Tuberculosis Surveillance in Romania Among Vulnerable Risk Groups Between 2015 and 2017

Ioana Munteanu; Nicoleta Cioran; Rob van Hest; Ibrahim Abubakar; Alistair Story; Domnica Chiotan; Gerard de Vries; Beatrice Mahler

doi:10.2147/TCRM.S347748

Tuberculosis Surveillance in Romania Among Vulnerable Risk Groups Between 2015 and 2017

Ther Clin Risk Manag. 2022 Apr 20:18:439-446. doi: 10.2147/TCRM.S347748. eCollection 2022.

Authors

Ioana Munteanu¹, Nicoleta Cioran^{1

2}, Rob van Hest^{3

4}, Ibrahim Abubakar⁵, Alistair Story^{6

7}, Domnica Chiotan¹, Gerard de Vries^{8

9}, Beatrice Mahler^{1

10}

Affiliations

¹ Department of Pneumology, Marius Nasta Institute of Pneumology, Bucharest, Romania.
² 3rd Department - Complementary Sciences, "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania.
³ Department of Tuberculosis Control, Regional Public Health Service Groningen, Groningen, The Netherlands.
⁴ Department of Lung Diseases and Tuberculosis, University Medical Centre Groningen (UMCG), Groningen, The Netherlands.
⁵ Institute for Global Health, University College London, London, UK.
⁶ Institute of Health Informatics, University College London, London, UK.
⁷ Find and Treat, University College Hospitals NHS Foundation Trust, London, UK.
⁸ KNCV Tuberculosis Foundation, The Hague, The Netherlands.
⁹ Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, The Netherlands.
¹⁰ 4th Department - Cardio-Thoracic Pathology, "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania.

Abstract

Purpose: Romania has the highest tuberculosis (TB) burden in the European Union/European Economic Area (EU/EEA) comprising almost a quarter (23.4%) of the reported patients in 2017, and a TB notification rate six times higher than the EU/EEA average. Although the overall TB notification rate in Romania declined from 154/100.000 individuals to 66/100.000 individuals in the general population between 2002 and 2017, TB notification rates remain high in certain vulnerable populations groups such as prisoners, the homeless population and among drug users.

Patients and methods: We conducted a descriptive study regarding TB monitoring data in Romania, including the aforementioned TB risk groups.

Results: Analysis regarding notified TB cases among these risk groups indicates that TB rates are 7 to 18 times higher than in the general population. One of the most alarming aspects regards the exceedingly high proportion of HIV-seropositivity among drug users and the high mortality rates among the homeless population and among drug users with TB.

Conclusion: This data underlines the importance of early identification among social risk groups using outreach active case-finding (ACF) activities, possibly combining TB screening with screening for other common, possibly life-threatening, co-morbidities for which an effective treatment is available. ACF could have a decisive role in TB control and eradication in Romania, when aimed at these high-risk groups.

Keywords: Romania; notification rate; risk groups; tuberculosis.