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Tuberculosis in Romania. Problems and solutions

Elmira Ibraim1, Ioan Paul Stoicescu1, Daniela Homorodean2, Cristina Popa1, Madalina Burecu1, Ileana Stoicescu1, Cristian Popa1, Ruxandra Spataru1, Anca Macri1, Cornelia Tudose1, Diana Ionita1, Mariana Andrei1
Tuberculosis in Romania. Problems and solutions


The analysis of the Management Unit of the National TB Programme (NTP) database, together with the reports of the TB county managers, allowed to the authors to identify some weaknesses of TB control in Romania in the recent years and to propose the appropriate measures.
- The marked decrease in the reduction of TB cases reported annually from 2,761 in 2005-2006, to 145 in 2007-2008 and the stagnation of mortality rate: 7.5%ooo in 2007 and 7.6%ooo in 2008.

- Deficiencies in data recording and reporting through informatics system of the NTP. Lack of financial resources for system maintenance and upgrade.

- Deficiencies in monitoring and control of mycobacterium resistance to antituberculous drugs phenomenon at national level. Sensitivity testing only for a small percentage of culture confirmed TB cases (21%). Higher percentage of MDR in new TB cases compared to the results of national survey of mycobacterium drug resistance 2003-2004.

- Lack of personnel: 16 TB dispensaries without any pulmonologist, vacancies for 259 doctors, 436 nurses and 433 auxiliary personnel. Important deficiencies in the NTP network's infrastructure and logistics countrywide.

- Discontinuities in the supply with first and second line antituberculous drugs resulting in interruption of treatments.

- Lack of an officially endorsed protocol for the diagnosis, treatment and monitoring of cases with TB/HIV co-infection.  

- Revitalization of monitoring-supervision activities of the NTP running countrywide, provision with necessary financial resources to perform the scheduled visits in counties. Providing maintenance and upgrade of the informatics system for data collection.

- Implementation of the necessary measures in order to attract and maintain the personnel in the NTP network.

- Conduct the national survey of mycobacterium susceptibility to first and second line antituberculous drugs and drug susceptibility testing of the most culture confirmed TB cases.

- Restore the centralized procurement of TB drugs.

- Finalization and official endorsement of the protocol for TB/HIV co-infection initiated in 2004.
We are thanking the county technical coordinators of the National Programme for Tuberculosis Control for delivering the data and the information used for making this paper. 


Contact: Dr. Elmira Ibraim, Coordinator of the National Programme for Tuberculosis Control, „Marius Nasta" Institute of Pulmonology, Sos. Viilor 90, Bucuresti, e-mail:


Keywords: tuberculosis, national control programme, problems, solutions