Global Tuberculosis Report -- 2012.pdf

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NIGERIAPopulation 2011 162 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) 27 (6.1–64) 17 (3.7–40)Prevalence (includes HIV+TB) 280 (71–620) 171 (44–382)Incidence (includes HIV+TB) 190 (90–330) 118 (55–204)Incidence (HIV+TB) 50 (23–86) 30 (14–53)Case detection, all forms (%) 45 (26–96)TB case notifications 2011NEW CASES (%) RETREATMENT CASES (%)Smear-positive 47 436 (56) Relapse 2 515 (29)Smear-negative 33 034 (39) Treatment after failure 719 (8)Smear-unknown/not done 0 (0) Treatment after default 1 587 (18)Extrapulmonary 3 793 (5) Other 3 966 (45)Other 0 (0)Total new 84 263 Total retreatment 8 787Mortality (excludes HIV+TB) (rateper 100 000 population per year)Prevalence(rate per 100 000 population)1201008060402001990 1995 2000 2005 20101200100080060040020001990 1995 2000 2005 2010Other (history unknown) 0Total new and relapse 86 778 Total cases notifi ed 93 050New casesSMEAR-NEGATIVE/SMEAR-POSITIVE UNKNOWN/NOT DONE EXTRAPULMONARYM:F ratio 1.6Age < 15 1 107Incidence (rate per 100 000population per year)700600500400300200100Laboratories 2011Smear (per 100 000 population) 0.8Culture (per 5 million population) 0.2Drug susceptibility testing (per 5 million population) 0.1Is second-line drug susceptibility testing available?Yes, outside countryIs there a national reference laboratory?YesTreatment success rate 2010 (%)New smear-positiveIs rifampicin used throughout(and/or culture-positive) 84 treatment for new patients? YesNew smear-negative/extrapulmonary 77Retreatment 82TB/HIV 2011 NUMBER (%)TB patients with known HIV status 75 772 (81)HIV-positive TB patients 19 553 (26)HIV-positive TB patients on co-trimoxazole preventive therapy (CPT) 13 301 (68)HIV-positive TB patients on antiretroviral therapy (ART) 8 410 (43)HIV-positive people screened for TB 223 933HIV-positive people provided with IPT 969Estimates 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 2 500 (80–5 700) 890 (180–1 600)<strong>Report</strong>ed cases of MDR-TB 2011 NEW RETREATMENT TOTALCases tested for MDR-TB 12 (
PAKISTANPopulation 2011 177 millionHIGH TB BURDEN | HIGH MDR-TB BURDENEstimates of TB burden a 2011NUMBER (thousands) RATE (per 100 000 population)Mortality (excludes HIV+TB) 59 (26–110) 33 (15–60)Prevalence (includes HIV+TB) 620 (280–1 100) 350 (158–618)Incidence (includes HIV+TB) 410 (340–490) 231 (190–276)Incidence (HIV+TB) 1.5 (0.99–2.1) 0.84 (0.56–1.2)Case detection, all forms (%) 64 (54–78)TB case notifications 2011NEW CASES (%) RETREATMENT CASES (%)Smear-positive 105 733 (41) Relapse 5 947 (52)Smear-negative 103 824 (41) Treatment after failure 896 (8)Smear-unknown/not done 0 (0) Treatment after default 1 282 (11)Extrapulmonary 45 537 (18) Other 3 282 (29)Other 0 (0)Total new 255 094 Total retreatment 11 407Mortality (excludes HIV+TB) (rateper 100 000 population per year)Prevalence(rate per 100 000 population)1005001990 1995 2000 2005 2010100080060040020001990 1995 2000 2005 2010Other (history unknown) 3 893Total new and relapse 261 041 Total cases notifi ed 270 394New casesSMEAR-NEGATIVE/SMEAR-POSITIVE UNKNOWN/NOT DONE EXTRAPULMONARYM:F ratio 1.1 1.0 0.8Age < 15 3 895 14 142 7 696Laboratories 2011Smear (per 100 000 population) 0.7Culture (per 5 million population) 0.3Drug susceptibility testing (per 5 million population) 0.3Is 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) 91 treatment for new patients? YesNew smear-negative/extrapulmonary 90Retreatment 84Incidence (rate per 100 000population per year)Treatment success rate (%)30020010001990 1995 2000 2005 2011Incidence Incidence (HIV+TB) Notifications1008060402001996 1998 2000 2002 2004 2006 2008 2010TB/HIV 2011 NUMBER (%)TB patients with known HIV status 8 322 (3)HIV-positive TB patients 33 (
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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
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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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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 124 and 125: INDONESIAPopulation 2011 242 millio
Page 126 and 127: MOZAMBIQUEPopulation 2011 24 millio
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
Page 174 and 175: -% OF TB PATIENTS WITHKNOWN HIV STA
Page 176 and 177: 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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-% OF TB PATIENTS WITHKNOWN HIV STA
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YEARTOTALCONFIRMEDCASES OFMDR-TB aE
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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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