Global Tuberculosis Report -- 2012.pdf

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ContentsAbbreviationsivAcknowledgementsvExecutive summary 1Chapter 1. Introduction 3Chapter 2. The burden of disease caused by TB 8Chapter 3. TB case notifications and treatment outcomes 29Chapter 4. Drug-resistant TB 41Chapter 5. Financing TB care and control 52Chapter 6. Diagnostics and laboratory strengthening 66Chapter 7. Addressing the co-epidemics of TB and HIV 74Chapter 8. Research and development 82Annexes1. Methods used to estimate the global burden of disease caused by TB 912. Country profiles 1053. Regional profiles 1294. Global, regional and country-specific data for key indicators 137GLOBAL TUBERCULOSIS REPORT 2012iii
AbbreviationsAFBAFRAIDSAMRARIARTBCGBRICSCDRCPTCBCDOTDOTSDR-TBDRSDSTECDCEMREQAERREUEURFINDGDPGLIacid-fast bacilliWHO African Regionacquired immunodeficiency syndromeWHO Region of the Americasannual risk of infectionantiretroviral therapyBacille-Calmette-GuérinBrazil, Russian Federation, India,China, South Africacase detection rateco-trimoxazole preventive therapycommunity-based TB caredirectly observed treatmentthe basic package that underpins theStop TB Strategydrug-resistant tuberculosisdrug resistance surveillance or surveydrug susceptibility testingEuropean Centre for Disease Preventionand ControlWHO Eastern Mediterranean RegionExternal quality assuranceElectronic recording and reportingEuropean UnionWHO European RegionFoundation for Innovative NewDiagnosticsgross domestic productGlobal Laboratory InitiativeGlobal Fund The Global Fund to fight AIDS,Tuberculosis and MalariaGlobal Plan Global Plan to Stop TB, 2011–2015GNI gross national incomeHBC high-burden country of which there are22 that account for approximately 80%of all new TB cases arising each yearHIV human immunodeficiency virusICD-10 International Classification of Diseases(tenth revision)IGRAIPTIRRLEDLPAMDGMDR-TBNGONTPPEPFARPOCPPMSEARSRLTBTB-TEAMTSTUNAIDSUNITAIDUSAIDVRWHAWHOWPRXDR-TBZNinterferon-gamma release assayisoniazid preventive therapyincidence rate ratioLight-emitting diodeLine-probe assayMillennium Development Goalmultidrug-resistant tuberculosis(resistance to, at least, isoniazid andrifampicin)nongovernmental organizationnational tuberculosis control programmeor equivalentUS President’s Emergency Plan for AIDSReliefpoint-of-carePublic–Private MixWHO South-East Asia Regionsupranational reference laboratorytuberculosisTuberculosis Technical AssistanceMechanismtuberculin skin testJoint United Nations Programme on HIV/AIDSinternational facility for the purchase ofdiagnostics and drugs for diagnosis andtreatment of HIV/AIDS, malaria and TBUnited States Agency for InternationalDevelopmentVital registrationWorld Health AssemblyWorld Health OrganizationWHO Western Pacific RegionExtensively drug-resistant TB, definedas MDR-TB plus resistance to afluoroquinolone and at least one of threeinjectable second-line drugs (amikacin,kanamycin or capreomycin)Ziehl Neelseniv GLOBAL TUBERCULOSIS REPORT 2012
Page 2 and 3: GLOBALTUBERCULOSISREPORT2012
Page 6 and 7: AcknowledgementsThis report on glob
Page 8 and 9: WHO Western Pacific RegionShalala A
Page 10 and 11: Executive SummaryThe World Health O
Page 12 and 13: CHAPTER 1IntroductionBOX 1.1Basic f
Page 14 and 15: TABLE 1.1 Targets for the scale-up
Page 16 and 17: TABLE 1.2 Reporting of data in the
Page 18 and 19: BOX 2.1Uncertainty in estimates of
Page 20 and 21: TABLE 2.2 Estimated burden of disea
Page 22 and 23: FIGURE 2.5 Estimated TB incidence r
Page 24 and 25: FIGURE B2.2.1Reporting of notificat
Page 26 and 27: FIGURE 2.8Estimated TB incidence ra
Page 28 and 29: FIGURE 2.11 Countries (in blue) for
Page 30 and 31: FIGURE 2.12 Trends in estimated TB
Page 32 and 33: ● producing and widely disseminat
Page 34 and 35: FIGURE 2.16 Progress in global cove
Page 36 and 37: BOX 2.6Efforts by the Task Force to
Page 38 and 39: CHAPTER 3TB case notificationsand t
Page 40 and 41: BOX 3.1 1Definitions of TB casesDef
Page 42 and 43: TABLE 3.3 Contribution of public-pr
Page 44 and 45: BOX 3.4Integrating community-based
Page 46 and 47: TABLE 3.4 Estimates of the case det
Page 48 and 49: TABLE 3.5 Treatment success for new
Page 50 and 51: CHAPTER 4Drug-resistant TBKEY FACTS
Page 52 and 53: FIGURE 4.2 Percentage of new TB cas
Page 54 and 55:
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
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FIGURE 8.1 The development pipeline
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sputum specimens and TB isolates fr
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cal trial sites and building labora
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new TB vaccine candidate. A Phase I
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This annex explains the methods tha
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2011. On average, 15 data points we
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may suffer from biases. These biase
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TABLE A1.3Parameter estimates used
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5. Estimates of TB prevalence, 1990
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the Republic of Moldova, Romania, t
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AFGHANISTANPopulation 2011 32 milli
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BRAZILPopulation 2011 197 millionHI
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CHINAPopulation 2011 1 348 millionH
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ETHIOPIAPopulation 2011 85 millionH
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INDONESIAPopulation 2011 242 millio
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MOZAMBIQUEPopulation 2011 24 millio
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NIGERIAPopulation 2011 162 millionH
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PHILIPPINESPopulation 2011 95 milli
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SOUTH AFRICAPopulation 2011 50 mill
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UGANDAPopulation 2011 35 millionHIG
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VIET NAMPopulation 2011 89 millionH
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ANNEX 3Regional profiles
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WHO REGION OF THE AMERICASPopulatio
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WHO EUROPEAN REGIONPopulation 2011
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WHO WESTERN PACIFIC REGIONPopulatio
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SUMMARY BY WHO REGIONTable A4.1 Est
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MORTALITY (EXCLUDING HIV) PREVALENC
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NEW AND RELAPSENOTIFICATION RATE aY
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-% OF TB PATIENTS WITHKNOWN HIV STA
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AFRICAN REGIONTable A4.1 Estimates
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INCIDENCE (INCLUDING HIV) INCIDENCE
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NEW AND RELAPSENOTIFICATION RATE aY
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NEW AND RELAPSENOTIFICATION RATE a1
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TREATMENT SUCCESS (%) a1995-2010YEA
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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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% 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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SMEAR LABS % OF SMEARPER 100K LABS
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