Global Tuberculosis Report -- 2012.pdf

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WHO EASTERN MEDITERRANEAN REGIONPopulation 2011 609 millionWHO MEMBER STATES 22OTHER COUNTRIES AND TERRITORIES 1Estimates of TB burden a 2011 NUMBER (thousands) RATE (per 100 000 population)Mortality (excludes HIV+TB) 99 (61–150) 16 (10–24)Prevalence (includes HIV+TB) 1 000 (660–1 500) 170 (108–246)Incidence (includes HIV+TB) 660 (590–740) 109 (97–122)Incidence (HIV+TB) 9 (8–10) 1.4 (1.3–1.6)Case detection, all forms (%) 62 (55–70)TB case notifications 2011NEW CASES (%) RETREATMENT CASES (%)Smear-positive 170 748 (43) Relapse 11 223 (53)Smear-negative 128 182 (32) Treatment after failure 1 977 (9.3)Smear-unknown/not done 7 206 (1.8) Treatment after default 2 867 (13)Extrapulmonary 93 605 (23) Other 5 258 (25)Other 623 (
WHO EUROPEAN REGIONPopulation 2011 899 millionWHO MEMBER STATES 53OTHER COUNTRIES AND TERRITORIES 1Estimates of TB burden a 2011 NUMBER (thousands) RATE (per 100 000 population)Mortality (excludes HIV+TB) 45 (44–46) 5 (4.9–5.1)Prevalence (includes HIV+TB) 500 (370–650) 56 (41–73)Incidence (includes HIV+TB) 380 (350–400) 42 (39–45)Incidence (HIV+TB) 23 (20–25) 2.5 (2.2–2.8)Case detection, all forms (%) 73 (69–78)TB case notifications 2011NEW CASES (%) RETREATMENT CASES (%)Smear-positive 79 831 (31) Relapse 22 838 (24)Smear-negative 121 362 (48) Treatment after failure 12 140 (13)Smear-unknown/not done 6 896 (2.7) Treatment after default 4 625 (4.8)Extrapulmonary 42 489 (17) Other 56 531 (59)Other 3 191 (1.3)Total new 253 769 Total retreatment 96 134Mortality (excludes HIV+TB) (rateper 100 000 population per year)Prevalence(rate per 100 000 population)864201990 1995 2000 2005 20101501005001990 1995 2000 2005 2010Other (history unknown) 7 502Total new and relapse 275 872 Total cases notifi ed 356 670New casesSMEAR-NEGATIVE/SMEAR-POSITIVE UNKNOWN/NOT DONE EXTRAPULMONARYM:F ratio 2.3 1.9 1.2age < 15 391 2 850 6 638Laboratories 2011NUMBER OF MEMBER STATES bSmear (per 100 000 population) ≥ 1 8 out of 53Culture (per 5 million population) ≥ 1 30 out of 53Drug susceptibility testing (per 5 million population) ≥ 1 25 out of 53Treatment success rate 2010 (%)New smear-positive (and/or culture-positive) 67New smear-negative/extrapulmonary 78Retreament 51MDR-TB (2009 cohort) 48TB/HIV 2011 NUMBER (%) cTB patients with known HIV status 187 233 (52)HIV-positive TB patients 12 317 (6.5)HIV-positive TB patients on co-trimoxazole preventive therapy (CPT) 828 (64)HIV-positive TB patients on antiretroviral therapy (ART) 3 487 (47)HIV-positive people screened for TB 9 173HIV-positive people provided with IPT 4 565Estimates of MDR-TB burden 2011 a NEW RETREATMENT% of TB cases with MDR-TB 15 (10–20) 44 (40–49)MDR-TB cases among notifi edpulmonary TB cases 32 000 (21 000–42 000) 42 000 (38 000–47 000)<strong>Report</strong>ed cases of MDR-TB 2011 NEW RETREATMENT TOTALCases tested for MDR-TB 69 467 (56%) 25 561 (27%) 99 470Laboratory-confi rmed MDR-TB cases 10 290 12 097 32 348Patients started on MDR-TB treatment 34 769Incidence (rate per 100 000population per year)Treatment success rate (%)Number of patients (thousands)8060402001990 1995 2000 2005 2011Incidence Incidence (HIV+TB) Notifications1008060402001996 1998 2000 2002 2004 2006 2008 2010New smear-positive (and/or culture-positive) RetreatmentNew smear-negative/extrapulmonary16128402004 2005 2006 2007 2008 2009 2010 2011HIV-positive TB patients on CPT on ARTFinancing TB control (low- and middle-income countries) d 2012 2013Total budget (US$ millions) 1 380 1 670Available funding (US$ millions) 1 350 1 550% of budget funded 98 92% available funding from domestic sources 96 98% available funding from <strong>Global</strong> Fund 3.7 1.9US$ millions(constant 2012 US$)200016001200800400abcdRanges represent uncertainty intervals.Data are not collected from all Member States.Calculations exclude countries with missing numerators or denominators.Financing indicators exclude funding for general healthcare services provided outside NTPs.02006 2007 2008 2009 2010 2011 2012 2013Total budgetAvailable funding134 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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FIGURE 6.3The Supranational Referen
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of TB disease by 65%, irrespective
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FIGURE 7.3Percentage of TB patients
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BOX 7.1Accelerating progress in pro
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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 134 and 135: UGANDAPopulation 2011 35 millionHIG
Page 136 and 137: VIET NAMPopulation 2011 89 millionH
Page 138: ANNEX 3Regional profiles
Page 141: WHO REGION OF THE AMERICASPopulatio
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
Page 186 and 187: INCIDENCE (INCLUDING HIV) INCIDENCE
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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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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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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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