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. Epidemiological Status of TB (Region of the Americas, 2004). Regional Program on Tuberculosis. Current Status of Tuberculosis Worldwide. Estimated Global Burden of TB (2002). 98% of all deaths from TB take place in developing countries.

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Epidemiological Status of TB

(Region of the Americas, 2004)

Regional Program on Tuberculosis

Epidemiological Status of TB (Americas, 2004)

slide2

Current Status

of Tuberculosis

Worldwide

Epidemiological Status of TB (Americas, 2004)

estimated global burden of tb 2002
Estimated Global Burden of TB (2002)

98% of all deaths from TB take place in developing countries.

Epidemiological Status of TB (Americas, 2004)

global status of expansion of dots taes strategy 2002
Global Status of Expansion of DOTS/TAES Strategy, 2002
  • Multi-resistance to anti-tubercular drugs (MDR-TB) en 63 of the 72 countries surveyed from 1994–1999.
  • 73.4% (155 out of 210) of the countries are currently applying DOTS/TAES.
  • 61% of the world population has access to the DOTS/TAES strategy.
  • 60% of all new infectious, contagious cases (Pulm Bk+) were detected using DOTS/TAES.
  • Compared to 1999, there has been an increase of 143,000 Bk+ cases reported using DOTS/TAES (2000–2001). With this increase, goals should be reached by 2013. The search for Bk+ cases would have to be increased by 330,000 yearly to reach the goals by 2005.

Epidemiological Status of TB (Americas, 2004)

forecast for case detection using dots taes
Forecast for Case Detection Using DOTS/TAES

80

WHO goal = 70%

70

60

Progress sped up:

2005 goal

50

Cases reported using DOTS (%)

40

Start of DOTS

30

1991

Average progress

20

10

2013 goal

0

1990

1995

2000

2005

2010

2015

Year

Source: WHO.

Epidemiological Status of TB (Americas, 2004)

tb in 2003 where are we
TB in 2003: Where are we?
  • Cases still on the upswing in Africa and the former USSR.
  • TB/HIV and MDR-TB are being treated as a problem but are far from being resolved.
  • Each country knows its own limitations best when it comes to controlling disease.
  • Weakness in public-health systems: communities, primary care, prisons, city governments, social-security systems.
  • Lack of participation on the part of the private sector.

End Result:At the global level, we are still in no position to reach our goals by 2005.

Epidemiological Status of TB (Americas, 2004)

current global challenges for tb control
Current Global Challenges for TB Control
  • Impact of HIV on TB.
  • MDR-TB.
  • Weakness in health systems:
    • Community health-workers unutilized.
    • Private doctors uninvolved.
    • Primary-care services respond insufficiently.
    • Prison system unassociated with DOTS/TAES.

Epidemiological Status of TB (Americas, 2004)

slide8

Status of TB

in the Americas

Epidemiological Status of TB (Americas, 2004)

trend for tb and baar cases in the region 1990 2002
Trend for TB and BAAR(+) Cases in the Region, 1990–2002

29–31 / 100,000 pop.

15–17 / 100,000 pop.

Epidemiological Status of TB (Americas, 2004)

reporting of tb cases by category region of the americas 2002
Reporting of TB Cases by Category (Region of the Americas, 2002)

Epidemiological Status of TB (Americas, 2004)

reporting of tb cases by gender region of the americas 2002
Reporting of TB Cases by Gender(Region of the Americas, 2002)

Epidemiological Status of TB (Americas, 2004)

burden of tb region of the americas 2002
Burden of TB(Region of the Americas, 2002)

Haiti

Dom. Rep.

Mexico

Honduras

Ecuador

Peru

Bolivia

Brazil

Nicaragua

75%

Total: 223,057

Peru

Brazil

50%

Epidemiological Status of TB (Americas, 2004)

estimated tb incidence rate latin america 2003
Estimated TB Incidence Rate(Latin America, 2003)

Epidemiological Status of TB (Americas, 2004)

prevalence of hiv infection among patients with tb selected countries of the americas 2002
Prevalence of HIV Infection among Patients with TB (selected countries of the Americas, 2002)

English-speaking Caribbean (2001)*

BAH 40%

BEL 12.8%

GUY 30.8%

JAM 30%

SUR 31.1%

TRT 52.8%

NY 1997 26%

HON 2002 6.0%

DOR 1997 17%

MEX1990-1994 3.1%

CR 2002 8.9%

GUT20008.0%

ELS20024.4%

NIC 2002 2.5%

Rio de Janeiro - BRA 1995-1998

35.6%

PER2002 1.99%

Source: Reports from TB control programs.

* Caribbean Epidemiology Centre (CAREC).

ARG 1995

2.2%

URU 1997

0.7%

Epidemiological Status of TB (Americas, 2004)

prevalence of tb aids
Prevalence of TB/AIDS

% TB cases among PLWHA

Country

Year

Type of AIDS epidemic

El Salvador

2002

11.5

Concentrated

Guyana

2000

13.7

Generalized

Haití

1999

63.8

Generalized

Honduras

2002

9

Generalized

Nicaragua

2002

2.5

Concentrated

Panama

2002

24.8

Generalized

Peru

2001

34.2

Concentrated

Source: Reports from national TB programs.

Epidemiological Status of TB (Americas, 2004)

status of prevalence of hiv aids among tb patients in the english speaking caribbean
Status of Prevalence of HIV/AIDS among TB Patients in the English-Speaking Caribbean

Epidemiological Status of TB (Americas, 2004)

slide17

Anti-TB Drug-Resistance Studies(Americas, 1999–2002)

Surveys completed

Surveys in progress

No survey project

Epidemiological Status of TB (Americas, 2004)

slide18

MDR in Initial Resistance to Anti-TB Drugs(Americas, 1994–2002)

CAN 1.2%

USA 1.2%

R.DOM 6.6%

PR2.5%

CUBA 0.3%

MEX 3 estados 2.4%

GUA 3.7%

HON 1.8%

VEN 0.3%

NIC 1.2%

COL 1.47%

ELS0.3%

ECU 5.0%

BRA 0.9%

No data

PERU 3.0%

BOL 1.2%

(MDR-TB >= 3%)

(MDR-TB < 3%)

CHI 0.6%

ARG

1.8%

(MDR-TB =< 1%)

URU

0.01%

Epidemiological Status of TB (Americas, 2004)

slide19

Initial Resistance (IR)

Acquired Resistance (AR)

IR 1994-

AR 1994-

Countries

Countries

Resistance

2002 or

2002 or

Resistance

Partial

Partial

Global

MDR

resistance

Global

resistance

MDR

Bolivia

1996

23.9

Bolivia

1996

42.1

4.7

1.2

Brazil

1995

8.6

Brazil

1995

14.4

5.4

0.9

Mexico

1997

14.1

Mexico

1997

41.1

22.4

2.4

Nicaragua

1997

15.6

Nicaragua

1997

 -

1.2

Puerto Rico

1997

11.3

Puerto Rico

1997

58.3

16.7

2.5

Dom. Rep.

1994

40.6

Rep. Dom.

1994

52.1

19.7

6.6

Uruguay

1997

1.7

Uruguay

1997

93.8

6.3

0

Venezuela

1998

7.3

Venezuela

1998

26.9

3.8

0.3

Chile

2001

10

Chile

2001

20.6

3.4

0.7

Colombia

1999

13.4

Colombia

1999 

 -

0.5

Cuba

2000

5

Cuba

2000

15.8

2.6

0.3

Ecuador*

2002

23.4

Ecuador

2002 

52.6 

24.8 

6.6

El Salvador

2001

6.5

El Salvador

2001

37

7

0.3

Honduras*

2002

17.2

Honduras*

2002

41.4

6.9

1.8

Peru

1999

18

Peru

 1999

23.5

12.3

3

Argentina

1999

10.2

Argentina

1994

22.8

9.4

1.8

Paraguay*

2002

17

0

Paraguay

2002

21

4

Guatemala

2002

40

3.7

Guatemala

2002

52.4

22.8

Figures on Resistance and MDR (by type and country, Americas, 1994 –2002)

Source: PAHO/WHO Registries.

Epidemiological Status of TB (Americas, 2004)