Underreporting of diagnosed tuberculosis cases to the national surveillance system in Armenia in 2017

Introduction: In 2017 the rate of tuberculosis (TB) in Armenia according to the national surveillance system was 28 per 100 000 population, yet the number estimated by WHO was 36 per 100 000 population. The aim of the study was therefore to assess the underreporting of TB cases in Armenia in 2017. Methodology: A retrospective inventory study was conducted by comparing TB cases reported electronically to the National Tuberculosis Program (NTP) via the national TB database e-TB Manager to 1) those recorded in two additional electronic national databases: the TB reference laboratory database and TB hospital database, 2) paper-based registers from Basic Management Units. The rate of underreporting was calculated as the number of TB patients not reported in the e-TB manager over the sum of both reported and unreported cases. Results: Of 760 TB cases identified in TB -laboratory and TBhospital databases, 691 TB cases were known to the e-TB Manager, meaning there were 69 cases not officially reported. The overall rate of underreporting was therefore 7.6%, although this rate was higher in certain populations including prisoners and Armenian citizens that are not permanently resident in the country. Conclusion: While the underreporting rate for new and relapse TB cases in Armenia at 7.6% could be further be reduced, this rate, at under ten percent is considered acceptable as per WHO guidelines.