportion of culture-confirmed new pulmonary TB cases in EU/EEA, 2011 61% of new pulmonary TB cases were culture-confirmed. The proportion varied widely across countries (range 33 – 98%).
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Figure 9: Proportion of new pulmonary TB cases confirmed by culture, 2011
0
10
20
30
40
50
60
70
80
90
100
Perc
enta
ge
Proportion of notified TB cases with multi-drug resistance among all confirmed TB cases in EU/EEA, 2011
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In 2011, the overall proportion of TB cases with multi-drug resistance in the EU/EEA was 4.5% (range 0 – 29.8%). Figure 10: Country-specific proportion of multidrug resistance among all confirmed TB cases, EU/EEA, 2011
2 to 4.9%
≥ 10%
1 to 1.9%
5 to 9.9%
< 1%
Not included or not reporting
Proportion of notified new TB cases with multidrug resistance in EU/EEA, 2011
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In 2011, the overall proportion of new TB cases with multi-drug resistance in the EU/EEA was 2.4% (range 0 – 23.3%).
Figure 11: Country-specific proportion of new TB cases with multidrug resistance, EU/EEA, 2011
2 to 4.9%
≥ 10%
1 to 1.9%
5 to 9.9%
< 1%
Not included or not reporting
Notification rates of new cases with multidrug resistant TB in EU/EEA, 2007−2011 The notification rate of multidrug resistant TB have remained stable at around 0.3 per 100 000 population.
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Figure 12: Trends in multidrug resistant TB notification rate in the EU/EEA, 2007−2011
0,33 0,35 0,33
0,30 0,30
0,0
0,1
0,2
0,3
0,4
2007 2008 2009 2010 2011
Year of reporting
Not
ifica
tion
rate
per
100
000
pop
ulat
ion
Proportion of notified previously treated TB cases with multidrug resistance in EU/EEA, 2011
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In 2011, the overall proportion of previously treated TB cases with multidrug resistance in the EU/EEA was 16.8% (range 0 – 57.7%). Figure 13: Country-specific proportion of previously treated TB cases with multi-drug resistance, EU/EEA, 2011
2 to 4.9%
≥ 10%
1 to 1.9%
5 to 9.9%
< 1%
Not included or not reporting
Proportion of TB cases with extensive drug resistance among MDR-TB cases with SLD ST* reported in EU/EEA, 2011
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In 2011, the proportion of extensive drug resistant cases among cases with multidrug resistance in EU/EEA was 13.4% (range 0 – 40.0%).
5 to 9%
≥ 20%
1 to 4%
10 to 19%
< 1%
*SLD ST – second line drug susceptibility testing result
Not included or not reporting Not included or not reporting
Figure 14: Country-specific proportion of extensively drug-resistant TB cases among TB cases with multi-drug resistance, EU/EEA, 2011
Proportion of HIV positive TB cases among all TB cases with known HIV status in EU/EEA, 2011
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In 2011, the overall proportion of HIV positive TB cases among TB cases with known HIV status in EU/EEA was 4.7% (range 0 – 40%). Figure 15: Country-specific proportion of HIV positive TB cases among TB cases with known HIV status, EU/EEA, 2011
2 to 4.9%
≥ 10%
1 to 1.9%
5 to 9.9%
< 1%
Not included or not reporting
Treatment success rate for new pulmonary TB cases in EU/EEA*, 2010 The treatment success rate for new culture-confirmed pulmonary TB cases notified in 2010 was 76.8% (range: 0 – 91.4%).
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Figure 16: Treatment success rate for new culture-confirmed pulmonary TB cases notified in 2010
* Five EU/EEA Member States did not report treatment outcome data.
0
20
40
60
80
100
Trea
tmen
t s
ucce
ss (
%)
Treatment success rate for new pulmonary TB cases by year of reporting in EU/EEA, 2006−2010 The treatment success rate for new culture-confirmed pulmonary TB cases notified between 2006 and 2010 has slightly decreased from 79.5% in 2006 to 76.8% in 2010.
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Figure 17: Treatment success rate for new culture-confirmed pulmonary TB cases notified in 2006−2010
79,5 79,2 79,5 78,9 76,8
0
20
40
60
80
100
2006 2007 2008 2009 2010
Year of reporting
Trea
tmen
t su
cces
s (%
)
Treatment success rate for previously treated pulmonary TB cases in EU/EEA*, 2010 The treatment success rate for previously treated culture-confirmed pulmonary TB cases notified in 2010 was 53.7% (range 31.4 – 85.7%).
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Figure 18: Treatment success rate for previously treated culture-confirmed pulmonary TB cases notified in 2010
* Iceland and Luxembourg reported zero previously treated TB cases in 2010. Seven EU/EEA Member States did not report stratified treatment outcome data
0
20
40
60
80
100
Trea
tmen
t su
cces
s (%
)
Treatment success rate for all notified pulmonary TB cases in EU/EEA*, 2010 The treatment success rate for all confirmed pulmonary TB cases notified in 2010 was 74.3% (range 0 – 90.1%).
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Figure 19: Treatment success rate for all confirmed pulmonary TB cases notified in 2010
* Five EU/EEA Member States did not report treatment outcome data
0
20
40
60
80
100
Trea
tmen
t su
cces
s (%
)
Treatment success* rate for extra- pulmonary TB cases in EU/EEA**, 2010 The treatment success rate for extrapulmonary TB cases notified in 2010 was 82.2% (range 21.1 – 100%).
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Figure 20: Treatment success rate for extrapulmonary TB cases notified in 2010
* Treatment success of extrapulmonary TB consists of cases reported as completed full course of anti-tuberculosis treatment ** Seven Member States did not report stratified treatment outcome data
0
20
40
60
80
100
Trea
tmen
t su
cces
s (%
)
Treatment success rate for notified multidrug-resistant TB cases in EU/EEA*, 2009 The treatment success rate for all confirmed multidrug-resistant TB cases notified in 2009 was 31.6% (range 0 – 84.6%).
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Figure 21: Treatment success rate for all confirmed multidrug-resistant TB cases notified in 2009
* Malta reported zero MDR TB cases in 2009, 11 Member States did not report treatment outcome data
0
20
40
60
80
100
Trea
tmen
t su
cces
s (%
)
Treatment outcome for multidrug-resistant TB cases notified in 2007−2009 Treatment outcomes for multidrug-resistant TB cases did not improve between the 2007 and 2009 cohort, EU/EEA.
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Figure 22: Treatment outcome at 24 months for multidrug-resistant TB cases diagnosed in 2009, compared with cases diagnosed in 2007 and 2008
0
5
10
15
20
25
30
35
Success Died Failed Defaulted Still on treatment
Transferred or unknown
Perc
enta
ge
cohort 2009 (18 countries)
cohort 2008 (20 countries)
cohort 2007 (15 countries)