DRAFT Programme
The Vilnius Tuberculosis Meetings
Monday 25th September – Wednesday 27th September, 2006
The Best Western Naujasis Hotel, Vilnius, Lithuania
WOLFHEZE WORKSHOPS FOR TUBERCULOSIS
CONTROL IN LOW AND MEDIUM INCIDENCE COUNTRIES
IN EUROPE
IN
JOINT SESSION WITH
EUROTB
THE VILNIUS TUBERCULOSIS MEETINGS ARE A COLLABORATION OF
EUROTB
KNCV TUBERCULOSIS FOUNDATION
WORLD HEALTH ORGANISATION
(HQ GENEVA AND WHO REGIONAL OFFICE FOR EUROPE)
Monday morning, 25 September 2006
Joint opening session EuroTB / KNCV Tuberculosis
Foundation / WHO Regional Office for Europe
CHAIR: Ministry of health of Lithuania
Time
Topic
8.00-8.30
Registration of participants
8.30 – 9.00
Opening remarks
Gudjon MAGNUSSON (WHO/EURO)
Mario RAVIGLIONE (WHO/HQ)
Martien BORGDORFF (KNCV TF)
Dennis FALZON (EuroTB)
Karoline FERNANDEZ de la HOZ
(ECDC)
9.00-9.45
- Key note speech: The Stop TB Strategy
- The International standards for TB Care
- The Patient’s Charter of the TB
Community
Mario RAVIGLIONE (WHO/HQ)
Leopold BLANC (WHO/HQ)
Anna WATTERSON (TB community
representative)
9.45-10-30
Discussion and formulation of specific
questions to the Technical Advisory Group
(TAG)
10.30-11.00
Tea/coffee break
11.00-11.45
- TB surveillance data of Eastern and
Western Europe
- Planning to Stop TB in Eastern Europe,
the European High Level Ministerial Forum
(HLMF) and its Declaration
- Planning for TB elimination in Western
Europe
11.45-13.00
Discussion on Planning to Stop TB in
Europe and the HLMF Declaration.
Formulation of specific questions to TAG
13.00
Lunch
Speaker / facilitator
Dennis FALZON
Richard ZALESKIS (WHO/EURO)
Martien BORGDORFF
WOLFHEZE WORKSHOP FOR LOW AND INTERMEDIATE INCIDENCE COUNTRIES
Monday afternoon 25 September 2006
Towards a joint language and practice in contact
tracing
CHAIR: Delphine ANTOINE
Time
Topic
Speaker / facilitator
14.00-14.20
Introduction to contact tracing and outbreak
management
Vincent KUYVENHOVEN
14.20-14.40
Policy and results of contact tracing in
Slovenia
Damjan ERZEN
14.40-15.00
Policy and results of contact tracing in
Barcelona
Joan CAYLÁ
15.00-15.30
Practices and data collection in contact
tracing in European countries. Results of an
inquiry.
Connie ERKENS
15.30-16.00
Tea/coffee break
16.00-17.30
Workshops on contact tracing
Group 1 Definitions
Group 2 Decision making on initiating and
extending contact tracing
Group 3 Monitoring results of contact tracing
Group 1: Roland DIEL
Group 2: Peter HELBLING
Group 3: Dennis FALZON
Motivation
Contact tracing (as a part of outbreak management and being an important intervention in
tuberculosis control in low and intermediate incidence countries) needs justification,
harmonization and more evidence.
Objective
To inform and to discuss data, experiences, definitions and organizational aspects of
contact tracing
Expected output
During the plenary discussion on Tuesday morning will be discussed how the results of the
working groups can be used to reach harmonization and to organize data collection in the
future in order to gather evidence in contact tracing in low and intermediate incidence
countries in Europe.
Outcome
A joint language and practice in contact tracing in countries with a low and intermediate
incidence of tuberculosis in Europe, which can be monitored on the country level and by
Euro TB.
Background
Contact tracing is, after proper diagnosis and treatment of patients, still the most
important intervention in tuberculosis control in low and intermediate burden countries.
Practices in these countries differ. This is a reason to present data, as far as they are
available, to discuss practices and to try to reach a common view on this intervention.
In December 2005 a USA-guideline on contact tracing was published. This guideline can be
used as an input for discussion and analysis.
JOINT SESSION EUROTB / WOLFHEZE WORKSHOP FOR LOW AND
INTERMEDIATE INCIDENCE COUNTRIES
Tuesday morning 26 September 2006
Current state of evidence of applying interferon
gamma release assays (IGRAs)
CHAIR: Francis DROBNIEWSKI
Time
Topic
Speaker / facilitator
9.00-10.00
Presentations from the 3 working groups of
Monday afternoon and discussion on how to
harmonize practices and collect data.
Chair: Delphine ANTOINE
10.10–10.30
Applying IGRAs in clinical and public health
practice: experiences from Switzerland
Jean-Pierre ZELLWEGER
10.30-11.00
Tea/coffee break
11.00-11.45
IGRAs. Current evidence and their role in TB
diagnosis and control
11.45-12.30
Questions & discussion
Frank COBELENS
Motivation
There is a lack of consensus in the public health and in the clinical field of tuberculosis
control for what purposes IGRAs can be used
Objectives
To show and discuss what is the current state of evidence of applying IGRA in LTBI
diagnosis
Expected output
An overlook of what we know and don’t know in relation to the main question: what is the
predictive value of a positive test result of IGRAs for the development of active TB
Outcome
A rational use of IGRAs in clinical care and public health practice
Background
In recent years IGRAs have been presented as an alternative for the tuberculin skin test
for diagnosing LTBI. A number of studies have been presented concerning the application
of the two currently available tests: the Quantiferon-TB-Gold and the T-Spot. TB. But the
results of these studies are sometimes conflicting and several questions are still unresolved.
During this morning session an overview will be given of the evidence that has been
gathered and of questions that still remain, leading to an understanding for what situations
the use of IGRAs is rational.
JOINT SESSION EUROTB / WOLFHEZE WORKSHOP FOR LOW AND
INTERMEDIATE INCIDENCE COUNTRIES
Tuesday afternoon 26 September 2006
What does countrywide, routine DNA fingerprinting
contribute to TB control in low incidence countries ?
CHAIR: John WATSON
Time
Topic
Speaker / facilitator
14.00-14.10
Introduction to the subject
John WATSON
14.10-14.30
Presentation on Germany
Roland DIEL
14.30-14.50
Presentation on Rotterdam
Gerard DE VRIES
14.50-15.10
Presentation on the United States
Kashef IJAZ
15.10-15.30
Presentation on Latvia
Timothy HOLTZ
15.30-16.15
Discussion
16.15-16.30
Tea/coffee break
Abstract session on TB in risk groups
16.30-17.30
17.30-18.00
Abstracts on risk group management
- TB trends in Germany 2001–2004 : a note
on foreign-born cases
- TB in health care workers - Romania 2002
- Impact of homelessness, imprisonment
and problem drug use on the management
of tuberculosis in London
- TB screening in illegal immigrants to Malta
Bonita BRODHUN
Elmira IBRAIM
Alistair STORY
Analita PACE-ASCIAK
Round up and general discussion about
significance of presented data for future
policy development
SUBJECT: What does countrywide, routine DNA fingerprinting
contribute to TB control in low incidence countries ?
a)
Motivation
There is a lack of consensus whether routine DNA fingerprinting of M.Tuberculosis complex
is a useful or even a necessary tool in TB control in low incidence countries
Objective
To exchange information about results of countrywide (or regional) routine DNA
fingerprinting
Expected output
Pro's and con's of nationwide, routine DNA fingerprinting are listed
Outcome
Consensus is reached on the usefulness of DNA fingerprinting M.Tuberculosis complex on a
routine basis in countries with a low and intermediate incidence of TB
Background
Since DNA fingerprinting of M.tuberculosis strains became available as a tool in
tuberculosis control in the early nineties many immuno-epidemiologic studies have been
done to demonstrate transmission routes, but only a few countries or regions have started
to perform DNA fingerprinting on a routine basis. Information should be exchanged what
the yield is of routine DNA fingerprinting on a regional or national scale.
b)
SUBJECT: Abstract session on TB in risk groups
Motivation
Risk group management is an important intervention in low incidence countries and
becomes more important in intermediate incidence countries, but there is a lack of
consensus about what are the important prerequisites for successful risk group
management.
Objective
To present examples of interventions for TB control in risk groups to learn about objectives,
definitions and important requisites to implement risk group management as an
intervention
Expected output
An inventory of what are possible objectives, definitions and important prerequisites to
successful risk group management
Outcome
Harmonization of vocabulary in risk group management in low and intermediate incidence
countries in order to develop monitoring tools.
Background
Different policies towards risk groups, different definitions of risk groups and risk group
management, incomplete monitoring in many countries and therefore impossibility to
compare data and to gather data for monitoring on the European level. This abstract based
session contributes to an inventory of policies in order to make an agenda for future policy
development on risk group management and monitoring.
SESSION EUROTB
Wednesday morning 27 September 2006
European TB surveillance: up to now, till 2007 and
beyond
CHAIR: Petri RUUTU
Time
Topic
Speaker
9.00 - 9.15
Main take-home messages from EuroTB
data and the recent literature on risk group
surveillance in Europe
Fatima BELGHITI
9.15 – 9.45
Discussion on the use of surveillance in
control among risk groups (from previous
afternoon)
9.45 – 10.30
Molecular surveillance of MDR-TB in Europe:
progress to date (presentation & discussion)
10.30 - 10.45
Tea/coffee break
10.45 - 11.15
Highlights of European TB surveillance –
1996 – 2004
Dennis FALZON /
Fatima BELGHITI
11.15 – 11.40
ECDC issues: past, present and future
11.40 - 12.00
Data collection 2006 & UNION Symposium
2007
Karoline FERNANDEZ DE LA
HOZ
Dennis FALZON
Isabelle DEVAUX
Motivation
The pattern of TB epidemiology and the priorities for control are different in the 52
countries of Europe. In low and medium-prevalence countries, a high risk approach is
crucial and molecular techniques are important in studying disease clusters extending
beyond national borders.
Objectives
1) the discussion on risk group surveillance finalized;
2) the relevance of the project on molecular surveillance of MDR discussed as an adjunct
to outbreak investigation;
3) the main findings of tuberculosis surveillance overviewed in the context of reforms in
European infectious disease surveillance and control;
4) the work-plan of future activities of EuroTB (next data collection, symposium at UNION
conference, ECDC evaluation, case definitions, evaluation 2007) is presented.
Expected output
Changes to the future work-plan based on the discussion on the different topics.
Outcome
Contribution to the policy document on outbreak management.
Preparation for the 2007 symposium of the UNION.
Background
EuroTB started its mission to improve the contribution of surveillance to European TB
control in 1996. Its funding is secured up till the end of 2007. This is the last of its Annual
Meetings before the European Commission hands over TB surveillance to the European
Centre for Disease Prevention and Control (ECDC) in Sweden.