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Background: Malta has one of the lowest incidence rates of tuberculosis in Europe and a comprehen... more Background: Malta has one of the lowest incidence rates of tuberculosis in Europe and a comprehensive free-of-charge health care system. Objective: To investigate whether Malta satisfies the criteria recommended by the International Union Against Tuberculosis and Lung Disease (IUATLD) in order to consider the discontinuation of the present school BCG vaccination programme. Method: Review of World Health Organization (WHO), and IUATLD guidelines for BCG use and discontinuation. Examination of surveillance data pertaining to tuberculosis in Malta, for the years 1979 to 2008. Findings: Malta has a long-standing, well-developed surveillance, treatment and follow-up programme for tuberculosis. The average annual notification rate of smear positive pulmonary tuberculosis was about 2 per 100,000 person-years since 1990. This is well below rates recommended by the IUATLD for the discontinuation of routine BCG vaccination programs. Conclusion: Malta satisfies established international criteria for discontinuation of the school BCG vaccination programme and therefore the programme should be reconsidered.
Lupus Vulgaris in a Maltese patient
Background: Malta, the smallest island state in Europe, with an approximate population of 400,000... more Background: Malta, the smallest island state in Europe, with an approximate population of 400,000, has one of the lowest reported incidence rates for tuberculosis (TB) in its native-born population. 1 Longterm trends for TB among this population were investigated. Methods: A period of 35 years (1979-2013) for the Malta-born population was investigated using single-age population numbers for each year, retrospective, and partly prospective analysis of notified TB cases. Mean five-yearly populations were then used to calculate 5yearly incidence rates for birth-cohorts, age-groups, major site and gender. Annual reported TB incidence rates were also calculated. Results: In the Malta-born population, over the 35year period, reported yearly TB incidence shows a downward, albeit decelerating trend. Consecutive follow-up of 5-year age-cohorts and 5-year age-groups confirms that incidence has fallen, with the highest rates being observed in progressively older age-groups. A falling trend in ...
Background: Malta has one of the lowest reported incidence rates of tuberculosis in Western Europ... more Background: Malta has one of the lowest reported incidence rates of tuberculosis in Western Europe, and was approaching the elimination phase. It was observed that a disproportionate number of cases were occurring among persons of advanced age. Objective: To investigate the epidemiology of tuberculosis in the elderly Malta-born population. Methods: A retrospective review of national TB surveillance data from 1995 to 2005 with estimation of 11-year means. Age stratified comparisons between the general, the younger, and the elderly Malta-born populations were made. Results: One hundred and seventeen Malta-born patients were included in the study; 99% of all notified cases. The mean stratified incidence rates of TB among the general population, those less than 65 years of age, and the elderly (65 years and over) were 2.8, 1.6, and 10.6 per 100,000 person-years respectively. When the study sample was stratified into 15-year age groups, their mean TB incidence showed an exponential incre...
Sputum induction is a procedure used to help patients expectorate samples of sputum for laborator... more Sputum induction is a procedure used to help patients expectorate samples of sputum for laboratory analysis. It is a simple, safe and standardised procedure which may avoid the use of more invasive and potentially harmful interventions such as fibreoptic bronchoscopy. This article gives an overview of the uses in particular categories of patients, arguments for and against the procedure, and some local data.
Background: Malta has one of the lowest incidence rates of tuberculosis in Europe and a comprehen... more Background: Malta has one of the lowest incidence rates of tuberculosis in Europe and a comprehensive free-of-charge health care system. Objective: To investigate whether Malta satisfies the criteria recommended by the International Union Against Tuberculosis and Lung Disease (IUATLD) in order to consider the discontinuation of the present school BCG vaccination programme. Method: Review of World Health Organization (WHO), and IUATLD guidelines for BCG use and discontinuation. Examination of surveillance data pertaining to tuberculosis in Malta, for the years 1979 to 2008. Findings: Malta has a long-standing, well-developed surveillance, treatment and follow-up programme for tuberculosis. The average annual notification rate of smear positive pulmonary tuberculosis was about 2 per 100,000 person-years since 1990. This is well below rates recommended by the IUATLD for the discontinuation of routine BCG vaccination programs. Conclusion: Malta satisfies established international criteria for discontinuation of the school BCG vaccination programme and therefore the programme should be reconsidered.
Lupus Vulgaris in a Maltese patient
Background: Malta, the smallest island state in Europe, with an approximate population of 400,000... more Background: Malta, the smallest island state in Europe, with an approximate population of 400,000, has one of the lowest reported incidence rates for tuberculosis (TB) in its native-born population. 1 Longterm trends for TB among this population were investigated. Methods: A period of 35 years (1979-2013) for the Malta-born population was investigated using single-age population numbers for each year, retrospective, and partly prospective analysis of notified TB cases. Mean five-yearly populations were then used to calculate 5yearly incidence rates for birth-cohorts, age-groups, major site and gender. Annual reported TB incidence rates were also calculated. Results: In the Malta-born population, over the 35year period, reported yearly TB incidence shows a downward, albeit decelerating trend. Consecutive follow-up of 5-year age-cohorts and 5-year age-groups confirms that incidence has fallen, with the highest rates being observed in progressively older age-groups. A falling trend in ...
Background: Malta has one of the lowest reported incidence rates of tuberculosis in Western Europ... more Background: Malta has one of the lowest reported incidence rates of tuberculosis in Western Europe, and was approaching the elimination phase. It was observed that a disproportionate number of cases were occurring among persons of advanced age. Objective: To investigate the epidemiology of tuberculosis in the elderly Malta-born population. Methods: A retrospective review of national TB surveillance data from 1995 to 2005 with estimation of 11-year means. Age stratified comparisons between the general, the younger, and the elderly Malta-born populations were made. Results: One hundred and seventeen Malta-born patients were included in the study; 99% of all notified cases. The mean stratified incidence rates of TB among the general population, those less than 65 years of age, and the elderly (65 years and over) were 2.8, 1.6, and 10.6 per 100,000 person-years respectively. When the study sample was stratified into 15-year age groups, their mean TB incidence showed an exponential incre...
Sputum induction is a procedure used to help patients expectorate samples of sputum for laborator... more Sputum induction is a procedure used to help patients expectorate samples of sputum for laboratory analysis. It is a simple, safe and standardised procedure which may avoid the use of more invasive and potentially harmful interventions such as fibreoptic bronchoscopy. This article gives an overview of the uses in particular categories of patients, arguments for and against the procedure, and some local data.