Towards tackling tuberculosis in vulnerable groups in the European Union: the E-DETECT TB consortium

Tuberculosis (TB) in the European Union (EU) is increasingly a public health problem that disproportionately and increasingly affects risk groups. The 30 EU/European Economic Area (EEA) countries reported 60 195 cases of TB in 2015; 4.1% of which was multidrug-resistant (MDR) TB [1]. The European Respiratory Society, the World Health Organization (WHO) European Region, European Centre for Disease Prevention and Control (ECDC) and other partners have articulated potential solutions that are embedded into the new global approach for TB control, the End TB Strategy [2–5]. Within the context of the TB elimination framework for low-incidence countries in Western Europe [5], and the TB action plan for the WHO European Region 2016–2020 that addresses the whole region with greater emphasis on high-burden countries [6], it is apparent that concrete trans-national evidence-based interventional projects are needed. To address the high disease burden of TB in vulnerable EU populations we have formed the Early DETECTion of tuberculosis consortium (E-DETECT TB). It brings together world leading TB experts in national public health agencies with industry and major academic centres, and its membership reflects the incidence of TB in different EU countries (figure 1). E-DETECT TB uses evidenced-based approaches to target vulnerable populations, including migrants to the EU, homeless persons, prisoners, problem drug users and those with MDR-TB (table 1). Here we outline the key objectives and progress of this major European TB initiative with a special focus on migrant screening in Italy and active case finding in vulnerable groups in Romania.