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TB and poverty agenda in WPR

TB and poverty agenda in WPR. WHO/WPRO Stop TB. Percentage of population living below US$1 a day. TB and poverty. 98% of 1.8 million TB deaths per year in developing countries. TB mortality rate 3 X higher in rural poor China than in more developed urban areas.

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TB and poverty agenda in WPR

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  1. TB and poverty agenda in WPR WHO/WPRO Stop TB

  2. Percentage of population living below US$1 a day

  3. TB and poverty • 98% of 1.8 million TB deaths per year in developing countries. • TB mortality rate 3 X higher in rural poor China than in more developed urban areas. • ARI in the Philippines 2.5 times higher among urban poor than urban non-poor. • Mexico and South Africa: no difference in socio-economic status between TB patients and non TB patients living in the same community

  4. TB incidence weakly related to social and economic variables: infant mortality 6.5 6.0 5.5 AF AS 5.0 CA 4.5 estimated TB incidence (log-transformed) EE SA 4.0 US WP 3.5 ME 3.0 WE Series10 2.5 2.0 1.5 1.5 2.0 2.5 3.0 3.5 4.0 4.5 5.0 5.5 Infant mortality rate 1991 (log-transformed)

  5. TB prevalence among poor and non-poor, Philippines Source: Philippines NTP, 2000

  6. S(+) prevalence rates: China Source: World Bank, 2000

  7. TB and poverty in China (1990)

  8. Prevalence of s(+) TB by ethnic group in China in 2000 Source: Ministry of Health of China, 2000

  9. Poverty and TB • Vulnerability to severe disease and death from TB • Delaying access to care • Inhibiting treatment adherence • Overcrowding associated with infection and outbreaks of TB • TB burden higher where poverty is higher

  10. S(+) TB notification rates versus income in Vietnam provinces Source: Ministry of Health of Vietnam, 2003

  11. TB notification rates and ethnic groups in Vietnam provinces Source: Ministry of Health of Vietnam, 2003

  12. TB notification rates and poverty in Cambodian provinces Source: Ministry of Health of Cambodia, 2002

  13. TB notification and poverty • TB notification is lower where poverty is higher in Vietnam • TB notification is at a similar level between poorer and less poor areas in Cambodia

  14. Poor compared to non-poor communities: Higher TB prevalence Lower or similar case notification rates  Lower TB Case Detection Rate in poorer areas Poverty and TB Case Detection Rate

  15. Expansion may not be enough Detection ‘The Missing Cases’ Coverage

  16. Progress in 2004Objective 1: Reaching the 70/85/100 targets *2004 figures are for high burden countries which account for 90% of the TB burden

  17. Impact of scenariosD70 and Dincreased on prevalence Decline in prevalence 300 250 200 rate per 100,000 D70 150 Dincreased 100 50 0 1990 1995 2000 2005 2010 2015 2020

  18. Impact of scenariosD70 and Dincreased on mortality

  19. Thank you!

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