[Epidemiology and control of tuberculosis in Italy]

In 2008, incidence of tuberculosis in Europe was 52.2 cases per 100,000 population, with lower rates in European Union (average 16.7 per 100.000) e and rates above 100 per 100.000 in the former Soviet Union. In Italy, incidence rates of tuberculosis have been fairly stable in the last two decades around 7 reported cases per 100.000 population. However, the epidemiological picture has clearly changed. Spread of HIV infection and immigration from high incidence countries had a major impact on epidemiological dynamics. In particular, the proportion of reported cases occurring among persons born in high incidence countries increase during the last decade, and it is now close to 50%. A similar trend has been observed in most Western European countries. Strategies for tuberculosis control should include: a general approach to tuberculosis which favor access to care and ensures rapid detection and treatment of all the cases; screening and provision of preventive treatment for contacts of contagious cases and for persons in other high risk groups. Upstream social determinants of tuberculosis need also to be addressed in order to move towards the goal of tuberculosis elimination.