AcknowledgementsThis report on global tuberculosis care and control was produced by a core team of 13 people: Hannah Monica Dias,Dennis Falzon, Christopher Fitzpatrick, Katherine Floyd, Philippe Glaziou, Tom Hiatt, Christian Lienhardt, Linh Nguyen,Charalambos Sismanidis, Hazim Timimi, Mukund Uplekar, Wayne van Gemert and Matteo Zignol. The team wasled by Katherine Floyd. Overall guidance was provided by the Director of the Stop TB Department, Mario Raviglione.The data collection forms (long and short versions) were developed by Philippe Glaziou and Hazim Timimi, withinput from staff throughout the Stop TB Department. Hazim Timimi led and organized all aspects of data management.Christopher Fitzpatrick, Inés Garcia and Andrea Pantoja conducted all review and follow-up of financial data. Thereview and follow-up of all other data was done by a team of reviewers that included Annabel Baddeley, AnnemiekeBrands, Hannah Monica Dias, Dennis Falzon, Linh Nguyen, Hazim Timimi, Wayne van Gemert and Matteo Zignol inWHO headquarters, Tom Hiatt in the Western Pacific Regional Office, and Suman Jain, Sai Pothapregada and MohammedYassin from the <strong>Global</strong> Fund. Data for the European Region were collected and validated jointly by the WHORegional Office for Europe and the European Centre for Disease Prevention and Control (ECDC), an agency of theEuropean Union based in Stockholm, Sweden.Philippe Glaziou and Charalambos Sismanidis analysed surveillance and epidemiological data and prepared thefigures and tables on these topics, with assistance from Tom Hiatt. Tom Hiatt, Linh Nguyen and Annabel Baddeleyanalysed TB/HIV data and prepared the associated figures and tables. Dennis Falzon and Matteo Zignol analysed dataand prepared the figures and tables related to drug-resistant TB, with assistance from Shu-Hua Wang. ChristopherFitzpatrick analysed financial data, and prepared the associated figures and tables. Tom Hiatt and Wayne van Gemertprepared figures and tables on laboratory strengthening and the roll-out of new diagnostics. Christian Lienhardt andKarin Weyer prepared the figures on the pipelines for new TB drugs, diagnostics and vaccines, with input from therespective Working Groups of the Stop TB Partnership. Tom Hiatt checked and finalized all figures and tables in anappropriate format, ensuring that they were ready for layout and design according to schedule, and was the focal pointfor communications with the graphic designer.The writing of the main part of the report was led by Katherine Floyd, with contributions from the following people:Philippe Glaziou, Charalambos Sismanidis and Jinkou Zhao (Chapter 2); Hannah Monica Dias, Haileyesus Getahun,Thomas Joseph and Mukund Uplekar (Chapter 3); Christopher Fitzpatrick and Christian Gunneberg (Chapter 5); andAnnabel Baddeley, Haileyesus Getahun and Linh Nguyen (Chapter 7). Chapter 4, on drug-resistant TB, was preparedby Dennis Falzon and Matteo Zignol, with input from Katherine Floyd, Philippe Glaziou, Ernesto Jaramillo and CharalambosSismanidis. Chapter 6, on diagnostics and laboratory strengthening, was prepared by Wayne van Gemert, withinput from Christopher Gilpin, Fuad Mirzayev and Karin Weyer. Chapter 8, on research and development, was writtenby Christian Lienhardt, Karin Weyer and Katherine Floyd, with input and careful review by the chairs and secretariatsof the Working Groups of the Stop TB Partnership: particular thanks are due to Michael Brennan, Uli Fruth and JenniferWoolley (new vaccines); Daniella Cirillo, Philippe Jacon and Alessandra Varga (new diagnostics); and Cherise Scottand Mel Spigelman (new TB drugs). Karen Ciceri edited the entire report.Annex 1, which explains methods used to produce estimates of the burden of disease caused by TB, was writtenby Philippe Glaziou, Katherine Floyd and Charalambos Sismanidis; we thank Colin Mathers of WHO’s Mortality andBurden of Disease team for his careful review and helpful suggestions. The country profiles that appear in Annex 2 andthe regional profiles that appear in Annex 3 were prepared by Hazim Timimi. Annex 4, which contains a wealth ofglobal, regional and country-specific data from the global TB database, was prepared by Tom Hiatt and Hazim Timimi.We thank Pamela Baillie in the Stop TB Department’s TB monitoring and evaluation team for impeccable administrativesupport, Doris Ma Fat from WHO’s Mortality and Burden of Disease team for providing TB mortality dataextracted from the WHO Mortality Database, Michel Beusenberg, Kusha Davar, Chika Hyashi and Yves Souteyrandof WHO’s HIV department for the close collaboration that facilitated joint review and validation of TB/HIV data, andDiana Weil for reviewing and providing helpful comments on the entire report. We also thank Taavi Erkkola, LuisaFrescura and Peter Ghys from UNAIDS for providing TB/HIV data collected as part of the joint reporting process onUniversal Access in the Health Sector and <strong>Global</strong> AIDS Response Progress and for following up TB/HIV-related dataGLOBAL TUBERCULOSIS REPORT 2012v
queries with countries, and Peter Ghys and Karen Stanecki (UNAIDS) for providing epidemiological data that wereused to estimate HIV-associated TB mortality.We thank Sue Hobbs for her excellent work on the design and layout of this report; her contribution, as in previousyears, is greatly appreciated.The principal source of financial support for WHO’s work on monitoring and evaluation of TB control is the UnitedStates Agency for International Development (USAID), without which it would be impossible to produce this reporton global TB care and control. Data collection, validation, analysis, printing and dissemination were also supportedby funding from the governments of Japan and the Republic of Korea. We acknowledge with gratitude their support.In addition to the core report team and those mentioned above, the report benefited from the input of many staffworking in WHO’s regional and country offices and hundreds of people working for national TB programmes or withinnational surveillance systems who contributed to the reporting of data and to the review of report material prior to publication.These people are listed below, organized by WHO region. We thank them all for their invaluable contributionand collaboration, without which this report could not have been produced.Among the WHO staff listed below, we thank in particular Amal Bassili, Andrei Dadu, Tom Hiatt, Khurshid AlamHyder, Daniel Kibuga, Rafael López Olarte, André Ndongosieme, Wilfred Nkhoma, Nobuyuki Nishikiori, AngélicaSalomão, Ward Schrooten, Marithel Tesoro and Henriette Wembanyama for their major contribution to data collection,validation and review.WHO staff in regional and country officesWHO African RegionEsther Aceng, Harura Adamu, Boubacar Abdel Aziz, Inacio Alvarenga, Balde Amadou, Cornelia Atsyor, AyodeleAwe, Sanni Babatunde, Nayé Bah, Marie Barouan, Abera Bekele, Norbert Bidounga, Françoise Bigirimana, ChristineChakanyuka, Gaël Claquin, Peter Clement, Claudina Cruz, Olusoti Daniel, Noel Djemadji, Louisa Ganda, BoingotloGasennelwe, Joseph Imoko, Michael Jose, Joël Kangangi, Nzuzi Katondi, Samson Kefas, Bah Keita, Daniel Kibuga,Hillary Kipruto, Mwendaweli Maboshe, Leonard Mbam Mbam, Azmera Molla, Julie Mugabekazi, André Ndongosieme,Denise Nkezimana, Nicolas Nkiere, Wilfred Nkhoma, Ghislaine Nkone, Ishmael Nyasulu, Laurence Nyiramasarabwe,Samuel Ogiri, Sally Ohene, Amos Omoniyi, Chijioke Osakwe, Philips Patrobas, Angélica Salomão, Neema Simkoko,Desta Tiruneh, Henriette Wembanyama, Assefash Zehaie.WHO Region of the AmericasRoberto del Aguila, Monica Alonso, Arletta Anez, Miguel Aragón, Denise Arakaki, Adriana Bacelar, Eldonna Boisson,Gustavo Bretas, Luis Gerardo Castellanos, Maggie Clay, Rachel Eersel, Gerry Eijkemans, Marcos Espinal, YitadesGebre, Mirtha Del Granado, Mónica Guardo, Jorge Hadad, Rosalinda Hernández, Vidalia Lesmo, Rafael López, TamaraMancero, Wilmer Marquiño, Mario Martínez, Fatima Marinho, Humberto Montiel, Romeo Montoya, Roberto Montoya,José Moya, Kam Mung, Soledad Pérez, Jean Rwangabwoba, Hans Salas, Roberto Salvatella, Thais dos Santos,Ward Schrooten, Alfonso Tenorio, Enrique Vazquez, Jorge Victoria, Anna Volz, Victor Zamora.WHO Eastern Mediterranean RegionAli Akbar, Mohamed Abdel Aziz, Samiha Baghdadi, Amal Bassili, Najwa ElEmam, Sevil Huseynova, Rhida Jebeniani,Wasiq Khan, Hamida Khattabi, Nuzhat Leiluma, Aayid Munim, Ali Reza Aloudel, Karam Shah, Ireneaus Sindani,Bashir Suleiman, Rahim Taghizadeh, Martin Van Den Boom.WHO European RegionEvgeny Belilovsky, Andreea Cassandra Butu, Silvu Ciobanu, Pierpaolo de Colombani, Andrei Dadu, Irina Danilova,Masoud Dara, Alain Disu, Jamshid Gadoev, Gayane Ghukasyan, Ogtay Gozalov, Sayohat Hasanova, Saliya Karymbaeva,Kristin Kremer, Mehmet Kontas, Nikoloz Nasidze, Dmitry Pashkevich, Robertas Petkevicius, Valiantsin Rusovich,Javahir Suleymanova, Vadim Testov, Bogdana Shcherbak-Verlan, Melita Vujnovic.WHO South-East Asia RegionIyanthi Abeyewickreme, Mohammad Akhtar, Vikarunnesa Begum, Vineet Bhatia, Erwin Cooreman, Puneet Dewan,Md Khurshid Alam Hyder, Navaratnasingam Janakan, Rim Kwang Il, Kim Son Il, Franky Loprang, Jorge Luna, ParthaMandal, La Win Maung, Nigor Muzafarova, Ye Myint, Eva Nathanson, Patanjali Nayar, Rajesh Pandav, Razia Pendse,Sri Prihatini, K Rezwan, Ray Serrano, Mukta Sharma, Aminath Shenalin, Achuthan Sreenivas, Chawalit Tantinimitkul,Kim Tong Hyok, Namgyel Wangchuk, Supriya Warusavithana, Sidharta Yuwono.vi GLOBAL TUBERCULOSIS REPORT 2012
- Page 2 and 3: GLOBALTUBERCULOSISREPORT2012
- Page 4 and 5: ContentsAbbreviationsivAcknowledgem
- 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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MORTALITY (EXCLUDING HIV) PREVALENC
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MORTALITY (EXCLUDING HIV) PREVALENC
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INCIDENCE (INCLUDING HIV) INCIDENCE
- Page 164 and 165:
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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TREATMENT SUCCESS (%) a1995-2010YEA
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TREATMENT SUCCESS (%) a1995-2010YEA
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-% OF TB PATIENTS WITHKNOWN HIV STA
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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
- Page 182 and 183:
MORTALITY (EXCLUDING HIV) PREVALENC
- Page 184 and 185:
MORTALITY (EXCLUDING HIV) PREVALENC
- Page 186 and 187:
INCIDENCE (INCLUDING HIV) INCIDENCE
- Page 188 and 189:
NEW AND RELAPSENOTIFICATION RATE a1
- Page 190 and 191:
NEW AND RELAPSENOTIFICATION RATE a1
- Page 192 and 193:
% OF COHORTTREATMENT SUCCESS (%) a1
- Page 194 and 195:
% OF COHORTTREATMENT SUCCESS (%) a1
- Page 196 and 197:
% OF COHORTTREATMENT SUCCESS (%) a1
- Page 198 and 199:
-% OF TB PATIENTS WITHKNOWN HIV STA
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YEARTOTALCONFIRMEDCASES OFMDR-TB aE
- Page 202 and 203:
MALEFEMALEYEAR 0-14 15-24 25-34 35-
- Page 204 and 205:
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
- Page 212 and 213:
% OF COHORTTREATMENT SUCCESS (%) a1
- Page 214 and 215:
% OF COHORTTREATMENT SUCCESS (%) a1
- Page 216 and 217:
-% OF TB PATIENTS WITHKNOWN HIV STA
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MALEFEMALEYEAR 0-14 15-24 25-34 35-
- Page 220 and 221:
EUROPEAN REGIONTable A4.1 Estimates
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MORTALITY (EXCLUDING HIV) PREVALENC
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MORTALITY (EXCLUDING HIV) PREVALENC
- Page 226 and 227:
INCIDENCE (INCLUDING HIV) INCIDENCE
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INCIDENCE (INCLUDING HIV) INCIDENCE
- Page 230 and 231:
NEW AND RELAPSENOTIFICATION RATE a1
- Page 232 and 233:
NEW AND RELAPSENOTIFICATION RATE a1
- Page 234 and 235:
% OF COHORTTREATMENT SUCCESS (%) a1
- Page 236 and 237:
% OF COHORTTREATMENT SUCCESS (%) a1
- Page 238 and 239:
% OF COHORTTREATMENT SUCCESS (%) a1
- Page 240 and 241:
-% OF TB PATIENTS WITHKNOWN HIV STA
- Page 242 and 243:
YEARTOTALCONFIRMEDCASES OFMDR-TB aE
- Page 244 and 245:
MALEFEMALEYEAR 0-14 15-24 25-34 35-
- Page 246 and 247:
MALEFEMALEYEAR 0-14 15-24 25-34 35-
- Page 248 and 249:
SOUTH-EAST ASIA REGIONTable A4.1 Es
- Page 250 and 251:
MORTALITY (EXCLUDING HIV) PREVALENC
- Page 252 and 253:
NEW AND RELAPSENOTIFICATION RATE a1
- Page 254 and 255:
% OF COHORTTREATMENT SUCCESS (%) a1
- Page 256 and 257:
YEARTOTALCONFIRMEDCASES OFMDR-TB aE
- Page 258:
SMEAR LABS % OF SMEARPER 100K LABS
- Page 261 and 262:
Estimates of mortality, prevalence
- Page 263 and 264:
YEARPOPULATION(MILLIONS)MORTALITY (
- Page 265 and 266:
YEARPOPULATION(MILLIONS)INCIDENCE (
- Page 267 and 268:
YEARPOPULATION(MILLIONS)INCIDENCE (
- Page 269 and 270:
NEW AND RELAPSENOTIFICATION RATE a1
- Page 271 and 272:
TREATMENT SUCCESS (%) a1995-2010YEA
- Page 273 and 274:
TREATMENT SUCCESS (%) a1995-2010YEA
- Page 275 and 276:
-% OF TB PATIENTS WITHKNOWN HIV STA
- Page 277 and 278:
YEARTOTALCONFIRMEDCASES OFMDR-TB aE
- Page 279 and 280:
MALEFEMALEYEAR 0-14 15-24 25-34 35-
- Page 281 and 282:
SMEAR LABS % OF SMEARPER 100K LABS