{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2024,5,10]],"date-time":"2024-05-10T12:55:02Z","timestamp":1715345702314},"reference-count":0,"publisher":"National Institute of Public Health NIH (National Research Institute)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Przegl Epidemiol"],"abstract":"<p><strong>ABSTRACT<\/strong><br \/><strong>AIM OF THE STUDY.<\/strong> To evaluate the main features of tuberculosis (TB) epidemiology in 2018 in Poland\u00a0and to compare with the situation in the EU\/EEA countries.<br \/><strong>METHODS.<\/strong> Analysis of case- based data on TB patients from National TB Register, data on anti-TB drug\u00a0susceptibility testing results in cases notified in 2018, data from National Institute of Public Health- National\u00a0Institute of Hygiene on HIV-positive subjects for whom TB was an AIDS-defining disease, data from Central\u00a0Statistical Office on deaths from tuberculosis based on death certificates, data from the report \u201e European\u00a0Centre for Disease Prevention and Control\/WHO Regional Office for Europe. Tuberculosis surveillance and\u00a0monitoring in Europe 2020- 2018 data. Stockholm: European Centre for Disease Prevention and Control, 2020\u201d.<br \/><strong>RESULTS.<\/strong> In 2018, 5487 TB cases were reported in Poland. The incidence rate was 14.3 cases per 100000, with\u00a0large variability between voivodeships from 7.3 to 23.4 per 100 000. The mean annual decrease of TB incidence\u00a0in 2014- 2018 was 3.8%. In 2018, 4852 cases were newly diagnosed with no history of previous treatment i.e.\u00a012.6 per 100 000. 635 cases i.e. 1.7 per 100 000 \u2013 11.6% of all registered subjects were previously treated for\u00a0tuberculosis. In 2018, the number of all pulmonary tuberculosis cases was 5224 i.e. 13.7 per 100000. Pulmonary\u00a0cases represented 95.2% of all TB cases. In 2018, 243 extrapulmonary TB cases were found i.e. 0.6 per 100\u00a0000. In the whole country there were 52 pediatric cases of tuberculosis. TB in children represented 0.9% of all\u00a0cases notified in Poland in 2018. The incidence rates of tuberculosis were growing along with the age group\u00a0from 0.9 per 100 000 among children to 24.7 per 100 000 among subjects in the age group 45-64 years (the\u00a0highest incidence rate). In 2018, the incidence rate in the age group \u226565 years was 21.3 per 100 000. The TB\u00a0incidence among men i.e. 21.0 per 100 000 was 2.6 times higher than among women i.e. 8.0 per 100 000. The\u00a0biggest difference in the TB incidence between the two sex groups occurred in persons aged 55 to 59 years \u2013\u00a044.9 vs. 9.8 and in age group 60- 64 years \u2013 43.7 vs. 10.2. The TB incidence in rural population was lower than\u00a0in urban, respectively 13.4 per 100 000 and 14.9 per 100 000. The number of all registered culture positive TB\u00a0cases was 4075. Pulmonary tuberculosis was bacteriologically confirmed in 3935 subjects. Cases confirmed by\u00a0culture represented 74.3% of all TB cases and 75.3% of all pulmonary TB cases. The number of smear-positive\u00a0pulmonary TB cases reported in 2018 was 2324 i.e. 6.1 per 100 000 accounting for 44.3% of all pulmonary TB\u00a0cases and 59.1% of pulmonary TB cases confirmed by culture. In all patients with tuberculosis in Poland in 2018\u00a0there were 48 cases with MDR-TB (among them 14 foreigners) and 83 patients with resistance to isoniazid only,\u00a0representing respectively 1.3% and 2.2% of cases with known DST results (DSTs were available in 90.7% of all\u00a0culture-confirmed TB cases). In 2018, there were 97 patients of foreign origin among all cases of tuberculosis\u00a0in Poland. TB was AIDS-indicative disease in 14 subjects with HIV co-infection. There were 490 deaths due to\u00a0tuberculosis reported in 2017 \u2013 1.3 per 100 000; 468 people died from pulmonary and 22 from extrapulmonary\u00a0tuberculosis. Mortality among males \u2013 2.1 per 100 000 \u2013 was 3.6 X higher than among females \u2013 0.5. 40.2% of\u00a0all TB deaths were cases 65 years old and older \u2013 3.1 per 100 000. In 2017, there was no death from tuberculosis\u00a0in children and no deaths in adolescents. In 2017, tuberculosis represented 0.1% of total mortality in Poland and\u00a025.4% of mortality from infectious and parasitic diseases.<br \/><strong>CONCLUSIONS.<\/strong> In 2018, the incidence of tuberculosis in Poland was lower than in 2017. Despite a continuous\u00a0decline it is still higher than the average in the EU\/EEA countries. The highest incidence rates were observed\u00a0in older age groups. The participation of pediatric cases is smaller than average in the EU\/EEA countries.\u00a0The incidence in males was more than 2 times higher than in females. The impact of migration on the\u00a0characteristics of tuberculosis in Poland is not substantial. In Poland, MDR-TB is less common than the\u00a0average in the EU\/EEA countries.<\/p>\n<p><strong>STRESZCZENIE<\/strong><br \/><strong>CEL PRACY.<\/strong> Analiza sytuacji epidemiologicznej gru\u017alicy w Polsce w 2018 roku przez por\u00f3wnanie z sytuacj\u0105\u00a0w tym przedmiocie w krajach Unii Europejskiej (UE) i Europejskiego Obszaru Gospodarczego (EOG).<br \/><strong>MATERIA\u0141 I METODY.<\/strong> Analiza danych zebranych w Krajowym Rejestrze Zachorowa\u0144 na Gru\u017alic\u0119 (Rejestr)\u00a0dotycz\u0105cych przypadk\u00f3w zarejestrowanych w 2018 roku, wynik\u00f3w lekowra\u017cliwo\u015bci pr\u0105tk\u00f3w z rejestr\u00f3w\u00a0laboratoryjnych, danych G\u0142\u00f3wnego Urz\u0119du Statystycznego o zgonach z przyczyny gru\u017alicy, danych Narodowego\u00a0Instytutu Zdrowia Publicznego- Pa\u0144stwowego Zak\u0142adu Higieny o przypadkach gru\u017alicy jako choroby\u00a0wska\u017anikowej AIDS oraz raportu Europejskiego Centrum do Spraw Zapobiegania i Kontroli Chor\u00f3b (ang. European\u00a0Centre for Disease Prevention and Control-ECDC) o gru\u017alicy w krajach UE\/EOG w 2018 roku.<br \/><strong>WYNIKI.<\/strong> W 2018 roku zarejestrowano w Polsce 5487 przypadk\u00f3w gru\u017alicy, 300 zachorowa\u0144 mniej ni\u017c w roku\u00a02017. Zapadalno\u015b\u0107 na gru\u017alic\u0119 wszystkich postaci wynosi\u0142a 14,3 (w roku 2017- 15,1). Najwi\u0119ksze wsp\u00f3\u0142czynniki\u00a0zapadalno\u015bci na gru\u017alic\u0119 wszystkich postaci zarejestrowano w wojew\u00f3dztwie lubelskim \u2013 23,4; \u015bl\u0105skim \u2013 18,6\u00a0i mazowieckim \u2013 17,7; najmniejszy- w wojew\u00f3dztwie podlaskim \u2013 7,3. W 11 wojew\u00f3dztwach dosz\u0142o do spadku\u00a0zapadalno\u015bci na gru\u017alic\u0119 w por\u00f3wnaniu z rokiem 2017. 88,4% wszystkich przypadk\u00f3w stanowi\u0142y nowe zachorowania\u00a0(4852 chorych, wsp\u00f3\u0142czynnik 12,6). Kolejne zachorowania stanowi\u0142y 11,6% wszystkich przypadk\u00f3w.\u00a05224 osoby (95,2% og\u00f3\u0142u) mia\u0142y gru\u017alic\u0119 p\u0142uc \u2013 wsp\u00f3\u0142czynnik 13,7. Chorzy wy\u0142\u0105cznie na gru\u017alic\u0119 pozap\u0142ucn\u0105\u00a0w liczbie 243, stanowili 4,4% wszystkich zachorowa\u0144. Najcz\u0119stsz\u0105 postaci\u0105 gru\u017alicy pozap\u0142ucnej by\u0142o gru\u017alicze\u00a0zapalenie op\u0142ucnej (89 zachorowa\u0144). U 11 chorych, w\u015br\u00f3d kt\u00f3rych by\u0142o dwoje dzieci w wieku do 14 lat, rozpoznano\u00a0gru\u017alicze zapalenie opon m\u00f3zgowo-rdzeniowych i m\u00f3zgu. W 3 935 przypadkach gru\u017alicy p\u0142uc (75,3%)\u00a0rozpoznanie choroby by\u0142o potwierdzone bakteriologicznie (wsp\u00f3\u0142czynnik zapadalno\u015bci\u2013 10,2). Chorzy na gru\u017alic\u0119\u00a0p\u0142uc, w liczbie 2 324, u kt\u00f3rych pr\u0105tki stwierdzono tak\u017ce w bakterioskopii, stanowili 44,3% wszystkich\u00a0przypadk\u00f3w gru\u017alicy p\u0142uc. 48 chorych (1,3% przypadk\u00f3w ze znanymi wynikami lekowra\u017cliwo\u015bci), w tym 14\u00a0cudzoziemc\u00f3w, mia\u0142o gru\u017alic\u0119 wielolekooporn\u0105 (ang. multidrug-resistant tuberculosis-MDR-TB). Wsp\u00f3\u0142czynniki\u00a0zapadalno\u015bci na gru\u017alic\u0119 ros\u0142y w kolejnych grupach wieku, ale tylko do wieku 45-64 lata. Zapadalno\u015b\u0107\u00a0u os\u00f3b w wieku 65 lat i starszych \u201321,3\u2013 by\u0142a mniejsza ni\u017c w wieku od 45 do 64 lat (24,7). Zg\u0142oszono 52 zachorowania\u00a0na gru\u017alic\u0119 u dzieci do 14 roku \u017cycia (0,9% og\u00f3\u0142u chorych) i 60 przypadk\u00f3w gru\u017alicy u m\u0142odzie\u017cy\u00a0w wieku od 15 do 19 lat \u2013 wsp\u00f3\u0142czynniki odpowiednio 0,9 i 3,3. Liczba przypadk\u00f3w i zapadalno\u015b\u0107 w grupie\u00a0nastolatk\u00f3w by\u0142y najmniejsze w historii Rejestru. W znacz\u0105cym odsetku m\u0142odocianych chorych (90,0%- 54\u00a0osoby) gru\u017alica zosta\u0142a potwierdzona bakteriologicznie; u dzieci odsetek chorych z pewnym rozpoznaniem\u00a0gru\u017alicy wynosi\u0142 40,4% (21 chorych). 66 nastolatk\u00f3w i 2 dzieci chorych na gru\u017alic\u0119 p\u0142uc mia\u0142o dodatnie tak\u017ce\u00a0wyniki bakterioskopii plwociny. Jak w latach wcze\u015bniejszych, zapadalno\u015b\u0107 na gru\u017alic\u0119 u m\u0119\u017cczyzn by\u0142a ponad\u00a0dwukrotnie wi\u0119ksza ni\u017c u kobiet. Zarejestrowano 3 900 zachorowa\u0144 u m\u0119\u017cczyzn \u2013 wsp\u00f3\u0142czynnik zapadalno\u015bci\u00a021,0 i 1587 zachorowa\u0144 u kobiet \u2013 wsp\u00f3\u0142czynnik 8,0. Najwi\u0119ksza r\u00f3\u017cnica zapadalno\u015bci mi\u0119dzy m\u0119\u017cczyznami\u00a0i kobietami wyst\u0119powa\u0142a u os\u00f3b w wieku od 55 do 59 lat (44,9 vs. 9,8) i od 60 do 64 lat (43,7 vs. 10,2). Cudzoziemcy\u00a0(97) stanowili 1,8% og\u00f3\u0142u chorych. Gru\u017alica by\u0142a chorob\u0105 wska\u017anikow\u0105 u 14 chorych na HIV\/AIDS.\u00a0<br \/>Areszty \u015bledcze i zak\u0142ady karne zg\u0142osi\u0142y w 2018 roku 171 przypadk\u00f3w gru\u017alicy wykrytej u os\u00f3b tam osadzonych\u00a0(wsp\u00f3\u0142czynnik zapadalno\u015bci 230,8 na 100 000 osadzonych). W 2017 roku gru\u017alica by\u0142a przyczyn\u0105 zgonu\u00a0490 os\u00f3b. Wsp\u00f3\u0142czynnik umieralno\u015bci \u2013 1,3 \u2013 by\u0142 mniejszy ni\u017c w roku poprzednim (1,4). Najwi\u0119kszy wsp\u00f3\u0142czynnik\u00a0umieralno\u015bci z powodu gru\u017alicy stwierdzono w grupie wieku \u2265 65 lat \u2013 3,1. Nie by\u0142o zgonu z powodu\u00a0gru\u017alicy u dzieci i m\u0142odzie\u017cy. Liczba zgon\u00f3w z powodu gru\u017alicy u m\u0119\u017cczyzn by\u0142a 3,6 razy wi\u0119ksza ni\u017c u kobiet.<br \/><strong>WNIOSKI.<\/strong> Zapadalno\u015b\u0107 na gru\u017alic\u0119 w Polsce w 2018 roku by\u0142a mniejsza ni\u017c w roku poprzednim. Utrzymuj\u0105\u00a0si\u0119 r\u00f3\u017cnice zapadalno\u015bci mi\u0119dzy wojew\u00f3dztwami. Odsetek przypadk\u00f3w gru\u017alicy z potwierdzeniem bakteriologicznym przekroczy\u0142 75%, co wskazuje, \u017ce tylko 25% chorych, mniej ni\u017c w krajach UE\/EOG, ma jedynie\u00a0kliniczne rozpoznanie gru\u017alicy. Najwi\u0119ksze wsp\u00f3\u0142czynniki zapadalno\u015bci stwierdza si\u0119 w Polsce w starszych\u00a0grupach wieku. Odsetek dzieci w\u015br\u00f3d og\u00f3\u0142u chorych na gru\u017alic\u0119 wynosi\u0142 0,9%, mniej ni\u017c \u015bredni w krajach\u00a0UE\/EOG (3,4%). Zapadalno\u015b\u0107 na gru\u017alic\u0119 u m\u0119\u017cczyzn jest w Polsce ponad dwukrotnie wi\u0119ksza ni\u017c u kobiet,\u00a0u chorych w wieku od 55 do 64 lat ponad czterokrotnie wi\u0119ksza. Umieralno\u015b\u0107 z powodu gru\u017alicy by\u0142a ni\u017csza ni\u017c\u00a0w latach poprzednich. Zapadalno\u015b\u0107 i umieralno\u015b\u0107 na gru\u017alic\u0119 w Polsce s\u0105 wci\u0105\u017c wi\u0119ksze ni\u017c \u015brednie w krajach\u00a0UE\/EOG. Zjawiskiem korzystnym jest natomiast mniejszy ni\u017c przeci\u0119tny w UE\/EOG odsetek zachorowa\u0144 na\u00a0MDR-TB. W por\u00f3wnaniu z wieloma krajami europejskimi odsetek cudzoziemc\u00f3w w\u015br\u00f3d chorych na gru\u017alic\u0119\u00a0jest w Polsce ma\u0142y.<\/p><\/jats:p>","DOI":"10.32394\/pe.74.19","type":"journal-article","created":{"date-parts":[[2020,10,26]],"date-time":"2020-10-26T14:16:04Z","timestamp":1603721764000},"page":"239-257","source":"Crossref","is-referenced-by-count":1,"title":["Tuberculosis in Poland in 2018"],"prefix":"10.32394","volume":"74","author":[{"given":"M","family":"Korzeniewska","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"17323","published-online":{"date-parts":[[2020,10,19]]},"container-title":["Przeglad Epidemiologiczny"],"original-title":["Gru\u017alica w Polsce w 2018 roku"],"link":[{"URL":"https:\/\/www.przeglepidemiol.pzh.gov.pl\/pdf-180933-101496","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.przeglepidemiol.pzh.gov.pl\/pdf-180933-101496","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,3,8]],"date-time":"2024-03-08T08:45:35Z","timestamp":1709887535000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.przeglepidemiol.pzh.gov.pl\/Tuberculosis-in-Poland-in-2018,180933,0,2.html"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,10,19]]},"references-count":0,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2020]]}},"alternative-id":["180933"],"URL":"https:\/\/doi.org\/10.32394\/pe.74.19","relation":{},"ISSN":["0033-2100","2545-1898"],"issn-type":[{"value":"0033-2100","type":"print"},{"value":"2545-1898","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,10,19]]}}}