Towards tackling tuberculosis in vulnerable groups in the European Union: the E-DETECT TB consortium

Abstract

Tuberculosis (TB) in the European Union (EU) is increasingly a public health problem that disproportionately and increasingly affects risk groups. The 30 EU/European Economic Area (EEA) countries reported 60 195 cases of TB in 2015; 4.1% of which was multidrug-resistant (MDR) TB [1]. The European Respiratory Society, the World Health Organization (WHO) European Region, European Centre for Disease Prevention and Control (ECDC) and other partners have articulated potential solutions that are embedded into the new global approach for TB control, the End TB Strategy [2][3][4][5]. Within the context of the TB elimination framework for low-incidence countries in Western Europe [5], and the TB action plan for the WHO European Region 2016-2020 that addresses the whole region with greater emphasis on high-burden countries [6], it is apparent that concrete trans-national evidence-based interventional projects are needed. To address the high disease burden of TB in vulnerable EU populations we have formed the Early DETECTion of tuberculosis consortium (E-DETECT TB). It brings together world leading TB experts in national public health agencies with industry and major academic centres, and its membership reflects the incidence of TB in different EU countries (figure 1). E-DETECT TB uses evidenced-based approaches to target vulnerable populations, including migrants to the EU, homeless persons, prisoners, problem drug users and those with MDR-TB (table 1). Here we outline the key objectives and progress of this major European TB initiative with a special focus on migrant screening in Italy and active case finding in vulnerable groups in Romania.Romania has the highest TB burden in the EU/EEA with more than a quarter (15 195) of the reported patients, and with the highest notification rate of 76 per 100 000 population, which is seven times higher than the EU/EEA average. The number of patients in Romania has declined dramatically since 2005 when

Effectiveness of interventions for reducing TB incidence in countries with low TB incidence: a systematic review of reviews

“…This systematic review was conducted as part of the European Commission funded E-DETECT TB (Early Detection and Integrated Management of Tuberculosis in Europe) project, which aims to improve TB control efforts across Europe through translational research designed to reach high-risk groups in EU/EEA countries, as well as the development of a practical evidence-based toolkit to support development and implementation of national TB plans [9,10]. The review protocol was defined in advance and registered with PROSPERO (www.crd.york.ac.uk/prospero/ CRD42017060096).…”

Tuberculosis in migrants – screening, surveillance and ethics

“…Electronic TB databases, such as E-detect in Europe [34] and eMedical in Australia [35] have been established for the better surveillance and epidemiological analysis to inform future TB control interventions [36]. E-detect arose from a tuberculosis consortium, shared by 6 European Union countries, Sweeden, Netherlands, UK, Italy, Romaina and Bulgaria, bringing together world leading TB experts in national public health agencies with industry and major academic centres to address the high disease burden of TB and multi-drug resistant TB through evidenced-based interventions, in vulnerable EU populations, including migrants [37]. E-detect is geared towards TB diagnosis and detection among new and settled asylum seekers and refugees and, importantly, linking patients into the health care system once they have been diagnosed.…”

Evaluation of the latent tuberculosis screening and treatment strategy for asylum seekers in Stockholm, Sweden 2015–2018: a record linkage study of the care cascade

“…It plans expansion to additional countries with a view to build a European migrant TB screening database that may inform policy in the participant countries, in Europe and globally. [10,26]…”