1. PROGRESS IN GLOBAL TB CONTROL
WITH SPECIAL REFERENCE TO THE WESTERN PACIFIC REGION
CHRIS DYE plus ~200 others
WORLD HEALTH ORGANIZATION
GENEVA

2. Tuberculosis in the world, 2002 numbers (rates/100K)
People infected 2 billion
New TB cases m (141)
New ss+ TB cases m (62)
Change incidence rate % / yr
Prevalence HIV in new adult cases %
Prevalence MDR in new cases %
Deaths from TB (inc HIV) m (29)

3. Most TB cases are in India and China
< 1 000
1 000 to 9 999 to to
or more
No Estimate
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 2002

4. Highest TB rates per capita are in Africa
25 to 49
50 to 99
100 to 299
< 10
10 to 24
300 or more
No Estimate
per 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 2002

5. Tuberculosis in the Western Pacific Region, 2002
People infected 200 m
New TB cases m (122)
New ss+ TB cases m (55)
Change incidence rate %/yr
Prevalence HIV in new adult cases 1%
Prevalence MDR in new cases %
Deaths from TB (inc HIV) K (22)

7. Estimated HIV Prevalence in TB cases, 2002
HIGH RATES OF HIV INFECTION IN AFRICA
GROWING NUMBERS IN ASIA?
HIV prevalence in TB cases, yrs (%)
< 5
5 - 19
50 or more
No estimate
The designations employed and the presentation of material 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. White lines on maps represent approximate border lines for which there may not yet be full agreement.
© WHO 2003

10. Global targets for TB control MILLENNIUM DEVELOPMENT GOALS
By 2005 (WHA):
70% case detection, 85% cure
By 2010 (G8 Okinawa):
Halve prevalence and deaths (rates)
By 2015:
"Have halted and begun to reverse…"

27. SURVEILLANCE REPORTS RECEIVED BY WHO IN 2003

33. Why are TB cases “undetected”?
estimated TB cases
all true TB cases
cases presenting to health facilities
cases presenting to public health facilities
cases presenting to DOTS facilities
cases correctly diagnosed by DOTS facilities
diagnosed cases reported by DOTS facilities

35. Few Chinese patients diagnosed in,
or transferred to, DOTS dispensaries
Other
Transfer
Private clinics
Diagnosis
Town/village clinics
TB hospitals
Trad med units
General hospitals
TB dispensaries 50
100
150
200
Source: 2000 prevalence survey
Number of patients

36. Improving case detection in China
627 patients with TB, seen by health services
100 90 80 70 60 50
Cumulative proportion TB patients (%) 40 30 20 10
Other
clinics
TB units
Private
General
hospitals
Township
clinics
Traditional
medics
TB hospitals
misdiagnosed
source: 2000 prevalence survey

37. Better treatment in DOTS dispensaries
China 2000 prevalence survey 70
TB dispensaries 60
Other units 50 40
Percent patients 30 20 10
Regular
Intermittent
Interrupted

39. Dynamics of pulmonary TB in Peru 1980-2000
220
DOTS 1990
200
case finding
180
Pulmonary TB cases/100,000
160
140
120
PTB falling at 6%/yr
100
1980
1985
1990
1995
2000

40. DOTS reduces prevalence of TB by 37% over a decade in China
250
DOTS
Other
200
150
Prevalence culture+
TB/100,000
100 50
1990
2000

42. WE’RE HALF WAY THERE Case detection 37/70 Treatment success 83/85
WPR /70
Treatment success 83/85
WPR /85

43. THE DATA CAN TELL US MORE THAN WE KNOW