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New issues in tuberculosis
  1. S Praprotnik1,
  2. B Rozman1,
  3. M Tomšič1
  1. 1Department of Rheumatology, University Medical Centre, Vodnikiva, 62 Ljubljana, Slovenia
  1. Correspondence to:
    Dr M Tomšič
  1. S H E Kaufmann2
  1. 2Max Planck Institute for Infection Biology, Department of Immunology, Schumannstr 21/22, 10117 Berlin, Germany

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We read with interest the recent article by Kaufmann,1 who reported new issues in the epidemiology and treatment of tuberculosis. Dr Kaufmann pointed out that tuberculosis remains a significant health threat in the new European Union member states, in contrast with the “old” EU member states, in which the incidence of this disease is decreasing. Accordingly, he reported the incidence for Slovenia as above 20/100 000.

It is important to clarify that the mentioned incidence was last reported in Slovenia in 1999. Since 1995 tuberculosis in Slovenia has been decreasing constantly, reaching an incidence of 17.5/100 000 in 2002.2 (Data also available on website, accessed 24 February 2005.) The preliminary data of the central registry for tuberculosis in Slovenia have shown a further decrease for 2003, with an incidence of 14.7/100 000 (personal report).

The importance of the omitted information is not only academic. Fictitious higher incidences of tuberculosis misrepresent the risk of this disease in Slovenian patients treated with biological drugs, which could be important in multicentre clinical studies.

Furthermore, we would like to mention that the incidence of tuberculosis in patients treated with biological agents in Slovenia is very low. This treatment is centrally indicated and evaluated. We have confirmed only one case of tuberculosis among 200 patients receiving biological agents (anakinra, infliximab, etanercept).


Author’s reply

I read with great interest the comments about the decreasing incidence of tuberculosis rates Slovenia. As is stated correctly, the incidence of tuberculosis in Slovenia is now below 20/100 000. Indeed, fig 1 of our report 1 shows the correct incidence rate and the text stating incidence “above 20/100 000” for Slovenia and Slovakia should read “above 15/100 000”. Data for 2002 provided by the most respected organisation, the World Health Organisation, were used for comparison of tuberculosis incidences in different EU member states.

I am pleased to witness a constant decrease in the incidence of tuberculosis in Slovenia (and other EU member states), which may have reached less than 15/100 000 in 2003.