There has been a steady decrease in TB cases (all forms) from 730 in 2002 to 483 in 2008, or a decline from 37.7 in 2002 to 23.8 in 2008 per 100,000 population. Mortality is very low with less than 2% over the same period and therefore shows a highly fluctuating pattern. (Fig 1).
The total number of notified TB patients in 2009 is 473, of them 417 (88%) are new cases. Smear positive are 198 (42% of all cases; gender distributi0n 59% men and 41 % female (male: female ratio almost 3:2) The proportion of TB in children from 0-14 years amounts to 6.5%. Among the new cases in 2009, 74% are pulmonary and 26 are extra-pulmonary TB cases. The average age of TB patients for many years is stable (25-44 years).The total number of previously treated cases was 56 (11.83%) and only 27 patients with smear positive results.
In 2008 a total of 483 cases were notified (82.2% of the WHO highest estimate for the new TB cases all forms). Of these cases 117/483 or 23.8% were extra-pulmonary, while the remaining 368 (76.19%) are pulmonary TB cases. 427/483 (88.4%) were new cases and 56 (11.59%) were relapses and treatment after default or failure. Out of 321 new PTB cases 188 (58.56%) were sputum smear positive (81.73% of the WHO highest estimate).
The higher TB incidence rate in 2008 was recorded in the North-Western part of the country where 46% of patients are registered. By ethnicity, the incidence in Macedonians was 14.6/100.000; Albanians 45.9/100.000, Roma 42.6/100.000 and other 33.3/100.000.
2 new MDR-TB cases were registered in 2008; cumulatively, 8 patients were under treatment in 2008. In 2009, two new MDR TB cases were registered, one with primary resistance and one who had been treated before. The cumulative MDRTB cases in 2009 were 10 (60% of the WHO estimate). If these estimates are correct, the annual case load is 15. One case of XDRTB has been identified in 2009.
In 2008, 98/483 TB patients were voluntary tested for HIV (17.4%) and only 2 TB cases were HIV positive (2%).
The absolute number of prisoners with TB is relatively low (2-8), but it translates to a rate of 307 per 100.000 population, which is more than 10 times higher than in general population.
Republic of Macedonia is low HIV prevalence country with one of the lowest HIV positive cases reported among the countries in the South Eastern European Region after Kosovo.
The first HIV infection was registered in 1987, and the first AIDS case in 1989. According to data reported by the Institute for Public Health, the cumulative number of registered HIV/AIDS cases as of June 2010 is 129 with 97 AIDS and 32 HIV positive. Almost one half of all HIV/AIDS cases have been reported in the last 7 years 2003-2009. It is most likely that the increased number is at least partially due to greater availability of TC services in the country during this period. In the period 2008-2010, 27 new HIV cases were registered; 10 in 2008, 8 in 2009 and 9 by June, 2010 (Figure 1).
Figure 1: Total number of registered HIV cases by mid of 2010 (total 129)
Source: IPH-Skopje, 30.06.2010
Out of 129 HIV/AIDS cases between 1987 and 2009, almost three quarters are males (72,3%). Heterosexual transmission was reported to be predominant mode of transmission with 52,94%, followed by homosexual transmission that accounts for 12,60% and blood borne transmission in intravenous injectors with 7.56% (Figure 2). Reported cases in age group 30-39 years (39.49%) and age group 20-29 years (26%) contribute to almost three quarter of all reported HIV/AIDS cases (Figure 3).
Figure 2. Mode of transmission Figure 3. Age groups
Source: IPH-Skopje, 30.06.2010 Source: IPH-Skopje, 30.06.2010
Since the onset of the epidemic until the end of 2005, most of the new reported HIV/AIDS cases were already AIDS patients. During 2006-2009, this trend reversed with higher proportion of HIV positive than AIDS cases detected, which could be associated with increased availability of TC services contributing to earlier diagnosis of HIV infection. To date, the death rate of the diagnosed with AIDS remains at the high end. However, his has been reversing since 2007, as people started being regularly admitted into treatment with ARVs.
|PREVENTION||COUNSELLING||CARE||ADVOCACY||BEST PRACTICES||PARTNERS / NETWORKING||ERNA CONTACT PERSON|
|Health promotion activities including HIV/AIDS, STI, Hepatitis
YPE in high and primary schools
HR activities- providing sterile injecting equipment, basic medical services, assistance in providing a social services, legal counseling , outreach activities), in three towns: Prilep, Kichevo and Veles.
Re-socialization for stabilized drug users and develop of their creative skills (creative workshops)
Overdose prevention and first aid in cases with overdose.TB activities —
Development of strategic and operational plans for control of Tuberculosis on local level- the red cross branches in municipalities using the PCD ( participatory community development) approach facilitate the process for adoption of local plans of action through participation of all relevant institutions and organization. The main aim is to establish more efficient control of TB on local level.
MRC in cooperation with the Institute for pulmonary diseases and tuberculosis-Skopje organize a fluorography screening targeted primarly for the roma population as a vulnerabile group exposed to great risk for infection with tb. The main purpose is to increase the rate of cure of TB.
The social mobilization, distribution of educational-informational material contributes for raising the awerness and the importance of this disease among the Roma population.
|VCCT is implemented with cooperation with NGO Hera and Public Health Institute||1st of December activities, RC week for fight against
HIV/AIDS 1-7 th December24 th March- World day for fight against TB ,
RC week for fight against TB and pulmonary diseases 14-21stSeptember
Advocacy Workshop for HR programme with media representatives from Veles, Kichevo and Prilep
|ERNA, NGO HOPS, Croatian RC, Ministry of health (GFATAM), German Red Cross, Italian Red Cross||E-mail: firstname.lastname@example.org|
|The Red Cross of The Former Yugoslav Republic of Macedonia|
|ERNA Contact Information||Head||Head||ERNA Contact Person|
|Name Surname||Dr. Milcho TRAJKOV||Mr Sait SAITI||Ms. Aneta Trgacevska, MD|
|Role in the National Society||President||Secretary General||Health Coordinator|
|Phone numbers||(389) 23 114 355||(389) 23 114 355||+389 2 3114355 ext. 133. m.+389 70 317 651|
|Fax||+389 23 230 542|
|Post address||bul. Koco Racin br. 13
1000 Skopje, Macedonia