IngentaConnect Epidemiology and control of tuberculosis in Western European citi...

Authors: Hayward A.C.¹; Darton T.²; Van-Tam J.N.²; Watson J.M.³; Coker R.⁴; Schwoebel V.⁵

Source: The International Journal of Tuberculosis and Lung Disease, Volume 7, Number 8, August 2003 , pp. 751-757(7)

Publisher: International Union Against Tuberculosis and Lung Disease

Abstract:

SETTING: Major cities of Western Europe.

OBJECTIVE: To describe major variations in the epidemiology and control of tuberculosis in large Western European Cities.

DESIGN: Postal survey using contacts identified through the EURO-TB surveillance network.

RESULTS: Twenty cities responded. In most cities, notification rates were substantially higher than national rates. Rates ranged from less than 10 per 100000 in Reykjavik and Belfast to over 70 per 100 000 in Lisbon. MDR-TB ranged from less than 1% of cases in many cities to over 5% in Rome and Milan. The proportion of patients estimated to be HIV-positive ranged from less than 5% in many countries to over 20% in Milan. These variations in epidemiology were accompanied by major variations in control policy, particularly in approaches to new entrant screening and BCG vaccination.

CONCLUSION: In Western Europe, tuberculosis is primarily a problem of large cities. Some of these cities have very high rates of tuberculosis. There is little consensus about the best approaches to control. The evidence base for the effectiveness of different aspects of TB control needs to be strengthened.

Keywords: tuberculosis; epidemiology; control; cities; Europe

Document Type: Regular paper

Affiliations: 1: Centre for Infectious Disease Epidemiology—Department of Primary Care and Population Sciences, University College London, London, United Kingdom 2: Department of Public Health and Epidemiology, University of Nottingham, Nottingham, Nottinghamshire, United Kingdom 3: Communicable Disease Surveillance Centre, Health Protection Agency, London, United Kingdom 4: London School of Hygiene and Tropical Medicine, London, United Kingdom 5: Institute de Veille Sanitaire, EURO-TB, Saint-Maurice, Paris, France

Epidemiology and control of tuberculosis in Western European cities