Abstract
Background: There is scientific evidence that poor treatment outcomes and suboptimal TB case management contribute to transmission of TB and development of drug resistance.
Aim: To evaluate the temporal trends of the proportions of treatment success and unfavourable outcomes in the Member States of the WHO European Region in 2004-2008.
Methods: Aggregated data on definitive treatment outcomes (cured and treatment completed, i.e. treatment success; died and failed, i.e. unfavourable outcome), collected from the national TB recording and reporting systems by WHO Europe, were analysed.
Results: During the period 2004-2008, the proportions of treatment success among new TB cases ranged from 64.6% (2,863/4,434) to 76.3% (5,997/7,860) and from 61.2% (70,211/114,721) to 72.0% (55,196/76,681) in low (L) vs middle-high (M-H) TB incidence (i.e., TB incidence < 20 vs. ≥ 20 cases per 100,000 population) countries, respectively. Only during the years 2004, 2007 and 2008 the proportion of treatment success was significantly higher in low TB incidence countries (P< 0.001). Re-treated cases were successfully treated in low incidence countries during the study period (average treatment success proportion in L and M-H TB incidence countries were 62.3% and 49.7%, respectively; P< 0.001). Failure trends were significantly higher in new and re-treated cases in M-H TB incidence countries (9.8% versus 5.0% and 19.6% versus 10.7% respectively; P< 0.001).
Conclusion: This analysis confirms that sub-optimal treatment outcomes in new and re-treated TB cases are frequently recorded in the WHO European Region setting. Introduction and/or strengthening of multidisciplinary interventions to improve treatment outcomes are urgently needed.
- © 2011 ERS