World TB Day 2018 - 24th March
World TB Day is held every year on March 24th with the aim of raising awareness about tuberculosis (TB) among health professionals and the public and to support global efforts to prevent and control TB. The day is an occasion to rally political and social commitment for further progress towards eliminating TB as a public health burden.
World TB Day commemorates the day in 1882 when Dr Robert Koch announced that he had discovered the cause of TB, the TB bacillus. This was a major step in the understanding of the disease which killed millions of people throughout Europe and the rest of the world at that time. Although great strides have been made in the prevention and control of TB in recent years, TB remains the ninth leading cause of death worldwide. The emergence of multidrug-resistant TB (MDR-TB) poses a major public health threat and could risk gains made in the fight against TB. In 2016, 10.4 million people fell ill with TB, and 1.8 million died including 250,000 children. Approximately 95% of TB cases and deaths occur in low- and middle-income countries.
Epidemiology of TB in Ireland
The incidence of TB in Ireland has declined in the past decade. The number of notified TB cases remained relatively stable between 2016 and 2017. In 2017, 321 cases of TB (crude incidence rate (CIR): 6.7 per 100,000) were provisionally notified compared to 315 cases (CIR: 6.6 per 100,000) in 2016. In the past decade, the number of cases of TB has decreased from 481 in 2007 to 321 in 2017. The CIR declined from 11.3 per 100,000 in 2007 to 6.7 per 100,000 in 2017.
In 2017, 45% of all TB cases notified were in Irish-born people (145 cases, CIR: 3.7 per 100,000). Foreign born cases accounted for 43% of all cases notified (138 cases, CIR: 17.0 per 100,000). Country of origin was unknown for 12% of cases.
Among the 321 cases reported in 2017, 210 cases (65.4%) were culture positive. Among these 188 (89.5%) had drug sensitivity data reported. Resistance was reported in 19 cases, two of these were MDR-TB and two were XDR-TB.
Theme of World TB Day 2018
Each year a theme is chosen for World TB Day. For 2018 the Stop TB partnership theme is “Wanted: Leaders for a TB-Free World. You can make history. End TB”.
This theme aims to develop a focus on building commitment to end TB, not only at political level but at all levels including community leaders, people affected with TB, health professionals, non-governmental organisations (NGOs) and other partners.
This is a critical theme, given the political importance of the upcoming UN General Assembly high-level meeting on TB in September, which will bring together Heads of State in New York. It follows on from a very successful Ministerial Conference on Ending TB in Moscow on 16-17 November, 2017 which resulted in high-level commitments from Ministers and other leaders from 120 countries to accelerate progress to end TB.
World TB Day 2018 – European focus
The European focus of World TB day is on the reinvigorating of political commitment and increased investment for immediate and bold actions to eliminate TB, linking to the Stop TB global theme; “Wanted: Leaders for a TB-Free World. You can make history. End TB”. The European TB action plan addresses the challenge of low detection and poor treatment outcome of drug resistant TB patients.
A report published this week by the European Centre for Disease Prevention and Control (ECDC) and the WHO Regional Office for Europe indicates that the number of new tuberculosis (TB) patients has been decreasing at an average rate of 4.3% per year in the WHO European Region over the last decade. Yet, despite being the fastest decline in the world, this trend is insufficient to end the TB epidemic by 2030, as envisioned in the End TB Strategy and the Sustainable Development Goals.
Despite progress, TB remains a major public health concern in the WHO European Region. The latest data indicate that one in four (25%) multi-drug-resistant TB (MDR-TB) cases are not detected in the WHO European Region. The diagnosis of MDR-TB patients increased from 33% in 2011 to 73% in 2016, but remains below the regional target of 85% defined in the European TB action plan.
Treating cases with drug resistant TB is another challenge: the observed increase in treatment success from 46% in 2013 to 55% in 2016 is still insufficient for European countries to achieve the 75% target for 2020 that they committed to in the action plan.
The spread of extensively drug-resistant TB (XDR-TB) is an additional threat to ending TB in the WHO European Region. On average only one in three patients with XDR-TB is cured.
This year, 2018 is an important year for TB prevention and care as it marks the tenth anniversary of the Berlin Declaration “All against Tuberculosis” and we are in the middle of implementation of Tuberculosis Action for WHO European Region 2016-2020. Further commitment is essential in addressing these issues and accelerating the pace of TB elimination. This entails using existing modern and rapid diagnostic technologies; enhancing research for new tools; developing and implementing regulations to scale up access to new medicines and shorter treatment regimens; and working together with all sectors, including civil society, patients and communities, in a whole-of-society approach. Increased collaboration and intensified allocation of resources are crucial to ensure that every TB-affected person has access to quality health services for early detection, successful treatment and people-centred care.
For more information on the epidemiology of TB in Ireland see the HPSC website
For more information on TB worldwide see:
Stop TB Partnership: http://www.stoptb.org/
Centers for Disease Control and Prevention, USA:
http://www.cdc.gov/tb/ and http://www.cdc.gov/tb/worldtbday/
European Centre for Disease Prevention and Control: https://ecdc.europa.eu/en/news-events/world-tuberculosis-day-2018
World Health Organization:
http://www.who.int/campaigns/tb-day/2018/event/en/
WHO Euro
http://www.euro.who.int/en/media-centre/events/events/2018/04/world-health-day-2018-health-for-all