Under-reporting of HIV infection among cohorts of TB patients in the WHO European Region, 2003-2004

SETTING: The World Health Organization (WHO) European Region, which includes 52 countries. OBJECTIVE: To assess an epidemiological data collection tool implemented in 2004 for recording human immunodeficiency virus (HIV) status among tuberculosis (TB) patients. DESIGN: Based on WHO estimates, the reported number of TB patients with HIV was compared with the number expected. The analysis included all forms of TB and was restricted to adults, wherever possible. The numbers of TB patients detected from HIV/acquired immune-deficiency syndrome (AIDS) programmes (NAPs) were also assessed. RESULTS: In 2003, 20 (38%) National TB Programmes (NTPs) reported 4602 (35%) HIV-infected TB cases of 13 117 expected; in 2004, 23 (44%) NTPs reported 5902 (42%) cases of 13 901 expected. In 2003, 47 (90%) NAPs reported 3575 (27%) TB cases as a new AIDS diagnosis, while in 2004, 40 (77%) NAPs reported 3901 (28%) TB cases. Those countries that did report, reported on average 60 - 65% of expected cases, irrespective of the kind of programme and the year. CONCLUSION: Most NTPs did not report TB cases with HIV infection. Overall, the number of cases reported in countries that reported data from either NTPs or NAPs was significantly lower than expected. Improved surveillance requires concerted efforts from both NTPs and NAPs