Tuberculosis in Poland in 2018

AIM OF THE STUDY

To evaluate the main features of tuberculosis (TB) epidemiology in 2018 in Poland and to compare with the situation in the EU/EEA countries.

METHODS

Analysis of case- based data on TB patients from National TB Register, data on anti-TB drug susceptibility testing results in cases notified in 2018, data from National Institute of Public Health- National Institute of Hygiene on HIV-positive subjects for whom TB was an AIDS-defining disease, data from Central Statistical Office on deaths from tuberculosis based on death certificates, data from the report " European Centre for Disease Prevention and Control/WHO Regional Office for Europe. Tuberculosis surveillance and monitoring in Europe 2020- 2018 data. Stockholm: European Centre for Disease Prevention and Control, 2020".

RESULTS

In 2018, 5487 TB cases were reported in Poland. The incidence rate was 14.3 cases per 100000, with large variability between voivodeships from 7.3 to 23.4 per 100 000. The mean annual decrease of TB incidence in 2014- 2018 was 3.8%. In 2018, 4852 cases were newly diagnosed with no history of previous treatment i.e. 12.6 per 100 000. 635 cases i.e. 1.7 per 100 000 - 11.6% of all registered subjects were previously treated for tuberculosis. In 2018, the number of all pulmonary tuberculosis cases was 5224 i.e. 13.7 per 100000. Pulmonary cases represented 95.2% of all TB cases. In 2018, 243 extrapulmonary TB cases were found i.e. 0.6 per 100 000. In the whole country there were 52 pediatric cases of tuberculosis. TB in children represented 0.9% of all cases notified in Poland in 2018. The incidence rates of tuberculosis were growing along with the age group from 0.9 per 100 000 among children to 24.7 per 100 000 among subjects in the age group 45-64 years (the highest incidence rate). In 2018, the incidence rate in the age group ≥65 years was 21.3 per 100 000. The TB incidence among men i.e. 21.0 per 100 000 was 2.6 times higher than among women i.e. 8.0 per 100 000. The biggest difference in the TB incidence between the two sex groups occurred in persons aged 55 to 59 years - 44.9 vs. 9.8 and in age group 60- 64 years - 43.7 vs. 10.2. The TB incidence in rural population was lower than in urban, respectively 13.4 per 100 000 and 14.9 per 100 000. The number of all registered culture positive TB cases was 4075. Pulmonary tuberculosis was bacteriologically confirmed in 3935 subjects. Cases confirmed by culture represented 74.3% of all TB cases and 75.3% of all pulmonary TB cases. The number of smear-positive pulmonary TB cases reported in 2018 was 2324 i.e. 6.1 per 100 000 accounting for 44.3% of all pulmonary TB cases and 59.1% of pulmonary TB cases confirmed by culture. In all patients with tuberculosis in Poland in 2018 there were 48 cases with MDR-TB (among them 14 foreigners) and 83 patients with resistance to isoniazid only, representing respectively 1.3% and 2.2% of cases with known DST results (DSTs were available in 90.7% of all culture-confirmed TB cases). In 2018, there were 97 patients of foreign origin among all cases of tuberculosis in Poland. TB was AIDS-indicative disease in 14 subjects with HIV co-infection. There were 490 deaths due to tuberculosis reported in 2017 - 1.3 per 100 000; 468 people died from pulmonary and 22 from extrapulmonary tuberculosis. Mortality among males - 2.1 per 100 000 - was 3.6 X higher than among females - 0.5. 40.2% of all TB deaths were cases 65 years old and older - 3.1 per 100 000. In 2017, there was no death from tuberculosis in children and no deaths in adolescents. In 2017, tuberculosis represented 0.1% of total mortality in Poland and 25.4% of mortality from infectious and parasitic diseases.

CONCLUSIONS

In 2018, the incidence of tuberculosis in Poland was lower than in 2017. Despite a continuous decline it is still higher than the average in the EU/EEA countries. The highest incidence rates were observed in older age groups. The participation of pediatric cases is smaller than average in the EU/EEA countries. The incidence in males was more than 2 times higher than in females. The impact of migration on the characteristics of tuberculosis in Poland is not substantial. In Poland, MDR-TB is less common than the average in the EU/EEA countries.

Tuberculosis in Poland in 2016

AIM OF THE STUDY

To evaluate the main features of TB epidemiology in 2016 in Poland and to compare with the situation in the EU/EEA countries.

METHODS

Analysis of case- based data on TB patients from National TB Register, data on anti-TB drug susceptibility testing results in cases notified in 2016, data from National Institute of Public Health- National Institute of Hygiene on cases of tuberculosis as AIDS-defining disease, data from Central Statistical Office on deaths from tuberculosis based on death certificates, data from ECDC report „ European Centre for Disease Prevention and Control/WHO Regional Office for Europe. Tuberculosis surveillance and monitoring in Europe 2018- 2016 data. Stockholm: European Centre for Disease Prevention and Control, 2018”.

RESULTS

In 2016, 6 444 TB cases were reported in Poland. The incidence rate was 16.8 cases per 100 000, with large variability between voivodships from 8.1 to 24.3 per 100 000. The average decline of TB incidence was 3.0% per year during 2012- 2016. 5 713 cases were new, never treated i.e. 14.9 per 100 000. 731 cases i.e. 1.9 per 100 000 – 11.3% of all registered subjects were previously treated. In 2016, 6 116 pulmonary tuberculosis cases occurred in Poland, equivalent to 15.9 per 100 000. Pulmonary cases represented 94.9% of all TB cases. The number of pulmonary TB cases with bacteriological confirmation was 4475 i.e. 12,0 per 100 000. In 2016, only 328 extrapulmonary TB cases were reported. Pediatric cases represented 1.6% of the total TB cases in Poland; 103 children with TB were notified. The incidence of tuberculosis has been growing along with the age group from 1.8 per 100 000 among children to 27.8 per 100 000 among patients aged 45 to 64 years. In the age group 65 years old and older the incidence was 26.0 per 100 000. The incidence among men i.e. 24.0 per 100 000 was >2 times higher than among women i.e. 10.0 per 100 000. The biggest difference in the TB incidence between the two sex groups occurred in persons aged 55 to 59 years – 51.9 vs. 11.5 and in subjects aged 60 to 64 years (45.9 vs. 11.7). The TB incidence in urban population was higher than in rural, respectively 17.3 per 100 000 and 15.9 per 100 000. In 2016, the number of all culture positive TB cases was 4619. Culture-confirmed cases represented 71.7% of all TB cases; culture-confirmed pulmonary TB – 73.2% of all pulmonary TB cases. In 2016, the number of smear-positive/culture positive pulmonary TB cases was 2612 (6.8 per 100 000) what represented 42.7% of all pulmonary TB cases. TB was initial AIDS indicative disease in 17 persons. In 2016, 46 cases with MDR-TB (among them 10 foreigners) and 101 patients with resistance solely to isoniazid were reported in Poland, representing respectively 1.1% and 2.4% of cases with known DST results (DSTs were done in 90.7% of all culture-confirmed TB cases). In 2016, there were 92 TB cases of foreign origin. In 2015, there were 537 deaths due to tuberculosis in Poland, which is equivalent to 1.4 deaths per 100 000 population; 520 people died from pulmonary and 17 from extrapulmonary tuberculosis. Mortality among males – 2.3 per 100 000 – was 3.8 x higher than among females – 0.6. The highest mortality rate was observed in subjects 65 years old and older – 3.3 per 100 000. There were no deaths from tuberculosis in children and adolescents. In 2015, TB mortality represented 0.14% of total mortality in Poland and 28.0% of mortality from infectious diseases.

CONCLUSIONS

In 2016, the incidence of tuberculosis in Poland was slightly higher than in 2015 and higher than the average in the EU/EEA countries. The highest incidence rates were observed in older age groups. The incidence in males was more than 2 times higher than in females. The impact of migration on the characteristics of tuberculosis in Poland is low. In Poland, tuberculosis in children, tuberculosis in persons infected with HIV and MDR-TB is less common than the average in the EU/EEA countries.

Tuberculosis in Poland in 2015

AIM OF THE STUDY

To evaluate the main features of TB epidemiology in 2015 in Poland and to compare with the data on the same phenomena in the EU/EEA countries.

METHODS

Analysis of case – based data on TB patients from National TB Register, data on anti-TB drug susceptibility testing results in cases notified in 2015, data from National Institute of Public Health- National Institute of Hygiene on cases of tuberculosis as AIDS-defining disease, data from Central Statistical Office on deaths from tuberculosis based on death certificates, data from ECDC report „ European Centre for Disease Prevention and Control/WHO Regional Office for Europe. Tuberculosis surveillance and monitoring in Europe 2017. Stockholm: European Centre for Disease Prevention and Control, 2017”.

RESULTS

6430 TB cases were reported in Poland in 2015. The incidence rate was 16.7 cases per 100 000, with large variability between voivodeships from 8.3 to 26.5 per 100 000. The mean annual decrease of TB incidence in 2011- 2015 was 5.5%. 5757 cases were new, never treated i.e. 15.0 per 100 000. 673 cases i.e. 1.8 per 100 000 – 10.5% of all registered subjects were previously treated. The number of all notified pulmonary tuberculosis cases in 2015 was 6078 i.e. 15.8 per 100 000. Pulmonary cases represented 94.5% of all TB cases. The number of pulmonary TB cases with bacteriological confirmation was 4472 i.e. 11,6 per 100 000. In 2015, only 352 extrapulmonary TB cases were reported. Children accounted for 1.3% of all TB cases in Poland; 81 pediatric cases were notified. The incidence of tuberculosis has been growing along with the age group from 1.4 per 100 000 among children to 28.1 per 100 000 among patients aged 45 to 64 years. In the age group 65 years old and older the incidence was 26.9 per 100 000. The incidence among men i.e. 24.0 per 100 000 was >2 times higher than among women i.e. 9.9 per 100 000. The biggest difference in the TB incidence between the two sex groups occurred in persons aged 50 to 54 years – 45.6 vs. 12.4 and in subjects aged 55 to 59 years (53.3 vs. 12.8). The TB incidence in rural population was lower than in urban, respectively 16.5 per 100 000 and 16.9 per 100 000. The number of all registered culture positive TB cases, including cases previously treated, was 4630. Cultureconfirmed cases constituted 72.0% of all TB cases; culture-confirmed pulmonary TB – 73.6% of all pulmonary TB cases. The number of smear-positive/culture positive pulmonary TB cases reported in 2015 was 2714 i.e. 7.1 per 100 000 respectively what constituted 44.7% of all pulmonary TB cases. TB was initial AIDS indicative disease in 20 persons. In Poland in 2015 there were 35 cases with MDR-TB (among them 5 foreigners) and 95 patients with resistance solely to isoniazid, constituting respectively 0.8% and 2.3% of cases with known DST results (DSTs were done in 91.6% of all culture-confirmed TB cases). There were 52 cases of tuberculosis registered among foreigners in 2015. There were 526 deaths due to tuberculosis reported in 2014 – 1.4 per 100 000; 504 people died from pulmonary and 22 from extrapulmonary tuberculosis. Mortality among males – 2.2 per 100 000 – was 3.6 x higher than among females – 0.6. The highest mortality rate was in subjects 65 years old and older – 3.8 per 100 000. There were no deaths from tuberculosis in children. TB was cause of death in one adolescent. TB mortality in 2014 constituted 0.14% of total mortality in Poland and 27.4% of mortality from infectious diseases.

CONCLUSIONS

In Poland in 2015 the incidence of tuberculosis was lower than in the past but higher than the average in the EU/EEA countries. The highest incidence rates occurred in older age groups. The incidence in men was more than 2 times higher than in women. In Poland, tuberculosis in children, tuberculosis in persons infected with HIV and MDR-TB are less common than in the EU/EEA countries.