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Collaborative tuberculosis/HIV activities in the European Region

Gerard de Vries, Sarah van de Berg, Anke van Dam, Sayohat Hasanova, Manish Pareek, Marieke J. van der Werf, Daria N. Podlekareva on behalf of the Wolfheze Working Group on Collaborative TB/HIV activities
ERJ Open Research 2021 7: 00721-2020; DOI: 10.1183/23120541.00721-2020
Gerard de Vries
1KNCV Tuberculosis Foundation, The Hague, The Netherlands
2National Institute for Public Health and the Environment, Bilthoven, The Netherlands
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  • ORCID record for Gerard de Vries
  • For correspondence: gerard.de.vries@rivm.nl
Sarah van de Berg
1KNCV Tuberculosis Foundation, The Hague, The Netherlands
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Anke van Dam
3AFEW International, Amsterdam, The Netherlands
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Sayohat Hasanova
4World Health Organization Regional Office for Europe, Copenhagen, Denmark
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Manish Pareek
5Dept of Respiratory Sciences, University of Leicester, Leicester, UK
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Marieke J. van der Werf
6European Centre for Disease Prevention and Control, Stockholm, Sweden
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Daria N. Podlekareva
7CHIP, Dept of Infectious Diseases, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
8See the Acknowledgements for a list of the Wolfheze Working Group participants
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  • FIGURE 1
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    FIGURE 1

    Tuberculosis (TB) and HIV incidence in responding countries. TB low, HIV low (<10 cases per 100 000 population): Austria, Cyprus, Czech Republic, Denmark, Finland, France, Germany, Greece, Hungary, Iceland, Israel, Italy, Monaco, the Netherlands, Norway, Slovakia, Slovenia, Sweden, Switzerland, the UK. TB high, HIV low (<10 cases per 100 000 population): Albania, Armenia, Azerbaijan, Belgium, Bulgaria, Croatia, Kosovo, Lithuania, Macedonia, Montenegro, Romania, Serbia, Spain, Turkey. TB low, HIV high (≥10 cases per 100 000 population): Ireland and Luxembourg; TB high, HIV high (≥10 cases per 100 000 population): Belarus, Estonia, Georgia, Kazakhstan, Kyrgyzstan, Latvia, Malta, Moldova, Portugal, Ukraine, Uzbekistan. No response from: Andorra, San Marino (TB low, HIV low), Bosnia and Herzegovina, Poland (TB high, HIV low), Tajikistan (TB high, HIV high), Liechtenstein (no TB incidence, HIV low), Russian Federation, Turkmenistan (TB high, no HIV incidence). Map produced on December 14, 2018. Administrative boundaries: EuroGraphics and United Nations Food and Agriculture Organization.

  • FIGURE 2
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    FIGURE 2

    Overview of treatment providers and locations for the diagnosis and ambulatory treatment of tuberculosis (TB)/HIV patients. ID: infectious diseases; PLHIV: people living with HIV. #: one country did not provide the HIV testing and TB screening location.

Tables

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  • TABLE 1

    Overview of respondents to the survey among TB and HIV Focal Points

    TB Focal PointsHIV Focal PointsTotal
    Separate responses by TB and HIV Focal Points#121212
    Joint response by TB and HIV Focal Points101010
    Response by TB Focal Point only1818
    Response by HIV Focal Point only77
    No response8
    Total402955

    Data are presented as n. #: discrepant results were identified by the authors and aligned by the responding Focal Points.

    • TABLE 2

      Country policies and recommendations on HIV testing, tuberculosis (TB) screening, latent TB infection (LTBI) testing, antiretroviral treatment (ART) and co-trimoxazole preventive treatment (CPT) based on the responses from 47 countries

      TB incidenceHIV incidenceTotal
      HighLow
      All countriesHigh11+14§25
      Low2ƒ20##22
      Policies and recommendations
       HIV test in TB patients#
        All patientsHigh11 (100)13 (93)24
      Low1 (50)15 (75)16
        Selected patientsHigh0 (0)1 (7)1
      Low0 (0)5 (25)5
       TB screening in PLHIV
        All patientsHigh11 (100)11 (79)22
      Low2 (100)10 (50)12
        Selected patientsHigh0 (0)3 (21)3
      Low0 (0)10 (50)10
       LTBI screening in PLHIV
        All patientsHigh5 (45)13 (93)18
      Low2 (100)10 (50)12
        Selected patientsHigh3 (27)1 (7)4
      Low0 (0)9 (45)9
        Not recommendedHigh3 (27)0 (0)3
      Low0 (0)1 (5)1
       Start of ART in TB/HIV patients
        All patientsHigh11 (100)13 (93)24
      Low1 (50)18 (90)19
        Selected patientsHigh0 (0)1 (7)1
      Low1 (50)2 (10)3
       CPT of TB/HIV patients¶
        All patientsHigh8 (73)8 (57)16
      Low0 (0)3 (15)3
        Selected patientsHigh2 (18)0 (0)2
      Low1 (50)4 (20)5
        Not recommendedHigh0 (0)6 (43)6
      Low0 (0)10 (50)10

      Data are presented as n or n (% of total number of countries in the category). PLHIV: people living with HIV. #: one country did not respond to this question. ¶: five respondents were not familiar with their country's recommendation for CPT. +: high TB, high HIV: Belarus, Estonia, Georgia, Kazakhstan, Kyrgyzstan, Latvia, Malta, Moldova, Portugal, Ukraine, Uzbekistan. §: high TB, low HIV: Albania, Armenia, Azerbaijan, Belgium, Bulgaria, Croatia, Kosovo, Lithuania, Macedonia, Montenegro, Romania, Serbia, Spain, Turkey. ƒ: low TB, high HIV: Ireland, Luxembourg. ##: low TB, low HIV: Austria, Cyprus, Czech Republic, Denmark, Finland, France, Germany, Greece, Hungary, Iceland, Israel, Italy, Monaco, the Netherlands, Norway, Slovakia, Slovenia, Sweden, Switzerland, the UK.

      Supplementary Materials

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        Supplementary material 00721-2020.SUPPLEMENT

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      Collaborative tuberculosis/HIV activities in the European Region
      Gerard de Vries, Sarah van de Berg, Anke van Dam, Sayohat Hasanova, Manish Pareek, Marieke J. van der Werf, Daria N. Podlekareva
      ERJ Open Research Jan 2021, 7 (1) 00721-2020; DOI: 10.1183/23120541.00721-2020

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      Collaborative tuberculosis/HIV activities in the European Region
      Gerard de Vries, Sarah van de Berg, Anke van Dam, Sayohat Hasanova, Manish Pareek, Marieke J. van der Werf, Daria N. Podlekareva
      ERJ Open Research Jan 2021, 7 (1) 00721-2020; DOI: 10.1183/23120541.00721-2020
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