24th March commemorates World Tuberculosis Day. The overall goal of this day is to raise awareness about the burden of TB worldwide, and the status of TB prevention and control efforts.

Malta is a low TB incidence country, with an average notification rate of 7.6 per 100,000 population, over a 15 year period. Like other Western European countries, the TB notification and incidence rates in Malta have decreased steadily among the Malta-born population in recent decades. In this population segment, it occurs mostly in the elderly, mainly due to reactivation of old TB.

A large proportion of TB cases in Malta are imported cases, in people coming from high TB endemic countries. In 2016, there were 51 notified TB cases. Of these, 96% were of foreign origin. Of all TB cases with a known HIV status, 17.4% had TB/HIV co-infection.

Various systems are in place to control TB in Malta. This includes:

o -Provision of TB treatment, free of charge, to all individuals with active and latent TB residing here;

o -Supervision of treatment by trained care workers to ensure that the treatment is taken properly, and completed. This is called directly observed therapy (DOT);

o -Follow-up of TB patients by infectious disease/TB specialists throughout the course of the treatment;

o -Screening of all asylum seekers and persons applying for an employment licence who come from high TB endemic countries;

o -Screening of people working/living in high risk environments;

o -Investigation and contact tracing of active TB cases, for the early identification of other possible related cases, to prevent transmission;

o -High-risk BCG vaccination programme for children under the age of 5 years whose parents came from high TB endemic countries.

According to the World Health Organization, TB is the world’s leading infectious disease killer. It kills more people annually than AIDS or malaria. Globally, 10.4 million people fell ill with TB, and 1.8 million died from the disease in 2015. Over 95% of TB deaths occurred in low- and middle-income countries. TB occurs in every part of the world, but the majority of cases are in Asia (61%) and Africa (26%).

TB remains a common infection in EU/EEA countries, and is an important cause of morbidity and mortality in Europe. In 2015, 60,195 TB cases were reported in the EU/EEA countries, a notification rate of 11.7 per 100,000 population. Notification rates are decreasing in most countries. Data shows that between 2011 and 2015, new tuberculosis (TB) cases and deaths have declined each year by 4.3% and 8.5% respectively in the 53 countries of the WHO European Region. The decline is encouraging. However, this is not enough to reach the target of TB elimination by 2050 in European low-incidence countries. Thirty per cent of TB cases in the region were of foreign origin.

TB is a leading killer among people living with HIV, and this deadly combination of TB/HIV co-infection has been sharply increasing from 5.5% to 9% over the last five years in the WHO European Region. One of the areas of focus of the Maltese Presidency of the Council of the European Union is on HIV, whereby a technical declaration on HIV was outlined by technical experts and was supported by health Ministers during the Informal Meeting of Ministers in Malta this week. The HIV declaration called for fast track actions on HIV and associated co-infections, including TB across Europe.

The global theme chosen for World TB day 2017 by the World Health Organization is “Unite to End TB”, because World TB Day provides an opportunity for people everywhere to unite in the fight against TB, by helping to educate others about TB, and by urging governments to take action so that together we can end TB once and for all.

Background Information on Tuberculosis

TB is a serious infectious disease caused by the bacterium Mycobacterium tuberculosis. It usually affects the lungs (pulmonary TB), but can also affect other parts of the body like the lymph nodes, the brain, and the bones (extra-pulmonary TB). TB is spread from person to person through the air. Only people with pulmonary or laryngeal TB are infectious. However it usually requires prolonged close contact with someone with the disease to get infected.

People who are infected will not necessarily get sick. Their immune system walls off the germs, which can lie dormant for years. This is called latent TB infection. People with latent TB infection have a lifetime risk of 10% of developing TB disease. When someone’s immune system is compromised, as happens with conditions like cancer, diabetes, and HIV, the chances of getting sick are greater.

Source: Government of Malta