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DOI: 10.1055/s-2008-1038265
Epidemiologie der Tuberkulose in der Welt und in Deutschland
Epidemiology of Tuberculosis in the World and in GermanyPublication History
Publication Date:
07 October 2008 (online)

Zusammenfassung
Die Tuberkulose ist weltweit unverändert eine der bedeutendsten Infektionskrankheiten. Aufgrund der vor allem in der Europaregion scheinbar unaufhaltsam fortschreitenden Verbreitung medikamentenresistenter Tuberkulosebakterienstämme stellt die Krankheit für Industriestaaten wie Deutschland auch heute noch eine Bedrohung dar. Daher dürfen die Bemühungen um eine effektive Tuberkulosekontrolle trotz hierzulande rückläufiger Fallzahlen nicht nachlassen, ganz im Gegenteil. Basierend auf einer möglichst genauen Kenntnis der epidemiologischen Situation und der Resistenzraten bedarf es daran ausgerichteter effektiver Kontrollstrategien und eines Auf- bzw. Ausbaus nationaler Tuberkulose- sowie HIV-Kontrollprogramme. Aber auch forcierte und langfristig ausgerichtete Forschungsanstrengungen sind erforderlich zur Entwicklung neuer antituberkulotischer Substanzen, einfacher und zuverlässiger Diagnostika sowie eines wirksamen Impfstoffes.
Abstract
Tuberculosis (TB) remains one of the most important infectious diseases worldwide. The seemingly unstoppable spread of drug-resistant TB strains, particularly in the European region, make it a continuing threat even to industrialized nations such as Germany. Therefore, effective TB control measures must not be neglected despite declining case numbers in this country – on the contrary. Detailed knowledge of the epidemiological situation and of resistance rates must be the basis for effective control strategies and for the introduction or improvement of national TB and HIV control programmes. There is likewise a need for intensified long-term research into new antituberculous substances, simple and reliable diagnostic methods, and a highly protective vaccine.
Literatur
- 1
Migliori G B, Loddenkemper R, Blasi F. et al .
125 years after Robert Koch’s discovery of the tubercle bacillus: Is “science” enough to tackle the epidemic?.
Eur Respir J.
2007;
29
423-427
MissingFormLabel
- 2
Cox H, Hargreaves S, Ismailov G.
Effect of multidrug resistance on global tuberculosis control.
Lancet.
2003;
362
858-1859
MissingFormLabel
- 3
Davies P DO.
The world wide increase in tuberculosis: how demographic change, HIV infection and
increasing numbers in poverty are increasing tuberculosis.
Ann Med.
2003;
35
235-243
MissingFormLabel
- 4 World Health Organization .Anti-tuberculosis drug resistance in the world. Report No. 4, 2008. WHO/HTM/TB/2008.394
MissingFormLabel
- 5 World Health Organization .Global tuberculosis control: surveillance, planning, financing: WHO report 2008. WHO, Geneva, Switzerland, WHO/HTM/TB/2008.393
MissingFormLabel
- 6
Cohen T, Colijn C, Wright A. et al .
Challenges in estimating the total burden of drug-resistant tuberculosis.
Am J Respir Crit Care Med.
2008;
177
302-1306
MissingFormLabel
- 7 The WORLD BANK Human Development Network Health, Nutrition & Population Team .Economic benefit of Tuberculosis Control. Policy Research Working Paper (WPS) 4295. 2007
MissingFormLabel
- 8 Broekmans J, Caines K, Paluzzi J E. et al .Investing in strategies to reverse the global incidence of TB. Earthscan London 2005
MissingFormLabel
- 9 World Health Organization .Addressing poverty in TB control. Options for national TB control programmes. WHO, Genf 2005. WHO/HTM/TB/2005.352
MissingFormLabel
- 10 World Health Organization .Tuberculosis control in prisons. A manual for programme managers. WHO Genf 2000. WHO/CDS/TB/2000.281
MissingFormLabel
- 11
Dye C, Maher D, Weil D. et al .
Targets for global tuberculosis control.
Int J Tuberc Lung Dis.
2006;
10
460-462
MissingFormLabel
- 12
Raviglione M C, Uplekar M W.
WHO's new Stop TB Strategy.
Lancet.
2006;
367
952-955
MissingFormLabel
- 13 World Health Organization .Guidelines for the programmatic management of drug-resistant tuberculosis. World Health Organization, Genf 2006
MissingFormLabel
- 14 World Health Organization .Plan to stop TB in 18 high-priority countries in the WHO European Region 2007–2015. WHO, Genf 2007 . http://www.euro.who.int/document/E91049.pdf
MissingFormLabel
- 15 World Health Organization .The Stop TB Strategy. Building on and enhancing DOTS to meet the TB-related Millenium
Development Goals. World Health Organization, Genf 2006. WHO/HTM/STB/2008
MissingFormLabel
- 16 World Health Organization .Guidelines for Establishing DOTS-Plus pilot projects for the management of multidrug-resistant
tuberculosis. WHO, Genf, 2000. WHO/DCS/TB/2000.279
MissingFormLabel
- 17 World Health Organization .Strategic framework to decrease the burden of HIV. WHO, Genf 2002. WHO/CDS/TB2002.296 WHO/HIV_AIDS/2002.2
MissingFormLabel
- 18
Friedland G, Churchyard G J, Nardell E.
Tuberculosis and HIV coinfection: current state of knowledge and research priorities.
J Infect Dis.
2007;
196
S1-S3
MissingFormLabel
- 19 Centers for Disease Control and Prevention .Managing drug interactions in the treatment of HIV-related tuberculosis [online] . http://www.cdc.gov/tb/TB_HIV_Drugs/default.htm
MissingFormLabel
- 20
Scholten J N, de Vlas S J, Zaleskis R.
Under-reporting of HIV infection among cohorts of TB patients in the WHO European
Region, 2003–2004.
Int J Tuberc Lung Dis.
2008;
12
85-91
MissingFormLabel
- 21 Konietzko N, Loddenkemper R. (Hrsg) .Tuberkulose. Georg Thieme Verlag Stuttgart New York 1999
MissingFormLabel
- 22
Cox H, Kebede Y, Allamuratova S. et al .
Tuberculosis recurrence and mortality after successful treatment: Impact of drug resistance.
PLoS Med.
2006;
3
e384
MissingFormLabel
- 23
Zignol M, Hosseini M S, Wright A. et al .
Global incidence of multidrug-resistant tuberculosis.
J Infect Dis.
2006;
194
479-485
MissingFormLabel
- 24
Centers for Disease Control and Prevention .
Notice to readers: Revised definition of extensively drug-resistant tuberculosis.
MMWR.
2006;
55
1176
MissingFormLabel
- 25
Migliori G B, Besozzi G, Girardi E. et al .
Clinical and operational value of the extensively drug-resistant tuberculosis definition.
Eur Respir J.
2007;
30
623-626
MissingFormLabel
- 26
Vier H, Schaberg T, Gillissen A.
XDR (extensive resistance)-Tuberkulose.
Pneumologie.
2007;
61
606-609
MissingFormLabel
- 27
Migliori G B, de Iaco G, Besozzi G. et al .
First tuberculosis cases in Italy resistant to all tested drugs.
Euro Surveill.
2007;
12(5)
-E070517.1
MissingFormLabel
- 28
Basu S, Andrew J R, Poolman E M. et al .
Prevention of nosocomial transmission of extensively drug-resistant tuberculosis in
rural South African district hospitals: an epidemiological modelling study.
Lancet.
2007;
370
1500-1507
MissingFormLabel
- 29
Lange C, Grobusch M P, Wagner D.
Extensiv-resistente Tuberkulose (XDR-TB).
Dtsch Med Wschr.
2008;
133
374-376
MissingFormLabel
- 30
Gandhi N R, Moll A, Sturm A W, Pawinski R. et al .
Extensively drug-resistant tuberculosis as a cause of death in patients co-infected
with tuberculosis and HIV in a rural area of South Africa.
Lancet.
2006;
368
1575-1580
MissingFormLabel
- 31 Euro TB and the national coordinators for tuberculosis surveillance in the WHO European
Region .Surveillance of tuberculosis in Europe. Report on tuberculosis cases notified in 2006. Institut de veille sanitaire, Saint-Maurice, France. März 2008
MissingFormLabel
- 32
Aerts A, Hauer B, Wanlin M. et al .
Tuberculosis and tuberculosis control in European prisons.
Int J Tuberc Lung Dis.
2006;
11
1213-1223
MissingFormLabel
- 33 Deutsches Zentralkomitee zur Bekämpfung der Tuberkulose: 31 .Informationsbericht,. Berlin 2008
MissingFormLabel
- 34 Deutsches Zentralkomitee zur Bekämpfung der Tuberkulose: 31 .Informationsbericht,. Berlin 2008 . http://www.euro.who.int/tuberculosis/tbforum/20070621_1
MissingFormLabel
- 35 European Centre for Disease Prevention and Control .Framework action plan to fight tuberculosis in the European Union. Stockholm Februar 2008 . http://www.euro.who.int/Document/E90833.pdf
MissingFormLabel
- 36
Broekmans J F, Migliori G B, Rieder H L. et al .
European framework for tuberculosis control and elimination in countries with a low
incidence. Recommendations of the World Health Organization (WHO), International Union
Against Tuberculosis and Lung Disease (IUATLD) and Royal Netherlands Tuberculosis
Association (KNCV) Working Group.
Eur Respir J.
2002;
19
765-775
MissingFormLabel
- 37 Robert Koch-Institut .Bericht zur Epidemiologie der Tuberkulose in Deutschland für 2006. Robert Koch-Institut, Berlin 2008 http://. www.rki.de
MissingFormLabel
- 38 Robert Koch-Institut .Infektionsepidemiologisches Jahrbuch meldepflichtiger Krankheiten für 2007. Robert Koch-Institut, Berlin 2008
MissingFormLabel
- 39 Robert Koch-Institut .Falldefinitionen des Robert Koch-Instituts zur Übermittlung von Erkrankungs- oder
Todesfällen und Nachweisen von Krankheitserregern. Ausgabe 2007
MissingFormLabel
- 40
Centers for Disease Control .
Trends in tuberculosis – United States, 2007.
MMWR weekly report.
2008;
57
281-285
MissingFormLabel
- 41
Borgdorff M W, Nagaldkerke N J, Dye C. et al .
Gender and tuberculosis: a comparison of prevalence surveys with notification data
to explore gender differences in case detection.
Int J Tuberc Lung Dis.
2000;
4
123-132
MissingFormLabel
- 42
Forssbohm M, Zwahlen M, Loddenkemper R. et al .
Demographic characteristics of patients with extrapulmonary tuberculosis in Germany.
Eur Respir J.
2008;
31
99-105
MissingFormLabel
- 43 Weiss M G, Auer C, Somma D B. et al .Gender and tuberculosis: cross-site analysis and implications of a multi-country study
in Bangladesh, India, Malawi, and Colombia. TDR/SDR/SEB/RP/06.1, WHO 2006
MissingFormLabel
- 44
Kunitz F, Brodhun B, Hauer B. et al .
Die aktuelle Tuberkulosesituation in Deutschland und die Auswirkungen der globalen
Situation.
Pneumologie.
2007;
61
467-477
MissingFormLabel
- 45 Statistisches Bundesamt Deutschland .Statistisches Jahrbuch für die Bundesrepublik Deutschland. 2007
MissingFormLabel
- 46
Blaas S H, Mutterlein R, Weig J. et al .
Extensively drug resistant tuberculosis in a high income country: A report of four
unrelated cases.
BMC Infect Dis.
2008;
8
60
MissingFormLabel
Bisher erschienene Beiträge dieser Serie
- 47
Murray J.
Die historische Entwicklung der Tuberkulose seit Robert Kochs Entdeckung des Tuberkelbazillus
1882.
Pneumologie.
2007;
61
64-771
MissingFormLabel
- 48
Ulrichs T.
Immunologie der Tuberkulose und Entwicklungsstand neuer Impfstoffe.
Pneumologie.
2008;
62
143-148
MissingFormLabel
- 49
Kalsdorf B, Strassburg A, Greinert U. et al .
Klinik und Diagnose der Tuberkulose.
Pneumologie.
2008;
62
284-294
MissingFormLabel
- 50
Rüsch-Gerdes S, Hillemann D.
Moderne mykobakteriologische Labordiagnostik.
Pneumologie.
2008;
62
533-540
MissingFormLabel
1 multidrug-resistant tuberculosis, MDR, d.h. mindestens Resistenz gegenüber Isoniazid und Rifampicin
2 extensively drug-resistant tuberculosis, XDR= MDR + Resistenz gegenüber einem Fluorchinolon und wenigstens gegen eines der injizierbaren Medikamente Capreomycin, Kanamycin und Amikacin
3 extremely drug-resistant tuberculosis, XXDR, resistent gegenüber allen antituberkulotischen Erst- und Zweitrangmedikamenten
Dr. Barbara Hauer, MPH
Deutsches Zentralkomitee zur Bekämpfung der Tuberkulose, Lungenklinik Heckeshorn,
HELIOS Klinikum Emil von Behring
Walterhöferstr. 11
14165 Berlin
Email: bhauer@dzk-tuberkulose.de