Post on 23-Dec-2015
transcript
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Global and Regional Tuberculosis (TB) update
ACSM workshop, Amman, Jordan April 13-17, 2008
Dr. Sevil Huseynova
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What is TB?
One of the oldest disease known Usually a respiratory disease due to infection by Mycobacterium tuberculosis. Mode of spread
TB Patient Cough infect others
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How big TB problem is?Leading infectious killer in the world Globally: 2.1 billion infected
9.2 million cases & 1.7 million deaths a year 0.7M cases & 0.2M deaths in HIV+ 500K people a year become infected with MDR-TB
25% of all avoidable deaths in economically productive age groups are due to TB.
Regionally: 180M infected 560,000 cases & 110,000 deaths a year
Yet it is completely curable and is (relatively) inexpensive to cure.
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Estimated TB incidence rate, 2006
Estimated new TB cases (all forms) per 100 000 population
The boundaries and names shown and the designations used on this map do not imply the expression of any opinion whatsoever on the part of the World Health Organization concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries.
Dotted lines on maps represent approximate border lines for which there may not yet be full agreement. WHO 2006. All rights reserved
No estimate
0-24
50-99
300 or more
25-49
100-299
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Estimated HIV prevalence in new TB cases, 2006
No estimate
0–4
20–49
50 or more
5–19
HIV prevalence in TB cases, (%)
The boundaries and names shown and the designations used on this map do not imply the expression of any opinion whatsoever on the part of the World Health Organization concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries.
Dotted lines on maps represent approximate border lines for which there may not yet be full agreement. WHO 2006. All rights reserved
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> 100
Incidence rate (/100 000)
50-100
< 20
Bahrain
Palestine
20-50
Estimated TB incidence rate in EMR
WHO Global TB Report 2007
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How to fight against TB?
Global Plan to Stop TB Comprehensive plan to
achieve 70/85 & MDG (2006-2015)
Activities & Cost USD 56 Billion for world USD 3.1 Billion for EMR
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Global Plan to Stop TB: Goals, Targets and Strategies for TB control
MILLENIUM DEVELOPMENT GOAL 6
Combat HIV/AIDS, malaria and other diseases
Target 8: Have halted by 2015 and begun to reverse the incidence of malaria and other major diseases
Indicator 23: The global burden of TB (per capita prevalence and death rates) will be reduced by 50% relative to 1990 levels
Prevalence 50% of ≈ 300/100K Deaths 50% of ≈ 30/100K (< 1m deaths) Indicator 24: proportion of TB cases detected and cured under DOTS Case detection 70% (> 6 m diagnosed) Treatment success 85% (> 5 m cured DOTS)
By 2050: The global incidence of active TB will be less than 1 case per million population per year (Stop TB Partnership).
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DOTS status in 2006: countries close to targets
99 countries reported treatment success rates 70% or over and DOTS detection rates 50% or over 32 countries (including 2 countries out of range of graph) have reached both targets.
Benin
Venezuela
Vanuatu
Uruguay
Turkmenistan
Turkey
Tunisia
Thailand
TFYR Macedonia
Sri Lanka
South Africa
Somalia
Slovenia
Singapore
Samoa
Romania
Qatar
Puerto Rico
Portugal
Poland
Philippines
Peru
Nicaragua
Nepal
Myanmar
Morocco
Mongolia
Mexico
Marshall Islands Maldives
Malaysia
Madagascar
Lithuania
Liberia
Lebanon
Latvia
Lao PDR
Kyrgyzstan
Kiribati
Kenya
Kazakhstan
JordanIran (islamic republic of)
Indonesia
India
Iceland
Honduras
Haiti
Guam
Georgia
French Polynesia
Fiji
Estonia
El Salvador
Egypt
DR Congo
DPR Korea
Dominican Republic
Czech Republic
Cuba
Costa Rica
China, Macao SAR
China
Cameroon
Cambodia
Bulgaria
Brunei Darussalam
Brazil
Bosnia & Herzegovina
Bolivia
Bhutan
Belize
Bangladesh
ArmeniaAngola
Algeria
Afghanistan
70
80
90
100
50 60 70 80 90 100 110 120
DOTS case detection rate (new smear-positive, %)
Tre
atm
ent
succ
ess
(%)
Target zone
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The components of the Stop TB Strategy (2006-2015)
1. DOTS expansion and enhancement2. Addressing TB/HIV, MDR-TB and
other challenges3. Contributing to health system
strengthening4. Engaging all care providers5. Empowering patients, and
communities6. Enabling and promoting research
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WHO Stop TB Strategy & “DOTS”
Care for TB patients & community participation in TB control
Diagnosis by laboratory (sputum examination)
6 month treatment with >95% efficacy Strategy to involve private sector &
community e.g. cure rate is above 85% in most EMR
countries