Global Tuberculosis Report -- 2012.pdf

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UGANDAPopulation 2011 35 millionHIGH TB BURDEN | HIGH HIV BURDENEstimates of TB burden a 2011NUMBER (thousands) RATE (per 100 000 population)Mortality (excludes HIV+TB) 5.0 (2.1–9.0) 14 (6.2–26)Prevalence (includes HIV+TB) 63 (33–100) 183 (95–298)Incidence (includes HIV+TB) 67 (54–81) 193 (156–234)Incidence (HIV+TB) 35 (28–42) 102 (82–123)Case detection, all forms (%) 69 (57–86)TB case notifications 2011NEW CASES (%) RETREATMENT CASES (%)Smear-positive 25 614 (57) Relapse 1 302 (32)Smear-negative 12 830 (29) Treatment after failure 306 (8)Smear-unknown/not done 1 559 (3) Treatment after default 1 206 (30)Extrapulmonary 5 001 (11) Other 1 198 (30)OtherTotal new 45 004 Total retreatment 4 012Mortality (excludes HIV+TB) (rateper 100 000 population per year)Prevalence(rate per 100 000 population)8060402001990 1995 2000 2005 201080060040020001990 1995 2000 2005 2010Other (history unknown)Total new and relapse 46 306 Total cases notifi ed 49 016New casesSMEAR-NEGATIVE/SMEAR-POSITIVE UNKNOWN/NOT DONE EXTRAPULMONARYM:F ratio 1.8Age < 15 695Incidence (rate per 100 000population per year)12001000800600400200Laboratories 2011Smear (per 100 000 population) 3.1Culture (per 5 million population) 1.0Drug susceptibility testing (per 5 million population) 1.2Is 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) 71 treatment for new patients? YesNew smear-negative/extrapulmonary 62Retreatment 65TB/HIV 2011 NUMBER (%)TB patients with known HIV status 39 394 (80)HIV-positive TB patients 20 725 (53)HIV-positive TB patients on co-trimoxazole preventive therapy (CPT) 19 258 (93)HIV-positive TB patients on antiretroviral therapy (ART) 6 720 (32)HIV-positive people screened for TB 553 057HIV-positive people provided with IPTEstimates of MDR-TB burden 2011 a NEW RETREATMENT% of TB cases with MDR-TB 1.4 (0.60–2.2) 12 (6.8–19)MDR-TB cases among notifi edpulmonary TB cases 560 (240–900) 480 (270–780)Reported cases of MDR-TB 2011 NEW RETREATMENT TOTALCases tested for MDR-TB 316 (1%) 360 (9%) 797Laboratory-confi rmed MDR-TB cases 7 43 71Patients started on MDR-TB treatment 7Treatment success rate (%)Number of patients01990 1995 2000 2005 2011908070605040302010025 00020 00015 00010 0005000025Incidence 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 ARTFinancing TB control 2012 2013Total budget (US$ millions) 20Available funding (US$ millions) 6.2% of budget funded 31% available funding from domestic sources 5% available funding from the Global Fund 56US$ millions201510502006 2007 2008 2009 2010 2011 2012 2013aRanges represent uncertainty intervals.Total budgetAvailable fundingGLOBAL TUBERCULOSIS REPORT 2012 Data can be downloaded from www.who.int/tb/data 125
UNITED REPUBLIC OF TANZANIAPopulation 2011 46 millionHIGH TB BURDEN | HIGH HIV BURDENEstimates of TB burden a 2011NUMBER (thousands) RATE (per 100 000 population)Mortality (excludes HIV+TB) 6.4 (3.3–11) 14 (7.1–23)Prevalence (includes HIV+TB) 82 (43–130) 177 (93–286)Incidence (includes HIV+TB) 78 (73–83) 169 (159–180)Incidence (HIV+TB) 30 (28–32) 65 (61–69)Case detection, all forms (%) 76 (71–81)TB case notifications 2011NEW CASES (%) RETREATMENT CASES (%)Smear-positive 24 115 (41) Relapse 1 079 (38)Smear-negative 20 438 (35) Treatment after failure 144 (5)Smear-unknown/not done 0 (0) Treatment after default 212 (7)Extrapulmonary 13 725 (24) Other 1 435 (50)Other 0 (0)Total new 58 278 Total retreatment 2 870Mortality (excludes HIV+TB) (rateper 100 000 population per year)Prevalence(rate per 100 000 population)60504030201001990 1995 2000 2005 201050040030020010001990 1995 2000 2005 2010Other (history unknown) 0Total new and relapse 59 357 Total cases notifi ed 61 148New casesSMEAR-NEGATIVE/SMEAR-POSITIVE UNKNOWN/NOT DONE EXTRAPULMONARYM:F ratio 1.8 1.3 1.1Age < 15 411 2 317 2 155Incidence (rate per 100 000population per year)30025020015010050Laboratories 2011Smear (per 100 000 population) 2.0Culture (per 5 million population) 0.5Drug susceptibility testing (per 5 million population) 0.1Is second-line drug susceptibility testing available?Yes, in and outside 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 89Retreatment 84TB/HIV 2011 NUMBER (%)TB patients with known HIV status 53 531 (88)HIV-positive TB patients 20 525 (38)HIV-positive TB patients on co-trimoxazole preventive therapy (CPT) 19 499 (95)HIV-positive TB patients on antiretroviral therapy (ART) 7 706 (38)HIV-positive people screened for TB 148 177HIV-positive people provided with IPTEstimates of MDR-TB burden 2011 a NEW RETREATMENT% of TB cases with MDR-TB 1.1 (0.30–2.8) 0.0 (0.0–7.3)MDR-TB cases among notifi edpulmonary TB cases 480 (130–1 200) 0 (0–210)Reported cases of MDR-TB 2011 NEW RETREATMENT TOTALCases tested for MDR-TB 83 (
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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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FIGURE 6.3The Supranational Referen
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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 132 and 133: SOUTH AFRICAPopulation 2011 50 mill
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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