Global Tuberculosis Control 2010 - Florida Department of Health

Number of TB patients (thousands)
500
400
300
200
100
0
Tested HIV-positive
2003 2004 2005 2006 2007 2008 2009
Percentage of HIV-positive TB patients
100
80
60
40
20
0
2003
27 (30%)
2004
24 (29%)
2005
39 (53%)
2006
55 (64%)
2007
73 (92%)
2008
86 (93%)
Percentage of HIV-positive TB patients
100
80
60
40
20
0
2003
47 (9%)
2004
24 (25%)
2005
47 (55%)
2006
69 (64%)
2007
93 (85%)
2008
109 (96%)
CPT
ART
CPT
2009
63 (75%)
ART
2009
89 (80%)
Region in 2008. The number of HIV-positive TB patients
enrolled on CPT and ART has been increasing in recent
years, especially since 2005 (). By 2009, almost
300 000 HIV-positive TB patients were started on CPT
and almost 140 000 were enrolled on ART. Almost 80%
of TB patients who were known to be HIV-positive were
started on CPT and almost 40% were enrolled on ART
( , ). Further efforts are needed to
reach the Global Plan target of starting 100% of HIVpositive
TB patients on both CPT and ART by 2015.
Screening for TB among HIV-positive people and
providing IPT to those without active TB have steadily
increased, particularly since 2007 (, ).
In 2009, 1.7 million HIV-positive people were screened
for TB and close to 80 000 of those without active TB
were enrolled on IPT. The numbers screened are equivalent
to about one third of the people living with HIV who
are on ART, about 10% of the people living with HIV who
are estimated to be in need of ART and about 5% of the
estimated total number of HIV-positive people worldwide.
The numbers started on IPT are less than 1% of the
estimated number of people living with HIV. Intensified
efforts are needed to approach the Global Plan target of
providing IPT to all those attending HIV care services
who are eligible for it by 2015.
Globally, just over 30 000 cases of MDR-TB were notified
to WHO in 2009, mostly by European countries and
South Africa (, ). This represents 12%
of the estimated number of cases of MDR-TB among all
notified cases of pulmonary TB in 2009 (). Country
plans suggest that, overall, the numbers of patients
diagnosed with MDR-TB and started on treatment will
almost double in 2010 and 2011, compared with 2009
( ). Substantial increases in the numbers of
patients diagnosed with MDR-TB and started on treatment
are expected in the three countries where the estimated
number of cases is highest: China, India and the
Russian Federation ().
There has been an impressive increase in the share
of notified cases enrolled on treatment in projects or
programmes approved by the Green Light Committee
(GLC), in which patients are known to be receiving treatment
according to international guidelines. The number
reached around 11 000 in 2009, and is expected to rise
to over 30 000 in 2011 (approximately 60% of all notifications
of MDR-TB that are projected by countries in
that year). This remains a small fraction of the estimated
number of TB patients who have MDR-TB (eighth column
from right, ). Much more rapid expansion
of diagnosis and treatment – within and outside projects
and programmes approved by the GLC – is needed to
approach the targets for MDR-TB that are included in
the Global Plan ().
National data on treatment outcomes among cohorts