Tuberculosis prevention and control
To reduce TB incidence, approaches need to be tailored to the specific epidemiological situation in each country. In low-incidence countries people at risk of contracting TB are often found in vulnerable populations, for example prison inmates, migrants or refugees, and homeless. In medium and high-burden countries, TB is more prevalent in the general population.
ECDC coordinates networks of epidemiological and laboratory experts in Europe. Within these networks, countries collaborate on standardised approaches, exchanges of experience and best practices. They work to identify sustainable solutions tailored to the European context, collaborate on cross-border threats and address public health gaps. ECDC is supporting EU/EEA Member States in their efforts to achieve Sustainable Development Goal target 3.3 to end the tuberculosis epidemic by 2030.
- Scientific advice
- Country visits
- Country support
- World TB Day campaign
ECDC’s scientific advice provides a summary of primary evidence, acknowledging uncertainties and interpreting data to support informed decisions and actions at the EU and country level in relation to public health measures to prevent and/or control tuberculosis.
Public health guidance on management of contacts of MDR TB and XDR TB patients
Managing the contacts of MDR and XDR TB patients is a key intervention in preventing further transmission. Within the EU/EEA, contact investigation is widely implemented. ECDC has published an evidence-based guidance that outlines different options for the management of contacts.
Public health guidance on TB control in vulnerable and hard-to-reach populations
Tuberculosis disproportionately affects vulnerable and hard-to-reach populations, especially in low-TB-incidence countries. ECDC provides guidance on how to prevent and control TB among groups whose socioeconomic conditions or lifestyle make it difficult to access health services, self-administer treatment and attend regular healthcare appointments.
Public health guidance on investigation and control of TB incidents affecting children in congregate settings
Children have a high risk of becoming infected with TB following exposure in congregate settings such as schools and nurseries. Rapid identification of the source of transmission and contact investigation in settings around the primary case is therefore essential to stop transmission. The guidance ‘Investigation and control of tuberculosis incidents affecting children in congregate settings’ details common practices and provides expert opinions on the investigation and control of TB incidents affecting children in congregate settings.
European Union Standards for Tuberculosis Care
ECDC and the European Respiratory Society (ERS) have developed the European Union Standards for Tuberculosis Care (ESTC). These standards are tailored to EU/EEA settings and are in line with accepted international principles and guidance outlined in the International Standards for Tuberculosis Care and the WHO Compendium of Tuberculosis Guidelines and Associated Standards.
Assembling evidence on the rational use of drugs
Drug-resistant TB is a threat within the EU/EEA and prevention is the key to ensuring progress towards TB elimination in the region. New drugs are available for the treatment of TB. From a public health perspective, it is vital to ensure that any such new drugs are introduced and used in a prudent manner. ECDC provides expert advice on the introduction of new drugs for TB control in the EU/EEA.
ECDC conducts country visits jointly with the World Health Organization’s Regional Office for Europe at the formal request of the Ministry of Health or corresponding competent body in a Member State. In cooperation with representatives of the national TB programme, the experts participating in the country visit identify strengths and challenges in the national TB programme. ECDC and WHO then produce a report based on the observations.
- Report of the joint WHO and ECDC programme review of the national TB control programme in the Netherlands
- Report of the joint ECDC and WHO review of the national tuberculosis programme in Bulgaria
- Mission Report, Tuberculosis in Latvia, 22–26 October 2012
To request a country visit, please approach your Ministry of Health, or contact the ECDC TB programme to facilitate the process of a formal request.
ECDC organises exchange visits, trainings and ad-hoc consultancies, facilitated by international experts, for the high-burden TB Member States in the EU/EEA: Bulgaria, Estonia, Latvia, Lithuania, and Romania.
The exchange visits take place in an EU country that has displayed exemplary progress in TB prevention and control. The country case study is explored through lectures, field visits and workshops in situ.
Past exchange visits:
2016 – TB contact investigation, Finland
2017 – From hospital to ambulatory care, Finland
2018 – Infection control: assessment and implementation of infection control procedures and measures, the Netherlands.
The training takes place in a high-burden country centering on a challenge relevant to the local context, equipping participants with the necessary knowledge to champion further change in their respective countries. The training consists of group exercises, practical sessions and case studies.
2016 - Latent tuberculosis infection management, Estonia
2017 - Prevention and control of TB among vulnerable, hard-to-reach groups and migrants, Bulgaria
2018 - Communication on tuberculosis to the general public, and use of social media, advocacy and communication to local government and policy makers, Lithuania.
Ad-hoc consultancies provide technical support to a country. Working with national representatives identified in the country, an outside expert collects and assesses background information and produces a draft guidance document, focusing on strengths and challenges in the national TB programme, system or service. The draft is developed further at a consensus-building meeting with a wide range of stakeholders and the finished output is disseminated in the country.
2016 – Integrated community support services for tuberculosis, Romania
2017 – LTBI guidelines for people living with HIV (PLHIV) and a plan for a surveillance registry of LTBI cases and TB contacts, Latvia
2018 – National guidelines on integrated services, with a focus on case management of MDR TB cases, TB/HIV co-infected cases and cases among vulnerable populations, Lithuania
World TB Day campaign
World TB Day, marked on 24 March each year, commemorates Dr. Robert Koch’s 1882 discovery of the causative agent of tuberculosis, Mycobacterium tuberculosis. The day marks an occasion to raise awareness of TB on a global scale. ECDC gathers and disseminates resources on TB activities from Member States and releases a joint surveillance report with the World Health Organization’s Regional Office for Europe on the TB situation in Europe.
ECDC has gathered below various materials on TB listed by countries and by other organisations.
European Union Standards for Tuberculosis Care
ECDC and the European Respiratory Society (ERS) have developed the European Union Standards for Tuberculosis Care (ESTC).
Management of latent TB infection
ECDC has developed various resources to help EU/EEA countries prevent and control latent TB infection (LTBI).
Policy briefing on interventions for TB prevention and control in vulnerable populations
This short document gives an overview of why interventions among vulnerable groups are necessary and what can be done, with examples and data to give evidence of the points raised.