The present project (EuroTB) builds on previous developments and intends to strengthen TB surveillance capacity at Community level taking into account the enlargement to the 10 new Member States and the need to prepare the future TB surveillance activities of the new European Centre for Disease Prevention and Control (ECDC).Its general objectives are to enhance surveillance of TB in EU and in the third countries in Europe and to apply innovative technologies to strengthen identification of emerging TB issues in Europe, including multidrug resistant TB (MDR-TB). Surveillance activities focus on the 25 Member States, EEA/EFTA and applicant countries and include as a core component the collection, validation, analysis and dissemination of data from national TB case reporting systems, based on individual case data sets. In these countries, beyond annual data collection on TB case notification, EuroTB is intended to: conduct ad hoc surveys on emerging issues in TB control and enlarge the panel of information on the characteristics and outcomes of TB control programmes; strengthen collaboration with other EU surveillance schemes (e.g. on HIV/AIDS, antimicrobial resistance) and projects (e.g. on training and on information dissemination).
Tuberculosis (TB) is an increasing public health threat in Europe. In the Eastern European countries, including the newly acceded EU countries, TB incidence is higher than the EU average. TB incidence rates are elevated in the population arriving in the EU from highly endemic areas. Rates of multidrug resistant TB are extremely high in the Baltic States and in other former countries of the Soviet Union bordering the enlarged EU. Enlargement and issues related to population mobility in the EU are likely to increase the opportunity for TB transmission. In this changing environment, a coordinated European approach to TB surveillance and control is needed.
Surveillance of tuberculosis in Europe has provided an understanding of the threatening developments in the epidemiology of TB in Europe and has been instrumental in strengthening the contribution of surveillance to the control of TB in Europe. An approach to TB surveillance following consensus recommendations at Community level has led to the gradual development of annual collation and analysis of surveillance data on TB incidence, drug resistance and outcome of treatment in Europe with a broad geographic coverage of all EU member states, candidate countries and third countries in the WHO European Region, including the former countries of the Soviet Union. Major efforts have been devoted to improve data comparability. Standardised data from 52 national TB case reporting systems are currently collected, collated, analysed and distributed.
- EU surveillance of anti-TB drug resistance linked with case notification, complemented by a molecular surveillance system for MDR-TB, in collaboration with the national Public Health Institute of the Netherlands (RIVM). This system, which proved feasible on the basis of research, aims to link epidemiological and genotyping information and should promote national collaboration between public health authorities and reference laboratories. - Agreement within the network on principles for investigation and management of TB events of international relevance. In case information on or indications about a potential public health threat due to TB, information about such events should be immediately brought to the attention of the national designated authorities responsible for early warning in line with Commission Decision 2000/57/EC on the Early Warning and Response System for the prevention and control of communicable diseases. - Coverage of third countries in Europe to be maintained through continued coordination with WHO surveillance activities, through a joint collection of selected aggregate TB surveillance data. - Submission of individual data to EuroTB encouraged and supported. - Project deliverables, mainly directed to the Community Network (Decision 2119/98/EC) and the international TB community, include annual surveillance reports, annual updates of individual and aggregate data sets, MDR-TB cluster analysis, and newsletters informing participants and interested parties about project activities. - The data dissemination strategy is centred on the project website including online access to European TB data sets to participants, to be enlarged to the scientific community.
Work package 1: Strengthening TB surveillance in the EU Individual TB datasets updated yearly. Extractions of individual TB case data uploaded into WHO and, if set up and request by the Commission, the ECDCTB datasets to avoid duplication of country work. Web-based consultation of TB data will be expanded. An annual report including country profiles will be disseminated in the public health community and in relevant institutions in the EU. Work package 2: Supporting TB surveillance in third countries in Europe Validation of data from third countries will be mainly done by WHO staff. Submission of individual TB case reporting datasets to EuroTB will be supported. EuroTB staff will participate in on-site country support activities, such as assessment visits and training to improve surveillance in third countries, contributing to the missions of WHO. Work package 3: Molecular surveillance of multidrug resistant tuberculosis in Europe Anonymous epidemiological data on cases included in the genotype dataset will be collected at InVS from the countries through country specific flows. Linked epidemiological and molecular information on clusters will be disseminated to participants four times yearly. Principles of collaboration for cluster investigation will be developed in co-ordination with the relevant Member States authorities and public health agencies/surveillance institutes, the Commission and the ECDC. A final report will be published in 2007. Work package 4: Dissemination of results Scientific papers will be published in Eurosurveillance and in other peer-reviewed journals. Scientific communication will include participation in congresses of the International Union against Tuberculosis and lung diseases (UNION) and in other EU and international congresses. Work package 5: Project co-ordination The project coordinator will provide three management plan reports and reports of meetings and other activities.