Tuberculosis elimination: theory and practice in Europe

Area of Science:

• Public Health
• Epidemiology
• Infectious Disease Control

Background:

• Europe identified a tuberculosis (TB) elimination pathway in 1990.
• Information on country preparedness programs for TB elimination in Europe is scarce.
• Low TB incidence countries (<20 cases/100,000 population) were surveyed.

Purpose of the Study:

• To assess the preparedness of European countries for tuberculosis (TB) elimination.
• To identify existing TB elimination activities and essential preparedness elements in low TB incidence European countries.

Main Methods:

• A questionnaire was distributed to national TB programme representatives in 38 European countries/territories.
• 31 countries provided complete answers regarding their TB elimination activities.
• Data collected included national TB programs, plans, guidelines, budgets, reference centers, surveillance, supervision, M&E, and drug availability.

Main Results:

• Only 54.8% of responding countries had a dedicated national TB programme, and 41.9% had elimination plans with targets.
• 71% had guidelines, but only 45.2% had a specific TB budget.
• Drug availability was a concern, with 71% reporting unavailability of all TB drugs and 38.7% experiencing stock-outs.
• While high-risk group screening occurred, only 19.4% reported preventive treatment completion rates.

Conclusions:

• Significant gaps exist in essential elements for tuberculosis (TB) elimination preparedness across low TB incidence European countries.
• Inconsistent availability of TB drugs and challenges in preventive treatment monitoring hinder progress.
• Strengthening national TB programmes, ensuring drug supply, and improving monitoring are crucial for achieving TB elimination in Europe.