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. 2020 Mar;25(12):1900568.
doi: 10.2807/1560-7917.ES.2020.25.12.1900568.

Completeness of tuberculosis (TB) notification: inventory studies and capture-recapture analyses, six European Union countries, 2014 to 2016

Masja Straetemans  1 , Mirjam I Bakker  1 , Sandra Alba  1 , Christina Mergenthaler  1 , Ente Rood  1 , Peter H Andersen  2 , Henrieke Schimmel  3 , Aleksandar Simunovic  4 , Petra Svetina  5 , Carlos Carvalho  6   7 , Outi Lyytikäinen  8 , Ibrahim Abubakar  9 , Ross J Harris  10   9 , Csaba Ködmön  11 , Marieke J van der Werf  11 , Rob van Hest  12   13
Affiliations

Completeness of tuberculosis (TB) notification: inventory studies and capture-recapture analyses, six European Union countries, 2014 to 2016

Masja Straetemans et al. Euro Surveill. 2020 Mar.

Abstract

BackgroundProgress towards the World Health Organization's End TB Strategy is monitored by assessing tuberculosis (TB) incidence, often derived from TB notification, assuming complete case detection and reporting. This assumption is unlikely to hold in many settings, including European Union (EU) countries.AimWe aimed to assess observed and estimated completeness of TB notification through inventory studies and capture-recapture (CRC) methodology in six EU countries: Croatia, Denmark, Finland, the Netherlands, Portugal Slovenia.MethodsWe performed record linkage, case ascertainment and CRC analyses of data collected retrospectively from at least three national TB-related registers in each country between 2014 and 2016.ResultsObserved completeness of TB notification by inventory studies was 73.9% in Croatia, 98.7% in Denmark, 83.6% in Finland, 81.6% in the Netherlands, 85.8% in Portugal and 100% in Slovenia. Subsequent CRC analysis estimated completeness of TB notification to be 98.4% in Denmark, 76.5% in Finland and 77.0% in Portugal. In Croatia, CRC analyses produced implausible results while in the Netherlands and Slovenia, it was methodologically considered not meaningful.ConclusionInventory studies and CRC methodology suggest a TB notification completeness between 73.9% and 100% in the six EU countries. Mandatory reporting by clinicians and laboratories, and cross-checking of registers, strongly contributes to accurate notification rates, but hospital episode registers likely contain a considerable proportion of false-positive TB records and are thus less useful. Further strengthening routine surveillance to count TB cases, i.e. incidence, accurately by employing record-linkage of high-quality TB registers should make CRC studies obsolete in EU countries.

Keywords: Croatia; Denmark; Finland; Netherlands; Portugal; Slovenia; epidemiology; statistics; surveillance; tuberculosis.

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Conflict of interest statement

Conflict of interest: None declared.

Figures

Figure
Figure
Schematic view of the registered number of tuberculosis (TB) cases after record linkage of three TB-related registers, six selected European Union countries, 2014–2016
See this image and copyright information in PMC

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