title: Tuberculosis surveillance and control in Germany - An application of the Berlin Declaration Monitoring and Evaluation Framework.
abstract: BACKGROUND
  In 2007, the 'Berlin Declaration on Tuberculosis' (BD) was signed by the Ministers of the WHO European Region Member States (MS) to address the re-emerging threat of tuberculosis (TB) by fully implementing the Stop TB strategy. WHO Euro developed a Monitoring and Evaluation (M&E) Framework using programmatic and epidemiological indicators to follow-up the BD from 2013 onwards. Ahead of this, we explored the Framework performance for Germany, a low TB incidence country.
  
  
  METHODS
  We selected from a surveillance perspective on five country-specific indicators asked for all MS. Information sources included guidelines, notification data and laboratory quality assurance results.
  
  
  RESULTS
  As to national TB guidelines (indicator 1.1.1), up-to-date guidance documents are available. Regarding external quality assurance (3.2) proficiency testing confirms high quality of culture and drug-susceptibility testing. M/XDR-TB prevention and control is reflected by a 1.7% MDR-TB rate in 2010 with decreasing tendency (4.1.2). As to treatment success (5), the WHO target of 85% is reached for all age groups except the elderly ≥60 years. Germany disposes of an electronic case-based surveillance providing evidence for TB policy and practices (5.2.2).
  
  
  CONCLUSIONS
  The selected M&E Framework indicators proved well applicable to a low-incidence country. The results show no specific gaps in TB surveillance and control in Germany.
authors.affiliation: 1Department for Infectious Disease Epidemiology, Respiratory Infections Unit, Robert Koch Institute Postfach 65 02 61, D-13302 Berlin +49-30-18-754-3328 +49-30-18-754-3341 HauerB@rki.de Germany.
authors.forename: B
authors.initials: B
authors.lastname: Hauer
authors.forename: L
authors.initials: L
authors.lastname: Fiebig
authors.forename: B
authors.initials: B
authors.lastname: Brodhun
authors.forename: W
authors.initials: W
authors.lastname: Haas
keywords: tuberculosis, Berlin Declaration (BD), monitoring, evaluation, framework, Germany