Estonia approaching low tuberculosis burden country status

Estonian TB registry director Piret Viiklepp.
Estonian TB registry director Piret Viiklepp. Source: ERR

The World Health Organization (WHO) has classified Estonia as a high tuberculosis (TB) risk country, but Estonia may soon have the chance to shake this classification. Nonetheless, while the number of TB cases is going down, compared with the rest of Europe, Estonia is seeing more cases of multidrug-resistant TB (MDR-TB).

Last year, a total of 151 cases of TB were registered in Estonia. The youngest patient, infected by their mother, was one year old; the oldest was 97. While Estonia is starting to reach the status of low TB burden country, compared with other European countries, Estonia has seen significantly more cases of MDR-TB.

According to Piret Viiklepp, director of the National Institute for Health Development's (TAI) TB registry, percentages in Estonia are high, but absolute numbers have fallen.

"While we had more than 100 MDR cases at the turn of the century, last year there were just 27," Viiklepp said. "20 of these were new cases. Among new cases, if the European average is below 4 percent, MDR cases account for 20 percent of new cases, but nearly half of previously treated cases are MDR in nature."

Tartu University Hospital (TÜK) doctor Manfred Danilovitš said that while Estonia with its high numbers of MDR cases stands out in scientific publications, the situation isn't as bad as the statistics make it out to be, noting that modern medical care is able to help those with a drug-resistant strain of TB as well.

Depending on the strain, treatment for TB can last from six months to two years, and is ensured for everyone in Estonia. Treatment costs €20,000-30,000, but patients themselves do not have to pay for it.

To prevent drug resistance, TB drugs must be taken in the presence of a nurse daily.

For the past 20 years, Estonia's goal has been to reach low tuberculosis burden country status, a goal it is set to reach soon. A new goal is to reduce the number of cases of MDR-TB, but to do so, everyone with the disease must be found as quickly as possible.

According to Danilovitš, a certain percentage of people seek medical treatment for their illness too late. "These are the types of people who aren't really very worried about their health; they cough for months and won't go to the doctor," he said.

While the rate of TB infection in Estonia is 11 per 100,000 residents, the corresponding figure in Finland is just five. Latvia and Lithuania, however, see two and three times more cases of TB than Estonia, respectively.


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Editor: Aili Vahtla

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