Drug-resistant tuberculosis continues to spread: new report. Concern about childhood tuberculosis

Copenhagen, 18 March 2011

A new report, Tuberculosis surveillance in Europe 2009, a joint publication from the European Centre for Disease Prevention and Control (ECDC) and the WHO Regional Office for Europe to mark World TB Day 2011, provides evidence for concern about the spread of multidrug-resistant tuberculosis (MDR TB) and the persistence of TB among children. Concerted action is being undertaken in developing a regional MDR TB plan as well as addressing childhood TB.

While the European Union (EU)/European Economic Area (EEA) Member States continue to mark a decline in the overall notification, the report highlights the need to address childhood TB as a key component on the way towards TB elimination. Almost 40 000 TB cases in children were notified in the past decade with more than 3 300 reported cases in 2009. In addition, only 19% of all childhood TB cases were confirmed bacteriologically – clearly indicating that TB diagnosis in children remains a major challenge even within the EU/EEA.  

In the WHO European Region the notification rates of TB have been declining since 2005 with a regional average of 36.8 notifications per 100 000 population in 2009. However, notification rates of newly-detected and relapse TB cases in 18 high-priority countries (1) remain almost eight times higher than in the rest of the Region (73.0 compared to 9.2 per 100 000).

Treatment outcome rates are the lowest recorded globally with the highest MDR TB rates in the world recorded within the Region. The number of deaths and patients lost to follow-up are still a matter for concern. Vulnerable populations, including children, still do not have ready access to quality and timely diagnosis and treatment. This remains a matter of urgency given the high prevalence of multi-/extensively drug-resistant TB (M/XDR TB) in the Region. In response to the threat of M/XDR TB, the WHO Regional Office for Europe and its partners are finalizing a consolidated action plan for M/XDR-TB setting out a five-year strategy to curb the TB drug resistance epidemic in the Region.

Progress towards TB elimination across Europe can only be achieved by addressing those who are most vulnerable when it comes to TB control and prevention: children. ECDC – in collaboration with the Stop TB Partnership – convened a meeting of global experts in the field of childhood TB in Stockholm on 17 and 18 March 2011 to identify possible strategies to improve diagnostics, treatment and prevention in the field of childhood TB.

“The problem of drug-resistant TB needs bold and concrete actions: failure is not an option. This is why I have set up a special project to prevent and combat M/XDR TB,” says Zsuzsanna Jakab, WHO Regional Director for Europe. “An important part of our work with scientific and research institutes, and for the consolidated action plan, will be on new and rapid child-friendly diagnostic tools and treatment.”

ECDC Director, Dr Marc Sprenger, stressed: “Preventing TB infection in children is vital on the way to a TB-free generation in Europe. We need to show serious commitment to improve rapid and quality diagnosis as well as better treatment among children suffering from TB.”

The spread of antimicrobial resistance will be in the spotlight again on World Health Day, 7 April, which this year highlights this urgent problem not only for TB but for all infections that are increasingly difficult to treat because of drug resistance.

(1) The 18 high-priority countries are: Armenia, Azerbaijan, Belarus, Bulgaria, Estonia, Georgia, Kazakhstan, Kyrgyzstan, Latvia, Lithuania, Republic of Moldova, Romania, Russian Federation, Tajikistan, Turkey, Turkmenistan, Ukraine and Uzbekistan.


Viv Taylor Gee,
Regional Adviser, Communications
WHO Regional Office for Europe
Tel +45 39 17 12 31;
Mobile + 45 22 72 36 91   
E-mail: vge@euro.who.int

Hans Kluge
Director, Division of Health Systems
Special Representative of the Regional Director to Prevent and Combat Multidrug and extensively drug-resistant Tuberculosis (M/XDR-TB), 
Tel: +45 39 17 13 96;
Mobile: + 45 51 83 90 62
E-mail: hkl@euro.who.int