Global Tuberculosis Report -- 2012.pdf

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SOUTH AFRICAPopulation 2011 50 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) 25 (11–44) 49 (21–87)Prevalence (includes HIV+TB) 390 (200–630) 768 (399–1 250)Incidence (includes HIV+TB) 500 (410–600) 993 (819–1 180)Incidence (HIV+TB) 330 (270–390) 650 (536–774)Case detection, all forms (%) 69 (58–83)TB case notifications 2011NEW CASES (%) RETREATMENT CASES (%)Smear-positive 129 770 (40) Relapse 18 394 (40)Smear-negative 70 341 (22) Treatment after failure 2 578 (6)Smear-unknown/not done 77 925 (24) Treatment after default 4 642 (10)Extrapulmonary 47 285 (15) Other 20 301 (44)Other 0 (0)Total new 325 321 Total retreatment 45 915Mortality (excludes HIV+TB) (rateper 100 000 population per year)Prevalence(rate per 100 000 population)1008060402001990 1995 2000 2005 20101200100080060040020001990 1995 2000 2005 2010Other (history unknown) 18 738Total new and relapse 343 715 Total cases notifi ed 389 974New casesSMEAR-NEGATIVE/SMEAR-POSITIVE UNKNOWN/NOT DONE EXTRAPULMONARYM:F ratio 1.2 1.0 1.0Age < 15 3 404 32 080 2 399Laboratories 2011Smear (per 100 000 population) 0.5Culture (per 5 million population) 1.5Drug susceptibility testing (per 5 million population) 1.5Is second-line drug susceptibility testing available?Yes, in countryIs there a national reference laboratory?YesTreatment success rate 2010 b (%)New smear-positiveIs rifampicin used throughout(and/or culture-positive) 79 treatment for new patients? YesNew smear-negative/extrapulmonary 37Retreatment 35TB/HIV 2011 NUMBER (%)TB patients with known HIV status 323 440 (83)HIV-positive TB patients 211 800 (65)HIV-positive TB patients on co-trimoxazole preventive therapy (CPT) 161 298 (76)HIV-positive TB patients on antiretroviral therapy (ART) 92 376 (44)HIV-positive people screened for TB 1 256 212HIV-positive people provided with IPT 372 994Estimates of MDR-TB burden 2011 a NEW RETREATMENT% of TB cases with MDR-TB 1.8 (1.4–2.3) 6.7 (5.5–8.1)MDR-TB cases among notifi edpulmonary TB cases 5 000 (4 000–6 300) 3 100 (2 500–3 700)Reported cases of MDR-TB 2011 NEW RETREATMENT TOTALCases tested for MDR-TB 33 576Laboratory-confi rmed MDR-TB cases 10 085Patients started on MDR-TB treatment 5 643Financing TB control 2012 2013Total budget (US$ millions)Available funding (US$ millions)% of budget funded% available funding from domestic sources% available funding from the Global FundabRanges represent uncertainty intervals.Treatment success rates are based on incomplete data.Incidence (rate per 100 000population per year)Treatment success rate (%)Number of patientsUS$ millions14001200100080060040020001990 1995 2000 2005 2011908070605040302010025 000020 000015 000010 000050 0000450400350300250200150100500Incidence 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 2011HIV-positive TB patients on CPT on ART2006 2007 2008 2009 2010 2011 2012 2013Total budgetAvailable fundingGLOBAL TUBERCULOSIS REPORT 2012 Data can be downloaded from www.who.int/tb/data 123
THAILANDPopulation 2011 70 millionHIGH TB BURDEN | HIGH HIV BURDENEstimates of TB burden a 2011NUMBER (thousands) RATE (per 100 000 population)Mortality (excludes HIV+TB) 9.8 (4.2–18) 14 (6.1–25)Prevalence (includes HIV+TB) 110 (51–200) 161 (73–282)Incidence (includes HIV+TB) 86 (71–100) 124 (102–147)Incidence (HIV+TB) 13 (10–15) 18 (15–22)Case detection, all forms (%) 76 (64–93)TB case notifications 2011NEW CASES (%) RETREATMENT CASES (%)Smear-positive 33 169 (52) Relapse 1 915 (51)Smear-negative 20 726 (32) Treatment after failure 406 (11)Smear-unknown/not done Treatment after default 556 (15)Extrapulmonary 10 014 (16) Other 890 (24)Other 0 (0)Total new 63 909 Total retreatment 3 767Mortality (excludes HIV+TB) (rateper 100 000 population per year)Prevalence(rate per 100 000 population)504030201001990 1995 2000 2005 201040030020010001990 1995 2000 2005 2010Other (history unknown) 0Total new and relapse 65 824 Total cases notifi ed 67 676New casesM:F ratio 2.4Age < 15 114SMEAR-NEGATIVE/SMEAR-POSITIVE UNKNOWN/NOT DONE EXTRAPULMONARYLaboratories 2011Smear (per 100 000 population) 1.6Culture (per 5 million population) 4.7Drug susceptibility testing (per 5 million population) 1.1Is second-line drug susceptibility testing available?Is there a national reference laboratory?Treatment success rate 2010 (%)Yes, in and outside countryNew smear-positiveIs rifampicin used throughout(and/or culture-positive) 85 treatment for new patients? YesNew smear-negative/extrapulmonary 79Retreatment 66YesIncidence (rate per 100 000population per year)Treatment success rate (%)2001501005001990 1995 2000 2005 2011Incidence Incidence (HIV+TB) Notifications1008060402001996 1998 2000 2002 2004 2006 2008 2010TB/HIV 2011 NUMBER (%)TB patients with known HIV status 49 770 (74)HIV-positive TB patients 7 326 (15)HIV-positive TB patients on co-trimoxazole preventive therapy (CPT) 5 509 (75)HIV-positive TB patients on antiretroviral therapy (ART) 4 348 (59)HIV-positive people screened for TB 41 131HIV-positive people provided with IPTEstimates of MDR-TB burden 2011 a NEW RETREATMENT% of TB cases with MDR-TB 1.7 (1.0–2.6) 35 (28–42)MDR-TB cases among notifi edpulmonary TB cases 890 (540–1 400) 1 300 (1 000–1 600)Number of patients10 00080006000400020000New smear-positive (and/or culture-positive) RetreatmentNew smear-negative/extrapulmonary2003 2004 2005 2006 2007 2008 2009 2010 2011Reported cases of MDR-TB 2011 NEW RETREATMENT TOTALHIV-positive TB patients on CPT on ARTCases tested for MDR-TB 4 939Laboratory-confi rmed MDR-TB cases 510Patients started on MDR-TB treatment 12360Financing TB control 2012 2013Total budget (US$ millions) 44 44Available funding (US$ millions) 41 41% of budget funded 94 94% available funding from domestic sources 98 98% available funding from the Global Fund 2 2US$ millions504030201002006 2007 2008 2009 2010 2011 2012 2013aRanges represent uncertainty intervals.Total budgetAvailable funding124 Data can be downloaded from www.who.int/tb/data GLOBAL TUBERCULOSIS REPORT 2012
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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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evised as a result of the introduct
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TABLE 6.2 Incorporation of WHO poli
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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 128 and 129: NIGERIAPopulation 2011 162 millionH
Page 130 and 131: PHILIPPINESPopulation 2011 95 milli
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
Page 178 and 179: MALEYEAR 0-14 15-24 25-34 35-44 45-
Page 180 and 181: 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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