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Slide1: 

Tuberculosis surveillance in the European Union and West EuroTB update March 2007 WHO Collaborating Centre

Slide2: 

TB notification rates, EU & West, 1995-2005 (1) Countries joining EU since 2004

Slide3: 

TB notification rates, EU & West*, 1995-2005 (2) Countries with rate < 10 per 100,000 in 2005 * Excluding new EU countries (see previous slide)

Slide4: 

TB notification rates, EU & West*, 1995-2005 (3) Countries with rate > 9 per 100,000 in 2005 * Excluding new EU countries (see slide before previous)

Slide5: 

TB notification rates, European Union By country group, 1996-2005 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.)

Slide6: 

* Excluding countries without data or with <60 cases in 2005 (Andorra, Cyprus, Iceland, Luxembourg, Malta, Monaco, San Marino) TB notification rates, EU & West*, 2001-2005 Mean annual percentage change Latvia Slovakia Finland Czech Republic Slovenia Portugal Netherlands Germany France Denmark Belgium Poland Lithuania Bulgaria Austria Italy Switzerland Romania Spain Norway Ireland United Kingdom Greece Sweden Hungary -12% -10% -8% -6% -4% -2% 0% 2% 4% 6% 8% 10% % change

Slide7: 

TB notification rates by age-group, sex and geographic origin, EU & West*, 2004 * Countries reporting population data by geographic origin: Austria, Belgium, Denmark, Finland, France, Germany, Iceland, Netherlands, Norway, Slovenia, Sweden, Switzerland, United Kingdom

Slide8: 

TB notifications by age-group and geographic origin, EU & West*, 2005 * Excluding countries with missing data (Monaco, San Marino)

Slide9: 

Foreign TB cases by area of origin, EU & West, 2005 (N=14,019)* * Cases born outside or not citizens of the country of report. Former Soviet Union excludes Baltic States. Excluding countries with missing data: Bulgaria, France, Israel, Monaco, Norway, Poland, San Marino, Spain.

Slide10: 

Localisation of disease by area of origin of foreign TB cases, EU & West*, 2005 * Cases born outside or not citizens of the country of report (number of cases in brackets next to each geographical area). Excluding countries without data: Bulgaria, France, Israel, Monaco, Norway, Poland, San Marino, Spain. † May include cases with both pulmonary and extrapulmonary sites of disease ‡ Includes the following Asian countries: Bangladesh, Bhutan, India, Maldives, Nepal, Pakistan, Sri Lanka 0% 20% 40% 60% 80% 100% Former Soviet Union (1,238) EU & West (1,356) Balkans (1,233) America & Oceania (564) Africa (4,613) Rest of Asia (1,501) Unknown (339) Indian Subcontinent ‡ (3,175) Pulmonary † Extrapulmonary Unknown

Slide11: 

* Excluding Cyprus, Greece, Luxembourg, Poland, Spain TB cases by geographic origin, EU & West*, 2000-2005

Slide12: 

HIV infection among TB cases EU & West*, 2000-2005 * Completeness of information differs between countries. Including only countries with >50 TB cases / year. Portugal Spain United Kingdom Estonia Latvia

Multidrug resistance (MDR), EU & West, 2005 (1) Mean combined MDR, Baltic States & Other countries*: 

Multidrug resistance (MDR), EU & West, 2005 (1) Mean combined MDR, Baltic States & Other countries* * Vertical lines denote country range of % MDR; including only countries with nationwide, representative data - Baltic States : Estonia, Latvia, Lithuania Other countries : Andorra, Austria, Belgium, Cyprus, Denmark, Finland, France, Germany, Iceland, Israel, Luxembourg, Netherlands, Norway, Romania (2003-2004), Slovenia, Sweden, Switzerland, United Kingdom

Multidrug resistance (MDR), EU & West*, 2005 (2) Combined MDR by area of origin: 

Multidrug resistance (MDR), EU & West*, 2005 (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

Slide15: 

Treatment outcome, EU & West*, 2004 (1) New pulmonary culture positive TB cases, by country * Including only countries with nationwide, complete data (smear positive cases in Sweden). † Defaulted, Transferred and Unknown. 0% 20% 40% 60% 80% 100% Hungary Sweden U. Kingdom Czech Rep. Austria Germany Estonia Belgium Lithuania Andorra Iceland Latvia Ireland Poland Bulgaria Israel Romania Netherlands Norway Denmark Portugal Slovakia Slovenia Malta Success Died Failed Still on treatment Other †

Slide16: 

Treatment outcome, EU & West*, 2004 (2) New pulmonary culture positive TB cases, by age-group * Pooled case-based records from Andorra, Austria, Belgium, Czech Republic, Denmark, Estonia, Germany, Hungary, Iceland, Ireland, Latvia, Lithuania, Malta, Netherlands, Norway, Poland, Portugal, Romania, Slovakia, Slovenia, United Kingdom. † Failed, Defaulted, Transferred, Still on treatment and Unknown. 0% 20% 40% 60% 80% 100% 0-14 15-44 45-64 65+ % cases Success Died Other †

Slide17: 

Treatment outcome, EU & West*, 2004 (3) All pulmonary TB cases, by geographic origin * Pooled case-based records from countries with nationwide, complete data: Andorra, Austria, Belgium, Czech Republic, Denmark, Estonia, Germany, Hungary, Iceland, Ireland, Latvia, Lithuania, Malta, Netherlands, Norway, Portugal, Romania, Slovakia, Slovenia, United Kingdom. † Failed, Defaulted, Transferred and Unknown.

Slide18: 

Treatment outcome, EU & West*, 2004 (4) All TB cases, by site of disease * Pooled case-based records from countries with nationwide, complete data: Andorra, Austria, Czech Republic, Denmark, Estonia, Germany, Hungary, Iceland, Ireland, Latvia, Lithuania, Malta, Netherlands, Norway, Portugal, Romania, Slovakia, Slovenia, United Kingdom. † Failed, Defaulted, Transferred and Unknown.

Slide19: 

TB mortality rates, EU & West (1) Total rates, selected countries, 2000-2004* * Source: WHO Mortality Database, November 2006 update. Including codes ICD9 020-025,029 or ICD10 A15-19.

Slide20: 

TB mortality rates, EU & West (2) Age-group specific rates, selected countries, 2004* * Source: WHO Mortality Database, November 2006 update. Including codes ICD9 020-025,029 or ICD10 A15-19.

Slide21: 

TB mortality rates, EU & West (3) TB death rates* versus notification rates, 2003-2004 * Source: WHO Mortality Database, November 2006 update. Including codes ICD9 020-025,029 or ICD10 A15-19.