Objectives of the workshop WHO / WPRO Stop TB unit 4 May 2004

TB control targets WHO/WPRO target MDG target (UNGA target) Process target: by 2005 70% case detection (notified cases/estimated incidence) 85% cure rate 100% DOTS coverage Impact target by 2010: 50% reduction of prevalence 50% reduction of mortality MDG target (UNGA target) Begin to revert incidence from 2015

TB control targets WHO/WPRO target MDG target (UNGA target) Process target: by 2005 70% case detection (notified cases/estimated incidence) 85% cure rate 100% DOTS coverage Impact target by 2010: 50% reduction of prevalence 50% reduction of mortality MDG target (UNGA target) Begin to revert incidence from 2015

Epidemiological indicators and progress since 1997 Notified cases: Ql improved w / DOTS expansion (PHL: 208 000 in 1997, 2% coverage  118 000 in 2002, >98%) Prevalence: New survey conducted in China, Cambodia, Philippines & Malaysia since 1997 Estimated incidence: Gradually updated as more country data available Mortality: Not much changed / dark area

Progress on DOTS implementation (2001-2002) Indicators 2001 2002 Population accessible to DOTS (among total population) 65% 77% (Target: 100%) DOTS enrolment rate (among detected cases) 78% 84% Case detection rate (among estimated cases) 41% 40% (Target: 70%) Cure rate in DOTS areas >85% >85% (T: 85%)

Detecting the missing cases What are the approaches Where are the cases What are the approaches a) Estimated TB cases 1. Epidemiological analysis 1. 2. b) All true TB cases 2. Access to TB control 3. c) Cases presenting to health facilities 4. 3. PPMD d) Cases presenting to public health facilities 5. 4. DOTS in public sector 6. e) Cases presenting to DOTS facilities 5. Ql of lab services 7. f) Cases correctly diagnosed by DOTS facilities 6. Ql of R & R g) Diagnosed cases reported by DOTS facilities 7. Quality of case holding

Detecting the missing cases What are the approaches Where are the cases What are the approaches a) Estimated TB cases 1. Epidemiological analysis 1. 2. b) All true TB cases 2. Access to TB control 3. c) Cases presenting to health facilities 4. 3. PPMD d) Cases presenting to public health facilities 5. 4. DOTS in public sector 6. e) Cases presenting to DOTS facilities 5. Ql of lab services 7. f) Cases correctly diagnosed by DOTS facilities 6. Ql of R & R g) Diagnosed cases reported by DOTS facilities 7. Quality of case holding

Objectives of the workshop Objective 1: Assess the morbidity (incidence and prevalence) & mortality data in 12 countries (Day 1) Objective 2: Learn/update the epidemiological methods for estimating morbidity & mortality (Day 2 & 3) Objective 3: Strengthen the skill of the participants in using available data and applying country specific methods to estimate morbidity & mortality (Day 2& 3) Objective 4: Facilitate NTP to review country situation and develop better plan towards 2005, 2010 & MDG (2015) target (Homework)

Workshop for surveillance & epidemiology in the WPR 10 participants from 7 countries 5 resource persons (WHO) Limited country data 2-3 computers Assess & analyse the data 2004 workshop 21 participants from 12 countries More than 20 resource persons (WHO+other agencies) More country data More than 30 computers Capacity building at country level