Tuberculosis is spreading in central and eastern Europe

BMJ 2000; 320 doi: (Published 08 April 2000) Cite this as: BMJ 2000;320:959
  1. Marta Balinska
  1. Warsaw

    More than 30000 people in the Russian Federation leave prison with tuberculosis every year, according to Dr Malgorzata Grzemska of the World Health Organization in Geneva, who spoke at a conference in Warsaw on emerging and drug resistant infections in central and eastern Europe. The conference was organised by the Polish National Institute of Hygiene and New York's state department of public health.

    Dr Grzemska told the conference that there were 80000 notified cases of tuberculosis in Russian prisons and about 300000 people entered or left prison each year. The WHO is calling for implementation of the directly observed treatment short course (DOTS plus) programme in which patients are closely monitored to ensure that they complete the course of treatment. The organization is also calling for pilot treatment protocols to be set up using second line antituberculous drugs. The Baltic states have recently had a sharp increase in the number of cases of tuberculosis and multidrug resistant tuberculosis. In Poland, where rates have generally been declining since 1956, doctors are worried that about 40% of cases are not being notified in certain regions. As yet, no significant overlap has been noted between cases of tuberculosis and HIV infection and AIDS in the region. Most countries, however, have recently registered a sudden increase in the number of cases of infection of HIV and AIDS (up to threefold in the last year) and often a corresponding rise in the number of intravenous drug users, who seem to account for the majority of people infected with HIV. Wieslaw Magdzik, professor at the National Institute of Hygiene in Poland, singled out Poland as a model for other countries in the region because it has been successful in controlling the spread of hepatitis B virus.

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