World Tuberculosis Day 2014
The TB situation in 2012: Findings from the joint TB
surveillance and monitoring report by
ECDC and the WHO Regional Office for Europe
ECDC TB Team
European Centre for Disease Prevention and Control
Stockholm, 24 March 2014
TB notifications by country
In 2012, 68 423 TB cases were reported in the EU/EEA.
The notification rate was 13.5 per 100 000 population
(range 3.4–85.2).
Figure 1: TB notification rate
per 100 000 population by
country, EU/EEA, 2012
< 10 per 100 000
10 to 19 per 100 000
20 to 49 per 100 000
50 to 99 per 100 000
Not included or not
reporting
2
EU definition: Confirmed TB cases*
Overall, 61.9% (range 21.5–91.4%) of TB cases reported
in the EU/EEA were laboratory confirmed.
Figure 2: Percentage of laboratoryconfirmed TB cases by country,
EU/EEA, 2012
< 60%
60 to 69%
70 to 79%
≥ 80%
Not included or not
reporting
* Confirmed by culture or by both a positive sputum microscopy result and Mycobacterium tuberculosis nucleic acid identified in
nucleic acid amplification test.
3
TB in children
In 2012, 2 845 TB cases in children were reported, accounting
for 4.2% of all notified TB cases (range 0–7.8%) in the EU/EEA.
Figure 3: TB notification rate in
children under 15 years of age
per 100 000 child population, by
country, EU/EEA, 2012
< 2 per
100 000 child population
2 to 3.9 per
100 000 child population
4 to 9.9 per
100 000 child population
≥ 10 per
100 000 child population
Not included or not
reporting
4
TB cases of foreign origin
In 2012, the overall proportion of TB cases of foreign
origin in the EU/EEA was 26.8% (range 0.2–85.4%).
Figure 4: Percentage of TB cases
of foreign origin by country,
EU/EEA, 2012
< 1%
1 to 24.9%
25 to 49.9%
50 to 74.9%
≥ 75%
Not included or not
reporting
5
Extrapulmonary TB cases
In 2012, the overall proportion of extrapulmonary TB
cases in the EU/EEA was 23.0% (range 2.9–48.6%).
Figure 5: Percentage of
extrapulmonary TB cases by
country, EU/EEA, 2012
< 10%
10 to 19.9%
20 to 29.9%
30 to 39.9%
≥ 40%
Not included or
not reporting
6
Extrapulmonary TB notification over time
Extrapulmonary TB notification rates have remained stable in the last
10 years.
Figure 6: Extrapulmonary TB notification rate per 100 000 population
by year, EU/EEA, 2003−2012
Notification rate per 100 000 population
4
3
2
1
0
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
Year of reporting
7
Multidrug-resistant TB
In 2012, the overall proportion of TB cases with
multi-drug resistance in the EU/EEA was 4.6%
(range 0–25.5%).
Figure 7: Percentage of
multidrug resistance among all
confirmed TB cases by country,
EU/EEA, 2012
< 1%
1 to 1.9%
2 to 4.9%
5 to 9.9%
≥ 10%
Not included or
not reporting
8
Multidrug-resistance among new
pulmonary TB cases
In 2012, the overall percentage of new pulmonary TB cases
with multidrug resistance in the EU/EEA was 2.6% (range
0–20.5%).
Figure 8: Percentage of new
pulmonary TB cases with
multidrug resistance by country,
EU/EEA, 2012
< 1%
1 to 1.9%
2 to 4.9%
≥ 5%
Not included or
not reporting
9
Multidrug-resistance among previously
treated pulmonary TB cases
In 2012, the overall proportion of previously treated
pulmonary TB cases with multidrug resistance in the
EU/EEA was 18.8% (range 0–50.0%).
Figure 9: Percentage of
previously treated pulmonary
TB cases with multidrug
resistance by country, EU/EEA,
2012
< 1%
1 to 9.9%
10 to 19.9%
≥ 20%
Not included or
not reporting
10
Extensively drug-resistant TB
In 2012, the proportion of extensively drug-resistant TB
cases among multidrug-resistant cases in EU/EEA was
13.7% (range 0–50.0%).
Figure 10: Percentage of
extensively drug-resistant TB
cases among multidrugresistant TB cases tested for
second-line drug susceptibility,
by country, EU/EEA, 2012
< 1%
1 to 9.9%
10 to 19.9%
≥20%
Not included or not
reporting
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TB/HIV co-infection
In 2012, the overall proportion HIV positive among TB cases
with known HIV status in EU/EEA was 5.5% (range 0–16.5%).
Figure 11: Percentage of HIVpositive cases among TB cases
with known HIV status, by
country, EU/EEA, 2012
< 1%
2 to 4.9%
5 to 9.9%
≥ 10%
Not included or not
reporting
12
Treatment success in new pulmonary TB
cases over time
The treatment success rate in new culture-confirmed pulmonary TB cases
notified between 2007 and 2011 has slightly decreased from 79.2% in
2007 to 76.5% in 2011.
Figure 12: 12-month treatment success rate in new cultureconfirmed pulmonary TB cases by year of initial case
reporting, EU/EEA, 2007–2011
Treatment success (%)
100
80
79.2
79.4
79.0
77.0
76.5
2007
2008
2009
Year of initial reporting
2010
2011
60
40
20
0
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Treatment success in new
pulmonary TB cases
Treatment success rate for culture-confirmed new pulmonary TB cases notified
in 2011 was 76.5% (range: 0–91.3%).
Figure 13: Treatment success rate in culture-confirmed new pulmonary TB cases
notified in 2011, by country, EU/EEA, 2012
Treatment success (%)
100
80
60
40
20
0
* Iceland and Malta reported zero new TB cases in 2011. Three EU/EEA Member States did not report treatment
outcome data
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Treatment success in previously treated
pulmonary TB cases
The treatment success rate for previously treated culture-confirmed pulmonary TB
cases notified in 2011 was 55.2% (range 25.0–100.0%).
Figure 14: Treatment success rate in previously treated culture-confirmed
pulmonary TB cases notified in 2011, by country, EU/EEA
%
Treatment success (%)
100
80
60
40
20
0
* Iceland and Malta reported zero previously treated TB cases in 2011. Three EU/EEA Member States did not report treatment
outcome data stratified by treatment history
15
Treatment success rate in confirmed
pulmonary TB cases*
The treatment success rate for all confirmed pulmonary TB cases notified
in 2011 was 72.4% (range 0–90.4%).
Figure 15: Treatment success rate in laboratory confirmed pulmonary
TB cases notified in 2011, by country, EU/EEA, 2012
Treatment success (%)
100
80
60
40
20
0
* Four EU/EEA Member States did not report treatment outcome data
16
Treatment success rate in
extrapulmonary TB*
The treatment success rate in extrapulmonary TB cases notified in 2011 was
82.2% (range 59.0–100%).
Figure 16: Treatment success rate in extrapulmonary TB cases notified in
2011, by country, EU/EEA, 2012
Treatment success (%)
100
80
60
40
20
0
* Five Member States did not report stratified treatment outcome data
17
Treatment success rate in
multidrug-resistant TB*
The treatment success rate for all multidrug-resistant TB cases notified in
2010 was 33.6% (range 0–100.0%).
Figure 17: 24-month treatment success rate in multidrug-resistant TB
cases notified in 2010, by country, EU/EEA, 2012
Treatment success (%)
100
80
60
40
20
0
* Slovenia reported zero MDR TB cases in 2010, 9 Member States did not report treatment outcome data for MDR TB cases
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Treatment outcome in
multidrug-resistant TB over time
Treatment outcomes for multidrug-resistant TB cases improved slightly
between the 2008 and 2010 cohort, EU/EEA.
Figure 18: 24-month treatment outcome in multidrug-resistant TB cases
notified from 2008 to 2010, by year of initial case reporting, EU/EEA, 2012
40
Treatment success (%)
cohort 2008
cohort 2009
30
cohort 2010
20
10
0
Success
Died
Failed
Defaulted
Still on treatment
Transferred or
unknown
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Treatment success in
extensively drug-resistant TB*
The treatment success rate in extensively drug-resistant TB cases notified in
2009 was 25.0% (range 0–66.7%).
Figure 19: 36-month treatment success rate in extensively drug-resistant
TB cases notified in 2009, by country, EU/EEA, 2012
Treatment success (%)
80
60
40
20
0
EU/EEA
Austria
Belgium
Bulgaria
Czech
Republic
Estonia
Latvia
Lithuania
Norway
Poland
Romania
United
Kingdom
* Cyprus, Denmark, Iceland, Malta, Slovakia, Slovenia and Sweden reported zero XDR TB cases in 2009, 12 countries did not
report SLD DST results or stratified treatment outcome data
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