Therapeutics and Clinical Risk Management (Apr 2022)

Tuberculosis Surveillance in Romania Among Vulnerable Risk Groups Between 2015 and 2017

  • Munteanu I,
  • Cioran N,
  • van Hest R,
  • Abubakar I,
  • Story A,
  • Chiotan D,
  • de Vries G,
  • Mahler B

Journal volume & issue
Vol. Volume 18
pp. 439 – 446

Abstract

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Ioana Munteanu,1 Nicoleta Cioran,1,2 Rob van Hest,3,4 Ibrahim Abubakar,5 Alistair Story,6,7 Domnica Chiotan,1 Gerard de Vries,8,9 Beatrice Mahler1,10 1Department of Pneumology, Marius Nasta Institute of Pneumology, Bucharest, Romania; 2 3rd Department – Complementary Sciences, “Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania; 3Department of Tuberculosis Control, Regional Public Health Service Groningen, Groningen, The Netherlands; 4Department of Lung Diseases and Tuberculosis, University Medical Centre Groningen (UMCG), Groningen, The Netherlands; 5Institute for Global Health, University College London, London, UK; 6Institute of Health Informatics, University College London, London, UK; 7Find and Treat, University College Hospitals NHS Foundation Trust, London, UK; 8KNCV Tuberculosis Foundation, The Hague, The Netherlands; 9Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, The Netherlands; 10 4th Department – Cardio-Thoracic Pathology, “Carol Davila” University of Medicine and Pharmacy, Bucharest, RomaniaCorrespondence: Nicoleta Cioran, Department of Pneumology, Marius Nasta Institute of Pneumology, Soseaua Viilor nr.90, Sector 5, Bucharest, Romania, Tel +40 745 419 994, Fax +40 213 373 801, Email [email protected]: Romania has the highest tuberculosis (TB) burden in the European Union/European Economic Area (EU/EEA) comprising almost a quarter (23.4%) of the reported patients in 2017, and a TB notification rate six times higher than the EU/EEA average. Although the overall TB notification rate in Romania declined from 154/100.000 individuals to 66/100.000 individuals in the general population between 2002 and 2017, TB notification rates remain high in certain vulnerable populations groups such as prisoners, the homeless population and among drug users.Patients and Methods: We conducted a descriptive study regarding TB monitoring data in Romania, including the aforementioned TB risk groups.Results: Analysis regarding notified TB cases among these risk groups indicates that TB rates are 7 to 18 times higher than in the general population. One of the most alarming aspects regards the exceedingly high proportion of HIV-seropositivity among drug users and the high mortality rates among the homeless population and among drug users with TB.Conclusion: This data underlines the importance of early identification among social risk groups using outreach active case-finding (ACF) activities, possibly combining TB screening with screening for other common, possibly life-threatening, co-morbidities for which an effective treatment is available. ACF could have a decisive role in TB control and eradication in Romania, when aimed at these high-risk groups.Keywords: Romania, tuberculosis, notification rate, risk groups

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