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Dr R.Reesaul Chest Physician Chest Clinic P. D`or Hospital

Epidemiology of Tuberculosis in The Republic of Mauritius “ Recent Trends ” (La Tuberculose à L`ile Maurice). Dr R.Reesaul Chest Physician Chest Clinic P. D`or Hospital. INCIDENCE AND MORTALITY OF TB WORLDWIDE PER 100,000 INHABITANTS 2006. 50. 12. 43. 8. 30. 6. 190. 125. 1M.

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Dr R.Reesaul Chest Physician Chest Clinic P. D`or Hospital

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  1. Epidemiology of Tuberculosis in The Republic of Mauritius“ Recent Trends ”(La Tuberculose à L`ile Maurice) Dr R.Reesaul Chest Physician Chest Clinic P. D`or Hospital

  2. INCIDENCE AND MORTALITY OF TB WORLDWIDE PER 100,000 INHABITANTS 2006 50 12 43 8 30 6 190 125 1M 25 3M 72 350 2M 122 100 2M 22 90 45 97 10 1/3 of world population infected 10 M new cases yearly 3 M cases of death yearly

  3. INCIDENCE AND RATE OF TB IN THE INDIAN OCEAN PER 100,000 INHABITANTS in 2006 75 1M 115 125 1M 2M 44 8000 350 2M 2M 25 20 17 120 97 40,000 Low incidence in a High risk region 10 115 9 75

  4. Tuberculosis in Mauritius • Population of 1.2 million( 2006) • Tuberculosis is a notified disease to the MOH • Free treatment of all persons with active TB • Anti- TB drugs(1st line and 2nd line drugs ) are available only at MOH central pharmacy • Only few cases treated in private

  5. ORGANIZATION AND SET UP OF TB IN MAURITIUS M.O.H In -patients 30 Beds TB AIDS Unit CHEST Clinic 5 Out- patients in Regional Hospitals W.H.O Africa Administration Procurement, Tenders Statistics, notifications… Specialized National Laboratory For TB detection Home Visits Specialized Nurses DOTS, Drugs Counselling Specialized Pharmacy Anti-TB Drugs BCG Screening Contacts Migrant workers Prisoners Homes High risks

  6. Notification and Incidence rate of Tuberculosis from 1974 to 2006

  7. INCIDENCE RATE OF TB PER 100,000 INHABITANTSYEAR1974 TO 2006

  8. Trend Incidence Pulmonary TB 2001-2005

  9. WHO Notification of TB 2002-2006

  10. INCIDENCE / among Migrant workers

  11. Age group and TB 2001-2005 Few cases <14 , protection BCG vaccin ? Max cases age 25-44

  12. Case notifications and sex ratio Sex ratio: M/F Age 15-24 : 2/1 Age 25-34 : 3/1 Age 35-44 :4/1 Age 45-54 : 2/1 Age >55 : 4/1

  13. Pulmonary and Extra-pulmonary TB 2001-2005

  14. Extra pulmonary TB 2001-2005

  15. Trend of Incidence TB in districts 2001-2005

  16. EVOLUTION INCIDENCE PER 100,000 INHABITANTS DISTRICT from 1993 AND 2005 17 14 13 12 23 40 20 13 4 9 4 13 5 08 6 13 14 10 Incidence 1993 - 15.6 per 100,000 inhabitants Incidence 2005 - 11 per 100,000 inhabitants

  17. DEATH RATE TB PER 100,000 INHABITANTS 1991 TO 2006

  18. Cumulative cases HIV/AIDS( 1st case at P D`or Hospital )

  19. CO-INFECTION TB / HIV-AIDS

  20. DOTS and case detection rate Objectives of WHO • Implementation of DOTS coverage ( Directly observed short course treatment) 100% • Case detection rate of at least 70% of smear positive pulmonary TB cases • Improve Cure rate > 80% • Non-compliance spread of infection lead to : MDR ( Resistance to INAH & Rifampicin ) XDR TB( MDR and resistance to at least 3 major second line drugs )

  21. DOTS monitoring & outcomes 1995-2005

  22. MDR TB 2001-2006

  23. Risk factors predisposing to TB in % admitted at Poudre D`or Hospital

  24. Conclusion • Incidence TB stable 10-14 /100,000 since 1995 • Incidence highest among age group 35-45 • Increase of extra-pulmonary TB since1992 • Low death rate < 1/100,000 since 1998 • Increase of TB among migrant workers noted since 1998 • Few cases of Co-infection TB / HIV-AIDS and MDR TB • Cases MDR TB not among HIV/AIDS patients

  25. Thank YouMerci

  26. 9 Districts in Mauritius population 1.2 M

  27. Tuberculosis in Mauritius • Capital –District of Port Louis • Area 1865 km² , 9 districts + Rodrigues • Population of 1.2 million( 2006) • Tuberculosis notified disease to MOH • Gross national income per capita USD :12.45 • Total expenditure on health as % GDP :4.3 • Life expectancy at birth M/F :69/76 • Free treatment of all persons with active TB • Anti- TB drugs available only at MOH central pharmacy and few cases treated in private

  28. Notified cases and incidence of Tb 2001-2006

  29. TREND OF NOTIFIED CASES YEAR 1974 -2006 YEARS

  30. WHO Case notifications 1998-2005

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