Comparison of tuberculosis surveillance systems in low-incidence industrialized countries

¹ Public Health Services, Ministry of Health, Jerusalem, Israel; and Hubert H. Humphrey fellowship program, International Institute of Education, Washington DC
² WHO Collaborating Centre for TB and Lung Diseases, Fondazione S. Maugeri, Care and Research Institute, Tradate, Italy
³ Division of Tuberculosis Elimination, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia, United States; and Northrop Grumman Information Technology, CDC Programs, Atlanta, Georgia, United States
⁴ German Central Committee against Tuberculosis, Berlin, Germany
⁵ National TB Surveillance Unit, Fac. Hospital Bulovka, Prague, Czech Republic
⁶ Division of Tuberculosis Elimination, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia, United States

^* To whom correspondence should be addressed. E-mail: iademarcoMF{at}state.gov.

	Abstract

Comparative analysis of national tuberculosis control programmes (NTP) in industrialized, low-tuberculosis-incidence countries is limited. Analysis of applied methods, function, and accumulated experience contributes to improving global tuberculosis control.

A questionnaire addressing NTP surveillance infrastructure and characteristics was completed by 19 industrialized countries, with populations greater than 3 million and annual tuberculosis notified incidence rates less than 16 cases per 100, 000 populations (2003).

All European countries surveyed adopted Euro-TB definitions. Surveillance information, which usually includes names, is transferred electronically to the national level in 17 of the 19 countries. Surveillance systems capture process and social determinants. Case notification to the central level occurred within a median period of seven days, independent of mandatory notification requirements. Average completeness of tuberculosis case-reporting was estimated as 93.5% (range 65%–100%). Integration between HIV and tuberculosis registries was performed in two countries, and in seven others, both databases were cross-matched periodically.

NTP function in industrialized, low-incidence countries utilizes well-established infrastructure and relies on centralized operations. Approaches are consistent with current WHO surveillance recommendations. This study lays collaborative groundwork for additional multinational analyses to enhance global tuberculosis surveillance, which may assist policy makers in countries moving from middle- to low-incidence rates.

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