SURVEILLANCE OF TUBERCULOSIS IN EUROPE

Consensus-based recommendations have been developed by a Working Group of the World Health Organization (WHO) and the European Region of the International Union Against Tuberculosis and Lung Disease (IUATLD) on uniform reporting of tuberculosis surveillance data in the countries of Europe. A uniform case definition and a minimum set of variables fo r reporting on each case have been agreed which, when collated on a na tional basis, will allow comparison of the epidemiology of tuberculosi s in different European countries. The Working Group recommends that t he case definition includes ''definite'' cases, where the diagnosis ha s been confirmed by culture (or supported by microscopy findings in co untries where diagnostic culture facilities are not available), and '' other than definite cases'' based on a clinical diagnosis of tuberculo sis combined with the intention to treat with a full course of antitub erculosis therapy, Both ''definite'' and ''other than definite'' cases should be notified by physicians and, in addition, laboratories shoul d be required to report ''definite'' cases. The minimum set of variabl es to be collected on each case of tuberculosis should include: date o f starting treatment, place of residence, date of birth, gender, and c ountry of origin, to characterize the patient, Recommended disease-spe cific variables include: site of disease, bacteriological status (micr oscopy and culture), and history of previous antituberculosis chemothe rapy. The minimum set of variables should be collated on all patients and should be as complete as possible, Additional variables may be col lected for individual, local or national purposes, but, in general, co mpleteness of reporting on cases is likely to be better if the informa tion requested is kept to a minimum. Timely reporting of cases is esse ntial for appropriate public health action, Cases should be reported t o the health authority at the local and/or regional level within 1 wee k of starting treatment, Individual-case based information should be r eported to the national level by the local or regional level, Feedback to reporters is essential, At the national level, preliminary quarter ly reports should be produced and final reports should be published an nually.