Munteanu Ioana, Cioran Nicoleta, van Hest Rob, Abubakar Ibrahim, Story Alistair, Chiotan Domnica, de Vries Gerard, Mahler Beatrice
Department of Pneumology, Marius Nasta Institute of Pneumology, Bucharest, Romania.
3rd Department - Complementary Sciences, "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania.
Ther Clin Risk Manag. 2022 Apr 20;18:439-446. doi: 10.2147/TCRM.S347748. eCollection 2022.
Romania has the highest tuberculosis (TB) burden in the European Union/European Economic Area (EU/EEA) comprising almost a quarter (23.4%) of the reported patients in 2017, and a TB notification rate six times higher than the EU/EEA average. Although the overall TB notification rate in Romania declined from 154/100.000 individuals to 66/100.000 individuals in the general population between 2002 and 2017, TB notification rates remain high in certain vulnerable populations groups such as prisoners, the homeless population and among drug users.
We conducted a descriptive study regarding TB monitoring data in Romania, including the aforementioned TB risk groups.
Analysis regarding notified TB cases among these risk groups indicates that TB rates are 7 to 18 times higher than in the general population. One of the most alarming aspects regards the exceedingly high proportion of HIV-seropositivity among drug users and the high mortality rates among the homeless population and among drug users with TB.
This data underlines the importance of early identification among social risk groups using outreach active case-finding (ACF) activities, possibly combining TB screening with screening for other common, possibly life-threatening, co-morbidities for which an effective treatment is available. ACF could have a decisive role in TB control and eradication in Romania, when aimed at these high-risk groups.
罗马尼亚是欧盟/欧洲经济区（EU/EEA）中结核病负担最高的国家，2017年报告的患者几乎占四分之一（23.4%），结核病通报率比欧盟/欧洲经济区平均水平高六倍。尽管2002年至2017年间罗马尼亚总体人群中的结核病通报率从每10万人154例降至每10万人66例，但在某些弱势群体中，如囚犯、无家可归者和吸毒者，结核病通报率仍然很高。
我们对罗马尼亚的结核病监测数据进行了描述性研究，包括上述结核病风险群体。
对这些风险群体中通报的结核病病例的分析表明，结核病发病率比普通人群高7至18倍。最令人担忧的方面之一是吸毒者中艾滋病毒血清阳性率极高，以及无家可归者和患有结核病的吸毒者中的高死亡率。
这些数据强调了利用外展主动病例发现（ACF）活动在社会风险群体中进行早期识别的重要性，可能将结核病筛查与对其他常见的、可能危及生命的合并症的筛查相结合，对于这些合并症有有效的治疗方法。当针对这些高危群体时，主动病例发现可能在罗马尼亚的结核病控制和根除中发挥决定性作用。
