Tuberculosis in Poland in 2014

AIM OF THE STUDY: To evaluate the main features of TB epidemiology in 2014 in Poland and to compare with the data on the same phenomena in EU/EEA countries.

METHODS: Analysis of case- based data on TB patients from National TB Register, data on anti-TB drugsusceptibility testing results in cases notified in 2014, data from National Institute of Public Health- NationalInstitute of Hygiene on cases of tuberculosis as AIDS-defining disease, data from Central Statistical Office ondeaths from tuberculosis based on death certificates, data from ECDC report „ European Centre for DiseasePrevention and Control/WHO Regional Office for Europe. Tuberculosis surveillance and monitoring in Europe 2016. Stockholm: European Centre for Disease Prevention and Control, 2016”.

RESULTS: 6 698 TB cases were reported in Poland in 2014. The incidence rate was 17.4 cases per 100 000, withlarge variability between voivodeships from 9.3 to 26.5 per 100 000. The mean annual decrease of TB incidence in 2010- 2014 was 2.1%. 6 066 cases had no history of previous treatment i.e. 15.8 per 100 000. 632 cases i.e. 1.6 per 100 000 – 9.4% of all registered subjects were relapses. The number of all notified pulmonary tuberculosis cases in 2014 was 6311 i.e. 16.4 per 100 000. Pulmonary cases represented 94.2% of all TB cases. In the presented year 387 extrapulmonary TB cases were reported. Children with TB (70 cases) accounted for 1.0% of all cases notified in Poland. The incidence of tuberculosis increases with age from 1.2 per 100 000 among children to 30.4 per 100 000 among patients 65 years old and older. The incidence among men i.e. 24.6 per 100 000 was 2.3 times higher than among women i.e. 10.7 per 100 000. The biggest difference in the TB incidence between the two sex groups occurred in persons aged 45 to 49 years – 40.4 vs. 9.3. The TB incidence in rural population was lower than in urban, respectively 17.0 per 100 000 and 17.7 per 100 000. The number of all registered culture positive TB cases, including relapses, was 4 781. Culture-confirmed cases constituted 71.4% of all TB cases and 72.9% of all pulmonary TB cases. The number of smear-positive pulmonary TB cases reported in 2014 was 2800 i.e. 7.3 per 100 000 respectively what constituted 44.4% of all pulmonary TB cases. TB was initial AIDS indicative disease in 13 persons. In Poland in 2014 there were 35 cases with MDR-TB (including 7 patients of foreign origin) and 97 patients with resistance to isoniazid only, constituting respectively 0.8% and 2.2% of cases with known DST results (DSTs were done in 93.3% of all culture-confirmed TB cases). In 2014, there were 49 foreign-origin TB cases reported in Poland. There were 532 deaths due to tuberculosis reported in 2013 – 1.4 per 100 000; 518 and 14 from extrapulmonary tuberculosis. Mortality among males – 2.2 per 100.000 – was 3.6 X higher than among females – 0.6. 38,5% of all TB deaths were cases 65 years old and older – 3.7 per 100 000. There were no deaths from tuberculosis in children. TB was cause of death in one adolescent. TB mortality in 2013 constituted 0.14% of total mortality in Poland and 27.1% of mortality from infectious diseases.

CONCLUSIONS: In Poland in 2014 the incidence of tuberculosis was higher than the average in 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, unfavorable phenomena as tuberculosis in children, tuberculosis in persons infected with HIV and MDR-TB are less common than in EU/EEA countries.