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Abstract

Monitoring the treatment outcome (TO) of tuberculosis (TB) is essential to evaluate the effectiveness of the intervention and to identify potential barriers for TB control. The global target is to reach a treatment success rate (TSR) of at least 85%. We aimed to assess the TB TO in the European Union and European Economic Area (EU/EEA) between 2002 and 2011, and to identify factors associated with unsuccessful treatment. Only 18 countries reported information on TO for the whole observation period accounting for 250,854 new culture-confirmed pulmonary TB cases. The 85% target of TSR was not reached in any year between 2002 and 2011 and was on average 78%. The TSR for multidrug-resistant (MDR)-TB cases at 24-month follow-up was 49%. In the multivariable regression model, unsuccessful treatment was significantly associated with increasing age (odds ratio (OR) = 1.02 per a one-year increase, 95% confidence interval (CI): 1.02–1.02), MDR-TB (OR = 8.7, 95% CI: 5.09–14.97), male sex (OR = 1.40, 95% CI: 1.28–1.52), and foreign origin (OR = 1.32, 95% CI: 1.03–1.70). The data highlight that special efforts are required for patients with MDR-TB and the elderly aged ≥65 years, who have particularly low TSR. To allow for valid monitoring at EU level all countries should aim to report TO for all TB cases.

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/content/10.2807/1560-7917.ES.2015.20.49.30087
2015-12-10
2025-07-14
/content/10.2807/1560-7917.ES.2015.20.49.30087
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References

  1. World Health Organization (WHO). 44th World Health Assembly, Resolutions and Decisions. Resolution WHA44.8. Geneva: WHO; 1991. Available from: http://www.who.int/tb/publications/tbresolution_wha44_8_1991.pdf?ua=1
  2. Stop TB Partnership and World Health Organization. Global Plan to Stop TB 2006-2015: Actions for Life – Towards a world free of tuberculosis. WHO/HTM/STB/2006.35. Geneva: WHO; 2006. http://www.stoptb.org/assets/documents/global/plan/globalplanfinal.pdf
  3. Rieder HL, Watson JM, Raviglione MC, Forssbohm M, Migliori GB, Schwoebel V, et al. Surveillance of tuberculosis in Europe. Working Group of the World Health Organization (WHO) and the European Region of the International Union Against Tuberculosis and Lung Disease (IUATLD) for uniform reporting on tuberculosis cases. Eur Respir J. 1996;9(5):1097-104. Available from:  https://doi.org/10.1183/09031936.96.09051097  PMID: 8793477 
  4. Veen J, Raviglione M, Rieder HL, Migliori GB, Graf P, Grzemska M, et al. Standardized tuberculosis treatment outcome monitoring in Europe. Recommendations of a Working Group of the World Health Organization (WHO) and the European Region of the International Union Against Tuberculosis and Lung Disease (IUATLD) for uniform reporting by cohort analysis of treatment outcome in tuberculosis patients. Eur Respir J. 1998;12(2):505-10. Available from:  https://doi.org/10.1183/09031936.98.12020505  PMID: 9727811 
  5. European Centre for Disease Prevention and Control (ECDC). A Framework Action Plan to fight Tuberculosis in the EU. Stockholm: ECDC; 2008. Available from: http://ecdc.europa.eu/en/publications/Publications/0803_SPR_TB_Action_plan.pdf
  6. European Centre for Disease Prevention and Control/WHO Regional Office for Europe (ECDC/WHO EURO). Tuberculosis surveillance and monitoring in Europe 2015. Stockholm: ECDC; 2015. Available from: http://ecdc.europa.eu/en/publications/Publications/tuberculosis-surveillance-monitoring-Europe-2015.pdf
  7. Falzon D, Scholten J, Infuso A. Tuberculosis outcome monitoring--is it time to update European recommendations? Euro Surveill. 2006;11(3):20-5. PMID: 16567878 
  8. Manissero D, Hollo V, Huitric E, Kodmon C, Amato-Gauci A. Analysis of tuberculosis treatment outcomes in the European Union and European Economic Area: efforts needed towards optimal case management and control. Euro Surveill. 2010;15(11). PMID: 20338143 
  9. Faustini A, Hall AJ, Perucci CA. Tuberculosis treatment outcomes in Europe: a systematic review. Eur Respir J. 2005;26(3):503-10. Available from:  https://doi.org/10.1183/09031936.05.00103504  PMID: 16135735 
  10. Falzon D, Le Strat Y, Belghiti F, Infuso A, Euro TB. Correspondents. Exploring the determinants of treatment success for tuberculosis cases in Europe. Int J Tuberc Lung Dis. 2005;9(11):1224-9. PMID: 16333929 
  11. van Hest R, Ködmön C, Verver S, Erkens CG, Straetemans M, Manissero D, et al. Tuberculosis treatment outcome monitoring in European Union countries: systematic review. Eur Respir J. 2013;41(3):635-43. Available from:  https://doi.org/10.1183/09031936.00030612  PMID: 22790913 
  12. Centers for Disease Control and Prevention (CDC). Reported Tuberculosis in the United States, 2013. Atlanta: CDC; October 2014. Available from: http://www.cdc.gov/tb/statistics/reports/2013/pdf/report2013.pdf
  13. Public Health Agency of Canada. Tuberculosis in Canada 2012 - Pre-Release. Ottawa (Canada): Minister of Public Works and Government Services Canada; 2014. Available from: http://www.phac-aspc.gc.ca/tbpc-latb/pubs/tbcan13pre/assets/pdf/tbcan13pre-eng.pdf
  14. Connolly C, Davies GR, Wilkinson D. Who fails to complete tuberculosis treatment? Temporal trends and risk factors for treatment interruption in a community-based directly observed therapy programme in a rural district of South Africa. Int J Tuberc Lung Dis. 1999;3(12):1081-7. PMID: 10599011 
  15. Valin N, Hejblum G, Borget I, Mallet HP, Antoun F, Che D, et al. Management and treatment outcomes of tuberculous patients, eastern Paris, France, 2004. Int J Tuberc Lung Dis. 2009;13(7):881-7. PMID: 19555539 
  16. Diel R, Niemann S. Outcome of tuberculosis treatment in Hamburg: a survey, 1997-2001. Int J Tuberc Lung Dis. 2003;7(2):124-31. PMID: 12588012 
  17. Caylà JA, Caminero JA, Rey R, Lara N, Vallés X, Galdós-Tangüis HWorking Group on Completion of Tuberculosis Treatment in Spain. Current status of treatment completion and fatality among tuberculosis patients in Spain. Int J Tuberc Lung Dis. 2004;8(4):458-64. PMID: 15141739 
  18. European Monitoring Centre for Drugs and Drug Addiction (EMCDDA). Selected Issue 2: A gender perspective on drug use and responding to drug problems. ISBN 92-9168-250-0. Lisbon: EMCDDA; 2006. Available from: http://www.drugs.ie/resourcesfiles/ResearchDocs/Europe/Research/2006/sel2006_2-en.pdf
  19. Nhamoyebonde S, Leslie A. Biological differences between the sexes and susceptibility to tuberculosis. J Infect Dis. 2014;209(3) Suppl 3;S100-6. Available from:  https://doi.org/10.1093/infdis/jiu147  PMID: 24966189 
  20. Lefebvre N, Falzon D. Risk factors for death among tuberculosis cases: analysis of European surveillance data. Eur Respir J. 2008;31(6):1256-60. Available from:  https://doi.org/10.1183/09031936.00131107  PMID: 18515556 
  21. Bustamante-Montes LP, Escobar-Mesa A, Borja-Aburto VH, Gómez-Muñoz A, Becerra-Posada F. Predictors of death from pulmonary tuberculosis: the case of Veracruz, Mexico. Int J Tuberc Lung Dis. 2000;4(3):208-15. PMID: 10751065 
  22. Hauer B, Brodhun B, Altmann D, Fiebig L, Loddenkemper R, Haas W. Tuberculosis in the elderly in Germany. Eur Respir J. 2011;38(2):467-70. Available from:  https://doi.org/10.1183/09031936.00199910  PMID: 21804163 
  23. Rajagopalan S. Tuberculosis and aging: a global health problem. Clin Infect Dis. 2001;33(7):1034-9. Available from:  https://doi.org/10.1086/322671  PMID: 11528577 
  24. Packham S. Tuberculosis in the elderly. Gerontology. 2001;47(4):175-9. Available from:  https://doi.org/10.1159/000052794  PMID: 11408720 
  25. Zevallos M, Justman JE. Tuberculosis in the elderly. Clin Geriatr Med. 2003;19(1):121-38. Available from:  https://doi.org/10.1016/S0749-0690(02)00057-5  PMID: 12735118 
  26. Naalsund A, Heldal E, Johansen B, Kongerud J, Boe J. Deaths from pulmonary tuberculosis in a low-incidence country. J Intern Med. 1994;236(2):137-42. Available from:  https://doi.org/10.1111/j.1365-2796.1994.tb01275.x  PMID: 8046312 
  27. Rieder HL, Kelly GD, Bloch AB, Cauthen GM, Snider DE Jr. Tuberculosis diagnosed at death in the United States. Chest. 1991;100(3):678-81. Available from:  https://doi.org/10.1378/chest.100.3.678  PMID: 1889256 
  28. World Health Organization (WHO). Framework towards tuberculosis elimination in low-incidence countries. WHO/HTM/TB/2014.13. Geneva: WHO; 2014. Available from: http://apps.who.int/iris/bitstream/10665/132231/1/9789241507707_eng.pdf?ua=1
  29. Ohmori M, Wada M, Yoshiyama T, Uchimura K. (Factors related to early case detection of tuberculosis in health service facilities for the elderly). Kekkaku. 2003;78(6):435-42. PMID: 12872702 
  30. Espinal MA, Kim SJ, Suarez PG, Kam KM, Khomenko AG, Migliori GB, et al. Standard short-course chemotherapy for drug-resistant tuberculosis: treatment outcomes in 6 countries. JAMA. 2000;283(19):2537-45. Available from:  https://doi.org/10.1001/jama.283.19.2537  PMID: 10815117 
  31. Noeske J, Nguenko PN. Impact of resistance to anti-tuberculosis drugs on treatment outcome using World Health Organization standard regimens. Trans R Soc Trop Med Hyg. 2002;96(4):429-33. Available from:  https://doi.org/10.1016/S0035-9203(02)90383-4  PMID: 12497982 
  32. Conaty SJ, Dart S, Hayward AC, Lipman MC. Reasons for low reported treatment success in notified tuberculosis patients from a London hospital according to new outcome reporting. Commun Dis Public Health. 2004;7(1):73-6. PMID: 15137286 
  33. World Health Organization (WHO). Resolution WHA 61.17. Health of migrants. In: Sixty-first World Health Assembly, Geneva, 19-24 May 2008. Resolutions and decisions, annexes. Geneva: WHO; 2008:2 (document WHA61/2008/REC/1). Available from: http://apps.who.int/gb/ebwha/pdf_files/WHA61-REC1/A61_REC1-en.pdf
  34. Fernandes A, Miguel JP. Health and migration in European Union: better health for all in an inclusive society. 291173/09. Lisboa. Instituto Nacional de Saúde Doutor Ricardo Jorge 2009. Available from: http://www.insa.pt/sites/INSA/Portugues/Publicacoes/Outros/Documents/Epidemiologia/HealthMigrationEU2.pdf
Tuberculosis treatment outcome in the European Union and European Economic Area: an analysis of surveillance data from 2002‒2011
<p class="citation"> <span>Citation style for this article:</span> <span class="meta-value authors"> <a href="/search?value1=Basel+Karo&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Karo Basel</a>, <a href="/search?value1=Barbara+Hauer&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Hauer Barbara</a>, <a href="/search?value1=Vahur+Hollo&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Hollo Vahur</a>, <a href="/search?value1=Marieke+J.+van+der+Werf&option1=author&noRedirect=true" class="nonDisambigAuthorLink">van der Werf Marieke J.</a>, <a href="/search?value1=Lena+Fiebig&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Fiebig Lena</a>, <a href="/search?value1=Walter+Haas&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Haas Walter</a></span>. Tuberculosis treatment outcome in the European Union and European Economic Area: an analysis of surveillance data from 2002‒2011. <a href="/content/ecdc">Euro Surveill.</a> 2015;20(49):pii=30087. <a href="https://doi.org/10.2807/1560-7917.ES.2015.20.49.30087" title="doi link" target="_blank">https://doi.org/10.2807/1560-7917.ES.2015.20.49.30087</a> <span class="ES_Article_citation"> <span class="generated">Received</span>: 03 Feb 2015;&nbsp;&nbsp; <span class="generated">Accepted</span>: 24 Jul 2015 </span> </p>
/content/10.2807/1560-7917.ES.2015.20.49.30087
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