scholarly journals Tuberculosis treatment outcome in the European Union and European Economic Area: an analysis of surveillance data from 2002‒2011

2015 ◽  
Vol 20 (49) ◽  
Author(s):  
Basel Karo ◽  
Barbara Hauer ◽  
Vahur Hollo ◽  
Marieke J. van der Werf ◽  
Lena Fiebig ◽  
...  
Keyword(s):  
European Union ◽  
Treatment Outcome ◽  
Treatment Success ◽  
The Elderly ◽  
European Economic Area ◽  
The European Union ◽  
European Economic ◽  
Economic Area ◽  
Unsuccessful Treatment ◽  
Mdr Tb

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.

scholarly journals Analysis of tuberculosis treatment outcomes in the European Union and European Economic Area: efforts needed towards optimal case management and control

2010 ◽  
Vol 15 (11) ◽  
Author(s):  
D Manissero ◽  
V Hollo ◽  
E Huitric ◽  
C Ködmön ◽  
A Amato-Gauci
Keyword(s):  
European Union ◽  
Treatment Outcome ◽  
Case Management ◽  
Success Rate ◽  
Treatment Outcomes ◽  
Treatment Success ◽  
European Economic Area ◽  
The European Union ◽  
Economic Area ◽  
Outcome Monitoring

An analysis of surveillance data was performed to assess treatment outcomes of patients belonging to selected calendar year cohorts. Twenty-two countries in the European Union (EU) and European Economic Area (EEA) reported treatment outcome monitoring data for culture-confirmed pulmonary tuberculosis (TB) cases reported in 2007. The overall treatment success rate was 73.8% for all culture-confirmed pulmonary cases and 79.5% for new culture-confirmed pulmonary cases. For the cohort of new culture-confirmed TB cases, only three countries achieved the target of 85% success rate. This underachievement appears to be a result of relative high defaulting and unknown outcome information. Case fatality remains high particularly among cases of national origin. This factor appears attributable to advanced age of the national cohort. Treatment outcomes for multidrug-resistant tuberculosis were reported by 15 countries, with a range of 19.8% to 100% treatment success at 24 months. The data underline the urgent need for strengthening treatment outcome monitoring in the EU and EEA in order to ensure an effective programme implementation and case management that will ultimately contribute to TB elimination.

scholarly journals Multidrug- and extensively drug-resistant tuberculosis: a persistent problem in the European Union and European Economic Area

2010 ◽  
Vol 15 (11) ◽  
Author(s):  
C Ködmön ◽  
V Hollo ◽  
E Huitric ◽  
A Amato-Gauci ◽  
D Manissero
Keyword(s):  
European Union ◽  
European Economic Area ◽  
Drug Resistant ◽  
The European Union ◽  
Persistent Problem ◽  
European Economic ◽  
Resistant Tuberculosis ◽  
Extensively Drug Resistant ◽  
Economic Area ◽  
Mdr Tb

Since 2008, the European Centre for Disease Prevention and Control has been collecting data from the European Union (EU) and European Economic Area (EEA) on resistance to first- and second-line drugs against tuberculosis (TB). In 2008, the proportion of multidrug-resistant tuberculosis (MDR TB) was 6.0% of the total case load for 25 countries reporting data. Extensively drug-resistant (XDR TB) reporting has increased since 2007 and was observed in 7.3% of the MDR TB cases in 13 reporting countries. MDR TB remains a threat and XDR TB is now established within the EU/EEA borders.

scholarly journals Childhood multidrug-resistant tuberculosis in the European Union and European Economic Area: an analysis of tuberculosis surveillance data from 2007 to 2015

2017 ◽  
Vol 22 (47) ◽  
Author(s):  
Csaba Ködmön ◽  
Martin van den Boom ◽  
Phillip Zucs ◽  
Marieke Johanna van der Werf
Keyword(s):  
European Union ◽  
Treatment Outcome ◽  
Odds Ratio ◽  
Drug Susceptibility ◽  
Multidrug Resistant ◽  
European Economic Area ◽  
The European Union ◽  
Adequate Treatment ◽  
Economic Area ◽  
Mdr Tb

Background Confirming tuberculosis (TB) in children and obtaining information on drug susceptibility is essential to ensure adequate treatment. We assessed whether there are gaps in diagnosis and treatment of multidrug-resistant (MDR) TB in children in the European Union and European Economic Area (EU/EEA), quantified the burden of MDR TB in children and characterised cases. Methods: We analysed surveillance data from 2007 to 2015 for paediatric cases younger than 15 years. Results: In that period, 26 EU/EEA countries reported 18,826 paediatric TB cases of whom 4,129 (21.9%) were laboratory-confirmed. Drug susceptibility testing results were available for 3,378 (17.9%), representing 81.8% of the confirmed cases. The majority (n = 2,967; 87.8%) had drug-sensitive TB, 249 (7.4%) mono-resistant TB, 64 (1.9%) poly-resistant TB, 90 (2.7%) MDR TB and eight (0.2%) had extensively drug-resistant (XDR) TB. MDR TB was more frequently reported among paediatric cases with foreign background (adjusted odds ratio (aOR) = 1.73; 95% confidence interval (95% CI): 1.12–2.67) or previous TB treatment (aOR: 6.42; 95% CI: 3.24–12.75). Successful treatment outcome was reported for 58 of 74 paediatric MDR TB cases with outcome reported from 2007 to 2013; only the group of 5–9 years-olds was significantly associated with unsuccessful treatment outcome (crude odds ratio (cOR) = 11.45; 95% CI: 1.24–106.04). Conclusions: The burden of MDR TB in children in the EU/EEA appears low, but may be underestimated owing to challenges in laboratory confirmation. Diagnostic improvements are needed for early detection and adequate treatment of MDR TB. Children previously treated for TB or of foreign origin may warrant higher attention.

scholarly journals HIV and AIDS in the European Union, 2011

2012 ◽  
Vol 17 (48) ◽  
Author(s):  
G Likatavicius ◽  
M Van de Laar
Keyword(s):  
European Union ◽  
Drug Users ◽  
Antiretroviral Treatment ◽  
Hiv And Aids ◽  
European Economic Area ◽  
The European Union ◽  
Late Presenters ◽  
European Economic ◽  
Economic Area ◽  
Sex With Men

In 2011, a total of 28,038 new HIV diagnoses were reported by European Union and European Economic Area countries. The annual rate of HIV diagnoses does not show clear signs of decrease and HIV continues to be concentrated in selected populations such as men who have sex with men and injecting drug users, and a high proportion reported as late presenters. Despite effective and available antiretroviral treatment, the number of AIDS cases increased in a few countries.

scholarly journals TB management in the European Union/European Economic Area: a multi‐centre survey

2021 ◽  
Vol 25 (2) ◽  
pp. 126-133
Author(s):  
G. Sotgiu ◽  
S. Rosales-Klintz ◽  
R. Centis ◽  
L. D'Ambrosio ◽  
R. Verduin ◽  
...  
Keyword(s):  
European Union ◽  
Infection Control ◽  
Multidrug Resistant ◽  
Control Measures ◽  
European Economic Area ◽  
The European Union ◽  
European Economic ◽  
Infection Control Measures ◽  
Treatment And Prevention ◽  
Economic Area

BACKGROUND: Essential TB care in the European Union/European Economic Area (EU/EEA) comprises 21 standards for the diagnosis, treatment and prevention of TB that constitute the European Union Standards for Tuberculosis Care (ESTC).METHODS: In 2017, we conducted an audit on TB management and infection control measures against the ESTC standards. TB reference centres in five EU/EEA countries were purposely selected to represent the heterogeneous European TB burden and examine geographic variability.RESULTS: Data from 122 patients, diagnosed between 2012 and 2015 with multidrug-resistant TB (n = 49), extensively drug‐resistant TB (XDR‐TB) (n = 11), pre‐XDR‐TB (n = 29) and drug‐susceptible TB (n = 33), showed that TB diagnosis and treatment practices were in general in agreement with the ESTC.CONCLUSION: Overall, TB management and infection control practices were in agreement with the ESTC in the selected EU/EEA reference centres. Areas for improvement include strengthening of integrated care services and further implementation of patient‐centred approaches.

scholarly journals Modified Legal Framework and Opening of the Liner Shipping Market in the Republic of Croatia to Shipping Companies from the European Economic Area

2017 ◽  
Vol 6 (2) ◽  
pp. 140-146
Author(s):  
Nikola Mandić
Keyword(s):  
European Union ◽  
Public Transport ◽  
Legal Framework ◽  
Liner Shipping ◽  
Transitional Period ◽  
European Economic Area ◽  
The European Union ◽  
European Economic ◽  
Economic Area ◽  
The Republic

Generally speaking, public transport is the transport of persons and cargo available for use to the general public, performed on the basis of a transport contract. Public transport costal liner shipping is the transport of passengers, cargo and vehicles in the internal marine waters and territorial sea ofthe Republic of Croatia performed on pre-established lines in compliance with the published terms and conditions of the sailing schedule and services pricelist. The Act on Transport in Liner Shipping and Occasional Costal Maritime Transport established the public transport system in the Republic of Croatia, ensuring regular connection of inhabited islands with the mainland and other inhabited islands, as well as between coastal towns, with an appropriate number of daily two-way connections, to improve the conditions of island life and stimulate their development. Prior to the accession of the Republic of Croatia to the European Union, the maritime liner shipping market in the Republic of Croatia was reserved primarily for Croatian shipping companies. Now, following the expiry of the transitional period negotiated in pre-accession negotiations with the European Union and the expiry of previously concluded concession contracts, the market is opening up to shipping companies from the European Economic Area. Hence, over the last couple of years, the Republic of Croatia was required to modify its legal framework regulating this subject matter. This paper presents novelties in the legal framework introduced in 2016 and 2017, which directly affect the opening of the maritime liner shipping market in the Republic of Croatia to shipping companies from the European Economic Area, with the critical analysis of the new solutions.

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