[Tuberculosis in Poland 2000--at the turn of the century].

Unlabelled: The aim of this paper was to evaluate incidence, prevalence and mortality from TB in Poland in 2000 and to examine trends of TB incidence. Individual date on tuberculosis cases reported to National TB Register and data of prevalence and mortality from TB were analysed. The paper presents the epidemiological situation of TB in Poland in 2000. The year of 2000 was the seventh consecutive year of decline at TB incidence after previous years (1991-1993) of increase. In 2000 there were 11,477 newly registered TB cases, of which 1428 were relapses. The incidence was 29.7 per 100,000 population, /26.0 were the new cases and 3.7 relapses/. Relapses represented 12.4% of all registered cases. The incidence in 2000 was 5.7% lower than in 1999, but the rate of decline was smaller than in previous year--8.4%. Among the total number of newly registered cases there were 6518 cases--16.9 per 100,000--bacteriologically confirmed, of which 3.713 cases were sputum smear positive. The proportion of bacteriologically confirmed cases was 56.8% and of sputum smear positive--33.9% which is rather low, but similar to previous years. In view of sufficient network of laboratory services this low proportion of bacteriological confirmation of diagnosis may indicate low quality of bacteriological examinations. In 95.5% of cases the diagnosis was respiratory tuberculosis. Low proportion--4.5%--of extrarespiratory tuberculosis, which have continued for many years, may indicate inadequacies in diagnosis and registration of this form of disease. The incidence of tuberculosis increases with age, from 1.4 in children up to 62.4 among 65 and older. The proportion of cases in the age group 20-44 years is still high (34.7%). The incidence in men (40.9) is two times higher than in women (19.1), and in rural population higher than in urban--30.5 and 29.2 respectively. The prevalence of tuberculosis at the end of 2000 was 38.5 (14,895 cases), of which 55.4% were bacteriologically confirmed cases (8252 cases). In the latter group there were 232 cases bacteriologically positive for longer than one year, and 369 cases resistant to at least 1 drug. The proportion of resistant cases (3.9%) is similar to previous years and does not seem to influence the overall effectiveness of chemotherapy. There were 1.022 (1.024) deaths due to tuberculosis 995 (985)--respiratory tuberculosis and 27 (39) extrarespiratory tuberculosis) reported in 1999 i.e. (2.6) per 100,000. Almost 43% of all deaths were in patients 65 year of age and older. Since many years the TB mortality is the order of 0.3% of total mortality.

Conclusions: In recent years incidence of TB in Poland decreased. The incidence of tuberculosis in Poland was about 2 times higher than the average for E.U. countries, but lower than in other Eastern European countries. The distance between Poland and countries with lowest incidence in Europe is estimated at 25-30 years. Tuberculosis has been and will remain a major public health problem in Poland for many decades.