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Epidemiological Status of TB (Region of the Americas, 2004)

. . 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)

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  1. . . Epidemiological Status of TB (Region of the Americas, 2004) Regional Program on Tuberculosis Epidemiological Status of TB (Americas, 2004)

  2. Current Status of Tuberculosis Worldwide Epidemiological Status of TB (Americas, 2004)

  3. Estimated Global Burden of TB (2002) 98% of all deaths from TB take place in developing countries. Epidemiological Status of TB (Americas, 2004)

  4. 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)

  5. 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)

  6. 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)

  7. 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)

  8. Status of TB in the Americas Epidemiological Status of TB (Americas, 2004)

  9. 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)

  10. Reporting of TB Cases by Category (Region of the Americas, 2002) Epidemiological Status of TB (Americas, 2004)

  11. Reporting of TB Cases by Gender(Region of the Americas, 2002) Epidemiological Status of TB (Americas, 2004)

  12. 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)

  13. Estimated TB Incidence Rate(Latin America, 2003) Epidemiological Status of TB (Americas, 2004)

  14. 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)

  15. 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)

  16. Status of Prevalence of HIV/AIDS among TB Patients in the English-Speaking Caribbean Epidemiological Status of TB (Americas, 2004)

  17. Anti-TB Drug-Resistance Studies(Americas, 1999–2002) Surveys completed Surveys in progress No survey project Epidemiological Status of TB (Americas, 2004)

  18. 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)

  19. 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)

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