Tuberculosis Treatment Outcomes in Europe: Based on Treatment Completion, Not Cure

What is it about?

For a tuberculosis patient to receive the outcome of cure, there needs to be a final confirmation test at the end of treatment. This test assesses the presence of tuberculosis bacteria in sputum. The current study shows that in Europe, this final confirmation test is not often done, albeit more frequently in countries with an intermediate or high burden of tuberculosis ("Central/Eastern Europe": around 45%), compared to countries with a low burden of tuberculosis ("Western Europe": around 5%). The main reason for the absence of the confirmation test is the inability of coughing of sputum, and/or unwillingness of treating physicians to perform it. Therefore, the formal outcome definitions, as proposed by the World Health Organization, are not connected with the everyday clinical management of tuberculosis patients in Europe.

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Why is it important?

This situation makes it difficult to properly assess the effectiveness of the treatment or the impact of a national tuberculosis control program. Instead of a proper indication of patients who are really cured, we have to rely on a much less precise measure of patients who "at least finish their prescribed treatment". There is an urgent need to rethink tuberculosis treatment outcomes.