Tuberculosis in Malta : thirty-five years of epidemiological trends in the native population

Abstract

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 Long- term trends for TB among this population were investigated. 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 5- yearly incidence rates for birth-cohorts, age-groups, major site and gender. Annual reported TB incidence rates were also calculated. In the Malta-born population, over the 35- year 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 TB incidence according major site and gender was also observed. TB is being successfully controlled among the Malta-born population, and confirmed to be slowly approaching the elimination phase.