Despite notable progress in the past decade, tuberculosis (TB) is still a public health concern in many countries across Europe. The high rates of TB and multidrug-resistant TB outside the European Union/European Economic Area (EU/EEA) are of particular concern, as are the significant number of TB cases among vulnerable populations within the EU/EEA.

1. World Tuberculosis Day 2016
TB situation in the EU/EEA, in 2014
Findings from the joint TB surveillance and monitoring report by ECDC
and WHO Regional Office for Europe
ECDC TB Team
European Centre for Disease Prevention and Control
Stockholm, 24 March 2016

2. TB Surveillance data, EU/EEA, 2014
2

3. TB notifications, EU/EEA, 2014
58 008 TB cases notified in 29 EU/EEA countries
Notification rate of 12.8 per 100 000 population
(range 2.5–79.7)
3
Not reporting
20 to 49 per 100 000
10 to 19 per 100 000
5 to 9 per 100 000
< 5 per 100 000
≥ 50 per 100 000
Source: European Centre for Disease Prevention and Control.
TB surveillance and monitoring in Europe, 2016.

4. Reported TB cases, EU/EEA, 2005 – 2014
Steady decline between 2005 and 2014:
• number of TB cases decreased by 35%
• notification rate decreased by 36%
4
0.0
2.0
4.0
6.0
8.0
10.0
12.0
14.0
16.0
18.0
20.0
10 000
20 000
30 000
40 000
50 000
60 000
70 000
80 000
90 000
2005 2006 2007 2008 2009 2010 2011 2012 2013 2014
TBcases/100000
TBcases
Year of reporting
TB cases TB cases/100 000
Source: European Centre for Disease Prevention and Control.
TB surveillance and monitoring in Europe, 2016.

5. Confirmed TB cases*, EU/EEA, 2014
5
70 to 79%
≥ 80%
60 to 69%
< 60%
Not reporting
* Confirmation identified by culture or by both sputum microscopy and
Mycobacterium tuberculosis nucleic acid amplification test
Source: European Centre for Disease Prevention and Control.
TB surveillance and monitoring in Europe, 2016.
65.3% of the reported TB cases were laboratory
confirmed (range 39.2–88.2%)

6. Notified previously treated TB cases,
EU/EEA, 2014
6
10 to 14.9%
≥ 15%
5 to 9.9%
< 5%
Not reporting
Source: European Centre for Disease Prevention and Control.
TB surveillance and monitoring in Europe, 2016.
11.5% of reported cases had been previously
treated (range 2.2–21.4%)

7. TB notification rate by age group, EU/EEA,
2005 – 2014
7
0.0
5.0
10.0
15.0
20.0
25.0
2005 2006 2007 2008 2009 2010 2011 2012 2013 2014
TBcases/100000
Year of reporting
0-4 5-14 15-24 25-44 45-64 65+
Source: European Centre for Disease Prevention and Control.
TB surveillance and monitoring in Europe, 2016.
Decreased by > 25% in all age groups over the period

8. Notified TB in children under 15, EU/EEA,
2014
8
Not reporting
4 to 9.9 per
100 000 child population
2 to 3.9 per
100 000 child population
≥ 10 per
100 000 child population
< 2 per
100 000 child population
Source: European Centre for Disease Prevention and Control.
TB surveillance and monitoring in Europe, 2016.
2 258 TB cases reported in children under 15 years.
That is 3.9% of all TB cases (range 0-13.7%) and
2.8 notifications per 100 000 child population (range
0–20.7).

9. Notified TB cases in persons of foreign
origin, EU/EEA, 2014
9
10 to 39.9%
≥ 75%
1 to 9.9%
40 to 74.9%
< 1%
Not reporting
Source: European Centre for Disease Prevention and Control.
TB surveillance and monitoring in Europe, 2016.
26.8% of TB cases occurred in persons of
foreign origin (range 0.3–100.0%)

10. Notified TB cases in persons of foreign
origin, EU/EEA, 2005 – 2014
10
* Slight decrease in the proportion of cases in persons of
foreign-origin in 2014, probably due to missing data from Italy
0
2
4
6
8
10
0
5
10
15
20
25
30
2005 2006 2007 2008 2009 2010 2011 2012 2013 2014
Cases/100000
Percentage
Year of reporting
Source: European Centre for Disease Prevention and Control.
TB surveillance and monitoring in Europe, 2016.
Percentage of cases in persons of foreign origin increased from
19% in 2005 to 27% in 2014.
Rate per 100 000 total population stable* between 3.4 and 3.8

11. Notified extrapulmonary TB cases, EU/EEA,
2014
11
10 to 19.9%
≥ 30%
0 to 9.9%
20 to 29.9%
Not reporting
Source: European Centre for Disease Prevention and Control.
TB surveillance and monitoring in Europe, 2016.
21.8% of TB cases were extrapulmonary TB
(range 3.2–46.0%)

12. Multidrug-resistant TB, EU/EEA, 2014
12
2 to 4.9%
≥ 10%
1 to 1.9%
5 to 9.9%
< 1%
Not reporting
* DST – drug susceptibility results reported for at least isoniazid and rifampicin
Source: European Centre for Disease Prevention and Control.
TB surveillance and monitoring in Europe, 2016.
4.0% of TB cases with DST* results were
multidrug-resistant (range 0–25.8%)

13. Multidrug-resistant TB notification rate,
EU/EEA, 2010 – 2014
13
0
0.1
0.2
0.3
0.4
0.5
2010 2011 2012 2013 2014
MDRTBcases/100000
Year of reporting
Source: European Centre for Disease Prevention and Control.
TB surveillance and monitoring in Europe, 2016.
Rate was stable at 0.3 per 100 000 population between
2010 and 2014

14. Multidrug resistance among new
pulmonary TB cases, EU/EEA, 2014
14
2 to 4.9%
≥ 10%
1 to 1.9%
5 to 9.9%
< 1%
Not reporting
Source: European Centre for Disease Prevention and Control.
TB surveillance and monitoring in Europe, 2016.
• DST – drug susceptibility test. (Results reported for at least isoniazid and
rifampicin)
2.4% of new pulmonary TB cases with DST*
results had multidrug-resistant TB
(range 0–19.5%)

15. Multidrug resistance among previously
treated pulmonary TB cases, EU/EEA, 2014
15
5 to 14.9%
≥ 25%
1 to 4.9%
15 to 24.9%
< 1%
Not reporting
Source: European Centre for Disease Prevention and Control.
TB surveillance and monitoring in Europe, 2016.
* DST – drug susceptibility test results for isoniazid and
rifampicin
17.7% (range 0–62.1%) of previously treated
pulmonary TB cases with DST* results had
multidrug-resistant TB

16. Extensively drug-resistant TB (XDR TB),
EU/EEA, 2014
16
10 to 14.9%
≥ 25%
1 to 9.9%
15 to 24.9%
< 1%
Not reporting
Source: European Centre for Disease Prevention and Control.
TB surveillance and monitoring in Europe, 2016.
* DST – drug susceptibility test
17.5% of MDR TB cases with 2nd line DST* were
extensively drug-resistant (range 0–50.0% and
5.7–26.1% for countries reporting more than one
case)

17. Notified TB/HIV co-infection, EU/EEA, 2014
17
10 to 14.9%
≥ 15%
1 to 9.9%
< 1%
Not reporting
* Among countries with at least 50% reporting completeness
for HIV status
Source: European Centre for Disease Prevention and Control.
TB surveillance and monitoring in Europe, 2016.
4.9% of TB cases with known HIV status*
were HIV positive (range 0–22.6%)

18. Treatment success of all TB cases, EU/EEA,
2014
18* Four EU/EEA Member States did not report treatment outcome data
0 10 20 30 40 50 60 70 80 90 100
EU/EEA
Luxembourg
Croatia
Cyprus
Finland
Denmark
Ireland
Poland
Germany
Lithuania
Czech Republic
Austria
Estonia
Portugal
Hungary
Malta
Spain
Latvia
Slovenia
Belgium
Romania
United Kingdom
Bulgaria
Norway
Netherlands
Sweden
Iceland
Slovakia
Treatment success (%)
Source: European Centre for Disease Prevention and Control.
TB surveillance and monitoring in Europe, 2016.
74.0% of all TB cases* had a successful treatment outcome after
12 months (range 0.0–92.8%)

19. Treatment success, EU/EEA, 2014
19* Four EU/EEA Member States did not report treatment outcome data
≥ 85%
60 to 84.9%
< 60%
Not reporting
Source: European Centre for Disease Prevention and Control.
TB surveillance and monitoring in Europe, 2016.
Treatment success rate for all TB cases has
been stable at 75% over the past five years

20. Treatment success in new confirmed
pulmonary TB cases and relapses, started
on treatment in 2013*, EU/EEA, 2014
20
* Cases started on second line treatment are excluded
0 20 40 60 80 100 120
EU/EEA
Cyprus
Finlande
Poland
Ireland
Denmark
Germany
Portugal
Czech Republic
Spain
Malta
Hungary
Austria
Lithuania
Belgium
Slovenia
United Kingdom
Latvia
Romania
Bulgaria
Netherlands
Norway
Sweden
Estonia
Slovakia
Iceland
Treatment success (%)
Source: European Centre for Disease Prevention and Control.
TB surveillance and monitoring in Europe, 2016.
77.6% of new confirmed pulmonary cases and relapses had a
successful treatment outcome (range 50.0–100.0%)

21. 21* Four EU/EEA Member States did not report treatment outcome data
≥ 85%
60 to 84.9%
< 60%
Not reporting
Source: European Centre for Disease Prevention and Control.
TB surveillance and monitoring in Europe, 2016.
77.6% of new confirmed pulmonary TB cases
and relapses had a successful treatment
outcome (range 50.0-100.0%).
Treatment success in new confirmed
pulmonary TB cases and relapses started
on treatment in 2013*, EU/EEA, 2014

22. Treatment success in multidrug-resistant
TB*, EU/EEA, 2014
22
* Cyprus, Luxembourg, Malta and Slovenia reported zero MDR TB cases in 2012, nine
Member States did not report treatment outcome data for MDR TB cases
0 10 20 30 40 50 60 70 80 90
EU/EEA
Slovakia
Poland
Czech Republic
Romania
Norway
Lithuania
Hungary
Germany
Portugal
Austria
United Kingdom
Bulgaria
Latvia
Estonia
Belgium
Netherlands
Ireland
Sweden
Treatment success (%)
Source: European Centre for Disease Prevention and Control.
TB surveillance and monitoring in Europe, 2016.
40.3% was the success rate for all multidrug-resistant TB cases
notified in 2012 (range 0–85.7%)

23. Treatment success in all cases with
multidrug-resistant TB*, EU/EEA, 2014
23
≥ 70%
40 to 69.9%
< 40%
Not reporting
* Cyprus, Luxembourg, Malta and Slovenia reported zero MDR TB cases in 2012.
Nine Member States did not report treatment outcome data for MDR TB cases.
Source: European Centre for Disease Prevention and Control.
TB surveillance and monitoring in Europe, 2016.
40.3% was the success rate for all multidrug-
resistant TB cases notified in 2012
(range 0–85.7%)

24. Treatment outcomes in MDR TB notified
in 2010-2012, EU/EEA, 2014
24
0
10
20
30
40
50
Success Died Failed Defaulted or
unknown
Still on
treatment
Percentage
MDR TB cohort 2010 MDR TB cohort 2011 MDR TB cohort 2012
Source: European Centre for Disease Prevention and Control.
TB surveillance and monitoring in Europe, 2016.
Treatment success rates increased from 32% to 40% in the 2010,
2011 and 2012 cohorts

25. 25
Treatment success in extensively drug-
resistant TB (XDR TB) cases, EU/EEA, 2014
25
* Bulgaria, Cyprus, Denmark, Slovakia and Slovenia reported zero XDR TB cases in 2011. 13 countries
did not report second line drug susceptibility testing results or XDR TB treatment outcome data.
0 20 40 60 80 100
EU/EEA
Czech Republic
Poland
Romania
Lithuania
Estonia
United Kingdom
Austria
Latvia
Portugal
Belgium
Germany
Treatment success (%)
Source: European Centre for Disease Prevention and Control.
TB surveillance and monitoring in Europe, 2016.
33.8% was the success rate in extensively drug-resistant TB cases
notified in 2011 (range 0–100.0%)