Tuberculosis Cases Five Times Higher in Greece

Tuberculosis Cases Five Times Higher in GreeceTuberculosis Cases Five Times Higher in GreeceTuberculosis Cases Five Times Higher in GreeceTuberculosis cases in Greece may be up to five times higher than officially recorded, according to experts who warn that social stigma, underreporting, and structural weaknesses in the healthcare system obscure the true scale of the disease.

Katerina Manika, Professor of Pulmonology–Tuberculosis at Aristotle University of Thessaloniki and the University Pulmonology Clinic at G.N.Th. “G. Papanikolaou”, said tuberculosis patients often remain “people without a voice” due to stigma that discourages them from publicly discussing their condition or seeking support.

In 2024, Greece recorded 400 active tuberculosis cases, representing a 19% decrease compared to 2023. However, experts attribute this decline to underdiagnosis and underreporting rather than a genuine reduction in infections. According to Manika, tuberculosis is a notifiable disease to the National Public Health Organisation (EODY), yet only one third to one fifth of actual cases appear in official records. While official data indicates an incidence of four cases per 100,000 people, the true rate is estimated to be closer to 20 per 100,000.

Researchers highlighted that medication consumption data reveals significantly more cases than those formally registered. Doctors do not always submit reporting forms to EODY, while outdated, non-digital reporting systems further complicate data collection.

A critical issue is the lack of outcome tracking for patients. Without follow-up data, authorities cannot determine how many patients die or fail to complete treatment. Tuberculosis treatment typically lasts six to nine months, but some patients stop therapy early once symptoms improve, increasing the risk of relapse and continued transmission.

Data from 2024 shows that half of tuberculosis patients in Greece were born in the country, while the remainder came from abroad, mainly Central and South Asia, Eastern Europe, and Sub-Saharan Africa. Approximately 16.5% of reported cases involved people living in group settings, including migrant facilities (57%), prisons (14%), and Roma settlements (14%). Twenty-five cases involved minors, accounting for 6% of the total, most of whom lived in refugee or migrant accommodation.

Treatment outcomes vary significantly across population groups. Around 15% of Greek-born patients with tuberculosis die, often due to older age, weakened immune systems, or underlying health conditions. By contrast, many foreign-born patients are younger but frequently interrupt treatment due to unstable living conditions and lack of support networks, increasing the risk of ongoing transmission. Experts reported that patients born outside Europe show particularly poor outcomes, with 55% experiencing negative treatment results due to interrupted therapy.

Manika stressed the urgent need for a comprehensive national tuberculosis strategy that includes improved patient monitoring, stronger healthcare coordination, better reporting systems, and targeted prevention measures such as chest X-rays for individuals entering migrant facilities or correctional institutions. She emphasised that solving tuberculosis requires political action, as effective medical treatments already exist.

In Europe, tuberculosis remains unevenly distributed, affecting vulnerable groups such as homeless individuals, prisoners, refugees, and people living with HIV. Although Europe accounts for only 2% of the global tuberculosis burden, one in six multidrug-resistant cases occurs on the continent, particularly in countries of the former Soviet Union.

Globally, the World Health Organization reported 10.7 million new tuberculosis cases in 2024, with 1.23 million deaths. Experts estimate that pandemic-related disruptions led to approximately 500,000 additional tuberculosis deaths worldwide due to delayed diagnosis and treatment during the COVID-19 crisis.

The interview with Professor Manika took place during an event marking World Tuberculosis Day at G.N.Th. “G. Papanikolaou”, a long-standing reference centre for tuberculosis diagnosis and treatment in Greece.