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Among the 51 countries
of the WHO European Region, all but one (Turkey) sent data
on tuberculosis cases notified in 1996:
- 47 countries reported all new and
recurrent cases;
- 2 countries (Greece and Kazakstan)
reported only new cases;
- 1 country (Spain) reported only new
respiratory cases.
Complementary information
on the characteristics of the national surveillance systems
according to the European recommendations (case definition,
population groups systematically excluded from the notification,
definitions of recurrent cases included in the notification,
of bacteriological confirmation and of smear positivity) was
provided by 46 countries. There were some differences in the
definition of recurrent cases included in the notification
(Table 1) :
- 20 countries reported only the relapses,
as defined by WHO [8] (cases in patients with a previous episode
of tuberculosis who completed a full treatment with anti-tuberculosis
drugs and were declared cured);
- 15 countries reported relapses and
other patients previously treated with anti-tuberculosis
drugs, such as patients returning after interruption of treatment
or patients with a previous episode of tuberculosis failing
to respond to anti- tuberculosis treatment;
- 7 countries reported cases in patients
with a previous episode of tuberculosis who were not treated
with anti-tuberculosis drugs (because anti-tuberculosis drugs
were not available at that time) in addition to the cases
mentioned above;
- 2 countries (Bosnia-Herzegovina,
United Kingdom) used different definitions of recurrent cases
in different parts of the country.
However, few countries
specified how these definitions were applied. Moreover, information
on previous history of tuberculosis is difficult to obtain
and differences in inclusion of recurrent cases may also result
from differences in the procedure used to retrieve previous
information.Population groups included in the notification
also differed (Table 2) :
- 8 countries included only nationals,
excluding all categories of foreigners;
- 13 countries included nationals and
legal immigrants, but excluded illegal immigrants and/or
asylum seekers;
- 12 countries excluded prisoners.
This information concerned
systematic exclusion from the notification and not underreporting,
which may also exist in the groups included in the notification.
Among the 50 countries reporting tuberculosis cases notified
in 1996, 19 provided individual computerised data, 31 provided
aggregate data. The availability of information varied between
countries (Box 4).
Seven countries (Belarus,
Greece, Kazakstan, Kyrgyzstan, Russian Federation, Tajikistan
and Ukraine) provided information on the characteristics the
new cases only. In order to present all the distributions on
the total number of cases (new and recurrent), results for
these countries are not included in the tables or country profiles
presented further in this report. |
