Eurosurveillance
Volume 19, Issue 9, 06 March 2014
http://www.eurosurveillance.org/Public/Articles/Archives.aspx?PublicationId=11678

Surveillance and outbreak reports
Epidemiology of tuberculosis in big cities of the European Union and European Economic Area countries
by G de Vries, RW Aldridge, JA Caylà, WH Haas, A Sandgren, NA van Hest, I Abubakar, the Tuberculosis in European Union Big Cities Working Group

Perspectives
Tuberculosis control in big cities and urban risk groups in the European Union: a consensus statement
N A van Hest1, R W Aldridge2, G de Vries3, A Sandgren4, B Hauer5, A Hayward2, W Arrazola de Oñate6, W Haas5, L R Codecasa7, J A Caylà8, A Story9, D Antoine10, A Gori11, L Quabeck12, J Jonsson13, M Wanlin6, À Orcau8, A Rodes14, M Dedicoat15, F Antoun16, H van Deutekom17, S T Keizer17, I Abubakar18
Date of submission: 26 February 2013
http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=20728

In low-incidence countries in the European Union (EU), tuberculosis (TB) is concentrated in big cities, especially among certain urban high-risk groups including immigrants from TB high-incidence countries, homeless people, and those with a history of drug and alcohol misuse. Elimination of TB in European big cities requires control measures focused on multiple layers of the urban population. The particular complexities of major EU metropolises, for example high population density and social structure, create specific opportunities for transmission, but also enable targeted TB control interventions, not efficient in the general population, to be effective or cost effective. Lessons can be learnt from across the EU and this consensus statement on TB control in big cities and urban risk groups was prepared by a working group representing various EU big cities, brought together on the initiative of the European Centre for Disease Prevention and Control. The consensus statement describes general and specific social, educational, operational, organisational, legal and monitoring TB control interventions in EU big cities, as well as providing recommendations for big city TB control, based upon a conceptual TB transmission and control model.