Global Tuberculosis Report -- 2012.pdf

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Contents Abbreviations iv Acknowledgements v Executive summary 1 Chapter 1. Introduction 3 Chapter 2. The burden of disease caused by TB 8 Chapter 3. TB case notifications and treatment outcomes 29 Chapter 4. Drug-resistant TB 41 Chapter 5. Financing TB care and control 52 Chapter 6. Diagnostics and laboratory strengthening 66 Chapter 7. Addressing the co-epidemics of TB and HIV 74 Chapter 8. Research and development 82 Annexes 1. Methods used to estimate the global burden of disease caused by TB 91 2. Country profiles 105 3. Regional profiles 129 4. Global, regional and country-specific data for key indicators 137 GLOBAL TUBERCULOSIS REPORT 2012 iii
Abbreviations AFB AFR AIDS AMR ARI ART BCG BRICS CDR CPT CBC DOT DOTS DR-TB DRS DST ECDC EMR EQA ERR EU EUR FIND GDP GLI acid-fast bacilli WHO African Region acquired immunodeficiency syndrome WHO Region of the Americas annual risk of infection antiretroviral therapy Bacille-Calmette-Guérin Brazil, Russian Federation, India, China, South Africa case detection rate co-trimoxazole preventive therapy community-based TB care directly observed treatment the basic package that underpins the Stop TB Strategy drug-resistant tuberculosis drug resistance surveillance or survey drug susceptibility testing European Centre for Disease Prevention and Control WHO Eastern Mediterranean Region External quality assurance Electronic recording and reporting European Union WHO European Region Foundation for Innovative New Diagnostics gross domestic product Global Laboratory Initiative Global Fund The Global Fund to fight AIDS, Tuberculosis and Malaria Global Plan Global Plan to Stop TB, 2011–2015 GNI gross national income HBC high-burden country of which there are 22 that account for approximately 80% of all new TB cases arising each year HIV human immunodeficiency virus ICD-10 International Classification of Diseases (tenth revision) IGRA IPT IRR LED LPA MDG MDR-TB NGO NTP PEPFAR POC PPM SEAR SRL TB TB-TEAM TST UNAIDS UNITAID USAID VR WHA WHO WPR XDR-TB ZN interferon-gamma release assay isoniazid preventive therapy incidence rate ratio Light-emitting diode Line-probe assay Millennium Development Goal multidrug-resistant tuberculosis (resistance to, at least, isoniazid and rifampicin) nongovernmental organization national tuberculosis control programme or equivalent US President’s Emergency Plan for AIDS Relief point-of-care Public–Private Mix WHO South-East Asia Region supranational reference laboratory tuberculosis Tuberculosis Technical Assistance Mechanism tuberculin skin test Joint United Nations Programme on HIV/ AIDS international facility for the purchase of diagnostics and drugs for diagnosis and treatment of HIV/AIDS, malaria and TB United States Agency for International Development Vital registration World Health Assembly World Health Organization WHO Western Pacific Region Extensively drug-resistant TB, defined as MDR-TB plus resistance to a fluoroquinolone and at least one of three injectable second-line drugs (amikacin, kanamycin or capreomycin) Ziehl Neelsen iv GLOBAL TUBERCULOSIS REPORT 2012
Page 2 and 3: GLOBAL TUBERCULOSIS REPORT 2012
Page 6 and 7: Acknowledgements This report on glo
Page 8 and 9: WHO Western Pacific Region Shalala
Page 10 and 11: Executive Summary The World Health
Page 12 and 13: CHAPTER 1 Introduction BOX 1.1 Basi
Page 14 and 15: TABLE 1.1 Targets for the scale-up
Page 16 and 17: TABLE 1.2 Reporting of data in the
Page 18 and 19: BOX 2.1 Uncertainty in estimates of
Page 20 and 21: TABLE 2.2 Estimated burden of disea
Page 22 and 23: FIGURE 2.5 Estimated TB incidence r
Page 24 and 25: FIGURE B2.2.1 Reporting of notifica
Page 26 and 27: FIGURE 2.8 Estimated TB incidence r
Page 28 and 29: FIGURE 2.11 Countries (in blue) for
Page 30 and 31: FIGURE 2.12 Trends in estimated TB
Page 32 and 33: ● producing and widely disseminat
Page 34 and 35: FIGURE 2.16 Progress in global cove
Page 36 and 37: BOX 2.6 Efforts by the Task Force t
Page 38 and 39: CHAPTER 3 TB case notifications and
Page 40 and 41: BOX 3.1 1 Definitions of TB cases D
Page 42 and 43: TABLE 3.3 Contribution of public-pr
Page 44 and 45: BOX 3.4 Integrating community-based
Page 46 and 47: TABLE 3.4 Estimates of the case det
Page 48 and 49: TABLE 3.5 Treatment success for new
Page 50 and 51: CHAPTER 4 Drug-resistant TB KEY FAC
Page 52 and 53: FIGURE 4.2 Percentage of new TB cas
Page 54 and 55:
BOX 4.1 Frequencies of resistance t
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FIGURE 4.6 Number of MDR-TB cases e
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FIGURE 4.7 Notified cases of MDR-TB
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egimens globally, providing more su
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5.1 Funding for TB care and control
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TABLE 5.2 NTP budgets, available fu
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FIGURE 5.5 Trends in domestic and d
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FIGURE 5.6 Domestic funding as a pe
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FIGURE 5.8 Cost per TB patient succ
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FIGURE 5.10 Total cost and unit cos
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● The 14 countries not included i
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on public health by an external Exp
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evised as a result of the introduct
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TABLE 6.2 Incorporation of WHO poli
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FIGURE 6.3 The Supranational Refere
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of TB disease by 65%, irrespective
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FIGURE 7.3 Percentage of TB patient
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BOX 7.1 Accelerating progress in pr
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TABLE 7.2 Assumptions used to estim
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FIGURE 8.1 The development pipeline
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sputum specimens and TB isolates fr
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cal trial sites and building labora
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new TB vaccine candidate. A Phase I
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This annex explains the methods tha
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2011. On average, 15 data points we
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may suffer from biases. These biase
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TABLE A1.3 Parameter estimates used
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5. Estimates of TB prevalence, 1990
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the Republic of Moldova, Romania, t
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AFGHANISTAN Population 2011 32 mill
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BRAZIL Population 2011 197 million
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CHINA Population 2011 1 348 million
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ETHIOPIA Population 2011 85 million
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INDONESIA Population 2011 242 milli
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MOZAMBIQUE Population 2011 24 milli
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NIGERIA Population 2011 162 million
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PHILIPPINES Population 2011 95 mill
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SOUTH AFRICA Population 2011 50 mil
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UGANDA Population 2011 35 million H
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VIET NAM Population 2011 89 million
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ANNEX 3 Regional profiles
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WHO REGION OF THE AMERICAS Populati
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WHO EUROPEAN REGION Population 2011
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WHO WESTERN PACIFIC REGION Populati
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SUMMARY BY WHO REGION Table A4.1 Es
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MORTALITY (EXCLUDING HIV) PREVALENC
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NEW AND RELAPSE NOTIFICATION RATE a
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- % OF TB PATIENTS WITH KNOWN HIV S
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AFRICAN REGION Table A4.1 Estimates
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INCIDENCE (INCLUDING HIV) INCIDENCE
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TREATMENT SUCCESS (%) a 1995-2010 Y
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YEAR TOTAL CONFIRMED CASES OF MDR-T
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MALE YEAR 0-14 15-24 25-34 35-44 45
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REGION OF THE AMERICAS Table A4.1 E
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% OF COHORT TREATMENT SUCCESS (%) a
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MALE FEMALE YEAR 0-14 15-24 25-34 3
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EASTERN MEDITERRANEAN REGION Table
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EUROPEAN REGION Table A4.1 Estimate
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SOUTH-EAST ASIA REGION Table A4.1 E
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SMEAR LABS % OF SMEAR PER 100K LABS
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Estimates of mortality, prevalence
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YEAR POPULATION (MILLIONS) MORTALIT
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YEAR POPULATION (MILLIONS) INCIDENC
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YEAR POPULATION (MILLIONS) INCIDENC
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SMEAR LABS % OF SMEAR PER 100K LABS
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