Background The epidemiology of tuberculosis (TB) in Romania highlights the need for early detection and directly observed therapy. This study analysed the evolution of the TB epidemic in Romania from 1990 to 2008 in order to evaluate the TB control strategy.

Methods A retrospective study describing the evolution of the main epidemiological indicators for TB in Romania, 1990–2008 was carried out. Incident TB cases were obtained from “Marius Nasta” Institute of Pulmonology from Bucharest, Ministry of Public Health Report 2008. Comparative European data were obtained from the European Health for All Database (HFA-DB) 2010 and WHO TB Report 2010.

Results The overall incidence of TB in Romania steadily declined from 142.2 per 100 000 in 2002 to 107.8 per 100 000 in 2008 at which time it was almost eight times higher than EU average (14.1 per 100 000); the fourth highest national incidence of TB in the WHO Europe Region. Of the 21 724 registered TB cases (incident and relapses) in 2008, 61% were smear-positive; of these 9511 were incident cases. The incidence in the paediatric population was 12.7 per 100 000 in 1990, peaking at 42 per 100 000 in 2000 before falling to 28.7 per 100 000 in 2008. Mortality from TB has progressively fallen from 12 per 100 000 in 1990 to 7.2 per 100 000 in 2008. In total 2.8% of all incident and 11% of all re-treatment cases in Romania were MDR TB cases in 2007, compared to 10% and 43% respectively in Europe. In 2008, 816 MDR TB cases were registered; 130 incident and 686 re-treatment cases.

Conclusions A reduction in the incidence of and mortality from TB since 2002 confirms the effectiveness of measures to control TB.