Tuberculosis in Poland in 2015

Abstract

Aim of the study: To evaluate the main features of TB epidemiology in 2015 in Poland and to compare with the data on the same phenomena in the EU/EEA countries.

Methods: Analysis of case – based data on TB patients from National TB Register, data on anti-TB drug susceptibility testing results in cases notified in 2015, data from National Institute of Public Health- National Institute of Hygiene on cases of tuberculosis as AIDS-defining disease, data from Central Statistical Office on deaths from tuberculosis based on death certificates, data from ECDC report „ European Centre for Disease Prevention and Control/WHO Regional Office for Europe. Tuberculosis surveillance and monitoring in Europe 2017. Stockholm: European Centre for Disease Prevention and Control, 2017”.

Results: 6430 TB cases were reported in Poland in 2015. The incidence rate was 16.7 cases per 100 000, with large variability between voivodeships from 8.3 to 26.5 per 100 000. The mean annual decrease of TB incidence in 2011- 2015 was 5.5%. 5757 cases were new, never treated i.e. 15.0 per 100 000. 673 cases i.e. 1.8 per 100 000 – 10.5% of all registered subjects were previously treated. The number of all notified pulmonary tuberculosis cases in 2015 was 6078 i.e. 15.8 per 100 000. Pulmonary cases represented 94.5% of all TB cases. The number of pulmonary TB cases with bacteriological confirmation was 4472 i.e. 11,6 per 100 000. In 2015, only 352 extrapulmonary TB cases were reported. Children accounted for 1.3% of all TB cases in Poland; 81 pediatric cases were notified. The incidence of tuberculosis has been growing along with the age group from 1.4 per 100 000 among children to 28.1 per 100 000 among patients aged 45 to 64 years. In the age group 65 years old and older the incidence was 26.9 per 100 000. The incidence among men i.e. 24.0 per 100 000 was >2 times higher than among women i.e. 9.9 per 100 000. The biggest difference in the TB incidence between the two sex groups occurred in persons aged 50 to 54 years – 45.6 vs. 12.4 and in subjects aged 55 to 59 years (53.3 vs. 12.8). The TB incidence in rural population was lower than in urban, respectively 16.5 per 100 000 and 16.9 per 100 000. The number of all registered culture positive TB cases, including cases previously treated, was 4630. Cultureconfirmed cases constituted 72.0% of all TB cases; culture-confirmed pulmonary TB – 73.6% of all pulmonary TB cases. The number of smear-positive/culture positive pulmonary TB cases reported in 2015 was 2714 i.e. 7.1 per 100 000 respectively what constituted 44.7% of all pulmonary TB cases. TB was initial AIDS indicative disease in 20 persons. In Poland in 2015 there were 35 cases with MDR-TB (among them 5 foreigners) and 95 patients with resistance solely to isoniazid, constituting respectively 0.8% and 2.3% of cases with known DST results (DSTs were done in 91.6% of all culture-confirmed TB cases). There were 52 cases of tuberculosis registered among foreigners in 2015. There were 526 deaths due to tuberculosis reported in 2014 – 1.4 per 100 000; 504 people died from pulmonary and 22 from extrapulmonary tuberculosis. Mortality among males – 2.2 per 100 000 – was 3.6 x higher than among females – 0.6. The highest mortality rate was in subjects 65 years old and older – 3.8 per 100 000. There were no deaths from tuberculosis in children. TB was cause of death in one adolescent. TB mortality in 2014 constituted 0.14% of total mortality in Poland and 27.4% of mortality from infectious diseases.

Conclusions: In Poland in 2015 the incidence of tuberculosis was lower than in the past but higher than the average in the EU/EEA countries. The highest incidence rates occurred in older age groups. The incidence in men was more than 2 times higher than in women. In Poland, tuberculosis in children, tuberculosis in persons infected with HIV and MDR-TB are less common than in the EU/EEA countries.

Keywords: tuberculosis (TB); TB cases; incidence; new cases; previously treated cases; pulmonary TB; extrapulmonary TB; TB confirmed by culture; TB in children and adolescents; foreign-origin TB cases; TB in prisons; TB/HIV coinfection; drug susceptibility; multi-drug resistant TB; mortality; Poland; the National uberculosis Register; 2015.