1. Martina Vasakova Emilia Kopecka Jitka Soukupova Thomayer University Hospital Prague Tuberculosis in the Czech Republic. MDR- TB Unit of the Czech Republic in Thomayer University Hospital

2. Tuberculosis in the Czech Republic Czech Republic belongs to low incidence countries Good policy against TB spread from the beginning of 20th century-Masaryk´s league against TB After the 2nd World War active policy against tuberculosis enhanced by development of new drugs against M. tuberculosis Active screening for new cases of tuberculosis- chest X-rays, investigation of contacts From 2000 starts active screening for LTBI- begins in healthcare workers- Thomayer University Hospital and Faculty Hospital Bulovka Experience in TB eradication, state pollicy against TB spread

3. TB incidence in some European states- The countries adjoining European Union after 2004 0 20 40 60 80 100 120 140 160 199519961997199819992000200120022003200420052006 TB cases / 100,000 Romania Lithuania Latvia Bulgaria Estonia Poland Hungary Slovakia Slovenia Czech Rep Malta Cyprus *

4. Thomayer University Hospital Modern developing hospital offering highly specialized health care 50.000 patients a year- one of the largest health institutions in the Czech Republic Founded in 1954 Fully equipped hospital with major surgical and internal departments 1984, after 30 years of its existence accepted amongst the University hospitals

5. Thomayer University Hospital Provides care mainly to patients from Prague Urgent and special cases from the whole of central Bohemia- heliport 33 focused departments covering all current medical areas Accent on traumatology (especially in children), oncology, respiratory diseases and pediatric care Holder of the international certificate BABY FRIENDLY HOSPITAL University hospital – education of young physicians and nurses

6. Department of Respiratory Diseases Respiratory care for patients from part of Prague and Central Bohemia, but in special cases for the whole Czech Republic Allergology and Clinial Immunology specialised care and consulting for the whole Czech Republic Teaching base of the 1 st Medical School of Charles University and Thomayer University Hospital One of the largest departments of the Thomayer University Hospital 80 beds for acute cases including 5-beds ICU 35 beds for long-term treatment of tuberculosis patients including multidrug-resistant one supplied with modern equipment enabling proper and quick diagnosis and treatment of large spectrum of pulmonary diseases. ambulant care in specialized outpatient ambulances - chronic obstructive lung disease (COPD), idiopathic pulmonary fibrosis and other interstitial lung diseases, with difficult-to-treat asthma, NTM Center for alpha 1 antitrypsin deficiency for the Czech Republic Projects and grants- COPD, IPF, asthma, A1-AT deficiency, LTBI

7. MDR TB Unit Within the department for tuberculosis Multidrug-Resistant tuberculosis Unit recognised by Ministry of Health from 2007 Serves for all MDR-TB patients diagnosed in the Czech Republic- for Czechs, but also other nations, mainly immigrants Development of the Microbiological department- widening the spectrum of molecular diagnostic methods for quick diagnosis of tuberculosis, including drug- susceptibility tests and quick diagnosis of drug resistance Grants and projects- -TB-NET- pan-European project on MDR-TB- - Norway Funds- Prevention of TB spread in the Czech Republic- TB of lungs and also urogenital system

8. MDR-TB in the Czech Republic Number of MDR-TB patients in the years 2000-2009 (to the end of September 2009) in the Czech Republic- 67 33 foreign immigrants and 34 Czech inhabitants

9. MDR TB in the Czech Republic YearMDR TB (No of persons) No of persons with resistance to H,S,E,R 20002312 20013211 2002238 2003137 20041911 20051712 20061814 20071410 2008126

10. MDR- TB in Thomayer University Hospital YearMDR TB Total No of patients Nationalities CzechFormer USSR VietnamPolandMongoli a 2000211 200116151 200214941 200393321 2004633 2005321 2006312 2007743 200894212 200971213

11. What do we offer? We offer the clinical base for investigation of tuberculosis including MDR-TB within the frames of multinational projects. We are well equipped not only for clinical care for the patients but also for the investigation including the basic research

12. Thank you for your kind attention