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  1. Trends of Tuberculosis Notification in Al Najaf Al Ashref Province,Iraq1995 - 2012Dr. mousa I. AL-Carawy M.B.CH.B .D.C.M Manager of NTP program in AL-Najaf Manager of Chest & TB Consultant Clinic in AL-Najaf G . T . C Member of Chest & TB Diseases Society of Iraq A.T.C.D.S.

  2. Background • Tuberculosis (TB) is one of the most prevalent and deadly infections on earth . • One third of the world’s population(Roughly 1.9 billion people) are infected with TB . • WHO declared T.B to be a global emergency in 1993. • T.B is the eighth leading cause of death in the world and causes more deaths Each year ( approximately 1.8 million in 2003) than all other infectious agents except HIV. • 75% of cases and 80% of deaths occur in young adults aged (15-44) years and the majority of cases occur in developing countries ( 60% of cases in the world )

  3. Background In Iraq , • Estimated number of new cases (in 2000): 30,211. • Estimated number of new cases of smear positive TB (2000): 13,595 . • A noticeable increase in the number of TB cases has been observed since 1990 • The estimated incidence of TB (estimated new cases/100,000/year) increased from 46.1 in 1989 to 131.6 in 2000.

  4. Objective To describe trends of tuberculosis case notification in Al Najaf Al Ashref Province, Iraq 1995 - 2012.

  5. Methodology Rretrospective analysis of all TB cases reported to TB and chest diseases clinic in Al Najaf Al Ashref province for 1995-2012 was conducted. Distribution of cases by age, Gender and according to lab. Results(Smear positive TB, Smear negative TB and Retreatment cases)

  6. Methodology Case Definition Smear positive TB: presence of TB bacilli in at least one sputum specimen. Smear negative TB: absence of bacilli in three sputum specimens in a patient with radiographic features consistent with TB. Retreatment cases: represent : Relapse: patient who developed active disease after completing treatment or cure. Returnees after default: those whose treatment was interrupted for at least two months. Treatment failures: having a positive sputum smear after five months of treatment or lateror become positive for pulmonary negative.

  7. Area: 1980 km2Populations:1354000 inhabitants.6 districts35 PHCCs7 Hospitals

  8. Results

  9. Distribution of smear positive cases by Gender/ Al Najaf Al Ashref,Iraq 1995-2012

  10. Distribution of smear positive cases by Age Group/ Al Najaf Al Ashref,Iraq 1995-2012

  11. Distribution of T.B cases by Lab. results/ Al Najaf Al Ashref,Iraq 1995-2012

  12. Distribution of smear positive cases and retreatment cases/ Al Najaf Al Ashref,Iraq 1995-2012

  13. Distribution of Retreatment cases/ Al Najaf Al Ashref,Iraq 1995-2012

  14. Conclusions An increase in the number of reported and retreatment cases were noted. we noticed that there is an increase in smear +ve Cases and reach peak in 2003 and then decrease until reach 114 case in 2012 and this is may be due to either: * Good Control of T.B . Or * There is a weak surveillance for T.B

  15. recommendations TB control interventions . evaluate the surveillance of T.B . intensified surveillance for drug resistance among retreatment cases.

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