Global Tuberculosis Report -- 2012.pdf

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INDONESIAPopulation 2011 242 millionHIGH TB BURDEN | HIGH HIV BURDEN | HIGH MDR-TB BURDENEstimates of TB burden a 2011NUMBER (thousands) RATE (per 100 000 population)Mortality (excludes HIV+TB) 65 (29–120) 27 (12–48)Prevalence (includes HIV+TB) 680 (310–1 200) 281 (130–489)Incidence (includes HIV+TB) 450 (370–540) 187 (155–222)Incidence (HIV+TB) 15 (11–20) 6.2 (4.4–8.3)Case detection, all forms (%) 70 (59–85)TB case notifications 2011NEW CASES (%) RETREATMENT CASES (%)Smear-positive 197 797 (63) Relapse 5 348 (69)Smear-negative 101 750 (32) Treatment after failure 432 (6)Smear-unknown/not done Treatment after default 933 (12)Extrapulmonary 14 054 (4) Other 994 (13)OtherTotal new 313 601 Total retreatment 7 707Mortality (excludes HIV+TB) (rateper 100 000 population per year)Prevalence(rate per 100 000 population)1008060402001990 1995 2000 2005 201080060040020001990 1995 2000 2005 2010Other (history unknown)Total new and relapse 318 949 Total cases notifi ed 321 308New casesSMEAR-NEGATIVE/SMEAR-POSITIVE UNKNOWN/NOT DONE EXTRAPULMONARYM:F ratio 1.5 1.3 0.9Age < 15 1 714 23 469 2 776Laboratories 2011Smear (per 100 000 population) 2.3Culture (per 5 million population) 0.9Drug susceptibility testing (per 5 million population) 0.1Is second-line drug susceptibility testing available?Yes, in countryIs there a national reference laboratory?YesTreatment success rate 2010 (%)New smear-positiveIs rifampicin used throughout(and/or culture-positive) 90 treatment for new patients? YesNew smear-negative/extrapulmonary 86Retreatment 73TB/HIV 2011 NUMBER (%)TB patients with known HIV status 3 511 (1)HIV-positive TB patients 1 280 (36)HIV-positive TB patients on co-trimoxazole preventive therapy (CPT) 1 182 (92)HIV-positive TB patients on antiretroviral therapy (ART) 544 (43)HIV-positive people screened for TBHIV-positive people provided with IPTEstimates of MDR-TB burden 2011 a NEW RETREATMENT% of TB cases with MDR-TB 1.9 (1.4–2.5) 12 (8.1–17)MDR-TB cases among notifi edpulmonary TB cases 5 700 (4 200–7 500) 920 (620–1 300)<strong>Report</strong>ed cases of MDR-TB 2011 NEW RETREATMENT TOTALCases tested for MDR-TB 5 (
KENYAPopulation 2011 42 millionHIGH TB BURDEN | HIGH HIV BURDENEstimates of TB burden a 2011NUMBER (thousands) RATE (per 100 000 population)Mortality (excludes HIV+TB) 9.2 (4.7–15) 22 (11–36)Prevalence (includes HIV+TB) 120 (63–200) 291 (152–475)Incidence (includes HIV+TB) 120 (110–120) 288 (276–300)Incidence (HIV+TB) 47 (45–49) 113 (109–118)Case detection, all forms (%) 81 (78–85)TB case notifications 2011NEW CASES (%) RETREATMENT CASES (%)Smear-positive 37 085 (39) Relapse 3 356 (34)Smear-negative 30 394 (32) Treatment after failure 263 (3)Smear-unknown/not done 9 416 (10) Treatment after defaultExtrapulmonary 17 069 (18) Other 6 398 (64)Other 0 (0)Total new 93 964 Total retreatment 10 017Mortality (excludes HIV+TB) (rateper 100 000 population per year)Prevalence(rate per 100 000 population)504030201001990 1995 2000 2005 201050040030020010001990 1995 2000 2005 2010Other (history unknown) 0Total new and relapse 97 320 Total cases notifi ed 103 981New casesSMEAR-NEGATIVE/SMEAR-POSITIVE UNKNOWN/NOT DONE EXTRAPULMONARYM:F ratio 1.6 1.2 1.2Age < 15 985 2 008 2 795Laboratories 2011Smear (per 100 000 population) 3.8Culture (per 5 million population) 0.7Drug susceptibility testing (per 5 million population) 0.1Is second-line drug susceptibility testing available?Is there a national reference laboratory?Treatment success rate 2010 (%)Yes, outside countryNew smear-positiveIs rifampicin used throughout(and/or culture-positive) 87 treatment for new patients? YesNew smear-negative/extrapulmonary 85Retreatment 79TB/HIV 2011 NUMBER (%)TB patients with known HIV status 97 136 (93)HIV-positive TB patients 38 172 (39)HIV-positive TB patients on co-trimoxazole preventive therapy (CPT) 37 147 (97)HIV-positive TB patients on antiretroviral therapy (ART) 24 497 (64)HIV-positive people screened for TBHIV-positive people provided with IPTEstimates of MDR-TB burden 2011 a NEW RETREATMENT% of TB cases with MDR-TB 3.1 (0.10–7.1) 10 (2.1–18)MDR-TB cases among notifi edpulmonary TB cases 2 400 (77–5 500) 1 000 (210–1 800)YesIncidence (rate per 100 000population per year)Treatment success rate (%)Number of patients40030020010001990 1995 2000 2005 201110080604020060 00050 00040 00030 00020 00010 0000Incidence Incidence (HIV+TB) Notifications1996 1998 2000 2002 2004 2006 2008 2010New smear-positive (and/or culture-positive)New smear-negative/extrapulmonaryRetreatment2003 2004 2005 2006 2007 2008 2009 2010 2011<strong>Report</strong>ed cases of MDR-TB 2011 NEW RETREATMENT TOTALHIV-positive TB patients on CPT on ARTCases tested for MDR-TB 92 (
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GLOBALTUBERCULOSISREPORT2012
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ContentsAbbreviationsivAcknowledgem
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AcknowledgementsThis report on glob
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WHO Western Pacific RegionShalala A
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Executive SummaryThe World Health O
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CHAPTER 1IntroductionBOX 1.1Basic f
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TABLE 1.1 Targets for the scale-up
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TABLE 1.2 Reporting of data in the
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BOX 2.1Uncertainty in estimates of
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TABLE 2.2 Estimated burden of disea
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FIGURE 2.5 Estimated TB incidence r
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FIGURE B2.2.1Reporting of notificat
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FIGURE 2.8Estimated TB incidence ra
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FIGURE 2.11 Countries (in blue) for
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FIGURE 2.12 Trends in estimated TB
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● producing and widely disseminat
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FIGURE 2.16 Progress in global cove
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BOX 2.6Efforts by the Task Force to
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CHAPTER 3TB case notificationsand t
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BOX 3.1 1Definitions of TB casesDef
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TABLE 3.3 Contribution of public-pr
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BOX 3.4Integrating community-based
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TABLE 3.4 Estimates of the case det
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TABLE 3.5 Treatment success for new
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CHAPTER 4Drug-resistant TBKEY FACTS
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FIGURE 4.2 Percentage of new TB cas
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BOX 4.1Frequencies of resistance to
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FIGURE 4.6 Number of MDR-TB cases e
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FIGURE 4.7Notified 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 5.5Trends in domestic and do
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FIGURE 5.6Domestic funding as a per
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FIGURE 5.8Cost per TB patient succe
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FIGURE 5.10 Total cost and unit cos
Page 74 and 75: ● The 14 countries not included i
Page 76 and 77: on public health by an external Exp
Page 78 and 79: evised as a result of the introduct
Page 80 and 81: TABLE 6.2 Incorporation of WHO poli
Page 82 and 83: FIGURE 6.3The Supranational Referen
Page 84 and 85: of TB disease by 65%, irrespective
Page 86 and 87: FIGURE 7.3Percentage of TB patients
Page 88 and 89: BOX 7.1Accelerating progress in pro
Page 90 and 91: TABLE 7.2 Assumptions used to estim
Page 92 and 93: FIGURE 8.1 The development pipeline
Page 94 and 95: sputum specimens and TB isolates fr
Page 96 and 97: cal trial sites and building labora
Page 98: new TB vaccine candidate. A Phase I
Page 102 and 103: This annex explains the methods tha
Page 104 and 105: 2011. On average, 15 data points we
Page 106 and 107: may suffer from biases. These biase
Page 108 and 109: TABLE A1.3Parameter estimates used
Page 110 and 111: 5. Estimates of TB prevalence, 1990
Page 112: the Republic of Moldova, Romania, t
Page 116 and 117: AFGHANISTANPopulation 2011 32 milli
Page 118 and 119: BRAZILPopulation 2011 197 millionHI
Page 120 and 121: CHINAPopulation 2011 1 348 millionH
Page 122 and 123: ETHIOPIAPopulation 2011 85 millionH
Page 126 and 127: MOZAMBIQUEPopulation 2011 24 millio
Page 128 and 129: NIGERIAPopulation 2011 162 millionH
Page 130 and 131: PHILIPPINESPopulation 2011 95 milli
Page 132 and 133: SOUTH AFRICAPopulation 2011 50 mill
Page 134 and 135: UGANDAPopulation 2011 35 millionHIG
Page 136 and 137: VIET NAMPopulation 2011 89 millionH
Page 138: ANNEX 3Regional profiles
Page 141 and 142: WHO REGION OF THE AMERICASPopulatio
Page 143 and 144: WHO EUROPEAN REGIONPopulation 2011
Page 145 and 146: WHO WESTERN PACIFIC REGIONPopulatio
Page 148 and 149: SUMMARY BY WHO REGIONTable A4.1 Est
Page 150 and 151: MORTALITY (EXCLUDING HIV) PREVALENC
Page 152 and 153: NEW AND RELAPSENOTIFICATION RATE aY
Page 154 and 155: -% OF TB PATIENTS WITHKNOWN HIV STA
Page 156 and 157: AFRICAN REGIONTable A4.1 Estimates
Page 162 and 163: INCIDENCE (INCLUDING HIV) INCIDENCE
Page 164 and 165: NEW AND RELAPSENOTIFICATION RATE aY
Page 166 and 167: NEW AND RELAPSENOTIFICATION RATE a1
Page 168 and 169: TREATMENT SUCCESS (%) a1995-2010YEA
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-% OF TB PATIENTS WITHKNOWN HIV STA
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YEARTOTALCONFIRMEDCASES OFMDR-TB aE
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MALEYEAR 0-14 15-24 25-34 35-44 45-
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REGION OF THE AMERICASTable A4.1 Es
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MORTALITY (EXCLUDING HIV) PREVALENC
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INCIDENCE (INCLUDING HIV) INCIDENCE
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NEW AND RELAPSENOTIFICATION RATE a1
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% OF COHORTTREATMENT SUCCESS (%) a1
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MALEFEMALEYEAR 0-14 15-24 25-34 35-
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EASTERN MEDITERRANEAN REGIONTable A
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EUROPEAN REGIONTable A4.1 Estimates
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SOUTH-EAST ASIA REGIONTable A4.1 Es
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SMEAR LABS % OF SMEARPER 100K LABS
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Estimates of mortality, prevalence
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YEARPOPULATION(MILLIONS)MORTALITY (
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YEARPOPULATION(MILLIONS)INCIDENCE (
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YEARPOPULATION(MILLIONS)INCIDENCE (
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TREATMENT SUCCESS (%) a1995-2010YEA
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TREATMENT SUCCESS (%) a1995-2010YEA
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SMEAR LABS % OF SMEARPER 100K LABS
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