Dutch National TB Control Plan 2016-2020 · National TB Control Plan 2016-2020 Risk group approaches in plan •Contact investigation (CI) •Screening other risk groups for TB and

Dutch National TB Control Plan 2016-2020

Towards eliminationGerard de Vries, MD MSc PhD

Coordinator TB control the Netherlands

KNCV Tuberculosis Foundation/RIVM-CIb

UNION European Region conference, Bratislava, Slovakia, 23 June 2016

The Netherlands

• 17.0 million people

• Member of the European Union (EU) (green countries).

• Low-lying country, with about 20% of its area (with 21% of its population) below sea level, and 50% of its land lying less than one meter above seas level.

The Netherlands

• Densely populated

• 4 big cities (Amsterdam, Rotterdam, The Hague and Utrecht)

Municipal public health centres (GGDs)

National Institute for Public Health & the Environment (RIVM)

KNCV

Health services

• 25 GGDs

• 8,879 General Practitioners (1 per 2,379 population)

• 90 hospitals

• 44 labs doing smears

• 29 labs doing culture

• 6 peripheral labs doing phenotypic DST for TB

• 30 prisons (excl. 7 juvenile and 2 forensic psychiatric prisons)

• ? centres for asylum seekers

• ? local services for drug addicts and homeless persons.

Tuberculosis centre Beatrixoord

Tuberculosis centre Dekkerswald

Towards regional/national TB expert centres

25 GGDs 7-8 backoffices 4 regional expert centres

(2003) (2015)

Number of TB patients in the Netherlands

5.1

33.8

1.5

0

500

1,000

1,500

2,000

2,500

1975 1977 1979 1981 1983 1985 1987 1989 1991 1993 1995 1997 1999 2001 2003 2005 2007 2009 2011 2013 2015

Nu

mb

er

of

TB p

atie

nts

Total Born in the Netherlands Foreign-born

Tuberculosis plans

National TB Control Plan

2011-2015

National TB Control Plan 2016-2020The process

• Kick-off meeting with stakeholders (March 2015)

• 2 meetings of Advisory Committee with stakeholders’ representation to discuss draft plans (July, September)

• Public consultation of TB-professionals by mail (October)

• Presentation at the Ministry of Health (March 2016)

www.kncvtbc.orgDisclaimer

National TB Control Plan 2016-2020The content

• Introduction + 10 chapters• 38 objectives and activities

Main objectives:• To reduce TB incidence with

25%• To reduce TB transmission

with 25%

Main new intervention is to screen migrants from high TB-incidence countries for LTBI and provide preventive treatment.

National TB Control Plan 2016-2020Risk group approaches in plan

• Contact investigation (CI)• Screening other risk groups for

TB and LTBI

Activities in the plan:1. Report annually numbers

screened and the yield in surveillance report (monitoring)

2. Evaluate CI and TB screening 2011-2015

3. Enhanced surveillance (e.g. clinical risk groups)

4. Measure TB transmission

National TB Control Plan 2016-2020Enhanced surveillance

National TB Control Plan 2016-2020Enhanced surveillance

National TB Control Plan 2016-2020Measuring TB transmission (in two ways)

RECENT TRANSMISSION• TB patients who were

infected in the Netherlands < 2 years (based on DNA fingerprints of bacteria + epidemiological information)

FORWARD TRANSMISSION• Number of newly

diagnosed TB and LTBI cases in contact investigations

This presentation is part of the project E-DETECT TB (709624) which has received funding from the EU’s Health Programme (2014-2020)

15

Aims and objectives of work package 7, E-DETECT TB

Support the development of action plans in member states, in close collaboration with ECDC and WHO, by taking best practice approaches from countries where E-DETECT TB partners have developed national and international strategies by:

1. reviewing existing action plans and strategies

2. consensus meeting of national experts

3. developing a strategy development guide

Survey (M12)Policy review

(M12)Expert meeting

(M20)

TB strategy prioritisation,

action and support plan (M24)

Thank you for your attention!

http://www.rivm.nl/en/Documents_and_publications/Scientific/Reports/2016/maart/National_Tuberculosis_Control_Plan_2016_2020_Towards_elimination

Or send a request to:[email protected]@rivm.nl