Assessment of Tuberculosis under- or over-Reporting through Inventory Studies

Project

We are assessing the completeness of tuberculosis notification data by retrospective analysis of multiple national tuberculosis databases in six selected EU/EEA Member States. This project will provide information on surveillance completeness and quality, an estimate of the incidence of tuberculosis and information on strengths and gaps in the national surveillance system in  six European countries.

Collecting and analyzing data

The European Centre for Disease Prevention and Control (ECDC) and World Health Organization (WHO) Europe coordinate the collection and analysis of tuberculosis (TB) surveillance data in Europe. The annual number of TB cases reported is assumed to reflect TB incidence, which may be incorrect due to underreporting. To assess the level of underreporting, we performed inventory studies examining different registers containing TB patient data, combined with capture-recapture modelling to estimate TB incidence. This is  a widely accepted methodology.

We assessed in which six European Union (EU) and European Economic Area (EEA) Member States (MS) TB inventory studies and capture-recapture modelling were most likely to be successful. We conducted a rapid feasibility assessment among 31 EU/EEA MS using an 11-item questionnaire distributed in person or by email. This was followed by an in-depth feasibility interview call among 14 selected EU/EEA MS. Based on the results of this assessment Denmark, the Netherlands and Portugal were selected to conduct a TB inventory study and capture recapture modelling in 2017, followed by Croatia, Finland and Slovenia in 2018. In January 2017 stakeholders of the selected countries were invited for a protocol development workshop at KIT.

Results

The project is ongoing and the results, when published, will shed light on the question of whether current data on TB reflect the true situation and the extent of any  under- or over-reporting.