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Original article

Vol. 151 No. 3536 (2021)

Surveillance of tuberculosis in Switzerland and the Principality of Liechtenstein, 2009 to 2019

  • Ekkehardt S. Altpeter
  • Axel J. Schmidt
DOI
https://doi.org/10.4414/SMW.2021.w30032
Cite this as:
Swiss Med Wkly. 2021;151:w30032
Published
01.09.2021

Abstract

OBJECTIVE: To describe the epidemiology of tuberculosis in Switzerland from 2009 to 2019.

METHODS: Analysis of Swiss notification data.

RESULTS: Tuberculosis cases declined from 553 (7.1/100,000) in 2009 to 437 (5.1/100,000) in 2019. The male-to-female ratio was 3:2. Although the number of tuberculosis cases of Swiss origin has steadily declined, the number of tuberculosis cases of foreign origin was rather stable but peaked in 2016. Overall, three quarters of tuberculosis cases were among people of foreign origin; of these, around half were from East Africa, Southern East Europe, and Southern Asia. Forty-nine percent had extrapulmonary manifestations. Every year, with little variation, 7–16 cases with rifampicin resistance were reported (2.9% overall). Independent risk factors for rifampicin resistance were prior anti-tuberculosis treatment, with an adjusted odds ratio (aOR) of 5.5 and a 95% confidence interval (CI) from 3.7 to 8.1, and foreign origin (aOR 3.6, 95% CI 2.0–7.0), particularly Georgia (aOR 10.0, 95% CI 4.0–23.1), Ethiopia (aOR 9.4, 95% CI 3.5–24.2), Tibet (aOR 6.9; 95% CI 2.9–16.6) and Somalia (aOR 8.1, 95% CI 4.0–17.2), together with Eritrea (aOR 2.6, 95% CI 1.1–5.9), accounting for more than half of all 134 cases . From 2016 to 2018, applying the World Health Organization definitions, overall treatment success in culture-confirmed pulmonary cases was 78%, and thus below the target of 85%. Since most cases with unsuccessful outcome are due to missing information, the proportion of unsuccessful outcome are overestimated.

CONCLUSION: Autochthonous tuberculosis has become rare in Switzerland and the new diagnoses are increasingly attributable to immigration. Rifampicin resistance remains rare. Switzerland currently fails to achieve international targets for treatment success.

References

  1. Houben RM, Dodd PJ. The Global Burden of Latent Tuberculosis Infection: A Re-estimation Using Mathematical Modelling. PLoS Med. 2016 Oct;13(10):e1002152. https://doi.org/10.1371/journal.pmed.1002152
  2. World Health Organization. Global tuberculosis report 2020. Geneva: WHO; 2020. Available from: https://www.who.int/publications/i/item/9789240013131
  3. Altpeter E, Schoch O, Helbling P. Tuberkulose in der Schweiz: selten, und manchmal kompliziert. Swiss Med Forum 2015;15:925-30.
  4. Helbling P, Altpeter E, Raeber PA, Pfyffer GE, Zellweger JP. Surveillance of antituberculosis drug resistance in Switzerland 1995-1997: the central link. Eur Respir J. 2000 Aug;16(2):200–2. https://doi.org/10.1034/j.1399-3003.2000.16b03.x
  5. World Health Organization. Definitions and reporting framework for tuberculosis—2013 revision (updated December 2014 and January 2020). Geneva: WHO; 2013. Report No.: WHO/HTM/TB/2013.2.
  6. Bundesamt für Statistik / Office fédéral de la statistique. Verzeichnis der Staaten und Gebiete. Neuchâtel: BFS / OFS; 2019. Report No.: be-b-00.04-sg-01. Available from: https://www.bfs.admin.ch/bfs/de/home/grundlagen/stgb.html
  7. International Organization for Standardization. Date and time — Representations for information interchange — Part 1: Basic rules. Geneva: ISO; 2016. Report No.: ISO 8601-1:2019. Available from: https://www.iso.org/standard/70907.html
  8. Helbling P, Altpeter E, Egger JM, Zellweger JP. Treatment outcomes of multidrug-resistant tuberculosis in Switzerland. Swiss Med Wkly. 2014 Dec;144:w14053. https://doi.org/10.4414/smw.2014.14053
  9. Swiss Lung Association, Federal Office of Public Health. Tuberculosis in Switzerland. Guidance for healthcare professionals. Bern Swiss Lung Association; 2019.
  10. McGill R, Tukey JW, Larsen WA. Variations of Box Plots. Am Stat. 1978;32:12–6.
  11. R Core Team. R: A language and environment for statistical computing. Vienna: R Foundation for Statistical Computing; 2020.
  12. Boehme CC, Nabeta P, Hillemann D, Nicol MP, Shenai S, Krapp F, et al. Rapid molecular detection of tuberculosis and rifampin resistance. N Engl J Med. 2010 Sep;363(11):1005–15. https://doi.org/10.1056/NEJMoa0907847
  13. Bundesamt für Gesundheit / Office Fédéral de la Santé Publique. Tuberkulose in der Schweiz. Bulletin. 1995;37:10–1.
  14. European Centre for Disease Prevention and Control, World Health Organization Regional Office for Europe. Tuberculosis surveillance and monitoring in Europe 2019 (2017 data). Stockholm: ECDC, WHO Regional Office for Europe; 2019.
  15. Ota M, Uchimura K. Trends of tuberculosis rates before and after the declaration as a public health emergency in Japan, 1992-2006. Int J Tuberc Lung Dis. 2019 Sep;23(9):1000–4. https://doi.org/10.5588/ijtld.18.0650
  16. Schwartz NG, Price SF, Pratt RH, Langer AJ. Tuberculosis - United States, 2019. MMWR Morb Mortal Wkly Rep. 2020 Mar;69(11):286–9. https://doi.org/10.15585/mmwr.mm6911a3
  17. Sahu S, Ditiu L, Lawson L, Ntoumi F, Arakaki D, Zumla A. UN General Assembly tuberculosis targets: are we on track? Lancet. 2020 Mar;395(10228):928–30. https://doi.org/10.1016/S0140-6736(20)30565-1
  18. Schneeberger Geisler S, Helbling P, Zellweger JP, Altpeter ES. Screening for tuberculosis in asylum seekers: comparison of chest radiography with an interview-based system. Int J Tuberc Lung Dis. 2010 Nov;14(11):1388–94.
  19. Rieder HL. Drug-resistant tuberculosis: issues in epidemiology and challenges for public health. Tuber Lung Dis. 1994 Oct;75(5):321–3. https://doi.org/10.1016/0962-8479(94)90075-2
  20. Reif LK, Rivera V, Bertrand R, Rouzier V, Kutscher E, Walsh K, et al. Outcomes across the tuberculosis care continuum among adolescents in Haiti. Public Health Action. 2018 Sep;8(3):103–9. https://doi.org/10.5588/pha.18.0021
  21. Berry KM, Rodriguez CA, Berhanu RH, Ismail N, Mvusi L, Long L, et al. Treatment outcomes among children, adolescents, and adults on treatment for tuberculosis in two metropolitan municipalities in Gauteng Province, South Africa. BMC Public Health. 2019 Jul;19(1):973. https://doi.org/10.1186/s12889-019-7257-4
  22. Helbling P, Medinger C, Altpeter E, Raeber PA, Beeli D, Zellweger JP. Outcome of treatment of pulmonary tuberculosis in Switzerland in 1996. Swiss Med Wkly. 2002 Sep;132(35-36):517–22.
  23. European Centre for Disease Prevention and Control, WHO Regional Office for Europe. Tuberculosis surveillance and monitoring in Europe 2021 – 2019 data. Copenhagen: WHO Regional Office for Europe; 2021.

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