Tuberculosis Surveillance in Romania Among Vulnerable Risk Groups Between 2015 and 2017

Figures & data

Figure 1 Trend of TB notification rates in Romania, 2002–2017.

Figure 2 Annual number of notified tuberculosis patients among inmates, homeless individuals and drug users in Romania, 2006–2017.

Figure 3 Overlap of tuberculosis risk groups (inmates, homeless individuals and drug users) in Romania, 2015–2017.

Table 1 Demographic and Disease Characteristics of TB Patients in Romania, 2015–2017, by Risk Group (None, Inmates, Homeless Individuals and Drug Users).*

	All TB Patients Without risk Profiles		Inmates with TB				Homeless Individuals with TB				Drug users with TB
	Number	%	Number	%	aOR	95% CI	Number	%	aOR	95% CI	Number	%	aOR	95% CI
Number	40,817		441				405				189
Male	27,982	68.6%	418	94.8%	10.8	7.0–16.4	347	85.7%	2.4	1.8–3.1	167	88.4%	4.0	2.4–6.4
0–19 years	3676	9.0%	17	3.9%	0.3	0.2–0.4	2	0.5%	0.1	0.0–0.5	5	2.6%	0.7	0.2–1.9
20–39 years	12,269	30.1%	290	65.8%	1	1	116	28.6%	1	1	154	81.5%	1	1
40–59 years	15,842	38.8%	117	26.5%	0.3	0.2–0.4	235	58.0%	1.4	1.1–1.8	27	14.3%	0.3	0.2–0.5
≥60 years	9030	22.1%	17	3.9%	0.1	0.1–0.1	52	12.8%	0.7	0.5–1.0	3	1.6%	0.2	0.1–0.7
Born in Romania	40,730	99.8%	439	99.5%	–	–	405	100.0%	–	–	189	100.0%	–	–
Urban residence	18,027	44.2%	229	51.9%	1.2	1.0–1.4	322	79.5%	5.1	4.0–6.5	168	88.9%	6.4	4.0–10.3
History of previous TB	8397	20.6%	82	18.6%	1.0	0.7–1.3	177	43.7%	2.1	1.7–2.6	48	25.4%	0.9	0.6–1.3
HIV co-infection	612	1.5%	85	19.3%	7.8	6.0–10.3	40	9.9%	5.4	3.8–7.8	164	86.8%	247	156–392
Pulmonary TB	34794	85.2%	411	93.2%	4.9	3.3–7.3	383	94.6%	1.7	1.0–2.7	163	86.2%	1.1	0.6–2.0
smear positivity (% of PTB)	22,388	64.1%	128	31.1%	0.3	0.2–0.3	273	71.3%	1.2	0.9–1.5	107	65.6%	1.3	0.9–2.0
Culture positive	28,449	69.7%	265	60.1%	0.9	0.7–1.2	324	80.0%	1.0	0.7–1.4	141	74.6%	1.5	1.0–2.4
RR/MDR (% of culture positive)	1526	5.4%	12	4.5%	0.6	0.3–1.2	47	14.5%	1.6	1.2–2.6	23	16.3%	1.0	0.6–1.9

Notes: *Multivariate logistic regression was performed comparing one of the risk groups with those without risk profiles, considering factors significant in the univariate analysis (all, except country of birth and culture confirmation). In red numbers and percentage of variables. Some patients had multiple risk profiles (see Figure 3 and text). The total number of patients in 2015–2017 was 41.789.

Abbreviations: aOR, adjusted odds ratio; 95% CI, 95% confidence interval; MDR, multidrug-resistant; RR, rifampicin resistant; TB, tuberculosis.

Table 2 Treatment Outcome for the 2015–2017 Cohorts for Non-Rifampicin-Resistant and Rifampicin-Resistant Tuberculosis (After 12 and 24 Months Respectively)

A
Treatment outcome (after 12 months) (for the 2015–2017 cohorts) (non RR/MDR) (n= 40,229)	All cases without risk profiles					Inmates with TB			Homeless individuals with TB					Drug users with TB
	n			%		n	%		n		%			n		%
Successful	33,096,096			84.3%		394	91.8%		216		60.3%			104		62.7%
Deceased	3147			8.0%		14	3.3%		57		15.9%			32		19.3%
Other	3033			7.7%		21	4.9%		85		23.7%			30		18.1%
B
Treatment outcome (after 24 months) for the 2015–2016 cohorts) (RR/MDR) (n=1150)		All cases without risk profiles			Inmates with TB					Homeless individuals with TB			Drug users with TB
		n	%		n			%		n		%	n		%
Successful		516	47.0%		3			37.5%		6		23.1%	5		26.3%
Deceased		192	17.5%		1			12.5%		7		26.9%	8		42.1%
Other		389	35.5%		4			50.0%		13		50.0%	6		31.6%

Notes: For 466 TB cases treatment outcome data are missing (437 TB cases without risk factors, 4 inmates with TB, 21 homeless individuals with TB and 4 problem drug users with TB).

Abbreviations: MDR, multidrug-resistant; RR, rifampicin resistant; TB, tuberculosis.