A new report from the European Centre for Disease Prevention and Control (ECDC) shows tuberculosis (TB) cases fell across the continent in 2021, but progress toward reaching TB reduction goals remains slow.
The report, published yesterday, shows that the 30 countries of the European Union/European Economic Area (EU/EEA) reported a total of 33,527 TB cases in 2021, for a notification rate of 7.4 cases per 100,000 population. That continues a downward trend observed since 2002.
But country-specific TB notification rates ranged widely, from 1.9 per 100,000 population in Iceland and Greece to 41.6 in Romania, which accounted for nearly 25% of all cases in 2021. In addition, the ECDC said the decline could reflect the continuing impact of the COVID-19 pandemic, which affected TB clinical services and surveillance around the world, resulting in fewer diagnoses.
The ECDC noted that rifampicin resistance/multidrug resistance (RR/MDR) was reported in 4.2% of 16,544 TB cases that received drug susceptibility testing, and that extensive drug resistance (XDR) was reported for 54.4% of 742 MDR-TB cases that underwent second-line drug susceptibility testing. That's up from 45.1% in 2020.
Challenges in achieving TB elimination
The ECDC also noted that, despite the decline in TB notifications, the EU/EEA is still not on track to meet the United Nations Sustainable Development Goal of 2.4 cases TB per 100,000 population by 2030, which would be an 80% reduction from the 2015 TB notification rate.
EU/EEA countries also need to improve on the treatment success rate, which was 71.7% in 2021, well below the World Health Organization (WHO) target rate of 85%.
Despite ongoing progress toward reaching the goals set by the United Nations and WHO, countries continue to face several challenges in achieving elimination.
"If the continued decline in TB incidence also observed during 2021 was real and not solely an artefact of the COVID-19 pandemic, this report indicates that despite ongoing progress toward reaching the goals set by the United Nations and WHO, countries continue to face several challenges in achieving elimination," the ECDC wrote. "Additional resources will be required to accelerate progress towards achieving these goals and to counteract any increase in TB cases resulting from the impact of the COVID-19 pandemic on TB services."