TB Unit, National Infection Service, Public Health England, London, UK.
KNCV Tuberculosis Foundation, Den Haag, The Netherlands.
Eur Respir J. 2018 Dec 6;52(6). doi: 10.1183/13993003.01449-2018. Print 2018 Dec.
How many European Union (EU) and European Economic Area (EEA) countries have national tuberculosis (TB) control plans/strategies, and what are the priority actions/populations and barriers to implementation?In order to answer this question, a survey of EU/EEA national TB programme leads was undertaken.The response rate was 100% (31 countries). 55% of countries reported having a national TB strategy, all of which were in implementation; five countries were preparing a strategy. 74% had a defined organisational TB control structure with central coordination and 19% had a costed programme budget; few organisational structures included patient/civil society representation. The most frequently mentioned priority TB control actions were: reaching vulnerable population groups (80%), screening for active TB in high-risk groups (63%), implementing electronic registries (60%), contact tracing and outbreak investigation (60%), and tackling multidrug-resistant TB (60%). Undocumented migrants were the most commonly (46%) identified priority population. Perceived obstacles to implementation included barriers related to care recipients (lack of TB knowledge, treatment seeking/adherence), care providers (including need for specialist training of nurses and doctors) and health system constraints (funding, communication between healthcare and social care systems).This survey has provided an insight into TB control programmes across the EU/EEA that will inform the development of a TB strategy toolkit for member states.
有多少欧盟（EU）和欧洲经济区（EEA）国家有国家结核病（TB）控制计划/策略，以及优先行动/人群和实施障碍是什么？为了回答这个问题，对欧盟/欧洲经济区国家结核病规划负责人进行了调查。回复率为 100%（31 个国家）。55%的国家报告有国家结核病战略，所有这些国家都在实施中；有五个国家正在制定战略。74%的国家有明确的组织结核病控制结构，并有中央协调，19%的国家有成本核算的方案预算；很少有组织结构包括患者/民间社会代表。最常提到的优先结核病控制行动包括：接触脆弱人群（80%）、对高危人群进行活动性结核病筛查（63%）、实施电子登记（60%）、接触者追踪和暴发调查（60%）以及解决耐多药结核病（60%）。无证件移民是最常被确定为优先人群的（46%）。实施的障碍包括与护理对象（缺乏结核病知识、寻求治疗/坚持治疗）、护理提供者（包括护士和医生的专业培训需求）以及卫生系统限制（资金、医疗保健系统和社会保健系统之间的沟通）有关的障碍。这次调查深入了解了欧盟/欧洲经济区的结核病控制规划，这将为成员国制定结核病战略工具包提供信息。
