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:: FIG. 4.14 Case notification rates (new and relapse cases, all forms) (black) compared with estimated TB incidence rates (green), 2000–2015, 30 high TB burden countries. Shaded areas represent uncertainty bands. Angola Bangladesh a Brazil Cambodia Central African Republic 300 60 800 1500 400 200 40 600 1000 400 200 100 20 200 500 0 0 0 0 0 China Congo DPR Korea DR Congo Ethiopia 600 600 600 400 100 400 400 300 400 50 200 200 200 100 200 0 0 0 0 0 India b Indonesia Kenya Lesotho Liberia Rate per 100 000 population per year 400 600 400 1500 400 300 300 300 400 1000 200 200 200 200 100 100 500 100 0 0 0 0 0 Mozambique Myanmar Namibia Nigeria Pakistan 800 600 1200 500 400 600 900 400 300 400 300 400 600 200 200 200 300 200 100 100 0 0 0 0 0 Papua New Guinea Philippines Russian Federation Sierra Leone South Africa 600 150 400 400 400 100 300 1000 200 200 50 200 100 500 0 0 0 0 0 400 300 200 100 Thailand UR Tanzania Viet Nam Zambia 800 600 400 200 200 100 900 600 300 Zimbabwe 800 600 400 200 0 0 0 0 0 2000 2005 2010 2015 2000 2005 2010 2015 2000 2005 2010 2015 2000 2005 2010 2015 2000 2005 2010 2015 a Estimates of TB incidence for Bangladesh will be reviewed once final results from the 2015/2016 national TB prevalence survey are available. b Estimates of TB incidence for India are interim in nature, pending results from the national TB prevalence survey planned for 2017/2018. GLOBAL <strong>TUBERCULOSIS</strong> REPORT 2016 :: 69
:: FIG. 4.15 Estimated TB treatment coverage (new and relapse patients as a percentage of estimated TB incidence) in 2015, 30 high TB burden countries, WHO regions and globally Russian Federation China Brazil Philippines DPR Korea Namibia Papua New Guinea Viet Nam Kenya Zimbabwe Ethiopia Myanmar Angola Pakistan South Africa Sierra Leone Cambodia India a Zambia Bangladesh b Congo Central African Republic Thailand DR Congo Lesotho Liberia Mozambique UR Tanzania Indonesia Nigeria Western Pacific The Americas Europe Eastern Mediterranean South-East Asia Africa Global 0 30 60 90 Treatment coverage (%) a Estimates of TB incidence for India are interim in nature, pending results from the national TB prevalence survey planned for 2017/2018. b Estimates of TB incidence for Bangladesh will be reviewed once final results from the 2015/2016 national TB prevalence survey are available. regions achieved higher levels of above 75%: the Region of the Americas, and the European and Western Pacific regions. Among the 30 high TB burden countries, the highest levels of treatment coverage in 2015 (>80%) were in Brazil, China, the Philippines and the Russian Federation. The lowest levels, with best estimates of 50% or less, were in the Democratic Republic of the Congo, Indonesia, Mozambique, Nigeria and the United Republic of Tanzania. Globally in 2015, there was a gap of about 4.3 million cases between the 6.1 million new and relapse cases that were notified, and the estimated 10.4 million incident TB cases in the same year (Fig. 4.1). Although notifications have increased in recent years, especially in India (Section 4.1.1), the size of this gap is larger than indicated in previous global TB reports following an upward revision to estimated TB incidence in India for 2015 and previous years (for further details, see Chapter 3 and in particular Box 3.3). However, using the entire updated time-series of estimates of TB incidence as shown in Fig. 4.1, the global gap has been narrowing, especially in the WHO Eastern Mediterranean and Western Pacific regions, and to a lesser extent in the WHO South-East Asia Region. 1 Ten countries account for 77% of the total estimated gap between incidence and notifications (Fig. 4.16a), and India, Indonesia and Nigeria alone account for almost half of the total. There are three main reasons for a gap between notifications and estimated incidence: ■ Underreporting of detected TB cases. In many countries, especially those without policies on mandatory notification and other measures to ensure reporting of detected cases by all care providers and large private health sectors, levels of underreporting may be high. ■ Underdiagnosis of people with TB. This can occur for reasons such as poor geographical and financial access to health care; failure to recognize TB signs and symptoms, and to test for TB when people do present to health facilities; and diagnostic tests that are not good enough to ensure accurate identification of all cases. 1 Time trends in countries and regions are shown in Annex 2 and Annex 3, respectively. 70 :: GLOBAL <strong>TUBERCULOSIS</strong> REPORT 2016
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GLOBAL REPORT TUBERCULOSIS 2016
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WHO Library Cataloguing-in-Publicat
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:: Abbreviations aDSM AE AIDS ART A
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The principal source of financial s
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Zhumagali Ismailov, Sarah Jackson,
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:: Executive Summary Background The
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TB prevention services South Africa
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Chapter 1 :: Introduction Tuberculo
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:: Box 2.1 The Sustainable Developm
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:: Box 2.3 The End TB Strategy at a
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:: TABLE 2.1 Top 10 indicators (not
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TABLE 2.2 :: The three TB high-burd
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Chapter 3 :: TB disease burden :: K
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:: Box 3.1 The WHO Global Task Forc
Page 30 and 31: :: Box 3.2 Updates to estimates of
Page 32 and 33: :: Box 3.3 Updated and interim esti
Page 34 and 35: :: FIG. 3.1 Strengthening national
Page 36 and 37: :: TABLE 3.2 Estimated epidemiologi
Page 38 and 39: :: FIG. 3.3 Estimated TB incidence
Page 40 and 41: :: FIG. 3.5 Global trends in the es
Page 42 and 43: :: FIG. 3.8 Trends in estimated TB
Page 44 and 45: :: FIG. 3.10a Top causes of death w
Page 46 and 47: :: FIG. 3.14 Trends in estimated TB
Page 48 and 49: :: FIG. 3.16 Data sources available
Page 50 and 51: :: TABLE 3.5 Estimated incidence of
Page 52 and 53: :: FIG. 3.20 Estimated incidence of
Page 54 and 55: :: FIG. 3.22 Global progress in imp
Page 56 and 57: :: TABLE 3.6 Number of TB cases fou
Page 58 and 59: :: TABLE 3.7 HIV-negative and HIV-p
Page 60 and 61: :: FIG. 3.29a The prevalence:notifi
Page 62 and 63: :: FIG. 3.31b The average CFR by st
Page 64 and 65: SIM and SINAN case-based databases,
Page 66 and 67: Prompt and accurate diagnosis of tu
Page 68 and 69: :: FIG. 4.2 New and relapse TB case
Page 70 and 71: :: FIG. 4.5 Percentage of new and r
Page 72 and 73: :: FIG. 4.8 Global numbers of notif
Page 74 and 75: :: TABLE 4.4 National guidance in p
Page 76 and 77: :: FIG. 4.9 Percentage of bacteriol
Page 78 and 79: :: FIG. 4.12 Number of MDR/RR-TB ca
Page 82 and 83: :: FIG. 4.16a The ten countries wit
Page 84 and 85: :: Box 4.5 Community contributions
Page 86 and 87: :: FIG. 4.18 Estimated ART treatmen
Page 88 and 89: issued in March 2013 and updated in
Page 90 and 91: :: FIG. 4.22 Treatment outcomes for
Page 92 and 93: :: Box 4.6 Active TB drug-safety mo
Page 94 and 95: Prevention of new infections of Myc
Page 96 and 97: :: TABLE 5.2 TB preventive treatmen
Page 98 and 99: :: TABLE 5.3 Provision of TB preven
Page 100 and 101: :: FIG. 5.5 Coverage of BCG vaccina
Page 102 and 103: This chapter aims to provide a tube
Page 104 and 105: :: FIG. 6.2 Government spending on
Page 106 and 107: :: Box 6.1 Implications for TB of e
Page 108 and 109: :: Box 6.2 Innovations in engaging
Page 110 and 111: :: Box 6.4 Reforming systems to exp
Page 112 and 113: :: TABLE 6.1 TB patient social supp
Page 114 and 115: :: FIG. 6.5 Surveys of costs faced
Page 116 and 117: :: TABLE 6.3 Status of selected SDG
Page 118 and 119: Continue current trend (base case s
Page 120 and 121: can provide insights into progress
Page 122 and 123: lion, most (US$ 4.4 billion, 67%) i
Page 124 and 125: :: Box 3.2 Updates to estimates of
Page 126 and 127: :: FIG. 7.5 Funding for NTP budgets
Page 128 and 129: :: Box 7.2 International donor fund
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:: FIG. 7.6 Reported funding gaps f
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:: Box 7.3 Methods used to estimate
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:: Box 8.1 WHO’s Global Action Fr
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is critical to allow for the time-s
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:: FIG. 8.2 The global development
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:: FIG. 8.3 The development pipelin
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Annex 1 Access to the WHO global TB
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A data dictionary that defines each
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Annex 2 Country profiles :: FOR 30
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Bangladesh population 2015 :: 161 m
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China population 2015 :: 1 376 mill
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Democratic Republic of the Congo po
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India population 2015 :: 1 311 mill
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Kenya population 2015 :: 46 million
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Myanmar population 2015 :: 54 milli
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Pakistan population 2015 :: 189 mil
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Russian Federation population 2015
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Thailand population 2015 :: 68 mill
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Viet Nam population 2015 :: 93 mill
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Central African Republic population
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Lesotho population 2015 :: 2.1 mill
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Namibia population 2015 :: 2.5 mill
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Sierra Leone population 2015 :: 6.5
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Zimbabwe population 2015 :: 16 mill
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WHO African Region WHO MEMBER STATE
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WHO Eastern Mediterranean Region WH
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WHO South-East Asia Region WHO MEMB
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Annex 4 TB burden estimates, notifi
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:: TABLE A4.1 TB incidence estimate
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:: TABLE A4.1 Table TB incidence A4
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:: Table TABLE A4.2 A4.2 Estimates
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Table :: TABLE A4.2 A4.2 Estimates
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:: TABLE A4.3 Measured percentage o
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:: TABLE A4.3 Measured Table A4.3 p
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:: TABLE A4.4 TB case notifications
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:: TABLE A4.4 TB case notifications
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:: TABLE A4.5 Treatment outcomes by
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:: TABLE A4.5 Treatment outcomes by
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ISBN 9 789241 565394 Ending TB by 2
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