scholarly journals A Framework Action Plan to fight Tuberculosis in the European Union

2008 ◽  
Vol 13 (12) ◽  
pp. 5-6
Author(s):  
K Fernandez de la Hoz ◽  
D Manissero ◽  
on behalf of the Tuberculosis Disease Programme*
Keyword(s):  
European Union ◽  
Action Plan ◽  
Multidrug Resistant ◽  
Incidence Rates ◽  
Vulnerable Groups ◽  
The European Union ◽  
Eu Member States ◽  
Resistant Tuberculosis ◽  
Mdr Tb ◽  
Low Incidence

Many European Union (EU) Member States show a decline in tuberculosis (TB) incidence and many have low incidence rates (15 countries reported less than 10 cases per 100,000 population in 2006). However, despite the progress in curbing the TB epidemic, the disease remains a public health threat in the EU. The epidemiological patterns are still very diverse between countries and control efforts are challenged by problems such as multidrug-resistant (MDR TB) and extensively drug-resistant tuberculosis (XDR TB), TB/HIV co-infection and the concentration of cases within vulnerable groups.

scholarly journals A joint cross-border investigation of a cluster of multidrug-resistant tuberculosis in Austria, Romania and Germany in 2014 using classic, genotyping and whole genome sequencing methods: lessons learnt

2017 ◽  
Vol 22 (2) ◽  
Author(s):  
Lena Fiebig ◽  
Thomas A Kohl ◽  
Odette Popovici ◽  
Margarita Mühlenfeld ◽  
Alexander Indra ◽  
...  
Keyword(s):  
Whole Genome Sequencing ◽  
Genome Sequencing ◽  
Universal Access ◽  
Multidrug Resistant ◽  
Whole Genome ◽  
The European Union ◽  
Cross Border ◽  
Resistant Tuberculosis ◽  
Multidrug Resistant Tuberculosis ◽  
Mdr Tb

Molecular surveillance of multidrug-resistant tuberculosis (MDR-TB) using 24-loci MIRU-VNTR in the European Union suggests the occurrence of international transmission. In early 2014, Austria detected a molecular MDR-TB cluster of five isolates. Links to Romania and Germany prompted the three countries to investigate possible cross-border MDR-TB transmission jointly. We searched genotyping databases, genotyped additional isolates from Romania, used whole genome sequencing (WGS) to infer putative transmission links, and investigated pairwise epidemiological links and patient mobility. Ten isolates from 10 patients shared the same 24-loci MIRU-VNTR pattern. Within this cluster, WGS defined two subgroups of four patients each. The first comprised an MDR-TB patient from Romania who had sought medical care in Austria and two patients from Austria. The second comprised patients, two of them epidemiologically linked, who lived in three different countries but had the same city of provenance in Romania. Our findings strongly suggested that the two cases in Austrian citizens resulted from a newly introduced MDR-TB strain, followed by domestic transmission. For the other cases, transmission probably occurred in the same city of provenance. To prevent further MDR-TB transmission, we need to ensure universal access to early and adequate therapy and collaborate closely in tuberculosis care beyond administrative borders.

Comparative characteristics of the epidemiological situation of chemoresistant tuberculosis in Germany and Ukraine

2021 ◽  
pp. 27-35
Author(s):  
I. Friesen ◽  
T. Ulrichs ◽  
L. Hryshchuk ◽  
H. Saturska
Keyword(s):  
Treatment Success ◽  
Scale Up ◽  
Multidrug Resistant ◽  
Incidence Rates ◽  
Resistant Tuberculosis ◽  
Epidemiological Trend ◽  
Poor Treatment ◽  
Mdr Tb ◽  
Detection And Diagnosis ◽  
Epidemiological Situation

Objective — to compare the epidemiological situation of chemoresistant tuberculosis in Germany and Ukraine, in addition analyzing the nature and features of chemoresistant tuberculosis in 192 patients treated at the Ternopil Regional TB Dispensary Ukraine during 2017—2018. Materials and methods. In order to study the comparative characteristics of the epidemiological situation with chemoresistant tuberculosis in Germany and Ukraine, modern literature sources were used with the search query «epidemiological situation with chemoresistant tuberculosis in Germany», «epidemiological situation with chemoresistant tuberculosis in Ukraine». Separatelly a retrospective cohort study was conducted. The nature and features of the course of chemoresistant tuberculosis in 192 patients who were treated in the Ternopil Regional TB Dispensary during 2017—2018 were analyzed. Results and discussion. Analysis of literature sources showed that multidrug resistant Tuberculosis (MDR-TB) is relatively seldom in Germany with around 100 cases annually. Overall, the epidemiological situation of MDR-TB has been stable since the beginning of the statistical recording of the disease in 2002. In 2013, the highest proportion of MDR TB was registered at 3.3 %. Detailed analysis of notifi cation data shows that the tuberculosis situation in Germany is mainly influenced by migratory movements and demographic changes in the population. Despite the positive overall epidemiological trend with decreasing incidence rates, however, the burden of TB in Ukraine remains significant. According to the latest WHO estimates for 2018, TB incidence in the country(new cases and relapses) is the 4th highest among 53 countries of the WHO European Region.To address the situation, reduce TB prevalence, scale up TB early detection and diagnosis, and ensure effective treatment, Ukraine adopted, in 2019, the 2020–2023 State Strategy for Development of Anti-Tuberculosis Care for the Population.The analysis performed of 192 patients of the MDR/XDR-TB Cohort from the TB-Dispensary Hospital in Ternopil (Ukraine) from 2017—2018, showed that the resistanse of mycobacteria to anti-TB drugs was dominated by cases of MDR-TB — 57.3 %. Among patients first diagnosed were 52.6 %, relapses were 46.4 %. Destruction in the lungs was detected in 71.9 %. 111 patients (57.8 %) had treatment success, and 81 (42.2 %) had poor treatment outcomes or were lost to follow-up. Conclusions. The epidemiological situation of tuberculosis in Germany is stable and improving. Despite the positive overall epidemiological trend, the burden of TB in Ukraine remains significant. In 2018, TB incidence in the country (new cases and relapses) was 80 per 100 thousands population. In Ukraine during the period (2015—2018), the proportion of «pre-XDR» and XDR cases increased from 47.4 to 51.3 %. Among patients with chemoresistant tuberculosis, MR TB predominates (57.3 %), with destruction in the lungs and only 57.8% are effectively treated.

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 Eligibility for shorter treatment of multidrug-resistant tuberculosis in the European Union

2017 ◽  
Vol 49 (3) ◽  
pp. 1601992 ◽  
Author(s):  
Marieke J. van der Werf ◽  
Vahur Hollo ◽  
Csaba Ködmön ◽  
Masoud Dara ◽  
Mike Catchpole
Keyword(s):  
European Union ◽  
Multidrug Resistant ◽  
The European Union ◽  
Resistant Tuberculosis ◽  
Multidrug Resistant Tuberculosis

scholarly journals Explaining the Variations in the Magnitude of Undeclared Work Across the 28 European Union Member States

2020 ◽  
pp. 203-223
Keyword(s):  
European Union ◽  
Policy Implications ◽  
Vulnerable Groups ◽  
The European Union ◽  
Member States ◽  
Eu Member States ◽  
Input Method ◽  
Undeclared Work ◽  
European Union Member States ◽  
Reporting Data

This paper evaluates the competing theories that seek to explain the greater magnitude of undeclared work in some nations than others. These theories variously explain the higher levels of undeclared work in some nations to be determined by either economic under-development and the lack of modern governance ("modernisation" theory), higher taxes and state over-interference ("neo-liberal" theory) or inadequate government intervention in work and welfare ("political economy" theory). Reporting data on the magnitude of undeclared work in the 28 member states of the European Union using the labour input method, the finding is that undeclared work is higher in EU member states with lower levels of GDP per capita, less modernised systems of government, higher levels of corruption, social transfers are less effective at reducing poverty, and there are lower levels of public expenditure on labour market interventions to protect vulnerable groups. The theoretical and policy implications are then discussed.

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 Transformation of joint EU defence capacities: A review of european defence action plan

2017 ◽  
Vol 69 (1) ◽  
pp. 5-19
Author(s):  
Milan Igrutinovic
Keyword(s):  
European Union ◽  
Action Plan ◽  
Global Strategy ◽  
The European Union ◽  
Political Aspect ◽  
Eu Member States ◽  
Rational Development ◽  
Defence Spending ◽  
Security Challenges ◽  
The Eu

The paper deals with activities aimed at the implementation of the EU Global Strategy tied to the effort to further integrate research and development of defence technologies through European Defence Action Plan adopted in November 2016. The author analyses the combined effect of multi-faceted security challenges that the European Union faces and the perception of a decreased and inadequate defence spending in the previous years. The part of the analysis focuses on the political aspect of security challenges and how Brussels? administration responds to those challenges. The author maintains that new European Union Global Strategy is based on the drive for the more rational development of defence industry, which is clearly manifested in setting up a new European Defence Fund as an instrument of the European Defence Action Plan. The recently designed institutional framework followed by adequate financial support may serve as a nudge to the EU Member States to make concrete steps towards the integration of their respective national defence capacities.

scholarly journals The value of the continuous genotyping of multi-drug resistant tuberculosis over 20 years in Spain

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
María José Iglesias ◽  
◽  
Daniel Ibarz ◽  
Alberto Cebollada ◽  
Jéssica Comín ◽  
...  
Keyword(s):  
Age Groups ◽  
Public Health Problem ◽  
Multidrug Resistant ◽  
Drug Resistant ◽  
The European Union ◽  
Drug Resistant Tuberculosis ◽  
Resistant Tuberculosis ◽  
Mdr Tb ◽  
Epidemiological Characteristics ◽  
Over Time

AbstractMolecular epidemiology of circulating clinical isolates is crucial to improve prevention strategies. The Spanish Working Group on multidrug resistant tuberculosis (MDR-TB) is a network that monitors the MDR-TB isolates in Spain since 1998. The aim of this study was to present the study of the MDR-TB and extensively drug-resistant tuberculosis (XDR-TB) patterns in Spain using the different recommended genotyping methods over time by a national coordinated system. Based on the proposed genotyping methods in the European Union until 2018, the preservation of one method, MIRU-VNTR, applied to selected clustered strains permitted to maintain our study open for 20 years. The distribution of demographic, clinical and epidemiological characteristics of clustered and non-clustered cases of MDR/XDR tuberculosis with proportion differences as assessed by Pearson’s chi-squared or Fisher’s exact test was compared. The differences in the quantitative variables using the Student's-t test and the Mann–Whitney U test were evaluated. The results obtained showed a total of 48.4% of the cases grouped in 77 clusters. Younger age groups, having a known TB case contact (10.2% vs 4.7%) and XDR-TB (16.5% vs 1.8%) were significantly associated with clustering. The largest cluster corresponded to a Mycobacterium bovis strain mainly spread during the nineties. A total of 68.4% of the clusters detected were distributed among the different Spanish regions and six clusters involving 104 cases were grouped in 17 and 18 years. Comparison of the genotypes obtained with those European genotypes included in The European Surveillance System (TESSy) showed that 87 cases had become part of 20 European clusters. The continuity of MDR strain genotyping in time has offered a widespread picture of the situation that allows better management of this public health problem. It also shows the advantage of maintaining one genotyping method over time, which allowed the comparison between ancient, present and future samples.

E-health developments in the system of health services in Hungary and the European Union

2014 ◽  
Vol 155 (21) ◽  
pp. 822-827
Author(s):  
Ágnes Váradi
Keyword(s):  
Health Care ◽  
European Union ◽  
Public Discourse ◽  
Action Plan ◽  
Fundamental Rights ◽  
Public Health Care ◽  
The European Union ◽  
Contemporary Issue ◽  
Definition Of ◽  
Basic Features

The question of electronic solutions in public health care has become a contemporary issue at the European Union level since the action plan of the Commission on the e-health developments of the period between 2012 and 2020 has been published. In Hungary this issue has been placed into the centre of attention after a draft on modifications of regulations in health-care has been released for public discourse, which – if accepted – would lay down the basics of an electronic heath-service system. The aim of this paper is to review the basic features of e-health solutions in Hungary and the European Union with the help of the most important pieces of legislation, documents of the European Union institutions and sources from secondary literature. When examining the definition of the basic goals and instruments of the development, differences between the European Union and national approaches can be detected. Examination of recent developmental programs and existing models seem to reveal difficulties in creating interoperability and financing such projects. Finally, the review is completed by the aspects of jurisdiction and fundamental rights. It is concluded that these issues are mandatory to delineate the legislative, economic and technological framework for the development of the e-health systems. Orv. Hetil., 2014, 155(21), 822–827.

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