One of the oldest diseases, tuberculosis is still prevalent in hundreds of countries and nearly every continent. Although many countries have been able to reduce their number of cases through medical intervention and policies, Eastern Europe remains affected by the disease. Despite the rising cases of tuberculosis in Eastern Europe, European and other governments are coming up with new solutions to better treat individuals with TB and potentially eradicate the disease. Here are five facts about tuberculosis in Eastern Europe.

5 Facts About Tuberculosis in Eastern Europe

1. Most of Europe’s tuberculosis cases are in Eastern Europe. According to the World Health Organization (WHO), Europe has the lowest incidence of tuberculosis in the world. However, the cases that do exist concentrate in Eastern Europe. The WHO found that 18 countries in Eastern Europe bear 85% of the tuberculosis burden for the continent. Over the past decade, cases of tuberculosis have halved throughout Europe. Despite this decrease, however, the number of cases in Eastern Europe is almost eight times higher than that of Central and Western Europe.
2. Eastern Europe has the highest rates of drug-resistant tuberculosis. Multidrug-Resistant Tuberculosis (MDR tuberculosis) is currently the most prevalent form of TB in Eastern Europe. MDR tuberculosis occurs when the bacteria that causes tuberculosis becomes resistant to at least isoniazid and rifampin, the two most common drugs doctors use to treat tuberculosis patients. Typically, this resistance occurs when patients do not finish their antibiotics or when tuberculosis infects a person more than once. In all of Europe, 99% of MDR tuberculosis cases occur in Eastern Europe. As a result, scientists need to develop new antibiotics or treatments for patients in that region.
3. Tuberculosis outbreaks are more common in poorer regions. In general, researchers tend to find tuberculosis in poorer and developing countries. Similarly, the levels of TB in Eastern Europe could connect to the overall poverty rates in the region. The poverty rates in Central and Western European countries such as the Czech Republic are as low as 10%. However, in Eastern European countries, such as Romania, the poverty rates are as high as 25%. In poorer countries, access to medical treatment and preventative care decreases. Thus, in Eastern Europe, a common struggle for individuals with tuberculosis is finding health care that is effective and affordable.
4. Problems with tuberculosis are worsening due to COVID-19. The COVID-19 pandemic has led countries to implement social distancing and stay-at-home policies. As a result, the circumstances for individuals with tuberculosis in Eastern Europe may worsen. A recent modeling study looked at the rate of incidence of tuberculosis and the tuberculosis mortality rate during the lockdown. The study predicted that both the number of cases and the number of deaths will rise as people remain in close quarters. For example, imagine the lockdown in a high-risk country such as Ukraine lasting for 3 months with a 10 month recovery period. The rate of incidence would increase by 10.7% and the mortality rate would increase by 16%. One reason for this increase is the lack of medical care available during the pandemic. As more supplies and medical officials go towards fighting COVID-19, other diseases such as tuberculosis could go unchecked during the lockdown.
5. Better diagnostic services are currently in progress. This year, in 2020, the European Lab Initiative (ELI) on tuberculosis, HIV and Viral Hepatitis, a regional center that has dedicated itself to the treatment of those three diseases, released its goals for 2020 and 2021. These goals, which include improved drug treatments and better tracking algorithms, hope to allow doctors in Eastern Europe to diagnose patients with tuberculosis faster. By diagnosing people earlier, the transmission of tuberculosis will slow, and those who test positive for tuberculosis will have a higher chance of recovery.

Although the rates of TB continue to drop in Western and Central Europe, wealth inequality and the COVID-19 pandemic are keeping the number of cases up in Eastern Europe. However, if progress on better diagnostic services continues, the occurrence of tuberculosis there will decrease.

– Sarah Licht 
Photo: Flickr