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Warning: This report is out-of-date. In particular, entire time-series of TB disease burden estimates are updated every year. For the latest data and analysis, please see the most recent edition of the global TB report. Global tuberculosis report 2013 WHO Library Cataloguing-in-Publication Data Global tuberculosis report 2013. 1.Tuberculosis – epidemiology. 2.Tuberculosis, Pulmonary – prevention and control. 3.Tuberculosis – economics. 4.Tuberculosis, Multidrug-Resistant. 5.Annual reports. I.World Health Organization. ISBN 978 92 4 156465 6 (NLM classification: WF 300) © World Health Organization 2013 All rights reserved. Publications of the World Health Organization are available on the WHO web site (www.who.int) or can be purchased from WHO Press, World Health Organization, 20 Avenue Appia, 1211 Geneva 27, Switzerland (tel.: +41 22 791 3264; fax: +41 22 791 4857; e-mail: bookorders@who.int). Requests for permission to reproduce or translate WHO publications – whether for sale or for non-commercial distribution – should be addressed to WHO Press through the WHO web site (www.who.int/about/licensing/copyright_form/en/index.html). The designations employed and the presentation of the material in this publication 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. The mention of specific companies or of certain manufacturers’ products does not imply that they are endorsed or recommended by the World Health Organization in preference to others of a similar nature that are not mentioned. Errors and omissions excepted, the names of proprietary products are distinguished by initial capital letters. All reasonable precautions have been taken by the World Health Organization to verify the information contained in this publication. However, the published material is being distributed without warranty of any kind, either expressed or implied. The responsibility for the interpretation and use of the material lies with the reader. In no event shall the World Health Organization be liable for damages arising from its use. Cover design by Tom Hiatt, Western Pacific Regional Office and Irwin Law, WHO headquarters. The front cover illustrates the latest status of global progress for five indicators that are part of the Millennium Development Goals framework. These are the incidence rate of tuberculosis disease per 100 000 population per year, the prevalence of tuberculosis disease per 100 000 population, the tuberculosis mortality rate per 100 000 population per year, the case detection rate (the number of cases detected and reported to national tuberculosis programmes divided by the estimated incidence) and the treatment success rate for new TB patients started on treatment. Each pair of shapes represents both the most recent level of the indicator and a baseline year against which progress is measured. For incidence (green and dark orange), prevalence (grey and pink) and mortality (light orange and light blue), the top of the combined height of each pair of shapes shows the level in 1990. The lower of the two shapes in each pair shows the level in 2012. For the case detection rate, the combined height of each pair of shapes (dark blue and brown) shows the level in 2012 and the lower of the two shapes (dark blue) illustrates the level in 1995. For the treatment success rate (red and yellow), the combined height of each pair shows the level in 2011 and the lower of the two shapes (red) shows the level in 1995. More information about these indicators and progress towards global targets are provided in Chapter 2 and Chapter 3 of the Global Tuberculosis Report 2013. Designed by minimum graphics Printed in France WHO/HTM/TB/2013.11 Contents Abbreviations iv Acknowledgements v Executive summary ix Chapter 1. Introduction 1 Chapter 2. The burden of disease caused by TB 6 %JCRVGT 6$ECUGPQVKßECVKQPUCPFVTGCVOGPVQWVEQOGU Chapter 4. Drug-resistant TB 45 Chapter 5. Diagnostics and laboratory strengthening 59 %JCRVGT #FFTGUUKPIVJGEQGRKFGOKEUQH6$CPF*+8 Chapter 7. Financing 75 %JCRVGT 4GUGCTEJCPFFGXGNQROGPV Annexes 1. Methods used to estimate the global burden of disease caused by TB 99 %QWPVT[RTQßNGU 4GIKQPCNRTQßNGU 4. Key indicators for the world, WHO regions and individual countries 145 GLOBAL TUBERCULOSIS REPORT 2013 iii Abbreviations ACSM ACTG ADR AFB AIDS ARI ART BCG BRICS CDR CEM CFR CFU CPT CBC DOTS DR-TB DRS DST DS-TB DTLC EBA ECDC ERR EU FDA FIND GDP GLC GLI GNI HBC HIV HR ICD-10 IDRI IGRA IPAQT IPT IRR LED LPA iv Advocacy, Communication and Social Mobilization AIDS Clinical Trials Group adverse drug reactions acid-fast bacilli acquired immunodeficiency syndrome annual risk of infection antiretroviral therapy Bacille-Calmette-Guérin Brazil, Russian Federation, India, China, South Africa case detection rate cohort event monitoring case fatality rate colony-forming units co-trimoxazole preventive therapy community-based care the basic package that underpins the Stop TB Strategy drug-resistant tuberculosis drug resistance surveillance drug susceptibility testing drug-susceptible tuberculosis District TB and Leprosy Coordinator early bactericidal activity European Centre for Disease Prevention and Control electronic recording and reporting European Union Food and Drug Administration Foundation for Innovative New Diagnostics gross domestic product Green Light Committee Global Laboratory Initiative gross national income high-burden country human immunodeficiency virus Hazard ratio International Classification of Diseases (10th revision) Infectious Disease Research Institute interferon-gamma release assay Initiative for Promoting Affordable, Quality TB Tests isoniazid preventive therapy incidence rate ratio light-emitting diode line-probe assay GLOBAL TUBERCULOSIS REPORT 2013 LTBI MDG MDR-TB MNCH NAAT NAP NFM NTP OECD latent TB infection Millennium Development Goal multidrug-resistant tuberculosis maternal, newborn and child health nucleic acid amplification test national AIDS programme new funding model national tuberculosis [control] programme Organisation for Economic Co-operation and Development OR Operational research PAL Practical Approach to Lung health PCR polymerase chain reaction PDA personal digital assistant PEPFAR US President’s Emergency Plan for AIDS Relief POC point of care PPM public–private mix QMS quality management system rGLC Regional Green Light Committee RNTCP Revised National TB Control Programme [India] rRNA ribosomal ribonucleic acid RR relative risk RR-TB rifampicin-resistant tuberculosis SD standard deviation SITT Integrated Tuberculosis Information System SRL supranational reference laboratory STAG-TB Strategy and Technical Advisory Group for TB TAG Treatment Action Group TB tuberculosis TB-MAC TB Modelling and Analysis Consortium TB-TEAM Tuberculosis Technical Assistance Mechanism TBVI Tuberculosis Vaccine Initiative TFM transitional funding mechanism TST tuberculin skin test UHC universal health coverage UN United Nations UNAIDS Joint United Nations Programme on HIV/AIDS UNITAID international facility for the purchase of diagnostics and drugs for diagnosis and treatment of HIV/AIDS, malaria and TB USAID United States Agency for International Development UNPD United Nations Population Division VR vital registration WHO World Health Organization XDR-TB extensively drug-resistant tuberculosis ZN Ziehl Neelsen Acknowledgements This global tuberculosis (TB) report was produced by a core team of 15 people: Annabel Baddeley, Anna Dean, Hannah Monica Dias, Dennis Falzon, Katherine Floyd, Inés Garcia, Philippe Glaziou, Tom Hiatt, Irwin Law, Christian Lienhardt, Linh Nguyen, Charalambos Sismanidis, Hazim Timimi, Wayne van Gemert and Matteo Zignol. The team was led by Katherine Floyd. Overall guidance was provided by the Director of the Global TB Programme, Mario Raviglione. The data collection forms (long and short versions) were developed by Philippe Glaziou and Hazim Timimi, with input from staff throughout the WHO Global TB Programme. Hazim Timimi led and organized all aspects of data management. Inés Garcia and Andrea Pantoja conducted all review and follow-up of financial data. The review and follow-up of all other data was done by a team of reviewers. This included Annabel Baddeley, Annemieke Brands, Andrea Braza, Katsura Danno, Anna Dean, Hannah Monica Dias, Dennis Falzon, Wayne van Gemert, Soleil Labelle, Knut Lönnroth, Linh Nguyen, Salah Ottmani, Hazim Timimi, Fraser Wares and Matteo Zignol at WHO headquarters; Amal Bassili from the Eastern Mediterranean Regional Office; and Suman Jain, Sai Pothapregada, Nino Mdivani, Eliud Wandwalo and Mohammed Yassin from the Global Fund. Data for the European Region were collected and validated jointly by the WHO Regional Office for Europe and the European Centre for Disease Prevention and Control (ECDC); we thank in particular Encarna Gimenez, Vahur Hollo and Csaba Ködmön from ECDC for providing validated data files and Andrei Dadu from the WHO Regional Office for Europe for his substantial contribution to follow-up and validation of data for all European countries. Review of TB/HIV data was undertaken in collaboration with Michel Beusenberg, Chika Hayashi, Lisa Nelson and Michelle Williams from the WHO HIV department. Victoria Bendaud, Josephine Dy, and Taavi Erkkola from UNAIDS managed the process of data collection from national AIDS programmes, provided a TB/HIV dataset and worked closely with WHO staff to review and validate TB/HIV data. Philippe Glaziou and Charalambos Sismanidis prepared estimates of TB disease burden and associated figures and tables (Chapter 2), with support from Tom Hiatt. Particular thanks are due to Carel Pretorius (Futures Institute), who worked closely with Philippe Glaziou on analyses and related estimates of TB mortality among HIV-positive people, as well as to Dennis Falzon for coordinating a systematic review that was used to produce estimates of mortality related to multidrug-resistant TB (MDR-TB) and to Harish Nair and Luciana Brondi from the University of Edinburgh for conducting this review. Tom Hiatt prepared all figures and tables on TB notification and treatment outcome data (Chapter 3). Anna Dean, Dennis Falzon and Matteo Zignol analysed data and prepared the figures and tables related to drug-resistant TB (Chapter 4), with input from Charalambos Sismanidis. Tom Hiatt and Wayne van Gemert prepared figures and tables on laboratory strengthening and the rollout of new diagnostics (Chapter 5). Annabel Baddeley, Katsura Danno, Tom Hiatt and Linh Nguyen analysed TB/HIV programmatic data and prepared the associated figures and tables (Chapter 6). Inés Garcia and Andrew Siroka analysed financial data, and prepared the associated figures and tables (Chapter 7). Christian Lienhardt, Christopher Gilpin and Karin Weyer prepared the figures on the pipelines for new TB drugs, diagnostics and vaccines (Chapter 8), with input from the respective Working Groups of the Stop TB Partnership. Tom Hiatt coordinated the finalization of all figures and tables and was the focal point for communications with the graphic designer. The writing of the main part of the report was led by Katherine Floyd, with contributions from Dennis Falzon, Philippe Glaziou, Irwin Law, Ikushi Onozaki, and Charalambos Sismanidis (Chapter 2); Hannah Monica Dias, Wayne van Gemert, Haileyesus Getahun, Thomas Joseph, Mukund Uplekar and Lana Tomaskovic (Chapter 3); and Inés Garcia and Christian Gunneberg (Chapter 7). Chapter 4, on drug-resistant TB, was prepared by Anna Dean, Dennis Falzon and Matteo Zignol, with input from Katherine Floyd, Philippe Glaziou and Charalambos Sismanidis. Chapter 5, on diagnostics and laboratory strengthening, was prepared by Wayne van Gemert, with input from Christopher Gilpin, Fuad Mirzayev and Karin Weyer. Chapter 6 was prepared by Annabel Baddeley, Haileyesus Getahun, Linh Nguyen and Katherine Floyd. Chapter 8, on research and development, was led by Christian Lienhardt, with inputs from Christopher Gilpin, Karin Weyer and Katherine Floyd. Chapter 8 was carefully reviewed by the chairs and secretariats of the Working Groups of the Stop TB Partnership. Particular thanks are due to Michael Brennan, Uli Fruth and Jennifer Woolley (new vaccines); Daniela Cirillo (new diagnostics); and Barbara Laughon and Mel Spigelman (new TB drugs). The report team is also grateful to Emily Bloss (US Centers for Disease Control and Prevention) and Hillary Kipruto (WHO Country Office, Kenya) for their contributions to content related to strengthening of TB surveillance in Chapter 2, including a case study of the introduction of GLOBAL TUBERCULOSIS REPORT 2013 v electronic recording and reporting in Kenya; to Rajendra Yadav and Masami Fujita (WHO Country Office, Cambodia) for their contribution to an analysis of the integration of TB, HIV and mother and child health services in Cambodia (Chapter 6); and to various internal and external reviewers for useful comments and suggestions on advanced drafts of chapter text. The special supplement on the “Countdown to 2015” that accompanies the global report was prepared by Anna Dean, Hannah Monica Dias, Katherine Floyd, Irwin Law, Mario Raviglione, Diana Weil and Karin Weyer, with valuable inputs from many people at global, regional and country levels. We thank in particular Sai Pothapregada and Eliud Wandwalo from the Global Fund, who facilitated discussions with and inputs from many Fund Portfolio Managers. Annex 1, which explains methods used to produce estimates of the burden of disease caused by TB, was written by Philippe Glaziou and Charalambos Sismanidis with very helpful input from Carel Pretorius. We thank Colin Mathers of the WHO Mortality and Burden of Disease team for his careful review. The country profiles that appear in Annex 2 and the regional profiles that appear in Annex 3 were prepared by Hazim Timimi. Annex 4, which contains a wealth of global, regional and country-specific data from the global TB database, was prepared by Tom Hiatt and Hazim Timimi. We thank Pamela Baillie in the Global TB Programme’s monitoring and evaluation team for impeccable administrative support, Doris Ma Fat from the WHO Mortality and Burden of Disease team for providing TB mortality data extracted from the WHO Mortality Database, and Peter Ghys, Mary Mahy and Karen Stanecki (UNAIDS) for providing epidemiological data that were used to estimate HIV-associated TB mortality. The entire report was edited by Tim France (Inis Communication). We thank him for his excellent work. We also thank, as usual, Sue Hobbs for her excellent work on the design and layout of this report. Her contribution, as in previous years, was greatly appreciated. The principal source of financial support for WHO work on global TB monitoring and evaluation is the United States Agency for International Development (USAID), without which it would be impossible to produce the Global Tuberculosis Report. Production of the report was also supported by the governments of Japan and the Republic of Korea. We acknowledge with gratitude their support. In addition to the core report team and those mentioned above, the report benefited from the input of many staff working in WHO regional and country offices and hundreds of people working for national TB programmes or within national surveillance systems who contributed to the reporting of data and to the review of report material prior to publication. These people are listed below, organized by WHO region. We thank them all for their invaluable contribution and collaboration, without which this report could not have been produced. Among the WHO staff not already mentioned above, we vi GLOBAL TUBERCULOSIS REPORT 2013 thank in particular Khurshid Alam Hyder, Daniel Kibuga, Rafael López Olarte, André Ndongosieme, Wilfred Nkhoma and Henriette Wembanyama for their major contribution to facilitation of data collection, validation and review. 9*1staHHinregionalandcoWntr[oHßces WHO African Region Harura Adamu, Boubacar Ould Abdel Aziz, Esther Aceng, Inacio Alvarenga, Balde Amadou, Ayodele Awe, Sanni Babatunde, Bazie Babou, Nayé Bah, Marie Barouan, Abera Bekele, Norbert Bidounga, Gaël Claquin, Augusto da Cruz Claudina, Peter Clement, Noel Djemadji, Ismael Hassen Endris, Amos Omoniyi Fadare, Louisa Ganda, Boingotlo Gasennelwe, Patrick Hazangwe, Joseph Imoko, Michael Jose, Joel Kangangi, Katherine Lao, Nzuzi Katondi, Bah Keita, Daniel Kibuga, Hillary Kipruto, Désiré Aristide Komangoya Nzonzo, Sharmila Lareef-Jah, Frank Lule, Mwendaweli Maboshe, Mbemba Leonard, Richard Mbumba, Julie Mugabekazi, André Ndongosieme, Denise Nkezimana, Wilfred Nkhoma, Nicolas Nkiere, Ghislaine Nkone Asseko, Ishmael Nyasulu, Laurence Nyiramasarabwe, Samuel Ogiri, Daniel Olusoti, Amos Omoniyi, Chijioke Osakwe, Felicia Owusu-Antwi, Philips Patrobas, Kalpeshsinh Rahevar, Bacary Sambou, Kefas Samson, Neema Simkoko, Desta Tiruneh, Alexis Tougordi, Henriette Wembanyama. WHO Region of the Americas Monica Alonso Gonzalez, Angel Manuel Alvarez, Luis Gerardo Castellanos, Gerardo de Cossio, Rachel Eersel, Marcos Espinal, Ingrid García, Mirtha Del Granado, Rosalinda Hernández, Vidalia Lesmo, Rafael López Olarte, Wilmer Marquiño, Thais dos Santos, Alfonso Tenorio, Jorge Victoria, Anna Volz. WHO Eastern Mediterranean Region Mohamed Abdel Aziz, Ali Akbar, Samiha Baghdadi, Amal Bassili, Najwa El Emam, Hamida Khattabi, Aayid Munim, Ghulam Nabi Kazi, Ali Reza Aloudel, Gabriele Riedner, Karam Shah, Sindani Ireneaus Sebit, Bashir Suleiman, Rahim Taghizadeh. WHO European Region Martin van den Boom, Brenda van den Bergh, Andreea Cassandra Butu, Silvu Ciobanu, Pierpaolo de Colombani, Andrei Dadu, Irina Danilova, Masoud Dara, Jamshid Gadoev, Gayane Ghukasyan, Sayohat Hasanova, Arax Hovhannesyan, Saliya Karymbaeva, Mehmet Kontas, Kristin Kremer, Dmitriy Pashkevich, Valiantsin Rusovich, Bogdana Shcherbak-Verlan, Javahir Suleymanova, Szabolcs Szigeti, Melita Vujnovic. WHO South-East Asia Region Mohammad Akhtar, Vikarunnesa Begum, Erwin Cooreman, Deki, Khurshid Alam Hyder, Navaratnasingam Janakan, Kim Tong Hyok, La Win Maung, Jorge Luna, Partha Mandal, Amaya Maw-Naing, Giampaolo Mezzabotta, Bo Myint, Ye Myint, Eva Nathanson, Rajesh Pandav, Razia Pendse, Sri Prihatini, K Rezwan, Rim Kwang Il, Hwang Kum Ryong, Mukta Sharma, Aminath Shenalin, Achuthan Nair Sreenivas, Chawalit Tantinimitkul, Wangchuk Lungten. 9*19GUVGTP2CEKßE4GIKQP Shalala Ahmadova, Niño Dayanghirang, Asaua Faasino, Salu Failauga, Ogtay Gozalov, Cornelia Hennig, Tom Hiatt, Tauhid Islam, Narantuya Jadambaa, Ridha Jebeniani, Sung Hye Kim, Miwako Kobayashi, Woo-Jin Lew, Katsunori Osuga, Khanh Pham, Fabio Scano, Jacques Sebert, Catharina van Weezenbeek, Rajendra Yadav, Dongbao Yu. National respondents who contributed to reporting and verißcation oH data WHO African Region Abdou-Salam Abderemane, Ouédraogo Adama, Abdelrahim Barka Abderramane, Jean Louis Abena Foe, Sofiane Alihalassa, Arlindo Amaral, Kouamé Amenan, Séverin Anagonou, Younoussa Assoumani, Georges Bakaswa, Adama Marie Bangoura, Jorge Noel Barreto, Ballé Boubakar, Victor Bonkoungou, Frank Adae Bonsu, Miguel Camara, Evangelista Chisakaitwa, Ernest Cholopray, Nkemdilim Chukwueme, Catherine Cooper, Swasilanne da Silva, B. de Sousa Bandeira, Isaias Dambe, Davi Kokou Mawulé, Serge Diagbouga, Aicha Diakité, Awa Helene Diop, Sicelo Dlamini, Themba Dlamini, Thaddée Ndikumana, Oumou Fofana, Susan Gacheri, Evariste Gasana, Michel Gasana, Sandile Ginindza, Martin Gninafon, Nii Nortey Hanson-Nortey, Adama Jallow, Saffa Kamara, Madou Kane, Henry Kanyerere, Nathan Kapata, Biruck Kebede, Kerram Aziza, Deogratias Kibambazi, Patrick Konwuloh, Jacquemin Kouakou, Popaul Kulonga, Rossin Lebeke, Lillian Ishengoma, Llang Bridget Maama-Maime, Marcel Lougue, Maxime Lunga, Ghislaine Mabeluanga Tshitenge, Jocelyn Mahoumbou, Angelo Makpenon, David Mametja, Ivan Manhiça, Tseliso Marata, Farai Mavhunga, Mba Bekolo Frenk José Mathieu, Salem Salem Mohameden, Louine Morel, Youwaoga Isidore Moyenga, James Mpunga, Frank Mugabe, Kenneth Mugisha, Clifford Munyandi, Lindiwe Mvusi, Aboubacar Mzembaba, Ronald Ncube, Fulgence Ndayikengurukiye, Yvon Martial Ngana, Antoine Ngoulou, Lourenço Nhocuana, Blasdus Franz Njako, Emmanuel Nkiligi, M Nkou, Joshua Obasanya, Davidson Ogunade, Hermann Ongouo, Abdelhadi Oumar, Issoufou Ousmane, Maria Conceição Palma, Victor Pereira, Thato Raleting, Sahondra Jeanine Randriambeloson, Rujeedawa Mohammed Fezul, Samey Agbenyegan, Charles Sandy, Kebba D Sanneh, Marie Sarr Diouf, Mineab Sebhatu, Mamie Shoma, Angele Shoma Matota, René Simalo, Joseph Sitienei, Nicholas Siziba, Philippe Takongo, Celstino Francisco Teixeira, Mohamed Abdallahi Traoré, Nassiama Traoré, Kassim Traoré, Alie Wurie, Eucher Dieudonné Yazipo, Ranivomahefa Myrienne Bakoliarisoa Zanajohary, Abbas Zezai, Eric Ismaël Zoungrana. WHO Region of the Americas Christian Acosta, Shalauddin Ahmed, Valentina Antonieta Alarcon Guizado, Xochil Alemán de Cruz, Kiran kumar Alla, Valeria Almanza Torrez, Mirian Alvarez, Raúl Álvarez, Aisha Andrewin, A. Alister Antoine, Chris Archibald, Carlos Alberto Marcos Ayala Luna, Wiedjaiprekash Balesar, Draurio Barreira, Patricia Bartholomay, Soledad Beltrame, María del Carmen Bermúdez, Lynrod Brooks, Marta Calona de Abrego, Martín Castellanos Joya, Jorge Castillo Carbajal, Kenneth Castro, Judith Cazares, Gemma Chery, Carlos Cuadra, Ofelia Cuevas, D’Auvergne Cleophas, Jose Davy, Cecilia de Arango, Eva de Weever-Lista, Camille Deleveaux, Dy-Juan De Roza, Roger Duncan, España Cedeño Mercedes, Manuel Salvador España Rueda, Fernandez Hugo, Cecilia Figueroa Benites, Victor Gallant, Julio Garay Ramos, Sarita Aguirre García, Izzy Gerstenbluth, Margarita Godoy, Roscio Gómez, Ilse Maria Góngora Rivas, Silvino González, Yaskara Halabi, Kevin Harvey, Dorothea Hazel, Maria Henry, Tania Herrera, Carla Jeffries, Dihadenys Lemus Molina, Athelene Linton, Maria Josefa Llanes Cordero, Marvin Andres Maldonado Rivera, Maldonado Saavedra Andrea, Marcelino Belkys, Eva Martìnez, María de Lourdes Martínez Olivares, Zeidy Mata Azofeifa, Joan McLeod-Simon, Timothy McLaughlin-Munroe, Roque Miramontes, Leilawatie Mohammed, Jeetendra Mohanlall, Ernesto Moreno, Francis Morey, Willy Morose, Michael Owen, Cheryl Peek-Ball, Janelle Pickering, Tomasa Portillo, Irad Potter, Manohar Singh Rajamanickam, Dottin Ramoutar, Anna Esther Reyes Godoy, Paul Ricketts, Jorge Rodriguez De Marco, Myrian Román, Nilda de Romero, Carolyn Russell, Wilmer Salazar, Deborah Stijnberg, Sutton Jackurlyn, Torres Clarita, Maribelle Tromp, William Turner, Melissa Valdez, Daniel Vázquez, Nestor Vera, Michael Williams, David Yost, Oritta Zachariah. WHO Eastern Mediterranean Region Fadhil Abbas, Mohammad S Abouzeid, Khaled Abu Ruhman, Nadia Abu Sabra, Ahmadi Shahnaz, Mohamed Redha Al Lawati, Al Saidi Fatmah, Samia Ali Alagab, Abdelbary Abdullah Ahmed Al-Hammadi, Abdullatif Al-Khal, Saeed Al Saffar, Kifah Alshaqeldi, Bahnasy Samir, Bennani Kenza, Kinaz Cheikh, Walid Daoud, Mohamed Furjani, Amal Galal, Dhikrayet Gamara, Assia Haissama Mohamed, Hiba Kamal Hamad Elneel, Kaalthoom Hassan, Hawa Hassan Guessod, Lou Joseph, Onwar Otien Jwodh Chol, Basharat Khan, Joseph Lasu, Sayed Daoud Mahmoodi, Khadiga Adam Mohammed, Mokhtar Alaa, Mulham Mustafa, Nasehi Mahshid, Ejaz Qadeer, Mohammad Khalid Seddiq, Sghiar Mohammed, Mohemmed Tabena, Tamara Tayeb, Najib Abdul aziz Abdullah Thabit, Seddik Walha, Yaacoub Hiam. WHO European Region Abildaev Tleukhan Shildebaevich, Mokhonim Abdulloeva, Ibrahim Abubakar, Rafig Abuzarov, Nurhan Albayrak, Natavan Alikhanova, Avtandil Alisherov, Ewa Augustynowicz- GLOBAL TUBERCULOSIS REPORT 2013 vii Kopeć, Ekkehardt Altpeter, Laura Anderson, Delphine Antoine, Trude Margrete Arnesen, Rusudan Aspindzelashvili, Andrei Astrovko, Elizabeta Bachiyska, Anna Ivanovna Barbova, Yana Besstraschnova, Venera Lazarevna Bismilda, Oktam Ikramovich Bobokhojaev, Olivera Bojovic, Eric C. Böttger, Bonita Brodhun, Noa Cedar, Daniel Chemtob, Domnica Ioana Chiotan, Ana Ciobanu, Nico Cioran, Andra Cirule, Thierry Comolet, Radmila Curcic, Manfred Danilovitš, Edita Davidaviciene, Hayk Davtyan, Pava Dimitrijevic, António Diniz, Francis Drobniewski, Raquel Duarte, Mladen Duronjic, Connie Erkens, Jennifer Fernandez Garcia, Lyalya Gabbasova, Viktor Gasimov, Lárus Jón Guðmundsson, Gennady Gurevich, Walter Haas, Hasan Hafizi, Evgeny Hanyukov, Armen Hayrapetyan, Peter Helbling, Sven Hoffner, Daniela Homorodean, Jahongir Jurakhonovich Ismoilov, Mamuka Japaridze, Vincent Jarlier, Soledad Jiménez Pajares, Jerker Jonsson, Abdullat Kadyrov, Gulmira Kalmambetova, Dmitry Klymuk, Maria KorzeniewskaKosela, Ainura Koshoeva, Košnik Mitja, Gabor Kovacs, Tiina Kummik, Nino Lomtadze, Stevan Lučić, Jasminka Maglajllic, Turid Mannsåker, Mathys Vanessa, Rafail Mehdiyev, Rukije Mehmeti, Donika Mema, Vladimir Milanov, Alvard Mirzoyan, Gjyle Mulliqi, Gulnora Murmusaeva, Seher Musaonbasioglu, Ucha Nanava, Zdenka Novakova, Joan O’Donnell, Analita Pace Asciak, Clara Palma Jordana, Elena Pavlenko, Olga Pavlova, Monique Perrin, Edita Pimkina, Monika Polanova, Georgeta Gilda Popescu, Gordana Radosavljevic Asic, Bozidarka Rakocevic, Thomas Rendal, Vija Riekstina, Jerome Robert, Elena Rodríguez Valín, Tom Rogers, Elena Romancenco, Kazimierz Roszkowski-Sliz, Sabine Rüsch-Gerdes, Branislava Savic, Gérard Scheiden, Hasia Kaidar Shwartz, Anabela Silva, Girts Skenders, Cathrine Slorbak, Erika Slump, Hanna Soini, Ivan Solovic, Dick van Soolingen, Flemming Stenz, Sergey Sterlikov, Jana Svecova, Svetina Šorli Petra, Silva Tafaj, Talevski Stefan, Odorina Tello Anchuela, Mirzagaleb Tillyashaykhov, Aida viii GLOBAL TUBERCULOSIS REPORT 2013 Ustamujic, Gulnoz Uzakova, Tonka Varleva, Piret Viiklepp, Cveta Vragoterova, Gerard de Vries, Jiri Wallenfels, Wanlin Maryse, Pierre Weicherding, Aysegul Yildirim, Zakoska Maja, Oksana Zalutskaya, Ilona Zemanová, Manca Žolnir Dovč, Hasan Zutic. WHO South-East Asia Region Shina Ahmed, Aminath Aroosha, Choe Kum Song, Emdadul Hoque, RS Gupta, Sirinapha Jittimanee, Suksont Jittimanee, Niraj Kulshrestha, Constantino Lopes, Thandar Lwin, Dyah Erti Mustikawati, Tin Zar Naing, Chawetsan Namwat, Md Nuruzzaman Haque, Nirupa Pallewatta, Rajendra Prasad Pant, Kiran Rade, Dyah Armi Riana, Chewang Rinzin, Sudath Samaraweera, Gamini Senevirathne, Janaka Thilakarathne, Sabino Viegas, Bimal Kumar Yadav. 9*19GUVGTP2CEKßE4GIKQP Paul Aia, Cecilia Teresa T. Arciaga, Nemia Bainivalu, Christina Bareja, Risa J. Bukbuk, Cheng Shiming, Phonenaly Chittamany, Chou Kuok Hei, Nese Ituaso Conway, Du Xin, Mayleen J. Ekiek, Fanai Saen, Rangiau Fariu, Ludovic Floury, Louise Fonua, Jiloris Frederick Dony, Anna Marie Celina Garfin, Go Un-Yeong, Shakti Gounder, Anie Haryani Hj Abdul Rahman, Noel Itogo, Tom Jack, Seiya Kato, Khin Mar Kyi Win, Lamar Daniel, Leo Lim, Liza Lopez, Sakiusa Mainawalala, Henri-Pierre Mallet, Tan Eang Mao, Markleen Tagaro, Serafi Moa, Suzana Mohd Hashim, Nguyen Binh Hoa, Nguyen Viet Nhung, Nou Chanly, Ochirbat Batbayar, Connie Bieb Olikong, Park Yoon-Sung, Nukutau Pokura, Waimanu Pulu, Purev Nasanjargal, Rabauliman Marcelina, Bereka Reiher, Bernard Rouchon, Temilo Seono, Tokuaki Shobayashi, Vita A. Skilling, Grant Storey, Phannasinh Sylavanh, Kenneth Reuee Tabutoa, Tam Cheuk Ming, Kyaw Thu, Tieng Sivanna, Tong Ka Io, Rosalind Vianzon, Wang Yee Tang, Wang Lixia. Executive summary Tuberculosis (TB) remains a major global health problem. In 2012, an estimated 8.6 million people developed TB and 1.3 million died from the disease (including 320 000 deaths among HIV-positive people).1 The number of TB deaths is unacceptably large given that most are preventable. Nearly 20 years after the WHO declaration of TB as a global public health emergency, major progress has been made towards 2015 global targets set within the context of the Millennium Development Goals (MDGs). Two years ahead of the deadline, the Global Tuberculosis Report 2013 and accompanying supplement Countdown to 2015 assess progress towards the 2015 targets and the top priority actions needed to achieve and/or move beyond them. C17N6&19N 61 key ßndings On track: The rate of new TB cases has been falling worldwide for about a decade, achieving the MDG global target. TB incidence rates are also falling in all six WHO regions. The rate of decline (2% per year) remains slow. Globally by 2012, the TB mortality rate had been reduced by 45% since 1990. The target to reduce deaths by 50% by 2015 is within reach. Two WHO regions have already achieved the 2015 targets for reduced incidence, prevalence and mortality: the Region of the Americas and the Western Pacific Region. Of the 22 high TB burden countries (HBCs) that account for about 80% of the world’s TB cases,2 seven have met all 2015 targets for reductions in TB incidence, prevalence and mortality. Four more HBCs are on track to do so by 2015. Off track: By 2012, the level of active TB disease in the community (prevalence) had fallen by 37% globally since 1990. The target of a 50% reduction by 2015 is not expected to be achieved. The African and European regions are currently not on track to achieve the mortality and prevalence targets. Among the 22 HBCs, 11 are not on track to reduce incidence, prevalence and mortality in line with targets. Reasons include resource constraints, conflict and instability, and generalized HIV epidemics. Progress towards targets for diagnosis and treatment of multidrug-resistant TB (MDR-TB) is far off-track. Worldwide and in most countries with a high burden of MDR-TB, less than 25% of the people estimated to have MDR-TB were detected in 2012. Many countries have made considerable progress to address the TB/HIV co-epidemic. However, globallevel targets for HIV testing among TB patients and provision of antiretroviral therapy (ART) to those who are HIV-positive have not been reached. Five priority actions required to accelerate progress towards 2015 targets: 1. Reach the missed cases. About 3 million people who developed TB in 2012 were missed by national notification systems. Key actions needed to detect people with the illness and ensure that that they get the right treatment and care include: expanded services (including rapid tests) throughout health systems bolstered by the support of nongovernmental organizations, community workers and volunteers to diagnosis and report cases; intensified collaboration with public hospitals and private health facilities who are treating patients but not reporting; instituting mandatory notification of cases in more countries; and better data compilation. 2. Address MDR-TB as a public health crisis. In high MDR-TB burden countries, increased capacity to diagnose MDR-TB must be matched with supplies of quality drugs and scaled-up country capacity to deliver effective treatment and care. This will require high-level political will and leadership and more collaboration among partners, including drug regulatory authorities, donor and technical agencies, civil society and the pharmaceutical industry. 3. Accelerate the response to TB/HIV. The top priority is to increase coverage of ART for HIV-positive TB patients towards the 100% target. Expanded coverage of TB preventive treatment among people living with HIV is the second priority. 4. Increase financing to close all resource gaps. An estimated US$ 7–8 billion per year is required for a full response to the TB epidemic in low- and middle-income countries in 2014 and 2015 (excluding research and development for new TB diagnostics, drugs and vaccines). Funding in 2013 is about US$ 6 billion. Increases in both domestic and donor financing are needed to close the gap of up to US$ 2 billion per year, including via the full replenishment of the Global Fund in 2013. Progress remains fragile and could be reversed without adequate funding. 5. Ensure rapid uptake of innovations. The fast uptake of new tools and strategies for better diagnosis, treatment and prevention of all forms of TB can be accelerated by country-specific operational research and translation of findings into policy and practice. GLOBAL TUBERCULOSIS REPORT 2013 ix ADDITIONAL FINDINGS The report is based primarily on data provided by WHO’s Member States. In 2013, data were reported by 178 Member States and a total of 197 countries and territories that collectively have more than 99% of the world’s TB cases. Burden of disease The current global picture of TB shows continued progress, but not fast enough. An estimated 1.1 million (13%) of the 8.6 million people who developed TB in 2012 were HIV-positive. About 75% of these cases were in the African Region. Globally in 2012, an estimated 450 000 people developed MDR-TB and there were an estimated 170 000 deaths from MDR-TB . Most TB cases and deaths occur among men, but TB remains among the top three killers of women worldwide. There were an estimated 410 000 TB deaths among women in 2012, including 160 000 among HIV-positive women. Half of the HIV-positive people who died from TB in 2012 were women. Of the estimated 8.6 million new TB cases worldwide in 2012, 2.9 million were women. There were an estimated 530 000 TB cases among children (under 15 years of age) and 74 000 TB deaths (among HIV-negative children) in 2012 (6% and 8% of the global totals, respectively). The majority of cases worldwide in 2012 were in the South-East Asia (29%), African (27%) and Western Pacific (19%) regions. India and China alone accounted for 26% and 12% of total cases, respectively. The TB incidence rate at country level ranges substantially, with around 1000 or more cases per 100 000 people in South Africa and Swaziland, and fewer than 10 per 100 000 population in parts of the Americas, several countries in western Europe, Japan, Australia and New Zealand. TB detection and treatment outcomes Millions of people access effective TB care each year but “missed cases” hold back gains. Between 1995 and 2012, 56 million people were successfully treated for TB in countries that had adopted WHO’s global TB strategy, saving 22 million lives. In 2012, 6.1 million cases of TB were notified to national TB programmes (NTPs). Of these, 5.7 million were people newly diagnosed in 2012 and 0.4 million were previously diagnosed TB patients whose treatment regimen was changed. In 2011, the treatment success rate continued to be high at 87% among all new TB cases. Notifications of TB cases have stabilized globally. In 2012, about 66% (5.7 million) of the estimated 8.6 million people who developed TB were notified as newly diagnosed cases. x GLOBAL TUBERCULOSIS REPORT 2013 About 75% of the estimated 2.9 million missed cases – people who were either not diagnosed or diagnosed but not reported to NTPs – were in 12 countries. In order of total numbers, these were India (31% of the global total), South Africa, Bangladesh, Pakistan, Indonesia, China, Democratic Republic of the Congo, Mozambique, Nigeria, Ethiopia, the Philippines and Myanmar. Xpert® MTB/RIF, a rapid molecular diagnostic test, is being rapidly adopted by countries to detect TB and rifampicin-resistant TB. By end June 2013, 1402 testing machines and 3.2 million test cartridges had been procured by 88 of the 145 countries eligible for concessional prices. Treatment success rates for TB remain lowest in the European Region, where in 2011 only 72% of new cases were successfully treated. MDR-TB and XDR-TB detection and treatment outcomes Undetected cases and treatment coverage gaps constitute a public health crisis. Globally in 2012, data from drug resistance surveys and continuous surveillance among notified TB cases suggest that 3.6% of newly diagnosed TB cases and 20% of those previously treated for TB had MDR-TB. The highest levels of MDR-TB are found in eastern Europe and central Asia, where in some countries more than 20% of new TB cases and more than 50% of those previously treated for TB have MDR-TB. A total of 94 000 TB patients eligible for MDR-TB treatment were detected in 2012: 84 000 people with confirmed MDR-TB (i.e. resistance to both rifampicin, the most powerful TB drug, and isoniazid), plus 10 000 with rifampicin resistance detected using Xpert MTB/ RIF. This was a 42% increase in detected cases eligible for treatment compared with 2011. The largest increases between 2011 and 2012 were in India, South Africa and Ukraine. Just over 77 000 people with MDR-TB were started on second-line treatment in 2012, equivalent to 82% of the 94 000 newly detected cases that were eligible for treatment globally. Treatment coverage gaps for detected cases were much larger in some countries, especially in the African Region (51% enrolled in treatment), and widened in China, Pakistan and South Africa. At least one case of extensively drug-resistant TB (XDRTB) had been reported by 92 countries by the end of 2012. On average, an estimated 9.6% of MDR-TB cases have XDR-TB. Globally, only 48% of MDR-TB patients in the 2010 cohort of detected cases were successfully treated, reflecting high mortality rates and loss to follow-up. A treatment success rate of 75% or more for patients with MDR-TB was achieved in 34 of 107 countries. Addressing TB-HIV TB-HIV collaborative services are expanding, but global targets are not yet in sight. The main interventions to reduce the burden of HIV in TB patients are HIV testing and provision of ART and cotrimoxazole preventive therapy (CPT) to those found to be HIV-positive. The main interventions to reduce TB among people living with HIV are regular screening for TB among people in HIV care and provision of isoniazid preventive therapy (IPT) to those without active TB who meet eligibility criteria (estimated at 50% of those newly enrolled in HIV care). Progress in the implementation of TB/HIV interventions was further consolidated in 2012. Globally, 46% of TB patients knew their HIV status (up from 40% in 2011). In the African Region that has the highest TB/ HIV burden, 74% of TB patients knew their HIV status (up from 69% in 2011). Among the 41 countries with the highest TB/HIV burden, more than 85% of TB patients knew their HIV status in 15 countries, and in 7 of these countries over 90% of patients knew their HIV status. The coverage of ART among TB patients who were known to be HIV-positive reached 57% in 2012, up from 49% in 2011. As in the past few years, about 80% of HIVpositive TB patients were treated with CPT. In 2012, 4.1 million people enrolled in HIV care were reported to have been screened for TB, up from 3.5 million in 2011. Of the reported 1.6 million people newly enrolled in HIV care in 2012, 0.5 million (31%) were provided with IPT. 6$ßPCPEKPI International donor funding and more domestic investments are essential. Of the US$ 7‒8 billion per year required in low and middle-income countries in 2014 and 2015, about two thirds is needed for the detection and treatment of drugsusceptible TB, 20% for treatment of MDR-TB, 10% for rapid diagnostic tests and associated laboratory strengthening, and 5% for collaborative TB/HIV activities. 1 2 Growth in domestic and international donor funding has been clearly documented since 2002. There is capacity to further increase domestic funding, especially in BRICS (Brazil, the Russian Federation, India, China and South Africa) that have almost 50% of global TB cases. International donor funding reported by NTPs amounted to US$ 0.8 billion in 2013, about three-quarters of which was from the Global Fund. To close resource gaps, at least US$ 1.6 billion is needed in both 2014 and 2015. International donor funding is crucial in many countries, accounting for more than 50% of total funding in the group of 17 HBCs excluding BRICS, and in all lowincome countries. The proportion is even higher in some individual countries. Research and development New TB diagnostics, medicines and vaccines are crucial to end the global TB epidemic. More than 50 companies are involved in development of new diagnostic tests. 10 new or repurposed TB drugs are in late phases of clinical development. In late 2012, bedaquiline became the first novel TB drug approved in 40 years. In June 2013, WHO issued interim guidance for its use in treatment of MDR-TB. There are 10 vaccines for TB prevention and two immunotherapeutic vaccines in the pipeline. In early 2013, results from a Phase IIb proof-of-concept study of one of the preventive vaccine candidates were published. While efficacy was not superior to the Bacille-Calmette-Guérin (BCG) vaccine alone, the study demonstrated that a trial of a novel TB vaccine is feasible in a high TB burden setting. Short, effective and well-tolerated treatments for latent TB infection, a point-of-care diagnostic test, and an effective post-exposure vaccine are needed to help end the global TB epidemic. The estimated number of TB deaths among HIV-positive people in 2011 was 336 000. Estimates of TB deaths among HIV-positive people for the entire period 1990‒2012 were updated in 2013 using the Spectrum software, which has been used for more than a decade to produce estimates of the burden of disease caused by HIV. In 2013, a TB module in Spectrum was available for the first time for use in the country consultations on HIV burden estimates that are organized by UNAIDS every two years. Estimation of the number of TB cases living with HIV, and of the number of TB deaths among HIV-positive people, was integrated into this process. The 22 HBCs are Afghanistan, Bangladesh, Brazil, Cambodia, China, the Democratic Republic of the Congo, Ethiopia, India, Indonesia, Kenya, Mozambique, Myanmar, Nigeria, Pakistan, the Philippines, the Russian Federation, South Africa, Thailand, Uganda, the United Republic of Tanzania, Viet Nam and Zimbabwe. GLOBAL TUBERCULOSIS REPORT 2013 xi %*#26'4 Introduction BOX 1.1 Basic facts about TB TB is an infectious disease caused by the bacillus Mycobacterium tuberculosis. It typically affects the lungs (pulmonary TB) but can affect other sites as well (extrapulmonary TB). The disease is spread in the air when people who are sick with pulmonary TB expel bacteria, for example by coughing. In general, a relatively small proportion of people infected with M. tuberculosis will develop TB disease; however, the probability of developing TB is much higher among people infected with HIV. TB is also more common among men than women, and affects mostly adults in the economically productive age groups. The most common method for diagnosing TB worldwide is sputum smear microscopy (developed more than 100 years ago), in which bacteria are observed in sputum samples examined under a microscope. Following recent breakthroughs in TB diagnostics, the use of rapid molecular tests for the diagnosis of TB and drug-resistant TB is increasing, as highlighted in Chapter 5 and Chapter 8 of this report. In countries with more developed laboratory capacity, cases of TB are also diagnosed via culture methods (the current reference standard). Without treatment, TB mortality rates are high. In studies of the natural history of the disease among sputum smearpositive/HIV-negative cases of pulmonary TB, around 70% died within 10 years; among culture-positive (but smearnegative) cases, 20% died within 10 years.a 'HHGEVKXGFTWIVTGCVOGPVUYGTGßTUVFGXGNQRGFKPVJG U6JGOQUVGHHGEVKXGßTUVNKPGCPVK6$FTWITKHCORKEKP became available in the 1960s. The currently recommended treatment for new cases of drug-susceptible TB is a sixOQPVJTGIKOGPQHHQWTßTUVNKPGFTWIU KUQPKC\KFTKHCORKEKP GVJCODWVQNCPFR[TC\KPCOKFG6TGCVOGPVUWEEGUUTCVGUQH QTOQTGHQTPGYECUGUCTGTGIWNCTN[TGRQTVGFVQ9*1 by Member States (Chapter 3). Treatment for multidrugTGUKUVCPV6$ /&46$ FGßPGFCUTGUKUVCPEGVQKUQPKC\KFCPF rifampicin (the two most powerful anti-TB drugs) is longer, and requires more expensive and more toxic drugs. For most RCVKGPVUYKVJ/&46$VJGEWTTGPVTGIKOGPUTGEQOOGPFGF by WHO last 20 months, and treatment success rates are much lower (Chapter 4 (QTVJGßTUVVKOGKPHQWTFGECFGU new TB drugs are starting to emerge from the pipeline and combination regimens that include new compounds are being tested in clinical trials, as discussed in Chapter 8. There are several TB vaccines in Phase I or Phase II trials (Chapter 8). For the time being, however, a vaccine that is effective in preventing TB in adults remains elusive. a Tuberculosis (TB) remains a major global health problem. It causes ill-health among millions of people each year and ranks as the second leading cause of death from an infectious disease worldwide, after the human immunodeficiency virus (HIV). The latest estimates included in this report are that there were 8.6 million new TB cases in 2012 and 1.3 million TB deaths (just under 1.0 million among HIV-negative people and 0.3 million HIV-associated TB deaths). Most of these TB cases and deaths occur among men, but the burden of disease among women is also high. In 2012, there were an estimated 2.9 million cases and 410 000 TB deaths among women, as well as an estimated 530 000 cases and 74 000 deaths among children.1 The number of TB deaths is unacceptably large given that most are preventable if people can access health care for a diagnosis and the right treatment is provided. Short-course regimens of first-line drugs that can cure around 90% of cases have been available for decades. These large numbers of cases and deaths notwithstanding, 20 years on from the 1993 World Health Organization (WHO) declaration of TB as a global public health emergency, major progress has been made. Globally, the TB mortality rate (deaths per 100 000 population per year) has fallen by 45% since 1990 and TB incidence rates (new cases per 100 000 population per year) are falling in most parts of the world. In the 18 years since the launch of a new international strategy for TB care and control by WHO in the mid-1990s (the DOTS strategy) and the subsequent global rollout of DOTS and its successor (the Stop TB Strategy,2 Box 1.2), a cumulative total of 56 million people were successfully treated for TB between 1995 and 2012, saving approximately 22 million lives. The overarching goal of the Stop TB Strategy is to achieve 2015 global targets (shown in Box 1.2) for reductions in the burden of disease caused by TB. The target set within the United Nations (UN) Millennium Development Goals (MDGs) is that TB incidence should be falling by 2015 (MDG Target 6.c). Besides incidence, four other TB indicators are included in the MDG monitoring framework: the prevalence rate, the mortality rate, the case detection rate (the number of notified cases divided by the estimated number of incident cases in the same year, expressed as a percentage), and the treatment success rate (the percentage 1 6KGOGTUOC'9GVCN0CVWTCNJKUVQT[QHVWDGTEWNQUKU FWTCVKQPCPF HCVCNKV[QHWPVTGCVGFRWNOQPCT[VWDGTEWNQUKUKP*+8PGICVKXGRCVKGPVU A systematic review. PLoS ONE G 2 The estimated number of deaths among children excludes TB deaths in HIV-positive children, for which estimates are not yet available. Further details are provided in Chapter 2. Raviglione M, Uplekar M. WHO’s new Stop TB strategy. The Lancet, 2006, 367: 952–5. GLOBAL TUBERCULOSIS REPORT 2013 1 BOX 1.2 The Stop TB Strategy at a glance THE STOP TB STRATEGY VISION A TB-free world GOAL To dramatically reduce the global burden of TB by 2015 in line with the Millennium Development Goals (MDGs) and the Stop TB Partnership targets OBJECTIVES ■ Achieve universal access to high-quality care for all people with TB ■ 4GFWEGVJGJWOCPUWHHGTKPICPFUQEKQGEQPQOKEDWTFGPCUUQEKCVGFYKVJ6$ ■ Protect vulnerable populations from TB, TB/HIV and drug-resistant TB ■ Support development of new tools and enable their timely and effective use ■ Protect and promote human rights in TB prevention, care and control TARGETS ■ /&)6CTIGVE *CNVCPFDGIKPVQTGXGTUGVJGKPEKFGPEGQH6$D[ ■ 6CTIGVUNKPMGFVQVJG/&)UCPFGPFQTUGFD[VJG5VQR6$2CTVPGTUJKR ¿ TGFWEGRTGXCNGPEGQHCPFFGCVJUFWGVQ6$D[EQORCTGFYKVJCDCUGNKPGQH ¿ GNKOKPCVG6$CUCRWDNKEJGCNVJRTQDNGO FGßPGFCU ECUGRGTOKNNKQPRQRWNCVKQPRGT[GCT COMPONENTS 1. Pursue high-quality DOTS expansion and enhancement C 5GEWTGRQNKVKECNEQOOKVOGPVYKVJCFGSWCVGCPFUWUVCKPGFßPCPEKPI b. Ensure early case detection, and diagnosis through quality-assured bacteriology E 2TQXKFGUVCPFCTFK\GFVTGCVOGPVYKVJUWRGTXKUKQPCPFRCVKGPVUWRRQTV d. Ensure effective drug supply and management e. Monitor and evaluate performance and impact 2. Address TB/HIV, MDR-TB, and the needs of poor and vulnerable populations a. Scale up collaborative TB/HIV activities D 5ECNGWRRTGXGPVKQPCPFOCPCIGOGPVQH/&46$ c. Address the needs of TB contacts, and of poor and vulnerable populations 3. Contribute to health system strengthening based on primary health care C *GNRKORTQXGJGCNVJRQNKEKGUJWOCPTGUQWTEGFGXGNQROGPVßPCPEKPIUWRRNKGUUGTXKEGFGNKXGT[CPFKPHQTOCVKQP b. Strengthen infection control in health services, other congregate settings and households c. Upgrade laboratory networks, and implement the Practical Approach to Lung Health F #FCRVUWEEGUUHWNCRRTQCEJGUHTQOQVJGTßGNFUCPFUGEVQTUCPFHQUVGTCEVKQPQPVJGUQEKCNFGVGTOKPCPVUQHJGCNVJ 4. Engage all care providers a. Involve all public, voluntary, corporate and private providers through public–private mix approaches b. Promote use of the International Standards for Tuberculosis Care 5. Empower people with TB, and communities through partnership C 2WTUWGCFXQECE[EQOOWPKECVKQPCPFUQEKCNOQDKNK\CVKQP b. Foster community participation in TB care, prevention and health promotion c. Promote use of the Patients’ Charter for Tuberculosis Care 6. Enable and promote research a. Conduct programme-based operational research b. Advocate for and participate in research to develop new diagnostics, drugs and vaccines 2 GLOBAL TUBERCULOSIS REPORT 2013 FIGURE 1.1 Seventeen annual WHO global TB reports, 1997–2012 1997: First report: epidemiology and surveillance 2002: Added financing and strategy for 22 high-burden countries (HBCs) 2003: Financing and strategy (all countries) of TB patients who are successfully treated). The Stop TB Partnership adopted the MDG target and in addition set global targets to halve TB prevalence and death rates by 2015 compared with their levels in 1990. The scale at which interventions included in the Stop TB Strategy need to be implemented to achieve the 2015 targets for reductions in disease burden, and the associated funding requirements, have been described in Global Plans developed by the Stop TB Partnership. The latest plan covers the period 2011– 2015 and has a price tag of US$ 47 billion.1 As the MDG target year of 2015 approaches, work on a post-2015 development framework is assuming increasing prominence. In June 2013, a high-level panel established by the UN Secretary General to provide recommendations about the content of a post-2015 development framework, including possible goals and targets, submitted its report.2 One of the twelve proposed goals for 2030 is to “Ensure healthy lives”, under which a suggested target is to “Reduce the burden of disease from HIV/AIDS, TB, malaria, neglected tropical diseases and priority noncommunicable diseases”. Important themes within the report are building on the MDGs and equity, and for health specifically the importance of steady progress towards universal health coverage (UHC) is highlighted. In line with the development of a post-2015 development framework and in response to a request from Member States, WHO began the process of developing a post-2015 global TB strategy in 2012. Following a series of consultations between June 2012 and July 2013, the draft strategy includes the goal of ending the global TB epidemic by 2035, with corresponding global targets for major reductions in TB cases and deaths by 2035 and milestones for 2020, 2025 and 2030. Achieving the proposed targets is based on three strategic pillars: integrated, patient-centred TB care 1 2 The Global Plan to Stop TB, 2011–2015. Geneva, World Health Organization, 2010 (WHO/HTM/STB/2010.2). Available at http://w w w.stoptb.org /assets/documents/global/plan/TB _ GlobalPlanToStopTB2011-2015.pdf http://www.un.org/sg/management/beyond2015.shtml July 2009: Online data collection introduced December 2009: Short update to 2009 report in transition to earlier reporting of data and report publication and prevention; bold policies and supportive systems; and intensified research and innovation. It is anticipated that the strategy will be reviewed by the WHO Executive Board in January 2014 and discussed at the World Health Assembly in May 2014. In the context of global TB strategies and targets, WHO has published a global TB report every year since 1997 (Figure 1.1). The main aim of the report is to provide a comprehensive and up-to-date assessment of the TB epidemic and progress in prevention, diagnosis and treatment of the disease at global, regional and country levels, based primarily on data that are reported by countries and territories to WHO in annual rounds of global TB data collection (Box 1.3). This 2013 global TB report is the eighteenth in the series of annual reports, and uses data reported by a total of 197 countries and territories including 178 Member States that account for over 99% of the world’s estimated cases of TB (Table 1.1). With just over two years remaining before the end of 2015, a special feature of this 2013 global report is that it is accompanied by a supplement focused on the ‘Countdown to 2015’ (Box 1.4). The main part of the report contains seven major chapters. Each chapter is intended to stand alone, but links to other chapters are highlighted where appropriate. Chapter 2 contains the latest estimates of the burden of disease caused by TB and assessment of progress towards the 2015 targets at global, regional and country levels. Estimates for women and children specifically are given particular attention. Following new analytical and modelling work in 2013, the chapter also contains new estimates of the number of cases of and deaths from MDR-TB and of HIV-related TB mortality. The latest status of efforts to improve measurement of TB cases and deaths at country level, with guidance and support from the WHO Global Task Force on TB Impact Measurement, is described. Chapter 3 presents data on the numbers of cases notified to NTPs and reported to WHO and their treatment outcomes, including breakdowns of TB cases by type, sex and age. Recent progress in increasing the reporting of cases by private sector providers through engagement of GLOBAL TUBERCULOSIS REPORT 2013 1310_0237_PM_003.indd 3 3 28/10/13 13:15 BOX 1.3 Data collected in the 2013 round of global TB data collection &CVCYGTGTGSWGUVGFQPVJGHQNNQYKPIVQRKEU 6$ECUGPQVKßECVKQPUCPFVTGCVOGPVQWVEQOGUKPENWFKPIDTGCMFQYPUD[6$ECUG type, age, sex and HIV status; an overview of services for the diagnosis and treatment of TB; laboratory diagnostic services; drug management; monitoring and evaluation; surveillance and surveys of drug-resistant TB; management of drug-resistant TB; collaborative TB/HIV activities; TB infection control; engagement of all care providers in TB control; the budgets of national TB EQPVTQNRTQITCOOGU 062U KPCPF WVKNK\CVKQPQHIGPGTCNJGCNVJUGTXKEGU JQURKVCNK\CVKQPCPFQWVRCVKGPVXKUKVU FWTKPI treatment; and NTP expenditures in 2012. A shortened version of the online questionnaire was used for high-income countries (that KUEQWPVTKGUYKVJCITQUUPCVKQPCNKPEQOGRGTECRKVCQHÜ75aaKPCUFGßPGFD[VJG9QTNF$CPM a and/or low-incidence EQWPVTKGU FGßPGFCUEQWPVTKGUYKVJCPKPEKFGPEGTCVGQH ECUGURGTaRQRWNCVKQPQT ECUGUKPVQVCN Countries reported data using an online web-based system (www.stoptb.org/tme). The system was opened for reporting on 14 /CTEJYKVJCFGCFNKPGQH/C[HQTCNN9*1TGIKQPUGZEGRVVJG4GIKQPQHVJG#OGTKECU /C[ CPFVJG'WTQRGCP4GIKQP /C[ %QWPVTKGUKPVJG'WTQRGCP7PKQPUWDOKVPQVKßECVKQPFCVCVQCU[UVGOOCPCIGFD[VJG'WTQRGCP%GPVTGHQT&KUGCUG2TGXGPVKQP and Control (ECDC). Data from the ECDC system were uploaded into the WHO online system. Data were reviewed, and followed up with countries where appropriate, by a team of reviewers from WHO (headquarters and TGIKQPCNQHßEGU CPFVJG)NQDCN(WPFVQ(KIJV#+&56WDGTEWNQUKUCPF/CNCTKC VJG)NQDCN(WPF 8CNKFCVKQPQHFCVCD[TGURQPFGPVU was also encouraged via a series of in-built, real-time checks of submitted data as well as a summary report of apparent inconsistencies or inaccuracies (this report can be generated at any time within the online system). Following corrections and updates by countries, the data used for the main part of this report were the data available in July 2013. Annex 4 was produced on 1 October, by which time additional data had been reported by a few European countries.b Besides the data reported through the standard TB questionnaire, data about screening for TB among people living with HIV and RTQXKUKQPQHKUQPKC\KFRTGXGPVKXGVJGTCR[ +26 VQVJQUGYKVJQWVCEVKXG6$YGTGEQNNGEVGFD[VJG*+8FGRCTVOGPVKP9*1CPFVJG,QKPV United Nations Programme on HIV/AIDS (UNAIDS). The data were jointly validated and imported into the global TB database. a. b. JVVR FCVCYQTNFDCPMQTICDQWVEQWPVT[ENCUUKßECVKQPU For this reason, there may be slight discrepancies between the main part of the report and Annex 4. TABLE 1.1 Reporting of data in the 2013 round of global TB data collection %17064+'5#0&6'44+614+'5 9*14')+10145'61(%17064+'5 07/$'4 /'/$'456#6'5 07/$'46*#64'2146'&# 07/$'4 07/$'46*#64'2146'&# #HTKECP4GIKQP 46 45 46 45 'CUVGTP/GFKVGTTCPGCP4GIKQP 23 23 22 22 'WTQRGCP4GIKQPa 54 42 53 41 4GIKQPQHVJG#OGTKECU 46 46 35 35 5QWVJ'CUV#UKC4GIKQP 11 11 11 11 9GUVGTP2CEKßE4GIKQP 36 30 27 24 High-burden countries (HBCs)b 22 22 22 22 216 197 194 178 World a Countries that did not report by the deadlines were mostly low-incidence countries in Western Europe. b 6JG*$%UCTG#HIJCPKUVCP$CPINCFGUJ$TC\KN%CODQFKC%JKPCVJG&GOQETCVKE4GRWDNKEQHVJG%QPIQ'VJKQRKC+PFKC+PFQPGUKC-GP[C/Q\CODKSWG/[CPOCT0KIGTKC 2CMKUVCPVJG2JKNKRRKPGUVJG4WUUKCP(GFGTCVKQP5QWVJ#HTKEC6JCKNCPF7ICPFCVJG7PKVGF4GRWDNKEQH6CP\CPKC8KGV0COCPF85% of estimated MDR-TB cases in the world – the proportion of TB patients who were tested ranged from 56 to 100% among new cases in 13 of the 14 European countries reporting data (17% in Tajikistan; no data reported by Azerbaijan), and exceeded 60% among previously treated cases in nine of these countries. Among non-European high MDR-TB burden countries, testing for MDR-TB among new cases was highest in China (3.6%). In previously treated cases, the coverage of testing was higher and reached 10% in Indonesia and 12% in China and the Philippines. In South Africa, 16% of TB cases overall were tested for MDR-TB although DST data were not available separately for new and previously treated cases. Five other countries did not report data, including India, the country estimated to have the highest number of MDR-TB cases among notified TB patients (Table 4.2). Among TB patients who were notified and confirmed to have MDR-TB in 2012, 23% were reported to have DST performed for both fluoroquinolones and second-line injectable drugs. Second-line DST coverage exceeded 90% in Armenia, Bulgaria, the Democratic Republic of the Congo, Georgia and Latvia. South Africa accounted for most of the global cases for which second-line DST data were reported, as well as the highest proportion observed in the African Region (the regional figure drops from 62% to 1% when South Africa is excluded). Second-line DST reports were available for 53% of MDR-TB cases in the Western Pacific Region, 47% in the Region of the Americas and 3–8% in the other regions. Improving the coverage of diagnostic DST is urgently needed to improve the detection of MDR-TB and XDR-TB. TABLE 4.2 DST coverage among TB and MDR-TB cases, globally and for 27 high MDR-TB burden countries and WHO regions, 2012 0'9$#%6'4+1.1)+%#..;215+6+8'%#5'5 07/$'49+6* DSTa4'57.65 Armenia #\GTDCKLCP Bangladesh Belarus Bulgaria China &4%QPIQ 41 7.0 3.6 12 95 1 931 India 46 541 49 100 12 2 042 65 100 55 1.3 – 4.4 – 45 341 – 597 10 43 – 2 – 45 142 11 472 100 71 1.0 92 % OF CASES WITH &564'57.65 142 Georgia Lithuania 557 100 07/$'49+6* DST b4'57.65 – 193 Latvia 27 90 469 -[TI[\UVCP %10(+4/'&/&46$%#5'5 % OF CASES WITH &564'57.65 2 164 Ethiopia -C\CMJUVCPc 64 4'64'#6/'06%#5'5 07/$'49+6* DSTa4'57.65 – Estonia Indonesia % OF CASES WITH &564'57.65 99 3.6 >100 10 443 93 57 662 61 511 53 666 97 100 106 96 1 017 100 350 100 210 77 – 11 Myanmar – – Nigeria 11 94 1.2 – Pakistan 461 0.4 154 1.3 – 35 – Philippines 4GRWDNKEQH/QNFQXC 1 264 67 933 63 4WUUKCP(GFGTCVKQP 32 647 79 12 324 24 South Africa Tajikistan Ukraine 7\DGMKUVCP – High MDR-TB burden countries 345 50 356 21 7.7 16 225 21 3.1 11 303 62 47 17 496 66 5 925 72 2 703 56 30 – 2 216 #/4 '/4 1 990 '74 5'#4 1 352 924 72 77 #(4 Global 11 046 919 77 277 3.9 0.3 22 1.1 72 0.1 – – Viet Nam – – – 42 851 3 969 1 617 37 774 2 292 3.3 136 630 5.1 59 267 23 7.6 41 0.7 10 8.7 – 51 3.2 2 523 6.7 1 619 2 365 53 19 245 23 Blank cells indicate data not reported. – indicates values that cannot be calculated. a &56KUHQTKUQPKC\KFCPFTKHCORKEKP b &56KUHQTCàWQTQSWKPQNQPGCPFCUGEQPFNKPGKPLGEVCDNGFTWI c #RQUUKDNGGZRNCPCVKQPHQTYJ[VJGRGTEGPVCIGHQTPGYECUGUKP-C\CMJUVCPGZEGGFUKUKPCFGSWCVGNKPMCIGUDGVYGGPENKPKECNCPFNCDQTCVQT[TGIKUVGTU GLOBAL TUBERCULOSIS REPORT 2013 51 FIGURE 4.5 DST coverage among new cases and enrolment on MDR-TB treatment, compared with the targets in the Global Plan to Stop TB, 2011–2015. Lines indicate the planned targets, blue squares show the situation in 2009–2012 and orange circles the projected enrolments 2013–2015. Data on projected enrolments in 2015 were incomplete. b. Enrolment on MDR-TB treatment 300 000 20 250 000 Number of patients Percentage of cases a. DST coverage among new bacteriologically-positive cases 25 15 10 5 2010 2011 2012 2013 2014 BOX 4.2 XDR-TB in Africa +PCENWUVGTQH:&46$RCVKGPVUKPTWTCN5QWVJ#HTKEC made international headlines.a All of the patients from this cluster who were tested for HIV were found to be infected. Most of these patients died very quickly. South Africa TGOCKPUVJGEQWPVT[VJCVTGRQTVUVJGOQUV:&46$ECUGU KPVJGYQTNFCPFCPPWCNPQVKßECVKQPUJCXGKPETGCUGFHTQO KPVQKP#DQWVQH/&46$ECUGU TGRQTVGFKPVJKUEQWPVT[JCXG:&46$ FIGURE B4.2.1 Treatment outcomes for 623 TB patients with XDRTB in South Africa, 2010 Completed 6% Died 49% Cured 12% Not evaluated 17% Treatment failed 8% Lost to follow-up 9% By the end of 2012, 15 countries in the African region had KFGPVKßGFCPFTGRQTVGFCVNGCUVQPGECUGQH:&46$ Figure 4.4 +PVYQJKIJ/&46$DWTFGPEQWPVTKGUKPVJG #HTKECP4GIKQP¿VJG&GOQETCVKE4GRWDNKEQHVJG%QPIQ CPF0KIGTKC¿GCEJTGRQTVGFVJGKTßTUV:&46$ECUG5GXGP #HTKECPEQWPVTKGUTGRQTVGFUVCTVKPI:&46$RCVKGPVUQP treatment in 2011 or 2012, most of them in South Africa. Treatment outcomes reported by South Africa reveal the very low likelihood of a favourable outcome in such patients and the high proportion of patients lost to or not evaluated by the health services (see Figure B4.2.1). 100 000 0 2009 2015 )CPFJK04/QNN#5VWTO#92CYKPUMK4)QXGPFGT6.CNNQQ7GVCN Extensively drug-resistant tuberculosis as a cause of death in patients co-infected with tuberculosis and HIV in a rural area of South Africa. The Lancet ¿ GLOBAL TUBERCULOSIS REPORT 2013 2010 2011 2012 2013 2014 2015 This requires the strengthening of laboratory capacity, the introduction of new rapid diagnostics and improved reporting from diagnostic centres (see Chapter 5). The identification of XDR-TB cases in countries worldwide (Box 4.2, Figure 4.4) reflects the risk of acquisition of additional second-line drug resistance and the transmission of resistant strains when TB care and prevention (including infection control) are inadequate. 0QVKßECVKQPQH/&46$ECUGUCPFGPTQNOGPV on treatment The low coverage of DST in many countries is one of the main constraints limiting the detection of MDR-TB among people diagnosed with TB. Globally, 83 715 cases of MDRTB were notified to WHO in 2012, with India, the Russian Federation and South Africa reporting more than a half of these cases (Table 4.3). In addition, just over 10 000 rifampicin-resistant TB (RR-TB) cases were reported to have been detected using rapid molecular techniques.1 India, Kyrgyzstan, the Philippines and Uzbekistan each reported >500 of such cases. The 83 715 reported cases of MDR-TB cases represented 28% of the 300 000 (range, 220 000–380 000) pulmonary TB patients estimated to have MDR-TB in 2012 (Table 4.3), up from 20% in 2011, and 19% of the 450 000 (range: 300 000‒600 000) estimated incident MDR-TB cases in the world in 2012. Much of the increase between 2011 and 2012 was accounted for by India (4237 to 16 588), South Africa (10 085 to 15 419)2 and Ukraine (4305 to 6934), although increases were reported by a total of 17 high MDR-TB burden countries and all WHO regions with the exception of the Region of the Americas. In the Democratic 1 2 52 150 000 50 000 0 2009 a 200 000 These are in addition to other rifampicin-resistant cases detected by Xpert MTB/RIF, which were included under MDR-TB notifications following subsequent testing for isoniazid resistance. In South Africa, the number of cases detected was above the estimated number of cases among pulmonary TB patients; this could reflect either that the estimates of the number of MDR-TB cases among TB patients are too conservative and/or the absence of linkages between the clinical and laboratory registers. TABLE 4.3 Estimated MDR-TB cases in 2012, notißed cases of MDR-TB and enrolments on MDR-TB treatment 2009–2012, and treatment outcome reporting for 2010 cohort, globally and for 27 high MDR-TB burden countries and WHO regions '56+/#6'&/&46$#/10)016+(+'& 27./10#4;6$%#5'5 BEST Armenia LOW NOTIFIED CASES HIGH 2009 250 220 #\GTDCKLCP 2 600 3 000 Bangladesh 4 200 3 100 5 200 Belarus 2 200 2 100 2 200 Bulgaria 156 1 342 2010 2011 /&46$%#5'5 4'2146'&9+6* 64'#6/'06176%1/' #%1*146 %#5'5'041..'&10/&46$64'#6/'06 2012 2012 NOTIFIED / ESTIMATED (%)a 177 79 92 37 552 596 21 339 509 513 12 1 576 1 594 1 604 73 2009 2010 134 352 2011 2012 %b N 154 101 132 75 592 406 263 339 390 513 329 97 200 1 446 1 442 91 100 100 130 43 56 55 49 49 43 56 42 36 56 59 000 52 000 66 000 474 2 792 1 601 3 007 5.1 1 222 1 155 1 906 1 222 44 2 900 670 5 100 91 121 65 2.2 176 191 179 105 121 70 56 63 62 63 75 54 64 102 Ethiopia 2 100 1 200 3 000 233 140 212 14 120 199 114 Georgia 630 570 690 369 359 475 346 55 266 737 665 504 140 64 000 49 000 79 000 1 660 2 967 4 237 26 1 136 2 967 14 143 74 6 900 5 200 6.2 20 142 260 426 140 77 China &4%QPIQ Estonia India Indonesia -C\CMJUVCP 9 000 3 644 3 209 5 705 5 261 7 213 5 777 -[TI[\UVCP 1 600 1 900 566 53 545 566 492 790 441 Latvia 120 100 140 131 105 110 92 124 103 110 101 Lithuania 300 270 330 322 310 296 271 90 322 310 296 271 310 100 Myanmar 6 000 4 600 7 500 192 690 13 64 192 163 442 Nigeria 3 600 2 700 4 500 21 95 107 3.0 0 23 125 23 110 Pakistan 11 000 0 29 000 49 444 344 1 602 15 424 344 1 045 195 44 Philippines 13 000 10 000 16 000 1 073 522 679 5.2 501 2 397 150 4GRWDNKEQH/QNFQXC 1 700 1 600 1 069 1 001 53 334 791 765 4WUUKCP(GFGTCVKQP 46 000 43 000 49 000 13 692 13 612 30 13 692 34 6 900 9 400 9 070 15 419 >100 4 143 5 402 5 643 6 494 66 910 1 000 319 333 604 694 76 52 245 535 245 74 Ukraine 6 500 7 000 5 336 4 305 6 934 >100 4 950 7 672 3 902 73 7\DGMKUVCP 4 000 3 700 4 300 654 1 023 43 464 1 491 61 Viet Nam 3 000 4 600 217 101 601 273 7.2 307 101 713 97 96 270 000 180 000 350 000 40 798 47 772 52 813 75 301 28 24 521 38 942 49 663 69 320 28 793 60 #(4 14 000 62 000 10 741 9 340 5 994 7 209 7 467 9 303 6 166 66 #/4 7 100 4 500 9 600 2 661 3 474 2 967 42 3 153 3 249 3 102 2 374 '/4 0 42 000 496 2 236 12 707 967 756 1 602 676 77 '74 74 000 60 000 33 776 34 199 50 17 169 36 313 42 399 19 496 5'#4 90 000 71 000 110 000 2 560 3 942 6 615 19 202 21 2 040 3 901 4 597 3 113 79 924 74 000 57 000 91 000 2 059 4 295 4 394 4 473 6.0 1 429 2 210 4 946 5 070 2 456 57 300 000 220 000 380 000 46 897 54 887 61 907 83 715 28 30 492 45 872 57 166 77 321 34 281 62 South Africa Tajikistan High MDR-TB burden countries Global – Blank cells indicate data not reported. – indicates values that cannot be calculated. 0QVKßGFECUGUQH/&46$KPCUCRGTEGPVCIGQHVJGDGUVGUVKOCVGQH/&46$ECUGUCOQPICNNECUGUQHRWNOQPCT[6$KPVJGUCOG[GCT6JGRGTEGPVCIGOC[GZEGGF KHGUVKOCVGUQHVJGPWODGTQH/&46$CTGVQQEQPUGTXCVKXGCPFKHNKPMCIGDGVYGGPVJGENKPKECNCPFNCDQTCVQT[TGIKUVGTUKUKPCFGSWCVG b 6JGRGTEGPVCIGQH/&46$ECUGUQTKIKPCNN[PQVKßGFKPYKVJQWVEQOGUTGRQTVGF6JGRGTEGPVCIGOC[GZEGGFCUCTGUWNVQHWRFCVGFKPHQTOCVKQPCDQWV/&46$ ECUGUKPKPCFGSWCVGNKPMCIGUDGVYGGPPQVKßECVKQPU[UVGOUHQT6$CPF/&46$CPFVJGKPENWUKQPKPVJGVTGCVOGPVEQJQTVQHECUGUQH/&46$ECUGUHTQOC[GCTRTKQTVQ 2010. a GLOBAL TUBERCULOSIS REPORT 2013 53 FIGURE 4.6 Number of MDR-TB cases estimated to occur among notißed pulmonary TB cases, 2012 MDR-TB cases 0–199 200–1999 2000–19 999 20 000–49 999 ≥ 50 000 No data Not applicable Republic of the Congo, the Philippines and Viet Nam, which detected less than 30% of their estimated burden in 2012, MDR-TB notifications decreased between 2011 and 2012. Of the MDR-TB cases reported globally in 2012, most (82%) were detected in either the European Region (36 708), India (16 588) or South Africa (15 419). Countries detecting close to 100% of the TB patients estimated to have MDR-TB in 2012 included Estonia, Kazakhstan, Latvia, Lithuania, South Africa and Ukraine (Table 4.3). In the African and European Regions and the Region of the Americas, about 50% of the TB patients estimated to have MDR-TB were detected in 2012. The lowest figures were in the two regions with the largest number of cases: the South-East Asia region (21%) and the Western Pacific Region (6%). India and China, the two countries estimated to have the largest numbers of TB patients with MDRTB (both over 50 000, Figure 4.6), strongly influence the overall figures for the South-East Asia and Western Pacific Regions. China and India, together with the Russian Federation – which ranks third globally in total cases of MDR-TB – detected and reported less than one third of the TB patients estimated to have MDR-TB (5%, 26% and 30% respectively). The absolute numbers of TB cases started on second-line treatment for MDR-TB increased from 30 492 in 2009 to 77 321 in 2012 (+154%). There was a 40% increase in enrolments between 2011 and 2012 in the 27 high MDR-TB burden countries, which reflected progress in 20 of these countries and especially in India, Kazakhstan and Ukraine (Table 4.3). The ratio of the numbers of patients starting treatment with second-line drug regimens for MDR-TB, to those notified with MDR-TB in 2012, was 92% globally 54 GLOBAL TUBERCULOSIS REPORT 2013 (82% when RR-TB cases are included), but was lower in the African (51%) and South-East Asia (83%) Regions (Table 4.3). Waiting lists of people requiring treatment for MDRTB are persisting or growing in several countries, particularly when additional RR-TB cases diagnosed using Xpert MTB/RIF are taken into account. Diagnosis:treatment gaps of 5% or more were evident in 14 of the high MDRTB burden countries in 2012 (Figure 4.7), and the ratio of MDR-TB cases diagnosed to enrolments on MDR-TB treatment increased by more than 10% between 2011 and 2012 in China, Pakistan and South Africa. The number of XDRTB cases reported worldwide increased from 1464 to 2230 between 2011 and 2012. All the WHO regions reported more XDR-TB cases enrolled on treatment in 2012 than in 2011, reaching 1557 globally in 2012. Common constraints to treatment scale up include a critical shortage of trained staff, insufficient availability of second-line medications, inadequate numbers of facilities for treatment and monitoring, incomplete diagnosis of patients and other weaknesses in the coordination of activities required for effective programmatic management of DR-TB. There is a global shortfall in capacity to place people diagnosed with MDR-TB on treatment, and increased resources for the programmatic management of MDR-TB are urgently required. In a few countries, such as Georgia, the Russian Federation and Ukraine, enrolments have outstripped notifications of MDR-TB in recent years. Possible explanations for this include frequent empirical treatment of TB patients considered at risk of having MDR-TB but for whom a laboratory-confirmed diagnosis is missing, incomplete report- FIGURE 4.7 MDR-TB cases (orange) and additional rifampicin-resistant TB cases (blue) detected compared with TB cases enrolled on MDR-TB treatment (green) 2009–2012, globally and in 27 high MDR-TB burden countries, 2009–2012 200 Armenia Azerbaijan 600 Bangladesh 2500 Belarus 800 2000 150 600 400 1500 100 400 1000 200 50 200 0 0 Bulgaria 500 0 China 60 3000 40 2000 0 DR Congo Estonia 200 100 80 150 60 100 40 20 1000 50 0 0 Ethiopia 0 Georgia 300 20 0 India Indonesia 800 500 15000 400 200 600 300 10000 200 100 400 5000 100 0 Number of cases 8000 200 Kazakhstan 0 1000 Kyrgyzstan 150 0 Latvia 350 330 750 6000 100 4000 500 2000 250 0 0 Lithuania 310 290 50 270 0 Nigeria Myanmar 800 250 Pakistan Philippines 2000 2500 1500 2000 1000 1500 500 1000 0 500 300 600 200 400 100 200 0 0 Russian Federation Republic of Moldova South Africa Tajikistan 20000 1100 800 15000 900 600 15000 10000 700 10000 500 300 5000 8000 Uzbekistan Ukraine 400 5000 200 0 0 2000 800 1500 600 1000 400 500 200 Viet Nam 100 000 Global 80 000 6000 60 000 40 000 4000 0 2000 2009 2010 2011 2012 2009 20 000 0 2010 2011 2012 2009 2010 2011 2012 0 2009 2010 2011 GLOBAL TUBERCULOSIS REPORT 2013 2012 55 BOX 4.3 Pharmacovigilance for TB care A PRACTICAL HANDBOOK ON THE PHARMACOVIGILANCE OF MEDICINES USED IN THE TREATMENT OF TUBERCULOSIS ENHANCING THE SAFETY OF THE TB PATIENT 2JCTOCEQXKIKNCPEGKUFGßPGFD[ 9*1CU ÄThe science and actiXities relatinI to the detection assessment understandinI and preXention of adXerse effects or any other druIrelated problem.” #FXGTUGFTWITGCEVKQPU #&4U ECP lead to a TB patient interrupting treatment before completion, thus contributing to avoidable morbidity, drug resistance, treatment failure, reduced quality of life, or death. It is important to routinely monitor VJGQEEWTTGPEGQH#&4UKP6$RCVKGPVUQPVTGCVOGPVKP062U This is particularly relevant in the care of patients with &46$CPFRCVKGPVUYJQCTG*+8RQUKVKXG 6JTGGCRRTQCEJGUVQRJCTOCEQXKIKNCPEGCTGKPWUG Spontaneous reporting. This involves the reporting of #&4U¿GIQVQVQZKEKV[CUUQEKCVGFYKVJCOKPQIN[EQUKFGU – to the national pharmacovigilance centre. Targeted spontaneous reporting. This is an extension of spontaneous reporting that can be focused on the UWTXGKNNCPEGQHUGTKQWUCFXGTUGGXGPVUKPURGEKßERCVKGPV ITQWRUUWEJCURCVKGPVUYKVJ/&46$ Cohort event monitoring (CEM). This is an active form of surveillance, similar in design and management to an epidemiological cohort study. CEM is particularly well suited to the post-marketing surveillance of new drugs. In 2012, WHO produced a handbook on pharmacovigilance for TB.a WHO offers technical assistance to countries for the introduction and strengthening of pharmacovigilance in their programmes. The handbook explains how pharmacovigilance can be effectively implemented in a TB programme through key stakeholders, including regulators and manufacturers, and provides a step-by-step approach to identifying signals, assessing the relationship between an event and a drug, determination of causality, acting on QDUGTXCVKQPUCPFEQOOWPKECVKQPQHßPFKPIU a # practical handbook on the pharmacoXiIilance of medicines used in the treatment of tuberculosis enhancinI the safety of the TB patient. )GPGXC9QTNF*GCNVJ1TICPK\CVKQP www.who.int/medicines/ RWDNKECVKQPURJCTOCEQXKIKNCPEGAVD). ing of laboratory data, or enrolment of ‘backlogs’ or waiting lists of MDR-TB patients who were detected before 2012. Among 119 countries reporting sex-disaggregated data for enrolments, the median male:female ratio was 2. Most countries that reported data on MDR-TB patient enrolments did not report the inclusion of any children. In the 44 countries that did, the proportion of children ranged from <1% to 33% of total enrolments. Many countries envisage increases in the number of patients enrolled on treatment for MDR-TB between 2013 and 2015. However, global projections remain well below Global Plan targets, partly as a result of slow rates of increase as well as incomplete information regarding forecasts, notably for China (2015) and the Russian Federation 56 GLOBAL TUBERCULOSIS REPORT 2013 (2013) (Figure 4.5b). To reach the targets set out in the Global Plan and advance towards universal access to treatment, a bold and concerted drive is still needed on many fronts of TB care, particularly in the countries where the burden is highest. The capacity to address this challenge has increased in recent years as a result of the intensified technical assistance provided by international organizations. With the reform of the Green Light Committee (GLC) structure in 2011, and the creation of regional level committees (rGLCs) in all six WHO regions, international support to national efforts to strengthen programmatic management of DR-TB is now focused on devolving available resources and technical assistance closer to countries. 4.2.3 Treatment outcomes for MDR-TB and XDR-TB Standardized monitoring methods and indicators have allowed countries to report MDR-TB treatment outcomes in a comparable manner for several years. In 2013, the definitions for treatment outcomes were simplified and the reporting requirements changed to allow for the inclusion of RR-TB cases in the MDR-TB cohort (Box 4.4). The number of cases reported in annual MDR-TB treatment outcome cohorts has tripled between 2007 and 2010, reflecting increases in all regions (Figure 4.8). All high MDR-TB burden countries have now reported treatment outcomes for at least one annual cohort since 2007. A total of 107 countries reported outcomes for more than 34 000 MDR-TB cases started on treatment in 2010 (Table 4.3). This is equivalent to 62% of the number of MDR-TB cases notified by countries in the same year. The low proportion reflects weaknesses in reporting systems to reconcile outcome data with notifications. The Global Plan envisages that by 2015, all countries will report outcomes for all notified MDR-TB cases. In 2010, only 71 countries – including 13 high MDR-TB burden countries – reported outcomes for a cohort whose size exceeded 80% of the original number of MDR-TB notifications in 2010. Overall, the proportion of MDR-TB patients in the 2010 cohort who successfully completed treatment was 48%, while 28% of cases were reported as lost to follow-up or had no outcome information. Treatment success was highest in the Eastern Mediterranean Region (56%), as well as in the Region of the Americas (54%) where this proportion has increased steadily since 2007 alongside a reduction in the proportion of patients whose treatment outcome was not evaluated. In the 2010 cohort, deaths were highest in the African Region (17%) and the proportion of patients whose treatment failed was highest in the European Region (11%). The Global Plan’s target of achieving at least 75% treatment success in MDR-TB patients by 2015 was only reached by 34/107 countries reporting outcomes for the 2010 cohort, but included three high MDR-TB burden countries: Bangladesh, Ethiopia and Viet Nam. Among a subset of 795 XDR-TB patients in 26 countries, treatment success was 20% overall and 44% of patients died; excluding South Africa, the figures were 27% and 28% respectively (Box 4.2). FIGURE 4.8 Treatment outcomes for patients diagnosed with MDR-TB by WHO region, 2007–2010 cohorts. The total numbers of cases with outcome data are shown beside each bar. Africa The Americas 2007 4 570 2007 1 458 2008 5 496 2008 1 732 2009 6 143 2009 2 298 2010 6 166 2010 2 374 Eastern Mediterranean Europe 2007 128 2007 4 097 2008 262 2008 6 904 2009 511 2009 12 131 2010 676 2010 19 496 South-East Asia Western Pacific 2007 253 2007 453 2008 413 2008 758 2009 1 140 2009 1 027 2010 3 113 2010 2 456 0% 20% 40% 60% 80% 100% Global 2007 10 959 2008 15 565 2009 23 250 2010 34 281 0% 20% 40% 60% 80% Cured Completed Died Treatment failed Lost to follow-up Not evaluated 100% Progressing towards the target for treatment success requires the scale up of treatment programmes globally, enhancing the effectiveness of drug regimens, support to patients to avoid treatment interruption and improved data collection. In particular, countries need to analyse the poor treatment outcomes observed in MDR-TB cases and intensify measures to improve adherence and monitoring. TB programmes need to apply a package of services for MDR-TB patients that include free TB and ancillary medications, free laboratory testing, enablers and social support, and the use of short treatment regimens following current WHO policy in selected patients. The treatment of XDR-TB patients in particular remains very unsatisfactory and more effective regimens for this condition are urgently required. 4.2.4 Other aspects of MDR-TB programme management During their illness, patients with MDR-TB may be cared for as either outpatients or within hospitals, usually secondary or tertiary facilities. WHO recommends that, where possible, patients with MDR-TB should be treated using ambulatory or community-based care rather than models of care based principally on hospitalization. National policies and practices differ in the predominant model of care that is employed. Among the high MDR-TB burden countries, the lowest level of hospitalization was reported by the Philippines (5% of MDR-TB patients), while levels in Eastern European countries ranged between 75 and 100% but were lower in Central Asia (30–50% in Kazakhstan, Tajikistan and Uzbekistan). In the African Region, there is wide variation in the extent to which GLOBAL TUBERCULOSIS REPORT 2013 57 patients with MDR-TB are hospitalized, ranging from 10% of patients (Democratic Republic of the Congo) to 100% (Ethiopia and Nigeria). Globally, the average duration of hospital stay ranged from 7 to 240 days (median: 84 days). The number of visits to a health facility after diagnosis of BOX 4.4 WHO deßnitions of treatment outcomes for RR-TB, MDR-TB and XDR-TB Cured Treatment completed as recommended by the national policy without evidence of failure AND three or more consecutive cultures taken at least 30 days apart are negative after the intensive phase. Treatment completed Treatment completed as recommended by the national policy without evidence of failure BUT no record that three or more consecutive cultures taken at least 30 days apart are negative after the intensive phase. Treatment failed Treatment terminated or need for permanent regimen change of at least two anti-TB drugs DGECWUGQH lack of conversion by the end of the intensive phase; or bacteriological reversion in the continuation phase after conversion to negative; or evidence of additional acquired resistance to àWQTQSWKPQNQPGUQTUGEQPFNKPGKPLGEVCDNGFTWIU QT adverse drug reactions. Died A patient who died for any reason during the course of treatment. Lost to follow-up A patient whose treatment was interrupted for two consecutive months or more. Not evaluated A patient for whom no treatment outcome is assigned (this includes cases ‘transferred out’ to another treatment unit and whose treatment outcome is unknown). Successfully treated The sum of cured and treatment completed. Cohort #ITQWRQHRCVKGPVUYJGTG446$JCUDGGP FKCIPQUGF KPENWFKPI/&46$CPF:&46$ CPFYJQYGTG UVCTVGFQPCHWNNEQWTUGQHCUGEQPFNKPG/&46$FTWI TGIKOGPFWTKPICURGEKßGFVKOGRGTKQF GIVJGEQJQTVQH /&46$ECUGUTGIKUVGTGFKPVJGECNGPFCT[GCT 6JKU group forms the denominator for calculating treatment QWVEQOGU9KVJVJGTGXKUGFFGßPKVKQPUany patient found to haXe druI-resistant TB and placed on second-line treatment is remoXed from the druI-susceptible TB outcome cohort. This means that management of the basic management unit TB register and of the second-line TB treatment register needs to be coordinated to ensure proper accounting of the outcomes of treatment. /QTGFGVCKNUQPVJGFGßPKVKQPQHEQPXGTUKQPTGXGTUKQPCPF the end of the intensive phase are provided in the WHO guidance.a a &eßnitions and reportinI framework for tuberculosis – 201 reXision 9*1*6/6$ )GPGXC9QTNF*GCNVJ1TICPK\CVKQP www. YJQKPVKTKUDKVUVTGCOAGPIRFH). GLOBAL TUBERCULOSIS REPORT 2013 MDR-TB also varies markedly among countries, from 30 or less (Bangladesh, the Democratic Republic of the Congo, Estonia, Pakistan, and Viet Nam) to over 600 (Bulgaria, Indonesia, Latvia, Tajikistan and Uzbekistan). Palliative and end-of-life care delivered through homebased or institutional services is fundamental to alleviate the suffering associated with MDR-TB, particularly in patients with advanced disease that is not responding to treatment. Only eleven high MDR-TB burden countries –10 in the European region plus South Africa – reported that they provided such care within the scope of their NTPs. When considered in the context of the poor outcomes reported in patients with MDR-TB and especially XDR-TB, this finding attests to the persistent, huge unmet need for palliative care services in countries with the largest burdens of drug-resistant TB. Among 18 high MDR-TB burden countries providing information on the quality of second-line drugs in the public sector in 2012, two countries reported that all of the drugs that they used conformed only to national regulatory norms. In the other 16 countries, most reported conformity to international standards for all supplies of kanamycin (11), capreomycin (9, with 2 other countries not using it), levofloxacin (10, with 1 other not using it), ethionamide/ prothionamide (12), cycloserine/terizidone (11) and p-aminosalicylic acid (10, with 2 others not using it). More information is required to adequately monitor TB patients on MDR-TB treatment than is needed for drugsusceptible TB. The definitions for monitoring of RR-TB and MDR-TB and their outcomes were revised in 2013 (see Chapter 3 and Box 4.4). The employment of electronic systems to manage patient data is therefore strongly encouraged. One of the Global Plan’s targets is that all 27 high MDR-TB countries manage their data on treatment of MDR-TB patients electronically by 2015. By 2012, 19 reported that national databases were in place for MDRTB patients (see Figure 2.16 in Chapter 2). These systems differ markedly from one country to another, varying from individual patient medical records accessible online to the periodic collation of records from registers across the country. Before introducing electronic systems to handle patient data, WHO recommends that NTPs undertake a detailed assessment of their needs and expectations and then try to match these with the best suited informatics solution. A fragmentary approach with parallel systems dealing with different programme components (for example, management of data for patients with drugsusceptible and drug-resistant TB in separate systems) should be avoided. Guidance on the design and implementation of electronic systems for recording and reporting data was produced by WHO and technical partners in 2012.1 4 Electronic recording and reporting for TB care and control. Geneva, World Health Organization, 2013 (WHO/HTM/TB/2011.22). %*#26'4 Diagnostics and laboratory strengthening KEY FACTS AND MESSAGES ■ The conventional laboratory tests for the diagnosis of TB, which have been used for decades, are sputum smear microscopy and bacterial culture. Diagnosis based on cultured specimens is the reference standard but results take weeks to obtain. Drug susceptibility testing (DST) on EWNVWTGUKUWUGFVQFGVGEVTGUKUVCPEGVQßTUVCPFUGEQPFNKPG TB drugs. ■ There have been important breakthroughs in TB FKCIPQUVKEUKPTGEGPV[GCTU+P9*1GPFQTUGFVJGßTUV rapid molecular test that can be used to simultaneously test HQTRWNOQPCT[6$CPFTKHCORKEKPTGUKUVCPEG:RGTV® MTB/ 4+(6JGUGPUKVKXKV[QHVJGVGUVKUOWEJDGVVGTVJCPUOGCT microscopy and is comparable to solid culture. In 2013, a review of the 2010 policy was initiated, to examine the substantial body of new evidence on the use and positioning QH:RGTV/6$4+(HQTVJGFKCIPQUKUQHRWNOQPCT[ extrapulmonary and paediatric TB. Updated guidance is expected in 2014. ■ :RGTV/6$4+(KUDGKPITCRKFN[CFQRVGFD[EQWPVTKGU $[VJGGPFQH,WPG)GPG:RGTVOCEJKPGUCPF OKNNKQP:RGTV/6$4+(ECTVTKFIGUJCFDGGPRTQEWTGF D[QHVJGEQWPVTKGUGNKIKDNGHQTEQPEGUUKQPCNRTKEGU Almost half (49%) of reporting low- and middle-income countries and territories indicated that WHO policy IWKFCPEGQP:RGTV/6$4+(JCFDGGPKPEQTRQTCVGFKPVQ VJGKTPCVKQPCNIWKFGNKPGU5QWVJ#HTKECKUVJGßTUVEQWPVT[VQ CFQRV:RGTV/6$4+(CUVJGRTKOCT[FKCIPQUVKEVGUVHQT6$ replacing smear microscopy. ■ Laboratory capacity to conduct high-quality sputum UOGCTOKETQUEQR[TGSWKTGUUKIPKßECPVUVTGPIVJGPKPI1PN[ 14 of the 22 HBCs met the target of having 1 microscopy EGPVTGRGTaRQRWNCVKQPKPCPFQPN[GKIJV reported a programme for external quality assessment that covered at least 95% of all centres in the country. ■ Globally, laboratory capacity to perform DST continues to be low and is not growing quickly enough to ensure that 6$RCVKGPVUYKVJ/&46$CTGRTQORVN[FKCIPQUGF(TQO 2009 to 2012, the percentage of new and previously treated TB patients receiving DST increased from 4% to 5% and HTQOVQTGURGEVKXGN[6JG':2#0&6$RTQLGEV which started in 2009 and has entered a phase of routine testing in 25 countries, shows how it is possible to introduce routine testing for drug resistance and achieve considerable KPETGCUGUKPVJGPWODGTQH/&46$ECUGUFGVGEVGF ■ The national reference laboratory of Uganda has become the newest member of the WHO/Global Laboratory Initiative ).+ 5WRTCPCVKQPCN4GHGTGPEG.CDQTCVQT[ 54. 0GVYQTM ßNNKPICETKVKECNIGQITCRJKECNICRKP'CUV#HTKEC The early, rapid and accurate detection of TB and drug resistance relies on a well-managed and equipped laboratory network. Laboratory confirmation of TB and drug resistance is critical to ensure that people with TB signs and symptoms are correctly diagnosed and have access to the correct treatment as soon as possible. The conventional laboratory tests for the diagnosis of TB, which have been used for decades, are sputum smear microscopy and culture. Diagnosis based on culture is the reference standard but results take weeks to obtain. Drug susceptibility testing (DST) on cultured specimens is the conventional method used to detect resistance to first- and second-line TB drugs. Following increased investments in TB research and development in the past decade (Chapter 8), there have been important breakthroughs in TB diagnostics. In 2008, rapid molecular tests (line probe assays, or LPAs) for detection of RR-TB and MDR-TB using positive sputum specimens or cultures were recommended by WHO. In 2010, the first rapid molecular test that can be used to simultaneously test for TB and rifampicin resistance, Xpert® MTB/RIF (Cepheid, Sunnyvale, CA, USA), was recommended for diagnosis of pulmonary TB and rifampicin resistance in adults. The sensitivity of the test is much better than smear microscopy and similar to solid culture.1 Although laboratories play a fundamental role in TB care and control, only 57% of the 4.6 million new pulmonary TB patients notified globally in 2012 were bacteriologically confirmed using a WHO-recommended diagnostic method. Low coverage of laboratory confirmation may result in people without TB needlessly being enrolled on TB treatment, while true TB cases are being missed. Furthermore, the 5.7 million incident (new and relapse) TB patients diagnosed and notified to NTPs in 2012 represent only 66% of the estimated 8.6 million incident TB cases globally. The gap reflects both underreporting of diagnosed TB cases and failure to diagnose cases at all; the latter can be attributed in part to weak laboratory capacity in many countries. Detection of TB without investigating for drug resistance can lead to poor treatment outcomes, additional and unnecessary suffering and costs for patients and further spread of drug-resistant strains. While there was a small increase between 2011 and 2012, only 5.1% of new cases and 8.7% of previously treated cases received DST in 2012. 1 Steingart KR et al. Xpert® MTB/RIF assay for pulmonary tuberculosis and rifampicin resistance in adults (Review). Cochrane Database of Systematic Reviews 2013, Issue 1. Art. No.: CD009593. 2013. GLOBAL TUBERCULOSIS REPORT 2013 59 Of the 300 000 cases of MDR-TB estimated to exist among notified TB patients with pulmonary TB in 2012 (i.e. the group of patients known to NTPs and that could be tested for drug resistance using WHO-recommended diagnostic tests), only 83 715 received a laboratory-confirmed diagnosis of MDR-TB and were notified in 2012. In addition, just over 10 000 RR-TB cases were detected using rapid molecular methods, though without results for isoniazid DST at the time of reporting. Given the large burden of undiagnosed DR-TB, strengthening DST capacity is a high priority for NTPs (see also Chapter 4). This chapter has three parts. Section 5.1 summarizes the key developments in WHO guidance on TB diagnostics and laboratory strengthening during 2012–2013. Section 5.2 provides the status of laboratory capacity globally, regionally and nationally based on data reported to WHO by countries in 2013. The focus is on the 36 countries in the combined list of 22 HBCs and 27 high MDR-TB burden countries. Innovative public–private mix (PPM) laboratory initiatives are highlighted as well. Section 5.3 describes recent achievements in strengthening TB laboratories, covering incorporation of WHO guidance into policy and practice at country level and the latest status of progress of two multinational projects (EXPAND-TB and TBXpert) that are helping to introduce new diagnostics. 5.1 Developments in WHO policy guidance on TB diagnostics and laboratory strengthening, 2012–2013 WHO follows a systematic process for policy development on TB diagnostics, involving synthesis of the available evidence through systematic reviews and meta-analyses where possible, assessment of the evidence by an external Expert Group using the GRADE approach,1 and development of policy guidance2 for dissemination to Member States and other stakeholders.3 Policy documents are reviewed every 3–5 years, and revised as necessary when new evidence becomes available. The first WHO policy guidance on the use of Xpert® MTB/RIF was issued in December 2010. The recommendations were that Xpert MTB/RIF should be used as the initial diagnostic test in individuals at risk of having MDRTB or HIV-associated TB (strong recommendation), and that Xpert MTB/RIF could be used as a follow-on test to microscopy in settings where MDR and/or HIV is of lesser concern, especially in smear-negative specimens (this was a conditional recommendation, recognizing major resource implications). The 2010 recommendations applied to the use of Xpert MTB/RIF in sputum specimens only, as data on its performance (sensitivity and specificity) for testing of extrapulmonary specimens at that time were limited. The recommendations applied to children, but only based on generalization of data from adults. Following rapid uptake of Xpert MTB/RIF (see section 5.2), a substantial body of new evidence had been generated by 2013.4 This included much more data about the test’s performance characteristics (sensitivity and specificity) in 60 GLOBAL TUBERCULOSIS REPORT 2013 a wide range of laboratory and epidemiological settings, additional data on test accuracy in detection of extrapulmonary and paediatric TB, and more evidence about affordability and cost-effectiveness from early implementers in a limited number of settings. WHO therefore embarked on a review of policy guidance in 2013. Three systematic reviews were commissioned on the sensitivity and specificity of Xpert MTB/RIF for the diagnosis of pulmonary and extrapulmonary TB and RR-TB, in adults and children. A review of published studies on the affordability and cost-effectiveness of Xpert MTB/RIF was also conducted. An Expert Group convened by WHO met in May 2013 to review the expanded body of evidence, according to GRADE procedures. Based on the outcomes of the review and the recommendations of the Expert Group, which were also supported by WHO’s Strategy and Technical Advisory Group for TB (STAG-TB) in June 2013, updated WHO policy guidance was under development at the time that the current report went to press. Upon finalization, the recommendations are expected to have a major impact on further country adoption of Xpert MTB/RIF into diagnostic and clinical algorithms. Several other new TB diagnostic tests are on the horizon, in various stages of research and development (see Chapter 8). Once data on their performance are available in varying epidemiological settings, WHO will be in a position to evaluate their performance and develop corresponding policy guidance. A comprehensive list of existing WHO policy documents, including those on the use of microscopy, culture, DST and non-commercial and molecular methods, can be found at: http://www.who.int/tb/laboratory/policy_ statements In addition to diagnostics, WHO also develops guidance in other areas of laboratory strengthening. In 2013, the WHO Tuberculosis laboratory biosafety manual was issued, featuring a risk-based approach that guides the essential biosafety measures required for performing different technical procedures. The manual describes the combination of good laboratory practices together with administrative controls, containment principles, safety equipment and laboratory facilities that are required to minimize the generation of infectious aerosols and thus prevent laboratory-acquired infections. The risk-based approach to laboratory biosafety is framed around a threetiered system of ‘low’, ‘moderate’ and ‘high’ TB risk precautions: 1 2 3 4 www.gradeworkinggroup.org WHO handbook for guideline development. Geneva, World Health Organization, 2012. WHO policies on TB diagnostics are available at: www.who.int/tb/ laboratory/policy_statements Weyer K et al. Rapid molecular TB diagnosis: evidence, policy-making and global implementation of Xpert® MTB/RIF. European Respiratory Journal. November 22, 2012, doi: 10.1183/09031936.00157212 Low TB risk precautions. These apply to direct acid-fast bacilli (AFB) microscopy and to Xpert MTB/RIF. Moderate TB risk precautions. These apply to the processing of sputum specimens for primary culture inoculation, direct testing (i.e. on sputum smear-positive samples) using direct non-commercial drug susceptibility assays and LPAs. High TB risk precautions in TB containment laboratories. These apply to procedures used to manipulate cultures (solid and liquid) for identification and DST, and for indirect testing (i.e. on culture isolates) using LPA and non-commercial DST. 5.2 Status of laboratory capacity globally, regionally and nationally Diagnosis of TB in most low- and middle-income countries still relies on low-cost sputum smear microscopy, despite its relatively low sensitivity and inability to detect drug resistance. The Global Plan to Stop TB 2011–2015 includes the target that countries maintain at least one smear microscopy centre per 100 000 population. Globally the target has been met (1.1 centres per 100 000 population in 2012), but considerable disparities remain at regional and country levels (Table 5.1). Eight of the 22 HBCs did not meet the target in 2012: Bangladesh, China, Myanmar, Nigeria, Pakistan, the Russian Federation, South Africa and Viet Nam. Overall, the Western Pacific and Eastern Mediterranean Regions had less than one centre per 100 000 population. Given the continued critical role of microscopy in TB detection and monitoring of treatment, ensuring high-quality performance of smear microscopy is essential. Of the 153 countries and territories that reported data on the number of smear microscopy centres in 2012, only 39% indicated the existence of an external quality assessment programme that covered all centres in the country. Among the 22 HBCs, only three reported such a programme that encompassed all centres in 2012 (Bangladesh, India and Viet Nam), five reported a programme that included at least 95% of centres (Cambodia, China, Myanmar, the Russian Federation and South Africa), and 14 reported a programme that included at least 80% of centres. In 2009, WHO recommended the use of the more sensitive fluorescent light-emitting diode (LED) microscopy as a replacement for traditional Ziehl–Neelsen (ZN) microscopy. Globally the switch to LED microscopes has been gradual, and they were reported to be present in only 2% of microscopy centres in 2012. Overall in 2012, the African Region was the most advanced in rolling out LED microscopes (6% of microscopy centres), led by South Africa where 97% of microscopy centres were reported to have them. Other HBCs in the African Region have shown significant increases in uptake from 2011 to 2012, including the United Republic of Tanzania (3% to 17% of microscopy centres) and Mozambique (<1% to 9%). The current target in the Global Plan to Stop TB 2011– 2015 for both culture and DST (to at least rifampicin and isoniazid) capacity is one laboratory per 5 million popu- lation. In 2012, 14 of the 27 high MDR-TB burden countries did not reach the target (Table 5.1; there were two additional countries that did not report data). Of these 27 countries, 9 reported more than one laboratory per 5 million population using LPAs – a high-throughput molecular tool that can be used at central and regional levels to rapidly detect resistance to rifampicin and, in some cases, isoniazid. The nine countries comprise eight European countries and South Africa. Of the 147 countries and territories that reported numbers of laboratories with capacity to perform DST, 22 indicated that such capacity did not exist in 2012. While countries and territories with small TB patient populations may find it more practical to send specimens to neighbouring countries for DST than to establish national capacity, countries with larger patient populations should aim as a priority to build sustainable DST capacity in-country to allow timely diagnosis of drug-resistant strains. Eight countries reported more than 1000 notified TB cases in 2012 yet reported having no capacity to perform DST: Afghanistan, Chad, Eritrea, Guinea-Bissau, Liberia, Papua New Guinea, Sierra Leone and Somalia. Quality-assured DST is critical to ensure accurate detection of drug resistance for subsequent treatment decisions and to avoid false diagnoses. Of the high TB and MDR-TB burden countries that reported on external quality assessment coverage of DST laboratories (34 of 36), 27 (79%) reported having a scheme that encompassed all DST laboratories. Of the 117 countries globally that reported on external quality assessment coverage of DST laboratories, 70% (82 countries) reported such a scheme. Given its high sensitivity to detect TB and rifampicin resistance together with its ability to be placed at relatively low levels of laboratory networks, Xpert MTB/RIF has been rapidly adopted by countries. By the end of June 2013, 3.2 million test cartridges and 1402 GeneXpert machines (comprising 7553 machine modules) had been procured in 88 of the 145 countries eligible to purchase machines and cartridges at concessional prices (Figure 5.1).1 The current price per cartridge is US$ 9.98, following a novel financing agreement reached in August 2012 between the manufacturer and the United States Agency for International Development (USAID), the United States President’s Emergency Plan for AIDS Relief (PEPFAR), UNITAID and the Bill & Melinda Gates Foundation. South Africa alone accounts for 43% of the modules and 60% of the cartridges procured globally, and is aiming to position Xpert MTB/RIF as a replacement for microscopy for the diagnosis of TB. After South Africa, leading procurers include India, Pakistan, Zimbabwe and Nigeria. The complete or partial replacement of microscopy by Xpert MTB/RIF as the initial diagnostic test and the increasing number of rifampicin-resistant cases being detected by Xpert MTB/RIF will require adjustment of countries’ smear, culture and DST capacities going forward. 1 http://www.who.int/tb/laboratory/mtbrifrollout/ GLOBAL TUBERCULOSIS REPORT 2013 61 TABLE 5.1 Laboratory capacity, 2012a 5/'#4/+%415%12; 2'4%'06#)'1( .#$14#614+'5 USING LED /+%415%12'5 07/$'41( .#$14#614+'5 .#$14#614+'52'4 5 MILLION POPULATION 07/$'4 OF .#$14#614+'5 Afghanistan 603 2.0 2 2 0.3 0 0 0 0 1 Armenia 30 1.0 0 1 1.7 1 1.7 1 1.7 0 #\GTDCKLCP 72 4 7 3 1.6 1 0.5 7 Bangladesh 1 070 0.7 2 3 3 1 12 Belarus 196 2.1 2 29 15 4.3 4.3 $TC\KN 4 000 2.0 – 220 Bulgaria 34 0.5 0 31 Cambodia 214 1.4 10 3 5.5 .#$14#614+'5 2'4/+..+10 POPULATION 07/$'4 OF LABO4#614+'5 .#$14#614+'5 2'4/+..+10 POPULATION :2'46 /6$4+( HIGH /&46$ $74&'0 NO .#$14#614+'5 2'4 POPULATION .+0'241$'#55#; HIGH TB $74&'0 ;'5 07/$'4 1(.#$14#614+'5 &47)575%'26+$+.+6; TESTING %7.674' 07/$'4 OF SITES 35 0.9 0.2 13 14 9.6 4 2.7 0 1.0 1 0.3 0 0 6 21 China 0.2 2 1 014 3.7 190 0.7 21 16 &4%QPIQ 1 522 2.3 4 0.3 2 0.2 1 26 Estonia 5 0.4 100 2 7.7 2 7.7 2 7.7 2 Ethiopia 2 531 0 5 0.3 1 5 0.3 7 Georgia 11 0.3 9 2 2.3 1 1.1 2 2.3 1 India 1.1 2 70 0.3 0.2 33 0.1 32 Indonesia 5 566 2.3 0 46 0.9 5 0.1 2 9 -C\CMJUVCP 466 2.9 0 22 22 11 3.4 4 Kenya 4.2 2 0.2 2 0.2 2 0.2 15 -[TI[\UVCP 122 2.2 0 11 3 2.7 2 7 16 0 4 1 2.4 1 2.4 2 – – 1.2 9 3 0.6 2 10 Latvia Lithuania /Q\CODKSWG Myanmar 0.9 14 2 0.2 Nigeria 1 314 2 5 0.1 300 9.7 – – – 0.4 0 0 12 2 0.2 2 0.2 3 3 4 0.1 32 Pakistan 7 0.2 4 0.1 2 15 Philippines 2 565 2.7 13 0.7 3 0.2 1 17 4GRWDNKEQH/QNFQXC – – 4WUUKCP(GFGTCVKQP 1 031 0.7 – 117 4.1 110 South Africa 0.4 97 15 1.4 15 1.4 – – – – 15 1.4 100 Tajikistan 1.1 4 3 1.9 1 0.6 1 0.6 3 Thailand 1.6 6 65 4.9 1.3 12 0.9 14 Uganda 1 152 3.2 4 0.6 4 0.6 4 0.6 25 Ukraine 5 9.4 41 4.5 0 0 15 746CP\CPKC 945 2.0 17 4 0.4 1 0.1 3 0.3 13 7\DGMKUVCP 291 1.0 1 7 1.2 3 0.5 3 0.5 7 Viet Nam 0.9 25 1.4 2 0.1 2 0.1 22 95% of total funding per year) meant that domestic funding dominated total funding for TB globally (88–92% per year). International donor funding in the 104 countries included in trend analyses grew from US$ 0.2 billion in 2002 to US$ 0.5 billion in 2011. There was striking variation among country groups in terms of the share of total funding provided from international donor sources. By 2011, donor funding represented 39% of total funding in the 17 HBCs excluding BRICS, which account for about one third of the world’s TB cases; 42% of funding in African countries excluding South Africa; and 67% of total funding in lowincome countries (25 of which are in Africa). The Global Fund accounted for 64% of all donor funding reported by countries during the decade 2002–2011. Most funding was used for the diagnosis and treatment of drug-susceptible TB (over 85% each year). Small amounts were used for diagnosis and treatment of MDRTB, although funding started to increase in BRICS, upper middle-income countries, and countries in Europe and Latin America around 2006. Despite growth in funding from domestic and international donor sources, NTPs were not able to mobilize all the funding that they estimated to be needed. Funding gaps (i.e. the difference between assessments by NTPs of funding needs for TB prevention, diagnosis and treatment and the actual amount of funds mobilized) persisted, and increased from US$ 257 million in 2002 to US$ 563 million in 2011. It should be noted that the funding gaps reported by NTPs are sometimes based on relatively conservative assessments of funding needs. When national strategic plans with more TABLE 7.1 125 countries included in analyses of TB ßnancing in 2013a,b LOW-INCOME QHPQVKßGFECUGUINQDCNN[ b 722'4/+&&.'+0%1/' QHPQVKßGFECUGUINQDCNN[ $4+%5 QHPQVKßGFECUGU globally) *+)*$74&'0%17064+'5 ':%.7&+0)$4+%5 QHPQVKßGFECUGU globally) African Benin, Burkina Faso, Burundi, Central #HTKECP4GRWDNKE Chad, Comoros, &4%QPIQ'TKVTGC Ethiopia, Gambia, Guinea, GuineaBissau, Kenya, Liberia, Madagascar, Malawi, /CNK/Q\CODKSWG 0KIGT4YCPFC Sierra Leone, Togo, 7ICPFC746CP\CPKC 500 μL is proportional to F (it was assumed that it was higher by a factor of 2.52). For each 100 μL CD4 decline in the remaining categories (350–499, 250–349, 200–249, 100–199, GLOBAL TUBERCULOSIS REPORT 2013 50–99 CD4 cells/μL, and CD4 count less than 50 cells μL), the risk of infection is represented as: F(c<500) = F(c>500)∙p(1)∙p(2)dc, where p(1) is a parameter that is used to recognize that people living with HIV who have high CD4 counts could be at higher risk of TB infection relative to those who are HIV-negative, and p(2) controls the exponential increase in RR that occurs with CD4 decline. dc is the number of 100μL CD4 decline associated with the midpoint of each CD4 category relative to 500: dc= (3.0, 4.4, 8.6, 12.9, 19.2, 28.6, 37.3) for the six CD4 categories. A reduction in RR is applied for those who have been on ART for more than one year. Parameter assumptions To match total TB incidence and estimates of the number of HIV-positive TB cases from HIV testing data where available, it was assumed that p(1)=2.5 and p(2) was fitted accordingly. In the RR-approach, the ‘biological meaning’ that should be attached to the parameters and a more straightforward interpretation of these parameters as regression coefficients need to be balanced. Both parameters can be fitted or both can be fixed. Varying at least p(2) captures the variation among countries that is expected due to variation in the baseline (HIV-negative) CD4 count, and it strikes a balance between the biological and regression mechanisms. The RR model approach to estimation of TB incidence was used for people on ART. Although an estimate of TB incidence among people on ART could be obtained from surveillance data reported to WHO (such that it is arguably not necessary to use the RR model), limitations of the ART data (in particular that some countries appear to report cumulative totals of people on ART) meant that the RR approach needed to be used. Hazard ratios (HR) of 0.35 were assumed for all CD4 at ART initiation categories. Suthar et al have reported HRs of 0.16, 0.35 and 0.43 for those on ART with CD4 count < 200, 200–350 and > 350,3 and these values could in principle be used. However, Spectrum tracks only CD4 at initiation, thus limiting the use of CD4-specific HRs for people on ART. It was further assumed that the HR of 0.35 applies only to patients on ART for more than six months. Spectrum’s ART-mortality estimates, derived mostly from ART cohorts in Sub-Saharan Africa, suggest that mortality remains very 1 2 3 Williams B. The impact of ART for HIV on TB. http://www.who.int/ hiv/topics/artforprevention/williams.pdf (accessed July 2013). Sonnenberg P, et al. How Soon after Infection with HIV Does the Risk of Tuberculosis Start to Increase? A Retrospective Cohort Study in South African Gold Miners. Journal of Infectious Diseases. 2005 Jan 15;191(2):150–8. Suthar AB, Lawn SD, del Amo J, Getahun H, Dye C, et al. (2012) Antiretroviral Therapy for Prevention of Tuberculosis in Adults with HIV: A Systematic Review and Meta-Analysis. PLoS Med 9(7): e1001270. doi:10.1371/journal.pmed.1001270 high in the first six months of ART. Since TB is a leading contributor to mortality among HIV-positive people, it was judged that the HR for patients on ART for 0‒6 months is likely to remain high; therefore, a reduction factor due to ART was not applied for this subset of patients. TABLE A1.5 Sources of data on HIV prevalence among incident TB cases &+4'%6/'#574'/'061(6*'24'8#.'0%'1(*+8+06$2#6+'065 National surveysa A simple least squares approach was used to fit the model to total TB incidence, and to all available estimates of TB incidence among people living with HIV. These estimates of TB incidence among people living with HIV were obtained by three sampling methods: population surveys of the prevalence of HIV among TB cases (least biased, but scarce due to logistical constraints), sentinel HIV data (biases include more testing of people with advanced HIV-related disease) and routine HIV testing of reported TB patients (variable coverage). To increase the influence of survey data, replicas of the survey data were included in the likelihood function. In other words, for years for which data from HIV testing were available, identical copies of the HIV-test data were added to the likelihood function. The estimate of total TB incidence was based on much more data, evenly spread out in the estimation period 1990–2015. Model testing showed that using two replicates of the HIV survey data (i.e. duplicating the survey data) and two replicates of the routine testing data with coverage greater than 90% was the best approach to disaggregating TB incidence: the fit passed close to the survey or highcoverage routine testing data points that were available. For each of a) HIV sentinel and b) routine testing with coverage between 50–90%, data were not used. A prototype Bayesian importance sampling (IMIS) algorithm was developed to handle complex data weighing possibilities, but it was based on subjective priors and likelihood functions and is more time-consuming to run than simple least squares. For the purposes of producing estimates for all countries automatically, the least squares method was used. In future, least squares and IMIS fitting could be made available to the end user. For countries with no data, a range for p(2) was estimated from countries with survey or testing data, which suggest that p(2) = 1.96 [1.8–2.1]. The RR-model was then fitted to total TB incidence only. There is no satisfactory way to verify results for TB incidence among people living with HIV when no HIV-testing data are available. However, comparison of the global estimate for TB incidence among people living with HIV produced by Spectrum and estimates previously published by WHO (based on a different method using HIV prevalence instead of CD4 distributions and using HIV-test data in a different way) suggests that the RR-model works reasonably well. Provider-initiated testing and counselling with at least 50% HIV testing coverage is the most widely available source of information on the prevalence of HIV in TB patients. However, this source of data is affected by biases, particularly when coverage is closer to 50% than to 100%. In all countries with repeat data from testing, the relation- 124 HIV sentinel surveillance Likelihood function a 07/$'41(%17064;;'#45 24 Provider-initiated testing and counselling with at least 50% coverage of testing 1297 Total, at least one data source available 1322 the reported survey number is over-stated as a number of country reports confused survey and routine testing with near 100% coverage ship between the prevalence of HIV in TB patients and the coverage of HIV testing was examined graphically. In some countries, the prevalence of HIV in TB patients was found to decrease with increasing HIV testing coverage while in others it increased with increasing HIV testing coverage; in most countries, the prevalence of HIV followed highly inconsistent patterns (with repeat changes in direction) as HIV testing coverage increased. Therefore, it was not possible to adjust for the effect of incomplete coverage of HIV testing on estimates of the prevalence of HIV among TB patients. The assumption was thus made that TB patients with an HIV test result were statistically representative of all TB cases. As coverage of HIV testing continues to increase globally, biases will decrease. For the 1003 country-year data points corresponding to countries for which no surveillance data were available, the prevalence of HIV was estimated indirectly according to the following equation: t= hl l + h(l – l) In this equation, t is HIV prevalence among incident TB cases, h is HIV prevalence among the general population (from the latest time-series provided by UNAIDS) and ρ is the incidence rate ratio (IRR) (defined as the incidence rate of TB in HIV-positive people divided by the incidence rate of TB in HIV-negative people). We then let logit(t) be log(t/ (1-t)) and logit(h) be log(h/(1-h)). Using data from countries where HIV prevalence has been estimated by UNAIDS as an independent variable, a linear model of logit-transformed t was fitted using logit-transformed h according to the following equation, written in matrix notation: T̂Xβ where T̂ is a vector of predicted logit(t), X is an n x 2 matrix in which the first column holds 1s, and the second column holds logit(h). The vector β holds estimated model parameters. Models were tested with lags set for logit(h) ranging from no lag to a lag of eight years. The best fit was obtained with a lag of one year. Models were run using Monte Carlo simulations in which h was drawn randomly from a Beta distribution with shape parameters computed as described in Section 4.1, (low and high uncertainty bounds are provided by UNAIDS – also see Table A1.5). The model was run 50 000 times GLOBAL TUBERCULOSIS REPORT 2013 109 using country-specific distributions for H and T (noted in capital letters to denote vectors or matrices) based on their uncertainty intervals. The uncertainty bounds for β were chosen as the 2.5th and 97.5th centiles. 5. Estimates of TB prevalence, 1990–2012 The best way to measure the prevalence of TB is through national population-based surveys of TB disease.1,2 Data from such surveys are available for an increasing number of countries (Chapter 2). It should be noted, however, that measurements of prevalence are typically confined to the adult population. Furthermore, prevalence surveys exclude extrapulmonary cases and do not allow the diagnosis of cases of culture-negative pulmonary TB. When there is no direct measurement from a national survey of the prevalence of TB disease, prevalence is the most uncertain of the three TB indicators used to measure disease burden. This is because prevalence is the product of two uncertain quantities: (i) incidence and (ii) disease duration. The duration of disease is very difficult to quantify because it cannot be measured during surveys of the prevalence of TB disease (surveys truncate the natural history of disease). Duration can be assessed in self-presenting patients, but there is no practical way to measure the duration of disease in patients who are not notified to NTPs. Indirect estimates of prevalence were calculated according to the following equation: P= - Ii,j d i,j , iD{1,2}, jD{1,2} where the index variable i denotes HIV+ and HIV–, the index variable j denotes notified and non-notified cases, d denotes the duration of disease in notified cases and I is total incidence. In the absence of measurements, we did not allow duration in notified cases to vary among countries. Given their underlying uncertainty, prevalence estimates should be used with great caution in the absence of direct measurements from a prevalence survey. Unless measurements were available from national programmes (for example, Turkey), assumptions of the duration of disease were used as shown in the last four rows of Table A1.3. 6. Estimates of the number of cases of and deaths from MDR-TB 2TQRQTVKQPQHPQVKßGFECUGUQH6$VJCVJCXG MDR-TB, 2012 Global and regional estimates of the proportion of new and retreatment cases of TB that had MDR-TB in 2012 were calculated using country-level information. If countries had reported data on the proportion of new and retreatment cases of TB that have MDR-TB from routine surveillance or a survey of drug resistance the latest available information was used. For countries that have not reported such data, estimates of the proportion of new and retreatment cases of TB that have MDR-TB were produced using modelling (including multiple imputation) that was based on data from countries for which data do exist. Estimates for countries without data were based on countries that were 110 GLOBAL TUBERCULOSIS REPORT 2013 considered to be similar in terms of TB epidemiology (for country groups see Appendix 1). The observed and imputed estimates of the proportion of new and retreatment cases of TB that have MDR-TB were then pooled to give a global estimate, with countries weighted according to their share of global notifications of new and retreatment cases. 6.2 MDR-TB mortality, 2012 The VR mortality data reported to WHO by Member States does not differentiate between MDR-TB and non-MDR-TB as a cause of death (there is no specific ICD-9 or ICD-10 codes for MDR-TB, although countries such as South Africa have allocated two specific codes U51 and U52 to classify deaths from MDR-TB and XDR-TB respectively).3 Therefore, a systematic review and meta-analysis of the published literature was undertaken to estimate the relative risk of dying from MDR-TB compared with non MDR-TB. The global estimate of MDR-TB deaths (Box 2.3) was then based on the following formula: m = M.p.r Where: m = global MDR-TB mortality, M = global TB mortality, p = overall proportion of MDR-TB among prevalent TB cases, approximated by the weighted average of the proportion of new and retreated cases that have MDRTB, r = the relative risk of dying from MDR-TB versus nonMDR-TB. 6.3 Numbers of incident cases of MDR-TB, 2012 The global estimate of MDR-TB incidence was calculated as the addition of three groups of MDR-TB incident cases: 1. incident MDR-TB among new pulmonary and extra-pulmonary incident TB cases, using the proportion of MDR-TB among new cases from drug resistance surveillance (DRS); 2. incident MDR-TB among relapses, using the proportion of MDR-TB among new cases from DRS and the estimated relative risk of MDR among relapse versus new cases; and 3. incident MDR-TB among retreated cases that are not relapses, which was assumed to follow a uniform distribution with min=0, max=upper limit of the global proportion of MDR-TB among retreated cases estimated from DRS. A second method to estimate global MDR-TB incidence was also explored, in which the global estimate of mortality due 1 2 3 Glaziou P et al. Tuberculosis prevalence surveys: rationale and cost. International Journal of Tuberculosis and Lung Disease, 2008, 12(9):1003–1008. TB prevalence surveys: a handbook. Geneva, World Health Organization, 2011 (WHO/HTM/TB/2010.17). Mortality and causes of death in South Africa, 2010: Findings from death notification. http://w w w.statssa.gov.za /publications/ p03093/p030932010.pdf to MDR-TB was divided by the estimated case fatality ratio (CFR) among cases of MDR-TB. The CFR was calculated as a weighted average of the case fatality ratio among patients that are treated and those that are not, according to the following formula: 4 = pt * 4t + (1-pt)*4un Where: pt = proportion treated, approximated by the proportion of enrolled MDR-TB patients on treatment out of those estimated to exist among notified TB patients with pulmonary TB; 4t = case fatality rate among patients treated for MDR-TB, using treatment outcome data for MDR-TB patient cohorts; 4un = case fatality rate among people with MDR-TB who are not treated, which was assumed to follow a uniform distribution with min=0.4, max=0.6. Outputs from both methods gave similar best estimates of MDR-TB incidence with largely overlapping confidence intervals. 6.4 Resistance to second-line drugs among patients with MDR-TB Data from 75 countries were used to produce global estimates of the following proportions: (i) patients with MDRTB who had XDR-TB; (ii) patients with MDR-TB who had fluoroquinolone resistance; (iii) patients with MDR-TB who had resistance to second-line injectable drugs and fluoroquinolones but not XDR-TB. The latest available national and subnational data from each country were analysed using logistic regression models with robust standard errors to account for the clustering effect at the level of the country or territory. The analysis was limited to countries in which more than 66% of MDR-TB cases received second-line DST. 7. Projections of incidence, prevalence and mortality up to 2015 Projections of TB incidence, prevalence and mortality rates up to 2015 enable assessment of whether global targets set for 2015 are likely to be achieved at global, regional and country levels. Projections for the years 2013–2015 were made using exponential smoothing models fitted to data from 2006–2012. 8. Estimation of uncertainty There are many potential sources of uncertainty associated with estimates of TB incidence, prevalence and mortality, as well as estimates of the burden of HIV-associated TB and MDR-TB. These include uncertainties in input data, in parameter values, in extrapolations used to impute missing data, and in the models used. We used fixed population values from the UNPD. We did not account for any uncertainty in these values. Notification data are of uneven quality. Cases may be underreported (for example, missing quarterly reports from remote administrative areas are not uncommon), misclassified (in particular, misclassification of recurrent cases in the category of new cases is common), or overreported as a result of duplicated entries in TB information systems. The latter two issues can only be addressed efficiently in countries with case-based nationwide TB databases that include patient identifiers. Sudden changes in notifications over time are often the result of errors or inconsistencies in reporting, but may sometimes reflect abrupt changes in TB epidemiology (for example, resulting from a rapid influx of migrants from countries with a high burden of TB, or from rapid improvement in case-finding efforts). Missing national aggregates of new and recurrent cases were imputed by interpolation. Notification trajectories were smoothed using a penalized cubic splines function with parameters based on the data. Attempts to obtain corrections for historical data are made every year, but only rarely do countries provide appropriate data corrections. Mortality estimates incorporated the following sources of uncertainty: sampling uncertainty in the underlying measurements of TB mortality rates from data sources, uncertainty in estimates of incidence rates and rates of HIV prevalence among both incident and notified TB cases, and parameter uncertainty in the Bayesian model. Time series of TB mortality were generated for each country through Monte Carlo simulations. Unless otherwise specified, uncertainty bounds and ranges were defined as the 2.5th and 97.5th centiles of outcome distributions. Throughout this report, ranges with upper and lower bounds defined by these centiles are provided for all estimates established with the use of simulations. When uncertainty was established with the use of observed or other empirical data, 95% confidence intervals are reported. The model used the following sequence: (1) Overall TB incidence estimation after review and cleaning of case notification data; (2) cleaning and adjustment of raw mortality data from VR systems and mortality surveys, followed by imputation of missing values in countries with VR or survey data – in some countries, step 1 was updated to account for mortality data; (3) cleaning of measurements of HIV prevalence among TB patients followed by estimating HIV-positive TB incidence using the Spectrum programme and HIV-positive TB mortality; (4) estimation of HIV prevalence among incident cases of TB through modelling in countries with no measurements; (5) estimation of HIV-negative TB mortality in countries with no VR data followed with an update of step 1 in some countries; (6) review of prevalence measurements, adjustments for childhood TB and bacteriologically unconfirmed TB, and estimation of prevalence followed with an update of step 1 in some countries; (7) estimation of incidence and mortality disaggregated by age and sex and disaggregated by drug resistance status. The general approach to uncertainty analyses was to draw values from specified distributions for every param- GLOBAL TUBERCULOSIS REPORT 2013 111 eter (except for notifications and population values) in Monte Carlo simulations, with the number of simulation runs set so that they were sufficient to ensure stability in the outcome distributions. For each country, the same random generator seed was used for every year, and errors were assumed to be time-dependent within countries (thus generating autocorrelation in time series). Regional parameters were used in some instances (for example, for CFRs). Summaries of quantities of interest were obtained by extracting the mean, 2.5th and 97.5th centiles of posterior distributions. Wherever possible, uncertainty was propagated analytically by approximating the moments of functions of random variables using Taylor expansions – such as when taking the product or the ratio of two random variables – rather than through Monte Carlo simulations, in order to shorten computing time. High-income countries: Andorra, Aruba, Australia, Austria, the Bahamas, Bahrain, Barbados, Belgium, Bermuda, Brunei Darussalam, Canada, the Cayman Islands, China, Hong Kong SAR, China Macao SAR, Croatia, Cyprus, the Czech Republic, Denmark, Equatorial Guinea, Estonia, Finland, France, French Polynesia, Germany, Greece, Greenland, Guam, Hungary, Iceland, Ireland, Israel, Italy, Japan, Kuwait, Luxembourg, Malta, Monaco, the Netherlands, the Netherlands Antilles, New Caledonia, New Zealand, Northern Mariana Islands, Norway, Oman, Poland, Portugal, Puerto Rico, Qatar, the Republic of Korea, Saint Kitts and Nevis, San Marino, Saudi Arabia, Singapore, Slovakia, Slovenia, Spain, Sweden, Switzerland, Trinidad and Tobago, the Turks and Caicos Islands, US Virgin Islands, United Arab Emirates, the United Kingdom, the United States. Appendix 1. Epidemiological regions used for analyses Eastern Mediterranean: Afghanistan, Egypt, Iran (Islamic Republic of), Iraq, Jordan, Lebanon, Libya, Morocco, Pakistan, Syrian Arab Republic, Tunisia, West Bank and the Gaza Strip, Yemen. Africa – countries with high HIV prevalence: Botswana, Burundi, Cameroon, the Central African Republic, the Congo, Côte d’Ivoire, the Democratic Republic of the Congo, Ethiopia, Gabon, Kenya, Lesotho, Malawi, Mozambique, Namibia, Nigeria, Rwanda, South Africa, South Sudan, Swaziland, Uganda, the United Republic of Tanzania, Zambia, Zimbabwe. Africa – countries with low HIV prevalence: Algeria, Angola, Benin, Burkina Faso, Cape Verde, Chad, the Comoros, Djibouti, Eritrea, the Gambia, Ghana, Guinea, Guinea-Bissau, Liberia, Madagascar, Mali, Mauritania, Mauritius, the Niger, Sao Tome and Principe, Senegal, Seychelles, Sierra Leone, Somalia, Sudan, Togo. Central Europe: Albania, Bosnia and Herzegovina, Montenegro, Serbia, the former Yugoslav Republic of Macedonia, Turkey. Eastern Europe: Armenia, Azerbaijan, Belarus, Bulgaria, Georgia, Kazakhstan, Kyrgyzstan, Latvia, Lithuania, the Republic of Moldova, Romania, the Russian Federation, Tajikistan, Turkmenistan, Ukraine, Uzbekistan. 112 GLOBAL TUBERCULOSIS REPORT 2013 Latin America: Anguilla, Antigua and Barbuda, Argentina, Belize, Bolivia (Plurinational State of), Bonaire, Saint Eustatius and Saba, Brazil, British Virgin Islands, Chile, Colombia, Costa Rica, Cuba, Curaçao, Dominica, the Dominican Republic, Ecuador, El Salvador, Grenada, Guatemala, Guyana, Haiti, Honduras, Jamaica, Mexico, Montserrat, Nicaragua, Panama, Paraguay, Peru, Saint Kitts and Nevis, Saint Lucia, Saint Vincent and the Grenadines, Sint Maarten (Dutch part), Suriname, Uruguay, Venezuela (Bolivarian Republic of). South East Asia: Bangladesh, Bhutan, Democratic People’s Republic of Korea, India, Indonesia, Maldives, Myanmar, Nepal, Sri Lanka, Thailand, Timor-Leste. West Pacific: American Samoa, Cambodia, China, Cook Islands, Fiji, Kiribati, Lao People’s Democratic Republic, Malaysia, Marshall Islands, Micronesia (Federated State of), Mongolia, Nauru, Niue, Palau, Papua New Guinea, the Philippines, Samoa, Solomon Islands, Tokelau, Tonga, Tuvalu, Vanuatu, Viet Nam, Wallis and Futuna Islands. #00': Country proßles AFGHANISTAN Mortality (excludes HIV+TB) (rate per 100 000 population per year) HIGH TB BURDEN Estimates of TB burdena 2012 07/$'4(thousands) 4#6' (per 100 000 population) ¿ ¿ /QTVCNKV[ GZENWFGU*+8 6$ /QTVCNKV[ *+8 6$QPN[ ¿ ¿ 2TGXCNGPEG KPENWFGU*+8 6$ ¿ ¿ +PEKFGPEG KPENWFGU*+8 6$ ¿ ¿ 0.31 (0.19–0.46) 1 (0.63–1.5) Incidence (HIV+TB only) 120 100 80 60 40 20 0 1990 1995 2000 2005 2010 1995 2000 2005 2010 2000 2005 52 (44–63) 6$ECUGPQVKßECVKQPU 0'9%#5'5 5OGCTRQUKVKXG 1000 4'64'#6/'06%#5'5 4GNCRUG Smear-negative 4 740 (17) Treatment after failure 160 (13) Smear-unknown / not done 2 665 Treatment after default 37 (3) Extrapulmonary 6 906 (24) Other 702 Total new (9) Prevalence (rate per 100 000 population) Case detection, all forms (%) Population 2012 30 million Other (2) 28 332 Total retreatment 1 246 750 500 250 0 1990 Other (history unknown) 6QVCNPGYCPFTGNCRUG 6QVCNECUGUPQVKßGF Incidence (rate per 100 000 population per year) 300 New cases 5/'#4215+6+8' / (TCVKQ #IG 5/'#40')#6+8'70-0190 016&10' ':64#27./10#4; Laboratories 2012 Smear (per 100 000 population) 2.0 Culture (per 5 million population) 0.3 Drug susceptibility testing (per 5 million population) 200 100 0 1990 1995 Incidence 2010 Incidence (HIV+TB) Notifications 0 +UUGEQPFNKPGFTWIUWUEGRVKDKNKV[VGUVKPICXCKNCDNG! ;GUQWVUKFGEQWPVT[ New smear-positive and/or culture-positive 91 0GYUOGCTPGICVKXGGZVTCRWNOQPCT[ 4GVTGCVOGPV Is rifampicin used throughout treatment for new patients? No TB/HIV 2012 TB patients with known HIV status 07/$'4 (%) 7 275 (25) *+8RQUKVKXG6$RCVKGPVU *+8RQUKVKXG6$RCVKGPVUQPEQVTKOQZC\QNGRTGXGPVKXGVJGTCR[ %26 *+8RQUKVKXGRGQRNGUETGGPGFHQT6$ HIV-positive people provided with IPT 25 Estimates of MDR-TB burden 2012a QH6$ECUGUYKVJ/&46$ /&46$ECUGUCOQPIPQVKßGF pulmonary TB cases 4'64'#6/'06 ¿ ¿ 750 (21–2 600) 400 (93–700) Reported cases of MDR-TB 2012 0'9 4'64'#6/'06 616#. .CDQTCVQT[EQPßTOGF/&46$ECUGU 2CVKGPVUUVCTVGFQP/&46$VTGCVOGPV %CUGUVGUVGFHQT/&46$ 60 40 20 1997 1999 2001 2003 2005 2007 2009 New smear-positive (and/or culture-positive) New smear-negative/extrapulmonary 0'9 80 0 1995 2011 Retreatment 6 Number of patients *+8RQUKVKXG6$RCVKGPVUQPCPVKTGVTQXKTCNVJGTCR[ #46 Treatment success rate (%) 100 6TGCVOGPVUWEEGUUTCVG 4 2 0 2003 2004 2005 2006 2007 2008 HIV-positive TB patients 2009 on CPT 2010 2011 2012 on ART 2013 0CVKQPCN6$RTQITCOOGDWFIGV 75OKNNKQPU % Funded domestically 3% % Funded internationally 65% % Unfunded 32% Total budget (US$ millions) 16 Financing TB control 12 8 4 0 Data are as reported to WHO. Estimates of TB and MDR-TB burden are produced by WHO in consultation with countries. a Ranges represent uncertainty intervals. Data for all years can be downloaded from www.who.int/tb/data 2009 2010 Funded domestically 2011 2012 Funded internationally GLOBAL TUBERCULOSIS REPORT 2013 2013 Unfunded 115 BANGLADESH Mortality (excludes HIV+TB) (rate per 100 000 population per year) HIGH TB BURDEN | HIGH MDR-TB BURDEN Estimates of TB burdena 2012 07/$'4 6*175#0&5 4#6'(per 100 000 population) /QTVCNKV[ GZENWFGU*+8 6$ ¿ ¿ /QTVCNKV[ *+8 6$QPN[ ¿ ¿ 2TGXCNGPEG KPENWFGU*+8 6$ ¿ ¿ +PEKFGPEG KPENWFGU*+8 6$ ¿ ¿ Incidence (HIV+TB only) 0.24 (0.2–0.29) 0.16 (0.13–0.19) 150 100 50 0 1990 1995 2000 2005 2010 1995 2000 2005 2010 2000 2005 49 (41–59) 6$ECUGPQVKßECVKQPU 0'9%#5'5 5OGCTRQUKVKXG 1000 4'64'#6/'06%#5'5 4GNCRUG 5OGCTPGICVKXG 6TGCVOGPVCHVGTHCKNWTG Smear-unknown / not done 0 'ZVTCRWNOQPCT[ (0) Treatment after default 257 (3) 1VJGT Other 0 Total new Total retreatment 6QVCNPGYCPFTGNCRUG (0) 161 790 1VJGT JKUVQT[WPMPQYP Prevalence (rate per 100 000 population) Case detection, all forms (%) Population 2012 155 million 8 001 6QVCNECUGUPQVKßGF 750 500 250 0 1990 New cases 5/'#4215+6+8' 5/'#40')#6+8'70-0190 016&10' ':64#27./10#4; / (TCVKQ #IG Laboratories 2012 Smear (per 100 000 population) Incidence (rate per 100 000 population per year) 400 0.7 %WNVWTG RGTOKNNKQPRQRWNCVKQP 300 200 100 0 1990 1995 &TWIUWUEGRVKDKNKV[VGUVKPI RGTOKNNKQPRQRWNCVKQP Incidence 2010 Incidence (HIV+TB) Notifications +UUGEQPFNKPGFTWIUWUEGRVKDKNKV[VGUVKPICXCKNCDNG! ;GUQWVUKFGEQWPVT[ New smear-positive and/or culture-positive 92 0GYUOGCTPGICVKXGGZVTCRWNOQPCT[ 4GVTGCVOGPV +UTKHCORKEKPWUGFVJTQWIJQWVVTGCVOGPVHQTPGYRCVKGPVU! ;GU TB/HIV 2012 07/$'4 6$RCVKGPVUYKVJMPQYP*+8UVCVWU HIV-positive TB patients 63 *+8RQUKVKXG6$RCVKGPVUQPEQVTKOQZC\QNGRTGXGPVKXGVJGTCR[ %26 HIV-positive people screened for TB 1999 2001 2003 2005 2007 2009 2011 Retreatment 80 0'9 4'64'#6/'06 ¿ ¿ 1 900 (920–3 300) 2 300 (1 900–2 700) Reported cases of MDR-TB 2012 %CUGUVGUVGFHQT/&46$ (3) 0'9 4'64'#6/'06 616#. .CDQTCVQT[EQPßTOGF/&46$ECUGU 2CVKGPVUUVCTVGFQP/&46$VTGCVOGPV Number of patients /&46$ECUGUCOQPIPQVKßGF pulmonary TB cases 1997 0 Estimates of MDR-TB burden 2012a QH6$ECUGUYKVJ/&46$ 60 New smear-positive (and/or culture-positive) New smear-negative/extrapulmonary 429 HIV-positive people provided with IPT 80 40 1995 (%) *+8RQUKVKXG6$RCVKGPVUQPCPVKTGVTQXKTCNVJGTCR[ #46 Treatment success rate (%) 100 6TGCVOGPVUWEEGUUTCVG 60 40 20 0 2003 2004 2005 2006 2007 2008 HIV-positive TB patients 2009 on CPT 2010 2011 2012 on ART 0CVKQPCN6$RTQITCOOGDWFIGV 75OKNNKQPU 2013 &CVCCTGCUTGRQTVGFVQ9*1'UVKOCVGUQH6$CPF/&46$DWTFGPCTGRTQFWEGFD[9*1KPEQPUWNVCVKQPYKVJ countries. a 4CPIGUTGRTGUGPVWPEGTVCKPV[KPVGTXCNU'UVKOCVGUQH6$FKUGCUGDWTFGPJCXGPQVDGGPCRRTQXGFD[ the national TB programme in Bangladesh and a joint reassessment will be undertaken following the completion of the prevalence survey planned for 2014. b Comprehensive data on domestic and international funding in 2013 could not be reported. Funding from 75#+&HQT1EVQDGT¿5GRVGODGTYCU75OKNNKQP 116 GLOBAL TUBERCULOSIS REPORT 2013 Total budget (US$ millions) 50 Financing TB controlb 40 30 20 10 0 2009 2010 Funded domestically Data for all years can be downloaded from www.who.int/tb/data 2011 2012 Funded internationally Unfunded BRAZIL Estimates of TB burdena 2012 07/$'4(thousands) 4#6' (per 100 000 population) 4.9 (4.6–5.2) 2.5 (2.3–2.6) 2.5 (2.2–3) 1.3 (1.1–1.5) Prevalence (includes HIV+TB) 120 (51–210) 59 (25–107) +PEKFGPEG KPENWFGU*+8 6$ ¿ ¿ +PEKFGPEG *+8 6$QPN[ ¿ ¿ %CUGFGVGEVKQPCNNHQTOU ¿ Mortality (excludes HIV+TB) Mortality (HIV+TB only) 6$ECUGPQVKßECVKQPU 0'9%#5'5 4GNCRUG 5OGCTPGICVKXG 6TGCVOGPVCHVGTHCKNWTG 6TGCVOGPVCHVGTFGHCWNV Extrapulmonary 10 297 (14) 1VJGT Other 4 133 (36) Total new 71 230 Other (history unknown) 25 6QVCNPGYCPFTGNCRUG 4 2 0 1990 1995 2000 2005 2010 1995 2000 2005 2010 2000 2005 300 4'64'#6/'06%#5'5 5OGCTRQUKVKXG 5OGCTWPMPQYPPQVFQPG 6 8 Total retreatment 11 500 6QVCNECUGUPQVKßGF Prevalence (rate per 100 000 population) 10 Mortality (excludes HIV+TB) (rate per 100 000 population per year) HIGH TB BURDEN | HIGH HIV BURDEN Population 2012 199 million 200 100 0 1990 New cases 5/'#4215+6+8' / (TCVKQ #IG 5/'#40')#6+8'70-0190 016&10' ':64#27./10#4; Laboratories 2012 Smear (per 100 000 population) 2.0 Culture (per 5 million population) 5.5 Drug susceptibility testing (per 5 million population) Incidence (rate per 100 000 population per year) 150 100 50 0 1990 1995 Incidence 2010 Incidence (HIV+TB) Notifications 0.9 +UUGEQPFNKPGFTWIUWUEGRVKDKNKV[VGUVKPICXCKNCDNG! ;GUKPEQWPVT[ New smear-positive and/or culture-positive 76 New smear-negative/extrapulmonary 70 4GVTGCVOGPV +UTKHCORKEKPWUGFVJTQWIJQWVVTGCVOGPVHQTPGYRCVKGPVU! ;GU TB/HIV 2012 07/$'4 (%) TB patients with known HIV status 45 733 (55) 9 049 (20) HIV-positive TB patients *+8RQUKVKXG6$RCVKGPVUQPEQVTKOQZC\QNGRTGXGPVKXGVJGTCR[ %26 *+8RQUKVKXG6$RCVKGPVUQPCPVKTGVTQXKTCNVJGTCR[ #46 Treatment success rate (%) 100 6TGCVOGPVUWEEGUUTCVG 80 60 40 20 0 1995 1997 1999 2001 2003 2005 2007 2009 New smear-positive (and/or culture-positive) New smear-negative/extrapulmonary HIV-positive people screened for TB 2011 Retreatment 10 000 Estimates of MDR-TB burden 2012a QH6$ECUGUYKVJ/&46$ /&46$ECUGUCOQPIPQVKßGF RWNOQPCT[6$ECUGU 0'9 4'64'#6/'06 ¿ ¿ ¿ ¿ Reported cases of MDR-TB 2012 %CUGUVGUVGFHQT/&46$ Number of patients HIV-positive people provided with IPT 0'9 4'64'#6/'06 .CDQTCVQT[EQPßTOGF/&46$ECUGU 2CVKGPVUUVCTVGFQP/&46$VTGCVOGPV 8000 6000 4000 2000 0 2003 2004 616#. 2005 2006 2007 2008 HIV-positive TB patients 2009 on CPT 2010 2011 2012 on ART 2013 0CVKQPCN6$RTQITCOOGDWFIGV 75OKNNKQPU (WPFGFFQOGUVKECNN[ % Funded internationally 2% % Unfunded 14% Total budget (US$ millions) 100 Financing TB control 80 60 40 20 0 Data are as reported to WHO. Estimates of TB and MDR-TB burden are produced by WHO in consultation with countries. a Ranges represent uncertainty intervals. Data for all years can be downloaded from www.who.int/tb/data 2009 2010 Funded domestically 2011 2012 Funded internationally GLOBAL TUBERCULOSIS REPORT 2013 2013 Unfunded 117 CAMBODIA Mortality (excludes HIV+TB) (rate per 100 000 population per year) HIGH TB BURDEN | HIGH HIV BURDEN Estimates of TB burdena 2012 07/$'4(thousands) 4#6'(per 100 000 population) 9.3 (4.3–16) 63 (29–110) Mortality (excludes HIV+TB) /QTVCNKV[ *+8 6$QPN[ 2TGXCNGPEG KPENWFGU*+8 6$ Incidence (includes HIV+TB) +PEKFGPEG *+8 6$QPN[ ¿ ¿ ¿ 61 (52–70) 411 (353–474) ¿ ¿ 400 300 200 100 0 1990 1995 2000 2005 2010 1995 2000 2005 2010 2000 2005 66 (57–77) 6$ECUGPQVKßECVKQPU 0'9%#5'5 5OGCTRQUKVKXG 2500 4'64'#6/'06%#5'5 4GNCRUG 5OGCTPGICVKXG 6TGCVOGPVCHVGTHCKNWTG Smear-unknown / not done 0 Extrapulmonary (0) 15 290 (40) Other 0 Total new 1 102 6QVCNPGYCPFTGNCRUG 22 (4) Other (0) 38 637 Other (history unknown) Treatment after default Total retreatment 519 6QVCNECUGUPQVKßGF Prevalence (rate per 100 000 population) Case detection, all forms (%) ¿ Population 2012 15 million 2000 1500 1000 500 0 1990 New cases 5/'#4215+6+8' 5/'#40')#6+8'70-0190 016&10' ':64#27./10#4; / (TCVKQ #IG Laboratories 2012 Smear (per 100 000 population) 1.4 Culture (per 5 million population) 1.0 Drug susceptibility testing (per 5 million population) 0.3 Is second-line drug susceptibility testing available? No Incidence (rate per 100 000 population per year) 1000 750 500 250 0 1990 1995 Incidence 2010 Incidence (HIV+TB) Notifications New smear-positive and/or culture-positive 93 New smear-negative/extrapulmonary 94 4GVTGCVOGPV +UTKHCORKEKPWUGFVJTQWIJQWVVTGCVOGPVHQTPGYRCVKGPVU! ;GU TB/HIV 2012 07/$'4 (%) 6$RCVKGPVUYKVJMPQYP*+8UVCVWU HIV-positive TB patients 1 433 (4) *+8RQUKVKXG6$RCVKGPVUQPEQVTKOQZC\QNGRTGXGPVKXGVJGTCR[ %26 *+8RQUKVKXG6$RCVKGPVUQPCPVKTGVTQXKTCNVJGTCR[ #46 Treatment success rate (%) 100 6TGCVOGPVUWEEGUUTCVG 80 70 1995 1997 1999 2001 2003 2005 2007 New smear-positive (and/or culture-positive) New smear-negative/extrapulmonary HIV-positive people screened for TB 2009 2011 Retreatment 6000 1 145 Estimates of MDR-TB burden 2012a 0'9 4'64'#6/'06 QH6$ECUGUYKVJ/&46$ ¿ ¿ /&46$ECUGUCOQPIPQVKßGF pulmonary TB cases 330 (160–590) 56 (21–110) Reported cases of MDR-TB 2012 Number of patients HIV-positive people provided with IPT %CUGUVGUVGFHQT/&46$ 90 0'9 4'64'#6/'06 .CDQTCVQT[EQPßTOGF/&46$ECUGU 2CVKGPVUUVCTVGFQP/&46$VTGCVOGPV 4000 2000 0 2003 2004 616#. 2005 2006 2007 2008 HIV-positive TB patients 2009 on CPT 2010 2011 2012 on ART 0CVKQPCN6$RTQITCOOGDWFIGV 75OKNNKQPU % Funded domestically 2013 5% % Funded internationally 34% % Unfunded 62% Total budget (US$ millions) 45 Financing TB control 30 15 0 Data are as reported to WHO. Estimates of TB and MDR-TB burden are produced by WHO in consultation with countries. a Ranges represent uncertainty intervals. GLOBAL TUBERCULOSIS REPORT 2013 2009 2010 Funded domestically Data for all years can be downloaded from www.who.int/tb/data 2011 2012 Funded internationally 2013 Unfunded CHINA Mortality (excludes HIV+TB) (rate per 100 000 population per year) HIGH TB BURDEN | HIGH HIV BURDEN | HIGH MDR-TB BURDEN Estimates of TB burdena 2012 07/$'4(thousands) 4#6' (per 100 000 population) 44 (43–46) 3.2 (3.1–3.3) ¿ ¿ 2TGXCNGPEG KPENWFGU*+8 6$ ¿ ¿ +PEKFGPEG KPENWFGU*+8 6$ Mortality (excludes HIV+TB) /QTVCNKV[ *+8 6$QPN[ ¿ ¿ +PEKFGPEG *+8 6$QPN[ ¿ ¿ %CUGFGVGEVKQPCNNHQTOU ¿ 6$ECUGPQVKßECVKQPU 0'9%#5'5 4GNCRUG 5OGCTPGICVKXG 6TGCVOGPVCHVGTHCKNWTG 5OGCTWPMPQYPPQVFQPG 6TGCVOGPVCHVGTFGHCWNV 'ZVTCRWNOQPCT[ 1VJGT 0 Total new Other (history unknown) 0 6QVCNPGYCPFTGNCRUG (0) 858 861 20 15 10 5 0 1990 1995 2000 2005 2010 1995 2000 2005 2010 2000 2005 300 4'64'#6/'06%#5'5 5OGCTRQUKVKXG Other 25 Prevalence (rate per 100 000 population) Population 2012 1 377 million Total retreatment 41 817 6QVCNECUGUPQVKßGF 200 100 0 1990 New cases 5/'#4215+6+8' 5/'#40')#6+8'70-0190 016&10' ':64#27./10#4; / (TCVKQ #IG Laboratories 2012 Smear (per 100 000 population) 0.2 Culture (per 5 million population) 3.7 Drug susceptibility testing (per 5 million population) Incidence (rate per 100 000 population per year) 200 150 100 50 0 1990 1995 Incidence 2010 Incidence (HIV+TB) Notifications 0.7 +UUGEQPFNKPGFTWIUWUEGRVKDKNKV[VGUVKPICXCKNCDNG! ;GUKPEQWPVT[ New smear-positive and/or culture-positive 95 New smear-negative/extrapulmonary 95 4GVTGCVOGPV +UTKHCORKEKPWUGFVJTQWIJQWVVTGCVOGPVHQTPGYRCVKGPVU! ;GU TB/HIV 2012 TB patients with known HIV statusb 07/$'4 (%) *+8RQUKVKXG6$RCVKGPVU *+8RQUKVKXG6$RCVKGPVUQPEQVTKOQZC\QNGRTGXGPVKXGVJGTCR[ %26 *+8RQUKVKXG6$RCVKGPVUQPCPVKTGVTQXKTCNVJGTCR[ #46 95 90 85 80 1995 1997 1999 2001 2003 2005 2007 2009 New smear-positive (and/or culture-positive) New smear-negative/extrapulmonary 2011 Retreatment HIV-positive people screened for TB Treatment success rate (%) 100 6TGCVOGPVUWEEGUUTCVG 294 795 6000 Estimates of MDR-TB burden 2012a 0'9 4'64'#6/'06 ¿ ¿ ¿ ¿ QH6$ECUGUYKVJ/&46$ /&46$ECUGUCOQPIPQVKßGF RWNOQPCT[6$ECUGU Reported cases of MDR-TB 2012 %CUGUVGUVGFHQT/&46$ 4'64'#6/'06 616#. 2CVKGPVUUVCTVGFQP/&46$VTGCVOGPV 4000 2000 0 2003 2004 0'9 .CDQTCVQT[EQPßTOGF/&46$ECUGU Number of patients HIV-positive people provided with IPT 2005 2006 2007 2008 HIV-positive TB patients 2009 on CPT 2010 2011 2012 on ART 2013 0CVKQPCN6$RTQITCOOGDWFIGV 75OKNNKQPU % Funded domestically 74% % Funded internationally 11% % Unfunded 15% Total budget (US$ millions) 400 Financing TB control 300 200 100 0 Data are as reported to WHO. Estimates of TB and MDR-TB burden are produced by WHO in consultation with countries. a Ranges represent uncertainty intervals. Data for all years can be downloaded from www.who.int/tb/data 2009 2010 Funded domestically 2011 2012 Funded internationally GLOBAL TUBERCULOSIS REPORT 2013 2013 Unfunded 119 DEMOCRATIC REPUBLIC OF THE CONGO Mortality (excludes HIV+TB) (rate per 100 000 population per year) HIGH TB BURDEN | HIGH HIV BURDEN | HIGH MDR-TB BURDEN Estimates of TB burdena 2012 07/$'4(thousands) Mortality (excludes HIV+TB) 4#6'(per 100 000 population) 36 (16–64) 54 (24–97) ¿ ¿ 2TGXCNGPEG KPENWFGU*+8 6$ ¿ ¿ +PEKFGPEG KPENWFGU*+8 6$ /QTVCNKV[ *+8 6$QPN[ ¿ ¿ Incidence (HIV+TB only) 16 (14–19) 25 (22–29) Case detection, all forms (%) 51 (44–59) 6$ECUGPQVKßECVKQPU 0'9%#5'5 4'64'#6/'06%#5'5 5OGCTRQUKVKXG 4GNCRUG 5OGCTPGICVKXG 6TGCVOGPVCHVGTHCKNWTG 5OGCTWPMPQYPPQVFQPG Extrapulmonary 6TGCVOGPVCHVGTFGHCWNV 20 669 (20) Other 2 321 (31) Total retreatment 7 492 Other Total new 105 007 Prevalence (rate per 100 000 population) Population 2012 66 million 150 100 50 0 1990 1995 2000 2005 2010 1995 2000 2005 2010 2000 2005 1500 1000 500 0 1990 Other (history unknown) 6QVCNPGYCPFTGNCRUG 6QVCNECUGUPQVKßGF 5/'#4215+6+8' / (TCVKQ 5/'#40')#6+8'70-0190 016&10' #IG ':64#27./10#4; Laboratories 2012 Smear (per 100 000 population) 2.3 Culture (per 5 million population) 0.3 Drug susceptibility testing (per 5 million population) 0.2 +UUGEQPFNKPGFTWIUWUEGRVKDKNKV[VGUVKPICXCKNCDNG! ;GUKPCPFQWVUKFGEQWPVT[ Incidence (rate per 100 000 population per year) 400 New cases 300 200 100 0 1990 1995 Incidence 2010 Incidence (HIV+TB) Notifications 0GYUOGCTRQUKVKXGCPFQTEWNVWTGRQUKVKXG 0GYUOGCTPGICVKXGGZVTCRWNOQPCT[ 4GVTGCVOGPV +UTKHCORKEKPWUGFVJTQWIJQWVVTGCVOGPVHQTPGYRCVKGPVU! ;GU TB/HIV 2012 07/$'4 (%) TB patients with known HIV status 35 097 (31) *+8RQUKVKXG6$RCVKGPVU *+8RQUKVKXG6$RCVKGPVUQPEQVTKOQZC\QNGRTGXGPVKXGVJGTCR[ %26 *+8RQUKVKXG6$RCVKGPVUQPCPVKTGVTQXKTCNVJGTCR[ #46 Treatment success rate (%) 100 6TGCVOGPVUWEEGUUTCVG 20 4'64'#6/'06 ¿ ¿ ¿ ¿ Number of patients 0'9 0'9 4'64'#6/'06 1999 2001 2003 2005 2007 2009 2011 Retreatment .CDQTCVQT[EQPßTOGF/&46$ECUGU 2CVKGPVUUVCTVGFQP/&46$VTGCVOGPV Financing TB control 0CVKQPCN6$RTQITCOOGDWFIGV 75OKNNKQPU % Funded domestically 6000 4000 2000 0 2003 2004 616#. 2013 1% % Funded internationally 25% % Unfunded 74% 2007 2008 2009 on CPT 2010 2011 2012 on ART 60 40 20 0 Data are as reported to WHO. Estimates of TB and MDR-TB burden are produced by WHO in consultation with countries. a Ranges represent uncertainty intervals. GLOBAL TUBERCULOSIS REPORT 2013 2005 2006 HIV-positive TB patients Total budget (US$ millions) Reported cases of MDR-TB 2012 120 1997 8000 Estimates of MDR-TB burden 2012a %CUGUVGUVGFHQT/&46$ 40 New smear-positive (and/or culture-positive) New smear-negative/extrapulmonary HIV-positive people provided with IPT /&46$ECUGUCOQPIPQVKßGF RWNOQPCT[6$ECUGU 60 0 1995 HIV-positive people screened for TB QH6$ECUGUYKVJ/&46$ 80 2009 2010 Funded domestically Data for all years can be downloaded from www.who.int/tb/data 2011 2012 Funded internationally 2013 Unfunded ETHIOPIA Estimates of TB burdena 2012 07/$'4(thousands) 4#6' (per 100 000 population) ¿ ¿ /QTVCNKV[ GZENWFGU*+8 6$ /QTVCNKV[ *+8 6$QPN[ ¿ ¿ 2TGXCNGPEG KPENWFGU*+8 6$ ¿ ¿ +PEKFGPEG KPENWFGU*+8 6$ ¿ ¿ Incidence (HIV+TB only) 23 (17–30) 25 (19–33) %CUGFGVGEVKQPCNNHQTOU ¿ 6$ECUGPQVKßECVKQPU 0'9%#5'5 4GNCRUG 5OGCTPGICVKXG 6TGCVOGPVCHVGTHCKNWTG 'ZVTCRWNOQPCT[ 6TGCVOGPVCHVGTFGHCWNV 1VJGT Other 0 Total new Other (history unknown) 0 6QVCNPGYCPFTGNCRUG (0) 143 503 20 0 1990 1995 2000 2005 2010 1995 2000 2005 2010 2000 2005 800 4'64'#6/'06%#5'5 5OGCTRQUKVKXG 5OGCTWPMPQYPPQVFQPG 40 60 Prevalence (rate per 100 000 population) 80 Mortality (excludes HIV+TB) (rate per 100 000 population per year) HIGH TB BURDEN | HIGH HIV BURDEN | HIGH MDR-TB BURDEN Population 2012 92 million Total retreatment 4 089 6QVCNECUGUPQVKßGF 600 400 200 0 1990 Incidence (rate per 100 000 population per year) 750 New cases 5/'#4215+6+8' / (TCVKQ #IG 5/'#40')#6+8'70-0190 016&10' ':64#27./10#4; Laboratories 2012 5OGCT RGTRQRWNCVKQP Culture (per 5 million population) 0.3 &TWIUWUEGRVKDKNKV[VGUVKPI RGTOKNNKQPRQRWNCVKQP 500 250 0 1990 1995 Incidence 2010 Incidence (HIV+TB) Notifications Is second-line drug susceptibility testing available? No 100 New smear-positive and/or culture-positive 90 0GYUOGCTPGICVKXGGZVTCRWNOQPCT[ 4GVTGCVOGPV +UTKHCORKEKPWUGFVJTQWIJQWVVTGCVOGPVHQTPGYRCVKGPVU! ;GU TB/HIV 2012 07/$'4 (%) TB patients with known HIV status 96 245 (65) *+8RQUKVKXG6$RCVKGPVU *+8RQUKVKXG6$RCVKGPVUQPEQVTKOQZC\QNGRTGXGPVKXGVJGTCR[ %26 *+8RQUKVKXG6$RCVKGPVUQPCPVKTGVTQXKTCNVJGTCR[ #46 HIV-positive people provided with IPT 30 395 Estimates of MDR-TB burden 2012a QH6$ECUGUYKVJ/&46$ /&46$ECUGUCOQPIPQVKßGF RWNOQPCT[6$ECUGU 4'64'#6/'06 ¿ ¿ ¿ ¿ Reported cases of MDR-TB 2012 %CUGUVGUVGFHQT/&46$ 0'9 4'64'#6/'06 .CDQTCVQT[EQPßTOGF/&46$ECUGU 2CVKGPVUUVCTVGFQP/&46$VTGCVOGPV 60 40 1995 1997 1999 2001 2003 2005 2007 2009 New smear-positive (and/or culture-positive) New smear-negative/extrapulmonary 0'9 80 2011 Retreatment 12 000 Number of patients *+8RQUKVKXGRGQRNGUETGGPGFHQT6$ Treatment success rate (%) 6TGCVOGPVUWEEGUUTCVG 8000 4000 0 2003 2004 616#. 2005 2006 2007 2008 HIV-positive TB patients 2009 on CPT 2010 2011 2012 on ART 2013 0CVKQPCN6$RTQITCOOGDWFIGV 75OKNNKQPU % Funded domestically 17% % Funded internationally 32% % Unfunded 51% Total budget (US$ millions) 180 Financing TB control 120 60 0 Data are as reported to WHO. Estimates of TB and MDR-TB burden are produced by WHO in consultation with countries. a Ranges represent uncertainty intervals. Data for all years can be downloaded from www.who.int/tb/data 2009 2010 Funded domestically 2011 2012 Funded internationally GLOBAL TUBERCULOSIS REPORT 2013 2013 Unfunded 121 INDIA Mortality (excludes HIV+TB) (rate per 100 000 population per year) HIGH TB BURDEN | HIGH HIV BURDEN | HIGH MDR-TB BURDEN Estimates of TB burdena 2012 07/$'4(thousands) 4#6'(per 100 000 population) 270 (170–390) 22 (14–32) Mortality (excludes HIV+TB) /QTVCNKV[ *+8 6$QPN[ ¿ ¿ 2TGXCNGPEG KPENWFGU*+8 6$ ¿ ¿ Incidence (includes HIV+TB) 2 200 (2 000–2 400) 176 (159–193) 130 (120–140) 10 (9.4–12) Incidence (HIV+TB only) 6$ECUGPQVKßECVKQPU 0'9%#5'5 4GNCRUG Smear-negative 317 616 (27) 5OGCTWPMPQYPPQVFQPG Extrapulmonary 40 20 0 1990 1995 2000 2005 2010 1995 2000 2005 2010 2000 2005 600 Treatment after failure 16 400 (6) 6TGCVOGPVCHVGTFGHCWNV 234 029 (20) 1VJGT 4'64'#6/'06%#5'5 5OGCTRQUKVKXG Other 96 567 (34) Total new 60 59 (54–66) 1 183 373 Total retreatment 284 212 Prevalence (rate per 100 000 population) Case detection, all forms (%) Population 2012 1 237 million 400 200 0 1990 Other (history unknown) 6QVCNPGYCPFTGNCRUG 6QVCNECUGUPQVKßGF Incidence (rate per 100 000 population per year) 300 New cases 5/'#4215+6+8' / (TCVKQ 5/'#40')#6+8'70-0190 016&10' #IG ':64#27./10#4; Laboratories 2012 Smear (per 100 000 population) 1.1 Culture (per 5 million population) 0.3 Drug susceptibility testing (per 5 million population) 200 100 0 1990 1995 Incidence 2010 Incidence (HIV+TB) Notifications 0.2 +UUGEQPFNKPGFTWIUWUEGRVKDKNKV[VGUVKPICXCKNCDNG! ;GUKPEQWPVT[ 0GYUOGCTRQUKVKXGCPFQTEWNVWTGRQUKVKXG New smear-negative/extrapulmonary 90 4GVTGCVOGPV +UTKHCORKEKPWUGFVJTQWIJQWVVTGCVOGPVHQTPGYRCVKGPVU! ;GU TB/HIV 2012 6$RCVKGPVUYKVJMPQYP*+8UVCVWU 07/$'4 (%) HIV-positive TB patients 44 063 (5) *+8RQUKVKXG6$RCVKGPVUQPEQVTKOQZC\QNGRTGXGPVKXGVJGTCR[ %26 *+8RQUKVKXG6$RCVKGPVUQPCPVKTGVTQXKTCNVJGTCR[ #46 *+8RQUKVKXGRGQRNGUETGGPGFHQT6$ Treatment success rate (%) 100 6TGCVOGPVUWEEGUUTCVG ¿ ¿ ¿ ¿ QH6$ECUGUYKVJ/&46$ /&46$ECUGUCOQPIPQVKßGF RWNOQPCT[6$ECUGU Reported cases of MDR-TB 2012 %CUGUVGUVGFHQT/&46$ 20 1997 4'64'#6/'06 616#. .CDQTCVQT[EQPßTOGF/&46$ECUGU 2CVKGPVUUVCTVGFQP/&46$VTGCVOGPV 2001 2003 2005 2007 2009 2011 Retreatment 40 000 30 000 20 000 10 000 0 2003 2004 0'9 1999 50 000 Number of patients 4'64'#6/'06 40 New smear-positive (and/or culture-positive) New smear-negative/extrapulmonary 0'9 60 0 1995 HIV-positive people provided with IPT Estimates of MDR-TB burden 2012a 80 2005 2006 2007 2008 HIV-positive TB patients 2009 on CPT 2010 2011 2012 on ART 2013 0CVKQPCN6$RTQITCOOGDWFIGV 75OKNNKQPU % Funded domestically 37% % Funded internationally 57% % Unfunded 6% &CVCCTGCUTGRQTVGFVQ9*1'UVKOCVGUQH6$CPF/&46$DWTFGPCTGRTQFWEGFD[9*1KPEQPUWNVCVKQPYKVJ countries. a 4CPIGUTGRTGUGPVWPEGTVCKPV[KPVGTXCNU'UVKOCVGUHQT+PFKCJCXGPQV[GVDGGPQHßEKCNN[CRRTQXGFD[VJG /KPKUVT[QH*GCNVJ(COKN[9GNHCTG)QXGTPOGPVQH+PFKCCPFUJQWNFVJGTGHQTGDGEQPUKFGTGFRTQXKUKQPCN 122 GLOBAL TUBERCULOSIS REPORT 2013 Total budget (US$ millions) 250 Financing TB control 200 150 100 50 0 2009 2010 Funded domestically Data for all years can be downloaded from www.who.int/tb/data 2011 2012 Funded internationally 2013 Unfunded INDONESIA Mortality (excludes HIV+TB) (rate per 100 000 population per year) HIGH TB BURDEN | HIGH HIV BURDEN | HIGH MDR-TB BURDEN Estimates of TB burdena 2012 07/$'4(thousands) 4#6'(per 100 000 population) /QTVCNKV[ GZENWFGU*+8 6$ ¿ ¿ /QTVCNKV[ *+8 6$QPN[ ¿ ¿ Prevalence (includes HIV+TB) 730 (350–1 200) 297 (144–506) +PEKFGPEG KPENWFGU*+8 6$ ¿ ¿ 7.5 (5.6–9.7) 3.1 (2.3–3.9) Incidence (HIV+TB only) %CUGFGVGEVKQPCNNHQTOU ¿ 6$ECUGPQVKßECVKQPU 0'9%#5'5 4GNCRUG 5OGCTPGICVKXG 6TGCVOGPVCHVGTHCKNWTG Treatment after default 954 (11) Extrapulmonary 15 697 (5) Other 1 179 (14) Total retreatment 8 542 Other Total new 322 882 100 50 0 1990 1995 2000 2005 2010 1995 2000 2005 2010 2000 2005 1000 4'64'#6/'06%#5'5 5OGCTRQUKVKXG Smear-unknown / not done 150 Prevalence (rate per 100 000 population) Population 2012 247 million 750 500 250 0 1990 Other (history unknown) 6QVCNPGYCPFTGNCRUG 6QVCNECUGUPQVKßGF New cases 5/'#4215+6+8' / (TCVKQ #IG 5/'#40')#6+8'70-0190 016&10' ':64#27./10#4; Laboratories 2012 Smear (per 100 000 population) 2.3 Culture (per 5 million population) 0.9 Drug susceptibility testing (per 5 million population) Incidence (rate per 100 000 population per year) 300 200 100 0 1990 1995 Incidence 2010 Incidence (HIV+TB) Notifications 0.1 +UUGEQPFNKPGFTWIUWUEGRVKDKNKV[VGUVKPICXCKNCDNG! ;GUKPEQWPVT[ New smear-positive and/or culture-positive 90 0GYUOGCTPGICVKXGGZVTCRWNOQPCT[ 4GVTGCVOGPV +UTKHCORKEKPWUGFVJTQWIJQWVVTGCVOGPVHQTPGYRCVKGPVU! ;GU TB/HIV 2012 07/$'4 6$RCVKGPVUYKVJMPQYP*+8UVCVWU *+8RQUKVKXG6$RCVKGPVU *+8RQUKVKXG6$RCVKGPVUQPEQVTKOQZC\QNGRTGXGPVKXGVJGTCR[ %26 HIV-positive people screened for TB 80 60 40 1995 (%) *+8RQUKVKXG6$RCVKGPVUQPCPVKTGVTQXKTCNVJGTCR[ #46 Treatment success rate (%) 100 6TGCVOGPVUWEEGUUTCVG 1997 1999 2001 2003 2005 2007 2009 New smear-positive (and/or culture-positive) New smear-negative/extrapulmonary 22 677 2011 Retreatment 3000 Estimates of MDR-TB burden 2012a QH6$ECUGUYKVJ/&46$ /&46$ECUGUCOQPIPQVKßGF RWNOQPCT[6$ECUGU 0'9 4'64'#6/'06 ¿ ¿ ¿ ¿ Reported cases of MDR-TB 2012 0'9 4'64'#6/'06 616#. .CDQTCVQT[EQPßTOGF/&46$ECUGU 2CVKGPVUUVCTVGFQP/&46$VTGCVOGPV %CUGUVGUVGFHQT/&46$ Number of patients HIV-positive people provided with IPT 2000 1000 0 2003 2004 2005 2006 2007 2008 HIV-positive TB patients 2009 on CPT 2010 2011 2012 on ART 2013 0CVKQPCN6$RTQITCOOGDWFIGV 75OKNNKQPU % Funded domestically 14% % Funded internationally 35% % Unfunded 51% Total budget (US$ millions) 125 Financing TB control 100 75 50 25 0 Data are as reported to WHO. Estimates of TB and MDR-TB burden are produced by WHO in consultation with countries. a Ranges represent uncertainty intervals. Data for all years can be downloaded from www.who.int/tb/data 2009 2010 Funded domestically 2011 2012 Funded internationally GLOBAL TUBERCULOSIS REPORT 2013 2013 Unfunded 123 KENYA Mortality (excludes HIV+TB) (rate per 100 000 population per year) HIGH TB BURDEN | HIGH HIV BURDEN Estimates of TB burdena 2012 07/$'4(thousands) 4#6'(per 100 000 population) Mortality (excludes HIV+TB) 9.5 (5.4–15) 22 (13–34) /QTVCNKV[ *+8 6$QPN[ ¿ ¿ Prevalence (includes HIV+TB) 130 (71–210) 299 (163–475) +PEKFGPEG KPENWFGU*+8 6$ ¿ ¿ Incidence (HIV+TB only) 45 (44–47) 105 (101–109) %CUGFGVGEVKQPCNNHQTOU ¿ 6$ECUGPQVKßECVKQPU 0'9%#5'5 4GNCRUG 5OGCTPGICVKXG 6TGCVOGPVCHVGTHCKNWTG 'ZVTCRWNOQPCT[ 6TGCVOGPVCHVGTFGHCWNV 1VJGT Other 0 Total new Other (history unknown) 0 6QVCNPGYCPFTGNCRUG (0) 89 568 40 20 0 1990 1995 2000 2005 2010 1995 2000 2005 2010 2000 2005 600 4'64'#6/'06%#5'5 5OGCTRQUKVKXG 5OGCTWPMPQYPPQVFQPG 60 Total retreatment 9 581 6QVCNECUGUPQVKßGF Prevalence (rate per 100 000 population) Population 2012 43 million 400 200 0 1990 New cases 5/'#4215+6+8' 5/'#40')#6+8'70-0190 016&10' ':64#27./10#4; / (TCVKQ #IG Laboratories 2012 Smear (per 100 000 population) 4.2 Culture (per 5 million population) 0.2 Drug susceptibility testing (per 5 million population) Incidence (rate per 100 000 population per year) 400 300 200 100 0 1990 1995 Incidence 2010 Incidence (HIV+TB) Notifications 0.2 +UUGEQPFNKPGFTWIUWUEGRVKDKNKV[VGUVKPICXCKNCDNG! ;GUKPCPFQWVUKFGEQWPVT[ 0GYUOGCTRQUKVKXGCPFQTEWNVWTGRQUKVKXG 0GYUOGCTPGICVKXGGZVTCRWNOQPCT[ 4GVTGCVOGPV +UTKHCORKEKPWUGFVJTQWIJQWVVTGCVOGPVHQTPGYRCVKGPVU! ;GU TB/HIV 2012 07/$'4 (%) 6$RCVKGPVUYKVJMPQYP*+8UVCVWU *+8RQUKVKXG6$RCVKGPVU *+8RQUKVKXG6$RCVKGPVUQPEQVTKOQZC\QNGRTGXGPVKXGVJGTCR[ %26 *+8RQUKVKXG6$RCVKGPVUQPCPVKTGVTQXKTCNVJGTCR[ #46 Treatment success rate (%) 100 6TGCVOGPVUWEEGUUTCVG 80 60 40 1995 1997 1999 2001 2003 2005 2007 New smear-positive (and/or culture-positive) New smear-negative/extrapulmonary HIV-positive people screened for TB 2009 2011 Retreatment 60 000 Estimates of MDR-TB burden 2012a QH6$ECUGUYKVJ/&46$ /&46$ECUGUCOQPIPQVKßGF RWNOQPCT[6$ECUGU 0'9 4'64'#6/'06 ¿ ¿ ¿ ¿ Reported cases of MDR-TB 2012 Number of patients HIV-positive people provided with IPT 0'9 4'64'#6/'06 616#. .CDQTCVQT[EQPßTOGF/&46$ECUGU 2CVKGPVUUVCTVGFQP/&46$VTGCVOGPV %CUGUVGUVGFHQT/&46$ 40 000 20 000 0 2003 2004 2005 2006 2007 2008 HIV-positive TB patients 2009 on CPT 2010 2011 2012 on ART 0CVKQPCN6$RTQITCOOGDWFIGV 75OKNNKQPU 2013 % Funded domestically 24% % Funded internationally 15% % Unfunded 61% Total budget (US$ millions) 60 Financing TB control 40 20 0 Data are as reported to WHO. Estimates of TB and MDR-TB burden are produced by WHO in consultation with countries. a Ranges represent uncertainty intervals. 124 GLOBAL TUBERCULOSIS REPORT 2013 2009 2010 Funded domestically Data for all years can be downloaded from www.who.int/tb/data 2011 2012 Funded internationally 2013 Unfunded MOZAMBIQUE Estimates of TB burdena 2012 07/$'4(thousands) 4#6'(per 100 000 population) ¿ ¿ /QTVCNKV[ GZENWFGU*+8 6$ /QTVCNKV[ *+8 6$QPN[ ¿ ¿ 2TGXCNGPEG KPENWFGU*+8 6$ ¿ ¿ +PEKFGPEG KPENWFGU*+8 6$ ¿ ¿ +PEKFGPEG *+8 6$QPN[ ¿ ¿ Case detection, all forms (%) 34 (25–50) 6$ECUGPQVKßECVKQPU 0'9%#5'5 4GNCRUG Smear-negative 19 797 (43) Extrapulmonary Other 0 Total new Other (history unknown) 0 6QVCNPGYCPFTGNCRUG Treatment after failure 243 (5) Other 2 595 (57) Total retreatment 4 537 (0) 46 290 100 0 1990 6QVCNECUGUPQVKßGF 1995 2000 2005 2010 1995 2000 2005 2010 2000 2005 3000 6TGCVOGPVCHVGTFGHCWNV 5 542 (12) 200 4'64'#6/'06%#5'5 5OGCTRQUKVKXG 5OGCTWPMPQYPPQVFQPG 300 Prevalence (rate per 100 000 population) 400 Mortality (excludes HIV+TB) (rate per 100 000 population per year) HIGH TB BURDEN | HIGH HIV BURDEN Population 2012 25 million 2000 1000 0 1990 Incidence (rate per 100 000 population per year) 1250 New cases 5/'#4215+6+8' 5/'#40')#6+8'70-0190 016&10' ':64#27./10#4; / (TCVKQ #IG Laboratories 2012 Smear (per 100 000 population) 1.2 Culture (per 5 million population) 0.6 Drug susceptibility testing (per 5 million population) 1000 750 500 250 0 1990 1995 Incidence 2010 Incidence (HIV+TB) Notifications 0.4 +UUGEQPFNKPGFTWIUWUEGRVKDKNKV[VGUVKPICXCKNCDNG! ;GUQWVUKFGEQWPVT[ New smear-positive and/or culture-positive New smear-negative/extrapulmonary 4GVTGCVOGPV +UTKHCORKEKPWUGFVJTQWIJQWVVTGCVOGPVHQTPGYRCVKGPVU! ;GU TB/HIV 2012 07/$'4 (%) TB patients with known HIV status 47 960 (94) *+8RQUKVKXG6$RCVKGPVU *+8RQUKVKXG6$RCVKGPVUQPEQVTKOQZC\QNGRTGXGPVKXGVJGTCR[ %26 *+8RQUKVKXG6$RCVKGPVUQPCPVKTGVTQXKTCNVJGTCR[ #46 Treatment success rate (%) 100 6TGCVOGPVUWEEGUUTCVG 80 60 40 20 0 1995 1997 1999 2001 2003 2005 2007 2009 New smear-positive (and/or culture-positive) New smear-negative/extrapulmonary HIV-positive people screened for TB 2011 Retreatment 30 000 17 317 Estimates of MDR-TB burden 2012a QH6$ECUGUYKVJ/&46$ /&46$ECUGUCOQPIPQVKßGF pulmonary TB cases 0'9 4'64'#6/'06 ¿ ¿ 1 400 (900–2 000) 540 (0–1 100) Reported cases of MDR-TB 2012 %CUGUVGUVGFHQT/&46$ Number of patients HIV-positive people provided with IPT 0'9 4'64'#6/'06 616#. .CDQTCVQT[EQPßTOGF/&46$ECUGU 2CVKGPVUUVCTVGFQP/&46$VTGCVOGPV 20 000 10 000 0 2003 2004 2005 2006 2007 2008 HIV-positive TB patients 2009 on CPT 2010 2011 2012 on ART 2013 0CVKQPCN6$RTQITCOOGDWFIGV 75OKNNKQPU % Funded domestically 19% % Funded internationally 51% % Unfunded 30% Total budget (US$ millions) 40 Financing TB control 30 20 10 0 Data are as reported to WHO. Estimates of TB and MDR-TB burden are produced by WHO in consultation with countries. a Ranges represent uncertainty intervals. Data for all years can be downloaded from www.who.int/tb/data 2009 2010 Funded domestically 2011 2012 Funded internationally GLOBAL TUBERCULOSIS REPORT 2013 2013 Unfunded 125 MYANMAR Mortality (excludes HIV+TB) (rate per 100 000 population per year) HIGH TB BURDEN | HIGH HIV BURDEN | HIGH MDR-TB BURDEN Estimates of TB burdena 2012 07/$'4(thousands) ¿ ¿ ¿ ¿ 2TGXCNGPEG KPENWFGU*+8 6$ ¿ ¿ Incidence (includes HIV+TB) /QTVCNKV[ *+8 6$QPN[ 200 (170–230) 377 (322–435) Incidence (HIV+TB only) 19 (16–21) 35 (30–41) %CUGFGVGEVKQPCNNHQTOU ¿ 6$ECUGPQVKßECVKQPU 0'9%#5'5 4GNCRUG Smear-negative 73 042 (53) Treatment after failure 1 671 (14) 0 Treatment after default 521 (5) 'ZVTCRWNOQPCT[ (0) 1VJGT Other 0 Total new (0) 136 612 Other (history unknown) 0 6QVCNPGYCPFTGNCRUG Total retreatment 11 537 6QVCNECUGUPQVKßGF 5/'#4215+6+8' / (TCVKQ 5/'#40')#6+8'70-0190 016&10' ':64#27./10#4; #IG 100 0 1990 1995 2000 2005 2010 1995 2000 2005 2010 Laboratories 2012 Smear (per 100 000 population) 2000 2005 0.9 Culture (per 5 million population) 1500 1000 500 0 1990 600 New cases 200 2000 4'64'#6/'06%#5'5 5OGCTRQUKVKXG Smear-unknown / not done 300 Prevalence (rate per 100 000 population) /QTVCNKV[ GZENWFGU*+8 6$ 4#6'(per 100 000 population) Incidence (rate per 100 000 population per year) Population 2012 53 million 400 200 0 1990 1995 Incidence 0.2 Drug susceptibility testing (per 5 million population) 2010 Incidence (HIV+TB) Notifications 0.2 +UUGEQPFNKPGFTWIUWUEGRVKDKNKV[VGUVKPICXCKNCDNG! ;GUKPCPFQWVUKFGEQWPVT[ 0GYUOGCTRQUKVKXGCPFQTEWNVWTGRQUKVKXG New smear-negative/extrapulmonary 90 4GVTGCVOGPV +UTKHCORKEKPWUGFVJTQWIJQWVVTGCVOGPVHQTPGYRCVKGPVU! ;GU TB/HIV 2012 07/$'4 (%) TB patients with known HIV status 19 219 (13) 5 161 (27) HIV-positive TB patients *+8RQUKVKXG6$RCVKGPVUQPEQVTKOQZC\QNGRTGXGPVKXGVJGTCR[ %26 *+8RQUKVKXG6$RCVKGPVUQPCPVKTGVTQXKTCNVJGTCR[ #46 Treatment success rate (%) 100 6TGCVOGPVUWEEGUUTCVG 1997 1999 2001 2003 2005 2007 New smear-positive (and/or culture-positive) New smear-negative/extrapulmonary 2009 2011 Retreatment 6000 Estimates of MDR-TB burden 2012a Number of patients HIV-positive people provided with IPT /&46$ECUGUCOQPIPQVKßGF pulmonary TB cases 60 40 1995 HIV-positive people screened for TB QH6$ECUGUYKVJ/&46$ 80 0'9 4'64'#6/'06 ¿ ¿ 4 900 (3 600–6 500) 1 200 (790–1 600) Reported cases of MDR-TB 2012 0'9 4'64'#6/'06 .CDQTCVQT[EQPßTOGF/&46$ECUGU 2CVKGPVUUVCTVGFQP/&46$VTGCVOGPV 2000 0 2003 2004 616#. %CUGUVGUVGFHQT/&46$ 4000 2005 2006 2007 2008 HIV-positive TB patients 2009 on CPT 2010 2011 2012 on ART Financing TB control 0CVKQPCN6$RTQITCOOGDWFIGV 75OKNNKQPU % Funded domestically 2013 2% % Funded internationally 39% % Unfunded 60% Total budget (US$ millions) 40 30 20 10 0 Data are as reported to WHO. Estimates of TB and MDR-TB burden are produced by WHO in consultation with countries. a Ranges represent uncertainty intervals. 126 GLOBAL TUBERCULOSIS REPORT 2013 2009 2010 Funded domestically Data for all years can be downloaded from www.who.int/tb/data 2011 2012 Funded internationally 2013 Unfunded NIGERIA Estimates of TB burdena 2012 07/$'4(thousands) 4#6'(per 100 000 population) ¿ ¿ /QTVCNKV[ GZENWFGU*+8 6$ Mortality (HIV+TB only) 19 (11–25) 11 (6.7–15) Prevalence (includes HIV+TB) 270 (43–710) 161 (25–420) +PEKFGPEG KPENWFGU*+8 6$ ¿ ¿ +PEKFGPEG *+8 6$QPN[ ¿ ¿ Case detection, all forms (%) 51 (29–110) 6$ECUGPQVKßECVKQPU 0'9%#5'5 4GNCRUG 6TGCVOGPVCHVGTHCKNWTG 4 432 (5) Treatment after default 1 174 (16) Other 3 249 (43) Total retreatment 7 548 Other Total new 90 305 50 0 1990 1995 2000 2005 2010 1995 2000 2005 2010 2000 2005 1500 5OGCTPGICVKXG Extrapulmonary 100 4'64'#6/'06%#5'5 5OGCTRQUKVKXG Smear-unknown / not done 150 Prevalence (rate per 100 000 population) 200 Mortality (excludes HIV+TB) (rate per 100 000 population per year) HIGH TB BURDEN | HIGH HIV BURDEN | HIGH MDR-TB BURDEN Population 2012 169 million 1000 500 0 1990 Other (history unknown) 6QVCNPGYCPFTGNCRUG 6QVCNECUGUPQVKßGF New cases 5/'#4215+6+8' 5/'#40')#6+8'70-0190 016&10' ':64#27./10#4; / (TCVKQ #IG Laboratories 2012 5OGCT RGTRQRWNCVKQP Culture (per 5 million population) 0.1 &TWIUWUEGRVKDKNKV[VGUVKPI RGTOKNNKQPRQRWNCVKQP Incidence (rate per 100 000 population per year) 600 500 400 300 200 100 0 1990 1995 Incidence 2010 Incidence (HIV+TB) Notifications +UUGEQPFNKPGFTWIUWUEGRVKDKNKV[VGUVKPICXCKNCDNG! ;GUQWVUKFGEQWPVT[ 0GYUOGCTRQUKVKXGCPFQTEWNVWTGRQUKVKXG 0GYUOGCTPGICVKXGGZVTCRWNOQPCT[ 4GVTGCVOGPV +UTKHCORKEKPWUGFVJTQWIJQWVVTGCVOGPVHQTPGYRCVKGPVU! ;GU TB/HIV 2012 07/$'4 (%) 6$RCVKGPVUYKVJMPQYP*+8UVCVWU HIV-positive TB patients 19 342 (23) *+8RQUKVKXG6$RCVKGPVUQPEQVTKOQZC\QNGRTGXGPVKXGVJGTCR[ %26 *+8RQUKVKXG6$RCVKGPVUQPCPVKTGVTQXKTCNVJGTCR[ #46 HIV-positive people screened for TB Treatment success rate (%) 100 6TGCVOGPVUWEEGUUTCVG 1997 1999 2001 2003 2005 2007 2009 2011 Retreatment 20 000 0'9 4'64'#6/'06 ¿ ¿ ¿ ¿ Reported cases of MDR-TB 2012 %CUGUVGUVGFHQT/&46$ 20 New smear-positive (and/or culture-positive) New smear-negative/extrapulmonary 0'9 4'64'#6/'06 616#. .CDQTCVQT[EQPßTOGF/&46$ECUGU 2CVKGPVUUVCTVGFQP/&46$VTGCVOGPV Number of patients /&46$ECUGUCOQPIPQVKßGF RWNOQPCT[6$ECUGU 40 2 257 Estimates of MDR-TB burden 2012a QH6$ECUGUYKVJ/&46$ 60 0 1995 140 460 HIV-positive people provided with IPT 80 15 000 10 000 5000 0 2003 2004 2005 2006 2007 2008 HIV-positive TB patients 2009 on CPT 2010 2011 2012 on ART 2013 0CVKQPCN6$RTQITCOOGDWFIGV 75OKNNKQPU (WPFGFFQOGUVKECNN[ % Funded internationally 24% 7PHWPFGF Total budget (US$ millions) 180 Financing TB control 120 60 0 Data are as reported to WHO. Estimates of TB and MDR-TB burden are produced by WHO in consultation with countries. a Ranges represent uncertainty intervals. Data for all years can be downloaded from www.who.int/tb/data 2009 2010 Funded domestically 2011 2012 Funded internationally GLOBAL TUBERCULOSIS REPORT 2013 2013 Unfunded 127 PAKISTAN Mortality (excludes HIV+TB) (rate per 100 000 population per year) HIGH TB BURDEN | HIGH MDR-TB BURDEN Estimates of TB burdena 2012 07/$'4(thousands) 4#6'(per 100 000 population) 62 (27–110) 34 (15–61) Mortality (excludes HIV+TB) /QTVCNKV[ *+8 6$QPN[ 2TGXCNGPEG KPENWFGU*+8 6$ Incidence (includes HIV+TB) +PEKFGPEG *+8 6$QPN[ %CUGFGVGEVKQPCNNHQTOU ¿ ¿ ¿ ¿ 410 (340–490) 231 (190–276) ¿ ¿ ¿ 6$ECUGPQVKßECVKQPU 0'9%#5'5 4'64'#6/'06%#5'5 5OGCTRQUKVKXG 4GNCRUG 5OGCTPGICVKXG 6TGCVOGPVCHVGTHCKNWTG Smear-unknown / not done 0 Extrapulmonary (0) 41 410 (16) Other 0 Total new Other (history unknown) 0 6QVCNPGYCPFTGNCRUG Treatment after default 1 241 (11) Other 3 534 (30) (0) 261 380 200 150 100 50 0 1990 1995 2000 2005 2010 1995 2000 2005 2010 2000 2005 Total retreatment 11 717 6QVCNECUGUPQVKßGF Prevalence (rate per 100 000 population) Population 2012 179 million 1500 1000 500 0 1990 New cases 5/'#4215+6+8' 5/'#40')#6+8'70-0190 016&10' ':64#27./10#4; / (TCVKQ #IG Laboratories 2012 5OGCT RGTRQRWNCVKQP Culture (per 5 million population) 0.2 Drug susceptibility testing (per 5 million population) Incidence (rate per 100 000 population per year) 400 300 200 100 0 1990 1995 Incidence 2010 Incidence (HIV+TB) Notifications 0.1 +UUGEQPFNKPGFTWIUWUEGRVKDKNKV[VGUVKPICXCKNCDNG! ;GUKPEQWPVT[ New smear-positive and/or culture-positive 92 New smear-negative/extrapulmonary 93 4GVTGCVOGPV +UTKHCORKEKPWUGFVJTQWIJQWVVTGCVOGPVHQTPGYRCVKGPVU! ;GU TB/HIV 2012 07/$'4 (%) TB patients with known HIV status 10 419 (4) *+8RQUKVKXG6$RCVKGPVU *+8RQUKVKXG6$RCVKGPVUQPEQVTKOQZC\QNGRTGXGPVKXGVJGTCR[ %26 *+8RQUKVKXG6$RCVKGPVUQPCPVKTGVTQXKTCNVJGTCR[ #46 Treatment success rate (%) 100 6TGCVOGPVUWEEGUUTCVG 80 60 40 20 0 1995 1997 1999 2001 2003 2005 2007 New smear-positive (and/or culture-positive) New smear-negative/extrapulmonary HIV-positive people screened for TB 2009 2011 Retreatment 40 Estimates of MDR-TB burden 2012a QH6$ECUGUYKVJ/&46$ /&46$ECUGUCOQPIPQVKßGF RWNOQPCT[6$ECUGU 0'9 4'64'#6/'06 ¿ ¿ ¿ ¿ Reported cases of MDR-TB 2012 %CUGUVGUVGFHQT/&46$ 0'9 4'64'#6/'06 616#. .CDQTCVQT[EQPßTOGF/&46$ECUGU 2CVKGPVUUVCTVGFQP/&46$VTGCVOGPV Number of patients HIV-positive people provided with IPT 30 20 10 0 2003 2004 2005 2006 2007 2008 HIV-positive TB patients 2009 on CPT 2010 2011 2012 on ART 0CVKQPCN6$RTQITCOOGDWFIGV 75OKNNKQPU % Funded domestically (WPFGFKPVGTPCVKQPCNN[ % Unfunded 2013 5% 9% Total budget (US$ millions) 80 Financing TB control 60 40 20 0 Data are as reported to WHO. Estimates of TB and MDR-TB burden are produced by WHO in consultation with countries. a Ranges represent uncertainty intervals. GLOBAL TUBERCULOSIS REPORT 2013 2009 2010 Funded domestically Data for all years can be downloaded from www.who.int/tb/data 2011 2012 Funded internationally 2013 Unfunded PHILIPPINES Mortality (excludes HIV+TB) (rate per 100 000 population per year) HIGH TB BURDEN | HIGH MDR-TB BURDEN Estimates of TB burdena 2012 07/$'4(thousands) 4#6'(per 100 000 population) 23 (22–25) 24 (22–26) 0.11 (0.09–0.13) 0.11 (0.09–0.14) 450 (390–500) 461 (405–520) Mortality (excludes HIV+TB) Mortality (HIV+TB only) Prevalence (includes HIV+TB) Incidence (includes HIV+TB) +PEKFGPEG *+8 6$QPN[ %CUGFGVGEVKQPCNNHQTOU 260 (210–310) 265 (219–316) ¿ ¿ ¿ 6$ECUGPQVKßECVKQPU 0'9%#5'5 5OGCTRQUKVKXG 4'64'#6/'06%#5'5 4GNCRUG Smear-negative Treatment after failure Extrapulmonary 591 (3) 0 (0) Treatment after default 3 270 (2) Other 17 575 (75) 0 (0) Total retreatment 23 489 Other Total new 115 263 (54) Smear-unknown / not done 212 119 Other (history unknown) 0 6QVCNPGYCPFTGNCRUG 80 60 40 20 0 1990 1995 2000 2005 2010 1995 2000 2005 2010 2000 2005 1 243 (5) 6QVCNECUGUPQVKßGF Prevalence (rate per 100 000 population) Population 2012 97 million 1500 1000 500 0 1990 Incidence (rate per 100 000 population per year) 600 New cases 5/'#4215+6+8' 5/'#40')#6+8'70-0190 016&10' ':64#27./10#4; / (TCVKQ #IG Laboratories 2012 Smear (per 100 000 population) 2.7 Culture (per 5 million population) 0.7 Drug susceptibility testing (per 5 million population) 400 200 0 1990 1995 Incidence 2010 Incidence (HIV+TB) Notifications 0.2 +UUGEQPFNKPGFTWIUWUEGRVKDKNKV[VGUVKPICXCKNCDNG! ;GUKPEQWPVT[ New smear-positive and/or culture-positive 90 0GYUOGCTPGICVKXGGZVTCRWNOQPCT[ 4GVTGCVOGPV +UTKHCORKEKPWUGFVJTQWIJQWVVTGCVOGPVHQTPGYRCVKGPVU! ;GU TB/HIV 2012 07/$'4 6$RCVKGPVUYKVJMPQYP*+8UVCVWU *+8RQUKVKXG6$RCVKGPVU Treatment success rate (%) 100 6TGCVOGPVUWEEGUUTCVG 60 40 20 0 1995 (%) 80 1997 1999 2001 2003 2005 2007 2009 New smear-positive (and/or culture-positive) New smear-negative/extrapulmonary *+8RQUKVKXG6$RCVKGPVUQPEQVTKOQZC\QNGRTGXGPVKXGVJGTCR[ %26 *+8RQUKVKXG6$RCVKGPVUQPCPVKTGVTQXKTCNVJGTCR[ #46 HIV-positive people screened for TB 2011 Retreatment 10 Estimates of MDR-TB burden 2012a QH6$ECUGUYKVJ/&46$ /&46$ECUGUCOQPIPQVKßGF RWNOQPCT[6$ECUGU 0'9 4'64'#6/'06 ¿ ¿ ¿ ¿ Reported cases of MDR-TB 2012 %CUGUVGUVGFHQT/&46$ 0'9 4'64'#6/'06 616#. .CDQTCVQT[EQPßTOGF/&46$ECUGU 2CVKGPVUUVCTVGFQP/&46$VTGCVOGPV Number of patients HIV-positive people provided with IPT 8 6 4 2 0 2003 2004 2005 2006 2007 2008 HIV-positive TB patients 2009 on CPT 2010 2011 2012 on ART 2013 0CVKQPCN6$RTQITCOOGDWFIGV 75OKNNKQPU % Funded domestically 16% % Funded internationally 15% % Unfunded 69% Total budget (US$ millions) 160 Financing TB control 120 80 40 0 Data are as reported to WHO. Estimates of TB and MDR-TB burden are produced by WHO in consultation with countries. a Ranges represent uncertainty intervals. Data for all years can be downloaded from www.who.int/tb/data 2009 2010 Funded domestically 2011 2012 Funded internationally GLOBAL TUBERCULOSIS REPORT 2013 2013 Unfunded 129 RUSSIAN FEDERATION Mortality (excludes HIV+TB) (rate per 100 000 population per year) HIGH TB BURDEN | HIGH HIV BURDEN | HIGH MDR-TB BURDEN Estimates of TB burdena 2012 07/$'4(thousands) 4#6'(per 100 000 population) ¿ ¿ /QTVCNKV[ *+8 6$QPN[ ¿ ¿ Prevalence (includes HIV+TB) 170 (73–320) 121 (51–221) Incidence (includes HIV+TB) /QTVCNKV[ GZENWFGU*+8 6$ 130 (110–150) 91 (77–106) Incidence (HIV+TB only) 9.3 (7.9–11) 6.5 (5.5–7.5) %CUGFGVGEVKQPCNNHQTOU ¿ 6$ECUGPQVKßECVKQPU 0'9%#5'5 4GNCRUG Smear-negative 59 019 (61) Treatment after failure 9 109 (17) Treatment after default 2 593 (5) 1 039 Extrapulmonary (1) 10 017 (10) Other 0 Total new Other (history unknown) 0 6QVCNPGYCPFTGNCRUG Other 32 466 (62) Total retreatment 52 379 (0) 97 542 15 10 5 0 1990 1995 2000 2005 2010 1995 2000 2005 2010 2000 2005 400 4'64'#6/'06%#5'5 5OGCTRQUKVKXG Smear-unknown / not done 25 20 6QVCNECUGUPQVKßGF Prevalence (rate per 100 000 population) Population 2012 143 million 300 200 100 0 1990 Incidence (rate per 100 000 population per year) 200 New cases 5/'#4215+6+8' / (TCVKQ 5/'#40')#6+8'70-0190 016&10' #IG ':64#27./10#4; Laboratories 2012 Smear (per 100 000 population) 0.7 Culture (per 5 million population) 4.1 &TWIUWUEGRVKDKNKV[VGUVKPI RGTOKNNKQPRQRWNCVKQP +UUGEQPFNKPGFTWIUWUEGRVKDKNKV[VGUVKPICXCKNCDNG! 150 100 50 0 1990 1995 Incidence 2010 Incidence (HIV+TB) Notifications ;GUKPEQWPVT[ New smear-positive and/or culture-positive 54 New smear-negative/extrapulmonary 73 4GVTGCVOGPV +UTKHCORKEKPWUGFVJTQWIJQWVVTGCVOGPVHQTPGYRCVKGPVU! ;GU TB/HIV 2012 TB patients with known HIV 07/$'4 statusb Treatment success rate (%) 100 6TGCVOGPVUWEEGUUTCVG 80 60 40 20 0 1995 (%) 1997 75 995 *+8RQUKVKXG6$RCVKGPVU *+8RQUKVKXG6$RCVKGPVUQPEQVTKOQZC\QNGRTGXGPVKXGVJGTCR[ %26 *+8RQUKVKXG6$RCVKGPVUQPCPVKTGVTQXKTCNVJGTCR[ #46 1999 2001 2003 2005 2007 New smear-positive (and/or culture-positive) New smear-negative/extrapulmonary HIV-positive people screened for TB 2009 2011 Retreatment 8000 Estimates of MDR-TB burden 2012a 0'9 4'64'#6/'06 ¿ ¿ ¿ ¿ QH6$ECUGUYKVJ/&46$ /&46$ECUGUCOQPIPQVKßGF RWNOQPCT[6$ECUGU Reported cases of MDR-TB 2012 %CUGUVGUVGFHQT/&46$ .CDQTCVQT[EQPßTOGF/&46$ECUGU 0'9 4'64'#6/'06 616#. 2CVKGPVUUVCTVGFQP/&46$VTGCVOGPV Number of patients HIV-positive people provided with IPT 6000 4000 2000 0 2003 2004 2005 2006 2007 2008 HIV-positive TB patients 2009 on CPT 2010 2011 2012 on ART 2013 0CVKQPCN6$RTQITCOOGDWFIGV 75OKNNKQPU % Funded domestically 100% (WPFGFKPVGTPCVKQPCNN[ % Unfunded 0% &CVCCTGCUTGRQTVGFVQ9*1'UVKOCVGUQH6$CPF/&46$DWTFGPCTGRTQFWEGFD[9*1KPEQPUWNVCVKQPYKVJ countries. a 4CPIGUTGRTGUGPVWPEGTVCKPV[KPVGTXCNU b The reported number of TB patients with known HIV status is for new TB patients in the civilian sector only. It was not possible to calculate the percentage of all TB patients with known HIV status. 130 GLOBAL TUBERCULOSIS REPORT 2013 Total budget (US$ millions) 1800 Financing TB control 1200 600 0 2009 2010 Funded domestically Data for all years can be downloaded from www.who.int/tb/data 2011 2012 Funded internationally 2013 Unfunded SOUTH AFRICA Estimates of TB burdena 2012 07/$'4(thousands) 4#6'(per 100 000 population) ¿ ¿ /QTVCNKV[ GZENWFGU*+8 6$ /QTVCNKV[ *+8 6$QPN[ ¿ ¿ 2TGXCNGPEG KPENWFGU*+8 6$ ¿ ¿ +PEKFGPEG KPENWFGU*+8 6$ ¿ ¿ Incidence (HIV+TB only) 330 (270–390) 631 (521–752) 0'9%#5'5 4'64'#6/'06%#5'5 4GNCRUG Smear-negative 63 210 (21) 5OGCTWPMPQYPPQVFQPG 6TGCVOGPVCHVGTFGHCWNV Extrapulmonary 42 467 (14) Other 0 Total new 100 50 0 1990 1995 2000 2005 2010 1995 2000 2005 2010 2000 2005 62 (52–75) 6$ECUGPQVKßECVKQPU 5OGCTRQUKVKXG 150 Treatment after failure 3 123 (6) Other 15 007 (29) Total retreatment 52 586 6QVCNECUGUPQVKßGF (0) 296 996 Other (history unknown) 0 6QVCNPGYCPFTGNCRUG 2000 Prevalence (rate per 100 000 population) Case detection, all forms (%) 200 Mortality (excludes HIV+TB) (rate per 100 000 population per year) HIGH TB BURDEN | HIGH HIV BURDEN | HIGH MDR-TB BURDEN Population 2012 52 million 1500 1000 500 0 1990 Incidence (rate per 100 000 population per year) 1250 New cases 5/'#4215+6+8' 5/'#40')#6+8'70-0190 016&10' ':64#27./10#4; / (TCVKQ #IG Laboratories 2012 Smear (per 100 000 population) 0.4 Culture (per 5 million population) 1.4 Drug susceptibility testing (per 5 million population) 1000 750 500 250 0 1990 1995 Incidence 2010 Incidence (HIV+TB) Notifications 1.4 +UUGEQPFNKPGFTWIUWUEGRVKDKNKV[VGUVKPICXCKNCDNG! ;GUKPEQWPVT[ 100 New smear-positive and/or culture-positive 79 New smear-negative/extrapulmonary 76 4GVTGCVOGPV +UTKHCORKEKPWUGFVJTQWIJQWVVTGCVOGPVHQTPGYRCVKGPVU! ;GU TB/HIV 2012 07/$'4 (%) HIV-positive TB patients 190 093 (65) *+8RQUKVKXG6$RCVKGPVUQPEQVTKOQZC\QNGRTGXGPVKXGVJGTCR[ %26 *+8RQUKVKXG6$RCVKGPVUQPCPVKTGVTQXKTCNVJGTCR[ #46 *+8RQUKVKXGRGQRNGUETGGPGFHQT6$ HIV-positive people provided with IPT 369 747 Estimates of MDR-TB burden 2012a QH6$ECUGUYKVJ/&46$ /&46$ECUGUCOQPIPQVKßGF RWNOQPCT[6$ECUGU 4'64'#6/'06 ¿ ¿ ¿ ¿ Reported cases of MDR-TB 2012 60 40 20 1997 4'64'#6/'06 616#. %CUGUVGUVGFHQT/&46$ .CDQTCVQT[EQPßTOGF/&46$ECUGU 2CVKGPVUUVCTVGFQP/&46$VTGCVOGPV 2001 2003 2005 2007 2009 2011 Retreatment 250 000 200 000 150 000 100 000 50 000 0 2003 2004 0'9 1999 New smear-positive (and/or culture-positive) New smear-negative/extrapulmonary 0'9 80 0 1995 Number of patients 6$RCVKGPVUYKVJMPQYP*+8UVCVWU Treatment success rate (%) 6TGCVOGPVUWEEGUUTCVG 2005 2006 2007 2008 HIV-positive TB patients 2009 on CPT 2010 2011 2012 on ART 2013 0CVKQPCN6$RTQITCOOGDWFIGV 75OKNNKQPU % Funded domestically 97% % Funded internationally 3% % Unfunded 0% Total budget (US$ millions) 500 Financing TB control 400 300 200 100 0 Data are as reported to WHO. Estimates of TB and MDR-TB burden are produced by WHO in consultation with countries. a Ranges represent uncertainty intervals. Data for all years can be downloaded from www.who.int/tb/data 2009 2010 Funded domestically 2011 2012 Funded internationally GLOBAL TUBERCULOSIS REPORT 2013 2013 Unfunded 131 THAILAND Mortality (excludes HIV+TB) (rate per 100 000 population per year) HIGH TB BURDEN | HIGH HIV BURDEN Estimates of TB burdena 2012 07/$'4(thousands) 4#6'(per 100 000 population) /QTVCNKV[ GZENWFGU*+8 6$ ¿ ¿ /QTVCNKV[ *+8 6$QPN[ ¿ ¿ 2TGXCNGPEG KPENWFGU*+8 6$ ¿ ¿ +PEKFGPEG KPENWFGU*+8 6$ ¿ ¿ +PEKFGPEG *+8 6$QPN[ ¿ ¿ Case detection, all forms (%) 76 (64–92) 6$ECUGPQVKßECVKQPU 0'9%#5'5 5OGCTRQUKVKXG 4GNCRUG Smear-negative 17 537 (31) Smear-unknown / not done 'ZVTCRWNOQPCT[ Treatment after failure 327 (12) Treatment after default 577 (21) 1VJGT Other Total new 57 387 Other (history unknown) 1 030 6QVCNPGYCPFTGNCRUG Total retreatment 2 791 6QVCNECUGUPQVKßGF 60 40 20 0 1990 1995 2000 2005 2010 1995 2000 2005 2010 2000 2005 500 4'64'#6/'06%#5'5 Prevalence (rate per 100 000 population) Population 2012 67 million 400 300 200 100 0 1990 New cases 5/'#4215+6+8' 5/'#40')#6+8'70-0190 016&10' ':64#27./10#4; / (TCVKQ #IG Laboratories 2012 Smear (per 100 000 population) 1.6 Culture (per 5 million population) 4.9 Drug susceptibility testing (per 5 million population) Incidence (rate per 100 000 population per year) 250 200 150 100 50 0 1990 1995 Incidence 2010 Incidence (HIV+TB) Notifications 1.3 +UUGEQPFNKPGFTWIUWUEGRVKDKNKV[VGUVKPICXCKNCDNG! ;GUKPEQWPVT[ 0GYUOGCTRQUKVKXGCPFQTEWNVWTGRQUKVKXG 0GYUOGCTPGICVKXGGZVTCRWNOQPCT[ 4GVTGCVOGPV +UTKHCORKEKPWUGFVJTQWIJQWVVTGCVOGPVHQTPGYRCVKGPVU! ;GU TB/HIV 2012 07/$'4 (%) TB patients with known HIV status 44 035 (72) *+8RQUKVKXG6$RCVKGPVU *+8RQUKVKXG6$RCVKGPVUQPEQVTKOQZC\QNGRTGXGPVKXGVJGTCR[ %26 *+8RQUKVKXG6$RCVKGPVUQPCPVKTGVTQXKTCNVJGTCR[ #46 Treatment success rate (%) 100 6TGCVOGPVUWEEGUUTCVG 1997 1999 2001 2003 2005 2007 New smear-positive (and/or culture-positive) New smear-negative/extrapulmonary 2009 2011 Retreatment 10 000 Estimates of MDR-TB burden 2012a 0'9 4'64'#6/'06 ¿ ¿ ¿ ¿ Reported cases of MDR-TB 2012 %CUGUVGUVGFHQT/&46$ Number of patients HIV-positive people provided with IPT /&46$ECUGUCOQPIPQVKßGF RWNOQPCT[6$ECUGU 60 40 1995 HIV-positive people screened for TB QH6$ECUGUYKVJ/&46$ 80 0'9 4'64'#6/'06 616#. .CDQTCVQT[EQPßTOGF/&46$ECUGU 2CVKGPVUUVCTVGFQP/&46$VTGCVOGPV 8000 6000 4000 2000 0 2003 2004 2005 2006 2007 2008 HIV-positive TB patients 2009 on CPT 2010 2011 2012 on ART 0CVKQPCN6$RTQITCOOGDWFIGV 75OKNNKQPU % Funded domestically 2013 b 92% % Funded internationally 2% % Unfunded 6% &CVCCTGCUTGRQTVGFVQ9*1'UVKOCVGUQH6$CPF/&46$DWTFGPCTGRTQFWEGFD[9*1KPEQPUWNVCVKQPYKVJ countries. a 4CPIGUTGRTGUGPVWPEGTVCKPV[KPVGTXCNU b Based on data reported for 2013 in the 2012 round of data collection. In 2013, Thailand was not able to report funding for the sub-national level. 132 GLOBAL TUBERCULOSIS REPORT 2013 Total budget (US$ millions) 50 Financing TB control 40 30 20 10 0 2009 2010 Funded domestically Data for all years can be downloaded from www.who.int/tb/data 2011 2012 Funded internationally 2013 Unfunded UGANDA Estimates of TB burdena 2012 07/$'4(thousands) 4#6'(per 100 000 population) ¿ ¿ /QTVCNKV[ GZENWFGU*+8 6$ /QTVCNKV[ *+8 6$QPN[ ¿ ¿ 64 (24–120) 175 (67–334) Incidence (includes HIV+TB) 65 (53–79) 179 (145–216) +PEKFGPEG *+8 6$QPN[ ¿ ¿ %CUGFGVGEVKQPCNNHQTOU ¿ Prevalence (includes HIV+TB) 6$ECUGPQVKßECVKQPU 0'9%#5'5 4GNCRUG 5OGCTPGICVKXG 6TGCVOGPVCHVGTHCKNWTG Extrapulmonary 5 143 (12) Other 0 Total new Other (history unknown) 0 6QVCNPGYCPFTGNCRUG 6TGCVOGPVCHVGTFGHCWNV Other 1 114 (29) Total retreatment 3 882 (0) 43 329 0 1990 1995 2000 2005 2010 1995 2000 2005 2010 2000 2005 2500 4'64'#6/'06%#5'5 5OGCTRQUKVKXG 5OGCTWPMPQYPPQVFQPG 100 200 6QVCNECUGUPQVKßGF Prevalence (rate per 100 000 population) 300 Mortality (excludes HIV+TB) (rate per 100 000 population per year) HIGH TB BURDEN | HIGH HIV BURDEN Population 2012 36 million 2000 1500 1000 500 0 1990 New cases 5/'#4215+6+8' 5/'#40')#6+8'70-0190 016&10' ':64#27./10#4; / (TCVKQ #IG Laboratories 2012 Smear (per 100 000 population) 3.2 Culture (per 5 million population) 0.6 Drug susceptibility testing (per 5 million population) Incidence (rate per 100 000 population per year) 1250 1000 750 500 250 0 1990 1995 Incidence 2010 Incidence (HIV+TB) Notifications 0.6 +UUGEQPFNKPGFTWIUWUEGRVKDKNKV[VGUVKPICXCKNCDNG! ;GUKPEQWPVT[ New smear-positive and/or culture-positive 77 New smear-negative/extrapulmonary 66 4GVTGCVOGPV +UTKHCORKEKPWUGFVJTQWIJQWVVTGCVOGPVHQTPGYRCVKGPVU! ;GU TB/HIV 2012 07/$'4 (%) 6$RCVKGPVUYKVJMPQYP*+8UVCVWU HIV-positive TB patients 20 376 (50) *+8RQUKVKXG6$RCVKGPVUQPEQVTKOQZC\QNGRTGXGPVKXGVJGTCR[ %26 *+8RQUKVKXG6$RCVKGPVUQPCPVKTGVTQXKTCNVJGTCR[ #46 Treatment success rate (%) 100 6TGCVOGPVUWEEGUUTCVG 80 60 40 20 0 1995 1997 1999 2001 2003 2005 2007 2009 New smear-positive (and/or culture-positive) New smear-negative/extrapulmonary HIV-positive people screened for TB 2011 Retreatment 25 000 Estimates of MDR-TB burden 2012a QH6$ECUGUYKVJ/&46$ /&46$ECUGUCOQPIPQVKßGF RWNOQPCT[6$ECUGU 0'9 4'64'#6/'06 ¿ ¿ ¿ ¿ Reported cases of MDR-TB 2012 Number of patients HIV-positive people provided with IPT 0'9 4'64'#6/'06 616#. .CDQTCVQT[EQPßTOGF/&46$ECUGU 2CVKGPVUUVCTVGFQP/&46$VTGCVOGPV %CUGUVGUVGFHQT/&46$ 20 000 15 000 10 000 5000 0 2003 2004 2005 2006 2007 2008 HIV-positive TB patients 2009 on CPT 2010 2011 2012 on ART 2013 0CVKQPCN6$RTQITCOOGDWFIGV 75OKNNKQPU % Funded domestically 7% % Funded internationally 62% % Unfunded 31% Total budget (US$ millions) 40 Financing TB control 30 20 10 0 Data are as reported to WHO. Estimates of TB and MDR-TB burden are produced by WHO in consultation with countries. a Ranges represent uncertainty intervals. Data for all years can be downloaded from www.who.int/tb/data 2009 2010 Funded domestically 2011 2012 Funded internationally GLOBAL TUBERCULOSIS REPORT 2013 2013 Unfunded 133 UNITED REPUBLIC OF TANZANIA Mortality (excludes HIV+TB) (rate per 100 000 population per year) HIGH TB BURDEN | HIGH HIV BURDEN Estimates of TB burdena 2012 07/$'4(thousands) 4#6'(per 100 000 population) ¿ ¿ /QTVCNKV[ GZENWFGU*+8 6$ /QTVCNKV[ *+8 6$QPN[ ¿ ¿ ¿ ¿ +PEKFGPEG KPENWFGU*+8 6$ ¿ ¿ +PEKFGPEG *+8 6$QPN[ ¿ ¿ %CUGFGVGEVKQPCNNHQTOU ¿ 2TGXCNGPEG KPENWFGU*+8 6$ 6$ECUGPQVKßECVKQPU 0'9%#5'5 4GNCRUG Smear-negative 21 393 (35) Treatment after failure 154 (6) 0 Treatment after default 201 (7) Extrapulmonary (0) 14 595 (24) Other 0 Total new Other (history unknown) 0 6QVCNPGYCPFTGNCRUG Other 1 359 (49) Total retreatment 2 766 (0) 61 126 60 40 20 0 1990 1995 2000 2005 2010 1995 2000 2005 2010 2000 2005 800 4'64'#6/'06%#5'5 5OGCTRQUKVKXG Smear-unknown / not done 80 6QVCNECUGUPQVKßGF Prevalence (rate per 100 000 population) Population 2012 48 million 600 400 200 0 1990 New cases 5/'#4215+6+8' / (TCVKQ 5/'#40')#6+8'70-0190 016&10' #IG ':64#27./10#4; Laboratories 2012 Smear (per 100 000 population) 2.0 Culture (per 5 million population) 0.4 Drug susceptibility testing (per 5 million population) Incidence (rate per 100 000 population per year) 300 200 100 0 1990 1995 Incidence 2010 Incidence (HIV+TB) Notifications 0.1 +UUGEQPFNKPGFTWIUWUEGRVKDKNKV[VGUVKPICXCKNCDNG! ;GUKPEQWPVT[ 0GYUOGCTRQUKVKXGCPFQTEWNVWTGRQUKVKXG 0GYUOGCTPGICVKXGGZVTCRWNOQPCT[ 4GVTGCVOGPV +UTKHCORKEKPWUGFVJTQWIJQWVVTGCVOGPVHQTPGYRCVKGPVU! ;GU TB/HIV 2012 07/$'4 (%) 6$RCVKGPVUYKVJMPQYP*+8UVCVWU HIV-positive TB patients 20 269 (39) *+8RQUKVKXG6$RCVKGPVUQPEQVTKOQZC\QNGRTGXGPVKXGVJGTCR[ %26 *+8RQUKVKXG6$RCVKGPVUQPCPVKTGVTQXKTCNVJGTCR[ #46 HIV-positive people screened for TB Treatment success rate (%) 100 6TGCVOGPVUWEEGUUTCVG /&46$ECUGUCOQPIPQVKßGF pulmonary TB cases ¿ ¿ 500 (140–1 300) 0 (0–160) 1999 2001 2003 2005 2007 2009 2011 Retreatment 20 000 15 000 10 000 5000 0 Reported cases of MDR-TB 2012 %CUGUVGUVGFHQT/&46$ 1997 25 000 Number of patients QH6$ECUGUYKVJ/&46$ 4'64'#6/'06 70 New smear-positive (and/or culture-positive) New smear-negative/extrapulmonary 357 400 0'9 80 60 1995 HIV-positive people provided with IPT Estimates of MDR-TB burden 2012a 90 0'9 4'64'#6/'06 616#. .CDQTCVQT[EQPßTOGF/&46$ECUGU 2CVKGPVUUVCTVGFQP/&46$VTGCVOGPV 2003 2004 2005 2006 2007 2008 HIV-positive TB patients 2009 on CPT 2010 2011 2012 on ART 0CVKQPCN6$RTQITCOOGDWFIGV 75OKNNKQPU 2013 % Funded domestically 14% % Funded internationally 19% % Unfunded 67% Total budget (US$ millions) 60 Financing TB control 40 20 0 Data are as reported to WHO. Estimates of TB and MDR-TB burden are produced by WHO in consultation with countries. a Ranges represent uncertainty intervals. 134 GLOBAL TUBERCULOSIS REPORT 2013 2009 2010 Funded domestically Data for all years can be downloaded from www.who.int/tb/data 2011 2012 Funded internationally 2013 Unfunded VIET NAM Mortality (excludes HIV+TB) (rate per 100 000 population per year) HIGH TB BURDEN | HIGH HIV BURDEN | HIGH MDR-TB BURDEN Estimates of TB burdena 2012 07/$'4(thousands) 4#6'(per 100 000 population) ¿ ¿ /QTVCNKV[ GZENWFGU*+8 6$ /QTVCNKV[ *+8 6$QPN[ ¿ ¿ 2TGXCNGPEG KPENWFGU*+8 6$ ¿ ¿ Incidence (includes HIV+TB) 130 (99–170) 147 (109–192) Incidence (HIV+TB only) 9.3 (6.9–12) 10 (7.6–13) Case detection, all forms (%) 76 (59–100) 6$ECUGPQVKßECVKQPU 0'9%#5'5 5OGCTRQUKVKXG 4GNCRUG Smear-negative 21 706 (23) Smear-unknown / not done 'ZVTCRWNOQPCT[ Treatment after failure 567 (6) Treatment after default 494 (5) 1VJGT Other 3 210 Total new (3) 94 853 80 60 40 20 0 1990 1995 2000 2005 2010 1995 2000 2005 2010 2000 2005 1000 4'64'#6/'06%#5'5 Total retreatment 9 053 Prevalence (rate per 100 000 population) Population 2012 91 million 750 500 250 0 1990 Other (history unknown) 6QVCNPGYCPFTGNCRUG 6QVCNECUGUPQVKßGF New cases 5/'#4215+6+8' 5/'#40')#6+8'70-0190 016&10' ':64#27./10#4; / (TCVKQ #IG Laboratories 2012 Smear (per 100 000 population) 0.9 Culture (per 5 million population) 1.4 Drug susceptibility testing (per 5 million population) Incidence (rate per 100 000 population per year) 400 300 200 100 0 1990 1995 Incidence 2010 Incidence (HIV+TB) Notifications 0.1 +UUGEQPFNKPGFTWIUWUEGRVKDKNKV[VGUVKPICXCKNCDNG! ;GUKPEQWPVT[ New smear-positive and/or culture-positive 93 New smear-negative/extrapulmonary 93 4GVTGCVOGPV Is rifampicin used throughout treatment for new patients? No TB/HIV 2012 07/$'4 (%) 6$RCVKGPVUYKVJMPQYP*+8UVCVWU HIV-positive TB patients 4 775 (7) *+8RQUKVKXG6$RCVKGPVUQPEQVTKOQZC\QNGRTGXGPVKXGVJGTCR[ %26 *+8RQUKVKXG6$RCVKGPVUQPCPVKTGVTQXKTCNVJGTCR[ #46 Treatment success rate (%) 100 6TGCVOGPVUWEEGUUTCVG 90 80 70 60 1995 1997 1999 2001 2003 2005 2007 2009 New smear-positive (and/or culture-positive) New smear-negative/extrapulmonary HIV-positive people screened for TB 2011 Retreatment 6000 5 663 Estimates of MDR-TB burden 2012a QH6$ECUGUYKVJ/&46$ /&46$ECUGUCOQPIPQVKßGF RWNOQPCT[6$ECUGU 0'9 4'64'#6/'06 ¿ ¿ ¿ ¿ Reported cases of MDR-TB 2012 %CUGUVGUVGFHQT/&46$ 0'9 4'64'#6/'06 Number of patients HIV-positive people provided with IPT 4000 2000 0 2003 2004 616#. .CDQTCVQT[EQPßTOGF/&46$ECUGU 2CVKGPVUUVCTVGFQP/&46$VTGCVOGPV 2005 2006 2007 2008 HIV-positive TB patients 2009 on CPT 2010 2011 2012 on ART 2013 0CVKQPCN6$RTQITCOOGDWFIGV 75OKNNKQPU (WPFGFFQOGUVKECNN[ % Funded internationally 20% % Unfunded 72% Total budget (US$ millions) 80 Financing TB control 60 40 20 0 Data are as reported to WHO. Estimates of TB and MDR-TB burden are produced by WHO in consultation with countries. a Ranges represent uncertainty intervals. Data for all years can be downloaded from www.who.int/tb/data 2009 2010 Funded domestically 2011 2012 Funded internationally GLOBAL TUBERCULOSIS REPORT 2013 2013 Unfunded 135 ZIMBABWE Mortality (excludes HIV+TB) (rate per 100 000 population per year) HIGH TB BURDEN | HIGH HIV BURDEN Estimates of TB burdena 2012 07/$'4(thousands) Mortality (excludes HIV+TB) 4#6'(per 100 000 population) 4.6 (0.16–16) 33 (1.2–117) /QTVCNKV[ *+8 6$QPN[ ¿ ¿ Prevalence (includes HIV+TB) 59 (13–140) 433 (92–1 034) Incidence (includes HIV+TB) 77 (60–97) 562 (434–706) +PEKFGPEG *+8 6$QPN[ ¿ ¿ Case detection, all forms (%) 46 (37–60) 6$ECUGPQVKßECVKQPU 0'9%#5'5 5OGCTRQUKVKXG 4GNCRUG Smear-negative 14 354 (42) 2 962 'ZVTCRWNOQPCT[ 1VJGT 0 Total new Other (history unknown) 0 6QVCNPGYCPFTGNCRUG 200 (5) Treatment after default 176 (4) (0) 34 391 Total retreatment 4 329 6QVCNECUGUPQVKßGF 150 100 50 0 1990 1995 2000 2005 2010 1995 2000 2005 2010 2000 2005 1500 Treatment after failure Smear-unknown / not done Other (9) 4'64'#6/'06%#5'5 Prevalence (rate per 100 000 population) Population 2012 14 million 1000 500 0 1990 New cases 5/'#4215+6+8' 5/'#40')#6+8'70-0190 016&10' ':64#27./10#4; / (TCVKQ #IG Laboratories 2012 Smear (per 100 000 population) 1.3 Culture (per 5 million population) 0.7 Drug susceptibility testing (per 5 million population) 0.7 Is second-line drug susceptibility testing available? No Incidence (rate per 100 000 population per year) 1000 750 500 250 0 1990 1995 Incidence 2010 Incidence (HIV+TB) Notifications 0GYUOGCTRQUKVKXGCPFQTEWNVWTGRQUKVKXG 0GYUOGCTPGICVKXGGZVTCRWNOQPCT[ 4GVTGCVOGPV +UTKHCORKEKPWUGFVJTQWIJQWVVTGCVOGPVHQTPGYRCVKGPVU! ;GU TB/HIV 2012 07/$'4 (%) 6$RCVKGPVUYKVJMPQYP*+8UVCVWU HIV-positive TB patients 23 957 (70) *+8RQUKVKXG6$RCVKGPVUQPEQVTKOQZC\QNGRTGXGPVKXGVJGTCR[ %26 *+8RQUKVKXG6$RCVKGPVUQPCPVKTGVTQXKTCNVJGTCR[ #46 Treatment success rate (%) 100 6TGCVOGPVUWEEGUUTCVG 80 60 40 20 0 1995 1997 1999 2001 2003 2005 2007 New smear-positive (and/or culture-positive) New smear-negative/extrapulmonary HIV-positive people screened for TB 2009 2011 Retreatment 40 000 Estimates of MDR-TB burden 2012a QH6$ECUGUYKVJ/&46$ /&46$ECUGUCOQPIPQVKßGF pulmonary TB cases 0'9 4'64'#6/'06 ¿ ¿ 570 (300–960) 360 (76–970) Reported cases of MDR-TB 2012 %CUGUVGUVGFHQT/&46$ Number of patients HIV-positive people provided with IPT 0'9 4'64'#6/'06 616#. .CDQTCVQT[EQPßTOGF/&46$ECUGU 2CVKGPVUUVCTVGFQP/&46$VTGCVOGPV 30 000 20 000 10 000 0 2003 2004 2005 2006 2007 2008 HIV-positive TB patients 2009 on CPT 2010 2011 2012 on ART 0CVKQPCN6$RTQITCOOGDWFIGV 75OKNNKQPU % Funded domestically 2013 4% % Funded internationally 39% % Unfunded 56% Total budget (US$ millions) 45 Financing TB control 30 15 0 Data are as reported to WHO. Estimates of TB and MDR-TB burden are produced by WHO in consultation with countries. a Ranges represent uncertainty intervals. 136 GLOBAL TUBERCULOSIS REPORT 2013 2009 2010 Funded domestically Data for all years can be downloaded from www.who.int/tb/data 2011 2012 Funded internationally 2013 Unfunded #00': Regional proßles WHO AFRICAN REGION Mortality (excludes HIV+TB) (rate per 100 000 population per year) WHO MEMBER STATES 46 Estimates of TB burdena 2012 07/$'4 thousands 4#6' per 100 000 population) ¿ ¿ /QTVCNKV[ GZENWFGU*+8 6$ /QTVCNKV[ *+8 6$QPN[ ¿ ¿ Prevalence (includes HIV+TB) 2 700 (2 100–3 300) 303 (239–373) Incidence (includes HIV+TB) 2 300 (2 100–2 500) 255 (235–275) ¿ ¿ +PEKFGPEG *+8 6$QPN[ 6$ECUGPQVKßECVKQPU 0'9%#5'5 4'64'#6/'06%#5'5 5OGCTRQUKVKXG 4GNCRUG Smear-negative 345 947 (27) 5OGCTWPMPQYPPQVFQPG 6TGCVOGPVCHVGTFGHCWNV 'ZVTCRWNOQPCT[ 1VJGT 1VJGT Treatment after failure 9 174 (7.2) Total new 80 60 40 20 0 1990 1995 2000 2005 2010 1995 2000 2005 2010 2000 2005 59 (55–64) 1 282 355 Other (history unknown) 2 017 6QVCNPGYCPFTGNCRUG Total retreatment 128 267 6QVCNECUGUPQVKßGF Prevalence (rate per 100 000 population) Case detection, all forms (%) Population 2012 893 million 750 500 250 0 1990 5/'#4215+6+8' 5/'#40')#6+8'70-0190 016&10' ':64#27./10#4; Laboratories 2012 07/$'41(/'/$'456#6'5b 5OGCT RGTRQRWNCVKQP Ü QWVQH %WNVWTG RGTOKNNKQPRQRWNCVKQP Ü QWVQH &TWIUWUEGRVKDKNKV[VGUVKPI RGTOKNNKQPRQRWNCVKQP Ü QWVQH 6TGCVOGPVUWEEGUUTCVG 300 200 100 0 1990 1995 Incidence Incidence (HIV+TB) 2010 Notifications 100 0GYUOGCTRQUKVKXGCPFQTEWNVWTGRQUKVKXG New smear-negative/extrapulmonary 76 4GVTGCVOGPV /&46$ EQJQTV TB/HIV 2012 TB patients with known HIV status 07/$'4 (%)c 1 040 292 (74) *+8RQUKVKXG6$RCVKGPVU *+8RQUKVKXG6$RCVKGPVUQPEQVTKOQZC\QNGRTGXGPVKXGVJGTCR[ %26 *+8RQUKVKXG6$RCVKGPVUQPCPVKTGVTQXKTCNVJGTCR[ #46 HIV-positive people screened for TB Treatment success rate (%) #IG 80 60 40 20 0 1995 1997 1999 2001 2003 2005 2007 2009 New smear-positive (and/or culture-positive) New smear-negative/extrapulmonary 2011 Retreatment 2 391 601 HIV-positive people provided with IPT 473 214 Estimates of MDR-TB burden 2012a QH6$ECUGUYKVJ/&46$ /&46$ECUGUCOQPIPQVKßGF pulmonary TB cases 0'9 4'64'#6/'06 ¿ ¿ 24 000 (2 100–46 000) 14 000 (5 600–22 000) Reported cases of MDR-TB 2012 %CUGUVGUVGFHQT/&46$ 500 0'9 4'64'#6/'06 616#. .CDQTCVQT[EQPßTOGF/&46$ECUGU 2CVKGPVUUVCTVGFQP/&46$VTGCVOGPV (KPCPEKPI6$EQPVTQN NQYCPFOKFFNGKPEQOGEQWPVTKGU 0CVKQPCN6$RTQITCOOGDWFIGV 75OKNNKQPU d Number of patients / (TCVKQ 400 300 200 100 0 2004 2005 2006 2007 2008 HIV-positive TB patients 2013 % Funded domestically 44 % Funded internationally 21 % Unfunded 36 &CVCCTGCUTGRQTVGFVQ9*1'UVKOCVGUQH6$CPF/&46$DWTFGPCTGRTQFWEGFD[9*1KPEQPUWNVCVKQPYKVJ countries. a 4CPIGUTGRTGUGPVWPEGTVCKPV[KPVGTXCNU b Data are not collected from all Member States. c Calculations exclude countries with missing numerators or denominators. d Financing indicators exclude funding for general healthcare services provided outside NTPs. 2009 2010 on CPT 2011 2012 on ART 1500 Total budget (US$ millions) Incidence (rate per 100 000 population per year) 400 New cases Data for all years can be downloaded from www.who.int/tb/data 1000 500 0 2009 2010 Funded domestically 2011 2012 Funded internationally GLOBAL TUBERCULOSIS REPORT 2013 2013 Unfunded 139 WHO REGION OF THE AMERICAS Mortality (excludes HIV+TB) (rate per 100 000 population per year) WHO MEMBER STATES 35 OTHER COUNTRIES AND TERRITORIES 11 Estimates of TB burdena 2012 07/$'4 thousands 4#6' per 100 000 population) 19 (16–21) 1.9 (1.7–2.2) ¿ ¿ Prevalence (includes HIV+TB) 390 (300–490) 40 (31–51) +PEKFGPEG KPENWFGU*+8 6$ ¿ ¿ +PEKFGPEG *+8 6$QPN[ ¿ ¿ %CUGFGVGEVKQPCNNHQTOU ¿ Mortality (excludes HIV+TB) /QTVCNKV[ *+8 6$QPN[ Population 2012 961 million 8 6 4 2 0 1990 1995 2000 2005 2010 1995 2000 2005 2010 2000 2005 4'64'#6/'06%#5'5 4GNCRUG Smear-negative 35 606 (17) 5OGCTWPMPQYPPQVFQPG 6TGCVOGPVCHVGTFGHCWNV 'ZVTCRWNOQPCT[ 1VJGT 1VJGT Treatment after failure 1 195 (5.0) Total new 208 845 Other (history unknown) 39 6QVCNPGYCPFTGNCRUG Total retreatment 23 811 6QVCNECUGUPQVKßGF New cases 5/'#4215+6+8' 5/'#40')#6+8'70-0190 016&10' ':64#27./10#4; / (TCVKQ #IG Laboratories 2012 QWVQH %WNVWTG RGTOKNNKQPRQRWNCVKQP Ü QWVQH &TWIUWUEGRVKDKNKV[VGUVKPI RGTOKNNKQPRQRWNCVKQP Ü QWVQH 6TGCVOGPVUWEEGUUTCVG New smear-negative/extrapulmonary 71 4GVTGCVOGPV /&46$ EQJQTV HIV-positive TB patients *+8RQUKVKXG6$RCVKGPVUQPEQVTKOQZC\QNGRTGXGPVKXGVJGTCR[ %26 *+8RQUKVKXG6$RCVKGPVUQPCPVKTGVTQXKTCNVJGTCR[ #46 *+8RQUKVKXGRGQRNGUETGGPGFHQT6$ *+8RQUKVKXGRGQRNGRTQXKFGFYKVJ+26 .CDQTCVQT[EQPßTOGF/&46$ECUGU 129 174 (56) 20 355 (16) ¿ ¿ ¿ ¿ 0'9 4'64'#6/'06 616#. (KPCPEKPI6$EQPVTQN NQYCPFOKFFNGKPEQOGEQWPVTKGU 0CVKQPCN6$RTQITCOOGDWFIGV 75OKNNKQPU 1995 Incidence (HIV+TB) 2010 Notifications d 60 40 20 1997 1999 2001 2003 2013 % Funded internationally 12 % Unfunded 19 &CVCCTGCUTGRQTVGFVQ9*1'UVKOCVGUQH6$CPF/&46$DWTFGPCTGRTQFWEGFD[9*1KPEQPUWNVCVKQPYKVJ countries. a 4CPIGUTGRTGUGPVWPEGTVCKPV[KPVGTXCNU b Data are not collected from all Member States. c Calculations exclude countries with missing numerators or denominators. d Financing indicators exclude funding for general healthcare services provided outside NTPs. 2005 2007 2009 2011 Retreatment 25 20 15 10 5 2005 2006 2007 2008 HIV-positive TB patients 69 GLOBAL TUBERCULOSIS REPORT 2013 80 0 2004 % Funded domestically 140 20 New smear-positive (and/or culture-positive) New smear-negative/extrapulmonary 4'64'#6/'06 2CVKGPVUUVCTVGFQP/&46$VTGCVOGPV 40 0 1995 0'9 Reported cases of MDR-TB 2012 %CUGUVGUVGFHQT/&46$ 07/$'4 (%)c Number of patients TB/HIV 2012 TB patients with known HIV status /&46$ECUGUCOQPIPQVKßGF RWNOQPCT[6$ECUGU 60 100 0GYUOGCTRQUKVKXGCPFQTEWNVWTGRQUKVKXG QH6$ECUGUYKVJ/&46$ 0 1990 Incidence Estimates of MDR-TB burden 2012a 50 0 1990 07/$'41(/'/$'456#6'5b 5OGCT RGTRQRWNCVKQP Ü 100 80 Treatment success rate (%) 5OGCTRQUKVKXG 2009 2010 on CPT 2011 2012 on ART 200 Total budget (US$ millions) 0'9%#5'5 Incidence (rate per 100 000 population per year) Prevalence (rate per 100 000 population) 150 6$ECUGPQVKßECVKQPU 150 100 50 0 2009 2010 Funded domestically Data for all years can be downloaded from www.who.int/tb/data 2011 2012 Funded internationally 2013 Unfunded WHO EASTERN MEDITERRANEAN REGION Mortality (excludes HIV+TB) (rate per 100 000 population per year) WHO MEMBER STATES 22 OTHER COUNTRIES AND TERRITORIES 1 Estimates of TB burdena 2012 07/$'4 thousands Mortality (excludes HIV+TB) 4#6' per 100 000 population) 100 (63–150) 16 (10–24) ¿ ¿ ¿ ¿ 670 (590–750) 109 (96–122) +PEKFGPEG *+8 6$QPN[ ¿ ¿ Case detection, all forms (%) 63 (56–71) /QTVCNKV[ *+8 6$QPN[ 2TGXCNGPEG KPENWFGU*+8 6$ Incidence (includes HIV+TB) Population 2012 617 million 60 40 20 0 1990 1995 2000 2005 2010 1995 2000 2005 2010 2000 2005 0'9%#5'5 4'64'#6/'06%#5'5 5OGCTRQUKVKXG 4GNCRUG Smear-negative 135 346 (33) Treatment after failure 2 007 (9.5) 6TGCVOGPVCHVGTFGHCWNV 90 943 (22) 1VJGT Other 5 200 (24) Total new 409 477 1VJGT JKUVQT[WPMPQYP 6QVCNPGYCPFTGNCRUG Total retreatment 21 228 6QVCNECUGUPQVKßGF 5/'#4215+6+8' 5/'#40')#6+8'70-0190 016&10' ':64#27./10#4; / (TCVKQ #IG Laboratories 2012 QWVQH %WNVWTG RGTOKNNKQPRQRWNCVKQP Ü QWVQH &TWIUWUEGRVKDKNKV[VGUVKPI RGTOKNNKQPRQRWNCVKQP Ü QWVQH 6TGCVOGPVUWEEGUUTCVG 0GYUOGCTPGICVKXGGZVTCRWNOQPCT[ 4GVTGCVOGPV /&46$ EQJQTV TB/HIV 2012 07/$'4 (%)c 6$RCVKGPVUYKVJMPQYP*+8UVCVWU HIV-positive TB patients 2 020 (3.5) *+8RQUKVKXG6$RCVKGPVUQPEQVTKOQZC\QNGRTGXGPVKXGVJGTCR[ %26 *+8RQUKVKXG6$RCVKGPVUQPCPVKTGVTQXKTCNVJGTCR[ #46 HIV-positive people screened for TB %CUGUVGUVGFHQT/&46$ ¿ ¿ 11 000 (320–36 000) 6 900 (2 400–11 000) 0'9 4'64'#6/'06 616#. (KPCPEKPI6$EQPVTQN NQYCPFOKFFNGKPEQOGEQWPVTKGU 0CVKQPCN6$RTQITCOOGDWFIGV 75OKNNKQPU % Funded domestically d Number of patients 4'64'#6/'06 2CVKGPVUUVCTVGFQP/&46$VTGCVOGPV 50 1995 Incidence (HIV+TB) 2010 Notifications 80 60 40 20 1997 1999 2001 2003 2005 2007 2009 2011 Retreatment 2.0 0'9 .CDQTCVQT[EQPßTOGF/&46$ECUGU 100 New smear-positive (and/or culture-positive) New smear-negative/extrapulmonary 243 Reported cases of MDR-TB 2012 150 0 1995 15 012 HIV-positive people provided with IPT /&46$ECUGUCOQPIPQVKßGF pulmonary TB cases 0 1990 100 0GYUOGCTRQUKVKXGCPFQTEWNVWTGRQUKVKXG QH6$ECUGUYKVJ/&46$ 100 Incidence Estimates of MDR-TB burden 2012a 200 0 1990 07/$'41(/'/$'456#6'5b 5OGCT RGTRQRWNCVKQP Ü 300 200 New cases 400 Treatment success rate (%) Extrapulmonary 1.5 1.0 0.5 0 2004 2005 2006 2007 2008 HIV-positive TB patients 2013 32 % Funded internationally 53 % Unfunded 16 &CVCCTGCUTGRQTVGFVQ9*1'UVKOCVGUQH6$CPF/&46$DWTFGPCTGRTQFWEGFD[9*1KPEQPUWNVCVKQPYKVJ countries. a 4CPIGUTGRTGUGPVWPEGTVCKPV[KPVGTXCNU b Data are not collected from all Member States. c Calculations exclude countries with missing numerators or denominators. d Financing indicators exclude funding for general healthcare services provided outside NTPs. 2009 2010 on CPT 2011 2012 on ART 200 Total budget (US$ millions) 5OGCTWPMPQYPPQVFQPG Incidence (rate per 100 000 population per year) Prevalence (rate per 100 000 population) 500 6$ECUGPQVKßECVKQPU Data for all years can be downloaded from www.who.int/tb/data 150 100 50 0 2009 2010 Funded domestically 2011 2012 Funded internationally GLOBAL TUBERCULOSIS REPORT 2013 2013 Unfunded 141 WHO EUROPEAN REGION Estimates of TB burdena Mortality (excludes HIV+TB) (rate per 100 000 population per year) WHO MEMBER STATES 53 OTHER COUNTRIES AND TERRITORIES 1 2012 07/$'4 thousands 4#6' per 100 000 population) 36 (35–36) 3.9 (3.9–4) ¿ ¿ Mortality (excludes HIV+TB) /QTVCNKV[ *+8 6$QPN[ 2TGXCNGPEG KPENWFGU*+8 6$ ¿ ¿ +PEKFGPEG KPENWFGU*+8 6$ ¿ ¿ Incidence (HIV+TB only) 19 (17–21) 2.1 (1.9–2.3) Case detection, all forms (%) 74 (70–79) Population 2012 905 million 10 8 6 4 2 0 1990 1995 2000 2005 2010 1995 2000 2005 2010 2000 2005 0'9%#5'5 4'64'#6/'06%#5'5 4GNCRUG 6TGCVOGPVCHVGTHCKNWTG 6TGCVOGPVCHVGTFGHCWNV Extrapulmonary 39 029 (16) 1VJGT Other 51 237 (55) Total new 242 266 Other (history unknown) 2 054 6QVCNPGYCPFTGNCRUG Total retreatment 92 847 6QVCNECUGUPQVKßGF New cases 5/'#4215+6+8' 5/'#40')#6+8'70-0190 016&10' ':64#27./10#4; / (TCVKQ #IG Laboratories 2012 07/$'41(/'/$'456#6'5b 5OGCT RGTRQRWNCVKQP Ü QWVQH &TWIUWUEGRVKDKNKV[VGUVKPI RGTOKNNKQPRQRWNCVKQP Ü QWVQH 6TGCVOGPVUWEEGUUTCVG New smear-negative/extrapulmonary 79 4GVTGCVOGPV /&46$ EQJQTV TB/HIV 2012 TB patients with known HIV status 07/$'4 (%)c 203 705 (60) 12 900 (6.3) HIV-positive TB patients *+8RQUKVKXG6$RCVKGPVUQPEQVTKOQZC\QNGRTGXGPVKXGVJGTCR[ %26 *+8RQUKVKXG6$RCVKGPVUQPCPVKTGVTQXKTCNVJGTCR[ #46 HIV-positive people screened for TB 23 567 *+8RQUKVKXGRGQRNGRTQXKFGFYKVJ+26 Estimates of MDR-TB burden 2012a 80 60 40 20 0 1990 1995 0'9 4'64'#6/'06 ¿ ¿ ¿ Reported cases of MDR-TB 2012 0'9 4'64'#6/'06 616#. 2CVKGPVUUVCTVGFQP/&46$VTGCVOGPV Incidence (HIV+TB) 2010 Notifications (KPCPEKPI6$EQPVTQN NQYCPFOKFFNGKPEQOGEQWPVTKGU 0CVKQPCN6$RTQITCOOGDWFIGV 75OKNNKQPU d 60 40 20 1997 1999 2001 2003 2007 92 % Funded internationally 3.7 % Unfunded 4.3 2011 10 5 2005 2006 2007 2008 HIV-positive TB patients 2013 2009 Retreatment 15 0 2004 &CVCCTGCUTGRQTVGFVQ9*1'UVKOCVGUQH6$CPF/&46$DWTFGPCTGRTQFWEGFD[9*1KPEQPUWNVCVKQPYKVJ countries. a 4CPIGUTGRTGUGPVWPEGTVCKPV[KPVGTXCNU b Data are not collected from all Member States. c Calculations exclude countries with missing numerators or denominators. d Financing indicators exclude funding for general healthcare services provided outside NTPs. 2005 New smear-positive (and/or culture-positive) New smear-negative/extrapulmonary % Funded domestically GLOBAL TUBERCULOSIS REPORT 2013 80 0 1995 ¿ QH6$ECUGUYKVJ/&46$ 142 0 1990 100 65 .CDQTCVQT[EQPßTOGF/&46$ECUGU 50 Incidence New smear-positive and/or culture-positive %CUGUVGUVGFHQT/&46$ 100 QWVQH %WNVWTG RGTOKNNKQPRQRWNCVKQP Ü /&46$ECUGUCOQPIPQVKßGF RWNOQPCT[6$ECUGU 150 100 Treatment success rate (%) 5OGCTWPMPQYPPQVFQPG Number of patients 5OGCTPGICVKXG 2009 2010 on CPT 2011 2012 on ART 2500 Total budget (US$ millions) 5OGCTRQUKVKXG Incidence (rate per 100 000 population per year) Prevalence (rate per 100 000 population) 200 6$ECUGPQVKßECVKQPU 2000 1500 1000 500 0 2009 2010 Funded domestically Data for all years can be downloaded from www.who.int/tb/data 2011 2012 Funded internationally 2013 Unfunded WHO SOUTH-EAST ASIA REGION Mortality (excludes HIV+TB) (rate per 100 000 population per year) WHO MEMBER STATES 11 Estimates of TB burdena 2012 07/$'4 thousands 4#6' per 100 000 population) ¿ ¿ /QTVCNKV[ GZENWFGU*+8 6$ /QTVCNKV[ *+8 6$QPN[ ¿ ¿ 2TGXCNGPEG KPENWFGU*+8 6$ ¿ ¿ +PEKFGPEG KPENWFGU*+8 6$ ¿ ¿ ¿ ¿ +PEKFGPEG *+8 6$QPN[ %CUGFGVGEVKQPCNNHQTOU ¿ 6$ECUGPQVKßECVKQPU 0'9%#5'5 5OGCTRQUKVKXG 6TGCVOGPVCHVGTHCKNWTG Smear-unknown / not done 0 'ZVTCRWNOQPCT[ (0) Treatment after default 69 100 (21) 1VJGT 1VJGT Total new 1 993 614 Other (history unknown) 5 261 6QVCNPGYCPFTGNCRUG 60 40 20 0 1990 1995 2000 2005 2010 1995 2000 2005 2010 2000 2005 600 4'64'#6/'06%#5'5 4GNCRUG 5OGCTPGICVKXG 80 Total retreatment 332 580 6QVCNECUGUPQVKßGF Prevalence (rate per 100 000 population) Population 2012 1 833 million 400 200 0 1990 300 5/'#4215+6+8' Laboratories 2012 07/$'41(/'/$'456#6'5b 5OGCT RGTRQRWNCVKQP Ü QWVQH %WNVWTG RGTOKNNKQPRQRWNCVKQP Ü QWVQH &TWIUWUEGRVKDKNKV[VGUVKPI RGTOKNNKQPRQRWNCVKQP Ü QWVQH 6TGCVOGPVUWEEGUUTCVG 0GYUOGCTPGICVKXGGZVTCRWNOQPCT[ 4GVTGCVOGPV /&46$ EQJQTV TB/HIV 2012 (%)c 07/$'4 TB patients with known HIV status 904 223 (39) 56 093 (6.2) HIV-positive TB patients *+8RQUKVKXG6$RCVKGPVUQPEQVTKOQZC\QNGRTGXGPVKXGVJGTCR[ %26 *+8RQUKVKXG6$RCVKGPVUQPCPVKTGVTQXKTCNVJGTCR[ #46 *+8RQUKVKXGRGQRNGUETGGPGFHQT6$ %CUGUVGUVGFHQT/&46$ 0'9 4'64'#6/'06 ¿ 36 000 (26 000–46 000) 54 000 (37 000–70 000) 0'9 4'64'#6/'06 616#. .CDQTCVQT[EQPßTOGF/&46$ECUGU 2CVKGPVUUVCTVGFQP/&46$VTGCVOGPV (KPCPEKPI6$EQPVTQN NQYCPFOKFFNGKPEQOGEQWPVTKGU 0CVKQPCN6$RTQITCOOGDWFIGV 75OKNNKQPU 2010 Notifications d 60 40 20 1997 1999 2001 2003 2007 2009 40 20 2005 2006 2007 2008 HIV-positive TB patients 2013 % Funded domestically 30 % Funded internationally 41 % Unfunded 29 2011 Retreatment 60 0 2004 &CVCCTGCUTGRQTVGFVQ9*1'UVKOCVGUQH6$CPF/&46$DWTFGPCTGRTQFWEGFD[9*1KPEQPUWNVCVKQPYKVJ countries. a 4CPIGUTGRTGUGPVWPEGTVCKPV[KPVGTXCNU b Data are not collected from all Member States. c Calculations exclude countries with missing numerators or denominators. d Financing indicators exclude funding for general healthcare services provided outside NTPs. 2005 New smear-positive (and/or culture-positive) New smear-negative/extrapulmonary ¿ Reported cases of MDR-TB 2012 Incidence (HIV+TB) 80 0 1995 *+8RQUKVKXGRGQRNGRTQXKFGFYKVJ+26 /&46$ECUGUCOQPIPQVKßGF pulmonary TB cases 1995 100 QH6$ECUGUYKVJ/&46$ 100 Incidence 0GYUOGCTRQUKVKXGCPFQTEWNVWTGRQUKVKXG Estimates of MDR-TB burden 2012a 200 0 1990 Treatment success rate (%) #IG ':64#27./10#4; Number of patients / (TCVKQ 5/'#40')#6+8'70-0190 016&10' 2009 2010 on CPT 2011 2012 on ART 600 Total budget (US$ millions) Incidence (rate per 100 000 population per year) New cases Data for all years can be downloaded from www.who.int/tb/data 400 200 0 2009 2010 Funded domestically 2011 2012 Funded internationally GLOBAL TUBERCULOSIS REPORT 2013 2013 Unfunded 143 WHO WESTERN PACIFIC REGION Mortality (excludes HIV+TB) (rate per 100 000 population per year) WHO MEMBER STATES 27 OTHER COUNTRIES AND TERRITORIES 9 Estimates of TB burdena 2012 07/$'4 thousands /QTVCNKV[ GZENWFGU*+8 6$ 4#6' per 100 000 population) ¿ ¿ 5 (4–5) 0.26 (0.23–0.29) 2TGXCNGPEG KPENWFGU*+8 6$ ¿ ¿ +PEKFGPEG KPENWFGU*+8 6$ ¿ ¿ Incidence (HIV+TB only) 24 (21–27) 1.3 (1.1–1.5) %CUGFGVGEVKQPCNNHQTOU ¿ Mortality (HIV+TB only) Population 2012 1 846 million 30 20 10 0 1990 1995 2000 2005 2010 1995 2000 2005 2010 2000 2005 0'9%#5'5 4'64'#6/'06%#5'5 5OGCTRQUKVKXG 4GNCRUG Smear-negative 691 714 (55) Treatment after failure 3 714 (4.6) 6TGCVOGPVCHVGTFGHCWNV 'ZVTCRWNOQPCT[ 1VJGT 1VJGT Total new 1 264 217 Other (history unknown) 1 232 6QVCNPGYCPFTGNCRUG Total retreatment 80 017 6QVCNECUGUPQVKßGF New cases 5/'#4215+6+8' 5/'#40')#6+8'70-0190 016&10' ':64#27./10#4; / (TCVKQ #IG Laboratories 2012 5OGCT RGTRQRWNCVKQP Ü QWVQH %WNVWTG RGTOKNNKQPRQRWNCVKQP Ü QWVQH &TWIUWUEGRVKDKNKV[VGUVKPI RGTOKNNKQPRQRWNCVKQP Ü QWVQH 6TGCVOGPVUWEEGUUTCVG 94 New smear-negative/extrapulmonary 93 4GVTGCVOGPV /&46$ EQJQTV TB/HIV 2012 TB patients with known HIV status HIV-positive TB patients 07/$'4 (%)c 451 302 (34) 14 119 (3.1) *+8RQUKVKXG6$RCVKGPVUQPEQVTKOQZC\QNGRTGXGPVKXGVJGTCR[ %26 *+8RQUKVKXG6$RCVKGPVUQPCPVKTGVTQXKTCNVJGTCR[ #46 %CUGUVGUVGFHQT/&46$ 0'9 4'64'#6/'06 ¿ ¿ ¿ ¿ 0'9 4'64'#6/'06 .CDQTCVQT[EQPßTOGF/&46$ECUGU 2CVKGPVUUVCTVGFQP/&46$VTGCVOGPV (KPCPEKPI6$EQPVTQN NQYCPFOKFFNGKPEQOGEQWPVTKGU 0CVKQPCN6$RTQITCOOGDWFIGV 75OKNNKQPU 50 1995 Incidence (HIV+TB) 2010 Notifications d 60 40 20 1997 1999 2001 2003 2007 2013 % Funded internationally 15 % Unfunded 36 2009 2011 Retreatment 5 2005 2006 2007 2008 HIV-positive TB patients &CVCCTGCUTGRQTVGFVQ9*1'UVKOCVGUQH6$CPF/&46$DWTFGPCTGRTQFWEGFD[9*1KPEQPUWNVCVKQPYKVJ countries. a 4CPIGUTGRTGUGPVWPEGTVCKPV[KPVGTXCNU b Data are not collected from all Member States. c Calculations exclude countries with missing numerators or denominators. d Financing indicators exclude funding for general healthcare services provided outside NTPs. 2005 10 0 2004 50 GLOBAL TUBERCULOSIS REPORT 2013 80 15 616#. % Funded domestically 144 100 New smear-positive (and/or culture-positive) New smear-negative/extrapulmonary *+8RQUKVKXGRGQRNGRTQXKFGFYKVJ+26 Reported cases of MDR-TB 2012 150 0 1995 Number of patients *+8RQUKVKXGRGQRNGUETGGPGFHQT6$ /&46$ECUGUCOQPIPQVKßGF RWNOQPCT[6$ECUGU 0 1990 100 New smear-positive and/or culture-positive QH6$ECUGUYKVJ/&46$ 100 Incidence Estimates of MDR-TB burden 2012a 200 0 1990 07/$'41(/'/$'456#6'5b Treatment success rate (%) 300 200 2009 2010 on CPT 2011 2012 on ART 800 Total budget (US$ millions) 5OGCTWPMPQYPPQVFQPG Incidence (rate per 100 000 population per year) Prevalence (rate per 100 000 population) 400 6$ECUGPQVKßECVKQPU 600 400 200 0 2009 2010 Funded domestically Data for all years can be downloaded from www.who.int/tb/data 2011 2012 Funded internationally 2013 Unfunded #00': Key indicators for the world, WHO regions and individual countries Summary by WHO region 147 #HTKECP4GIKQP 4GIKQPQHVJG#OGTKECU 'CUVGTP/GFKVGTTCPGCP4GIKQP 'WTQRGCP4GIKQP 5QWVJ'CUV#UKC4GIKQP 9GUVGTP2CEKßE4GIKQP 57//#4;$;9*14')+10 Table A4.1 Estimates of the burden of disease caused by TB, 1990–2012 149 6CDNG# +PEKFGPEGPQVKßECVKQPCPFECUGFGVGEVKQPTCVGUCNNHQTOU¿ 6CDNG# %CUGPQVKßECVKQPU¿ Table A4.4 Treatment outcomes, new smear-positive cases, 1995–2011 152 Table A4.5 Treatment outcomes, retreatment cases, 1995–2011 152 6CDNG# *+8VGUVKPICPFRTQXKUKQPQH%26#46CPF+26¿ 6CDNG# 6GUVKPIHQT/&46$CPFPWODGTQHEQPßTOGFECUGUQH/&46$¿ 6CDNG# 0GYUOGCTRQUKVKXGECUGPQVKßECVKQPD[CIGCPFUGZ¿ Estimates of mortality, prevalence and incidence Estimated values are shown as best estimates followed by lower and upper bounds. The lower and upper bounds are defined as the 2.5th and 97.5th centiles of outcome distributions produced in simulations. See ANNEX 1 for further details. Estimated numbers are shown rounded to two significant figures. Estimated rates are shown rounded to three significant figures unless the value is under 100, in which case rates are shown rounded to two significant figures. Estimates for all years are recalculated as new information becomes available and techniques are refined, so they may differ from those published in previous reports in this series. The main updates implemented in this report are explained in Box 2.1 of Chapter 2. Estimates published in previous global TB control reports should no longer be used. Data source Data shown in this annex are taken from the WHO global TB database on 1 October 2013. Data shown in the main part of the report were taken from the database in July 2013. As a result, data in this annex may differ slightly from those in the main part of the report. Data for all years can be downloaded from www.who.int/tb/data. GLOBAL TUBERCULOSIS REPORT 2013 Data for all years can be downloaded from www.who.int/tb/data 7$%/($(VWLPDWHVRIWKHEXUGHQRIGLVHDVHFDXVHGE\7% ± Global 1990 1995 2000 2005 2010 2011 2012 Africa 1990 1995 2000 2005 2010 2011 2012 The Americas 1990 1995 2000 2005 2010 2011 2012 Eastern 1990 Mediterranean 1995 2000 2005 2010 2011 2012 Europe 1990 1995 2000 2005 2010 2011 2012 South-East 1990 Asia 1995 2000 2005 2010 2011 2012 Western 1990 Pacific 1995 2000 2005 2010 2011 2012 a POPULATION (MILLIONS) 5 298 5 718 6 102 6 489 6 890 6 972 7 054 503 577 655 744 847 870 893 727 783 841 892 942 951 961 378 429 480 533 593 605 617 849 863 870 882 899 902 905 1 310 1 435 1 560 1 682 1 790 1 812 1 833 1 532 1 630 1 697 1 756 1 820 1 833 1 846 NUMBER (THOUSANDS) 1 300 1 400 1 400 1 200 1 000 980 940 210 230 250 240 230 230 230 43 37 29 24 21 19 19 120 130 140 120 100 100 100 39 60 71 66 44 40 36 570 640 680 620 500 480 450 320 260 200 150 120 110 110 (1 100–1 500) (1 100–1 600) (1 100–1 600) (1 000–1 400) (850–1 200) (820–1 100) (790–1 100) (120–340) (140–350) (130–400) (130–390) (160–310) (160–310) (160–310) (35–52) (32–42) (25–33) (21–27) (18–24) (17–22) (16–21) (57–200) (67–210) (70–230) (65–190) (61–150) (62–150) (63–150) (36–43) (58–62) (69–73) (64–67) (43–46) (39–41) (35–36) (410–750) (460–840) (500–890) (480–780) (370–660) (350–620) (330–590) (280–350) (230–300) (160–230) (140–170) (110–130) (100–120) (96–120) RATEa 25 24 22 19 15 14 13 43 41 38 32 27 26 26 5.9 4.7 3.5 2.7 2.2 2 1.9 32 30 29 23 17 17 16 4.6 6.9 8.1 7.4 4.9 4.5 3.9 43 44 43 37 28 26 25 21 16 12 8.6 6.4 6.1 5.8 (21–29) (20–28) (18–27) (16–22) (12–17) (12–16) (11–16) (24–67) (24–61) (20–61) (17–53) (19–36) (18–35) (18–35) (4.8–7.1) (4.1–5.4) (3.0–4.0) (2.3–3.1) (1.9–2.5) (1.8–2.3) (1.7–2.2) (15–54) (16–50) (15–48) (12–36) (10–25) (10–25) (10–24) (4.2–5.1) (6.7–7.2) (7.9–8.4) (7.3–7.6) (4.8–5.1) (4.4–4.6) (3.9–4.0) (31–57) (32–58) (32–57) (29–47) (21–37) (19–34) (18–32) (18–23) (14–18) (9.6–14) (7.9–9.5) (5.9–7.1) (5.5–6.7) (5.2–6.4) PREVALENCE (INCLUDING HIV) NUMBER (THOUSANDS) 15 000 16 000 16 000 15 000 13 000 12 000 12 000 2 000 2 300 2 600 2 700 2 700 2 700 2 700 750 600 510 440 390 400 390 1 100 1 200 1 200 1 200 1 100 1 100 1 100 610 1 000 1 100 910 620 580 510 6 100 6 700 7 000 6 300 5 200 5 000 4 800 4 000 3 900 3 600 3 100 2 500 2 500 2 400 (13 000–16 000) (14 000–17 000) (14 000–18 000) (13 000–16 000) (11 000–14 000) (11 000–14 000) (11 000–13 000) (1 300–3 000) (1 600–3 200) (1 700–3 700) (1 800–3 800) (2 100–3 300) (2 100–3 300) (2 100–3 300) (540–990) (470–750) (390–640) (340–550) (300–490) (300–500) (300–490) (600–1 600) (720–1 700) (740–1 800) (740–1 700) (710–1 500) (720–1 600) (730–1 600) (500–720) (840–1 200) (890–1 400) (700–1 100) (470–790) (440–740) (380–650) (5 200–7 000) (5 800–7 700) (6 000–8 100) (5 300–7 400) (4 000–6 600) (3 900–6 400) (3 700–6 100) (3 600–4 400) (3 500–4 300) (3 200–4 000) (2 700–3 400) (2 300–2 800) (2 200–2 700) (2 100–2 600) RATEa 274 275 263 225 182 176 169 404 405 397 364 318 310 303 103 76 60 49 41 42 40 279 272 256 216 184 182 180 71 120 129 103 68 64 56 465 469 449 375 293 278 264 261 238 210 174 139 134 128 (249–302) (251–301) (237–290) (200–250) (160–205) (155–198) (149–190) (254–590) (276–558) (257–567) (239–515) (249–395) (244–383) (239–373) (74–136) (59–95) (47–76) (38–61) (32–52) (32–53) (31–51) (159–433) (168–401) (155–383) (138–312) (120–260) (119–258) (118–256) (59–85) (97–144) (103–159) (79–130) (52–87) (49–82) (42–72) (400–535) (404–538) (387–516) (314–442) (224–371) (213–352) (203–333) (238–286) (216–262) (187–234) (156–193) (124–153) (120–148) (115–142) INCIDENCE (INCLUDING HIV) NUMBER (THOUSANDS) 7 800 8 400 9 000 9 200 8 800 8 700 8 600 1 200 1 600 2 000 2 300 2 300 2 300 2 300 430 380 340 310 280 280 280 460 530 560 600 650 660 670 370 560 640 570 420 400 360 2 900 3 100 3 400 3 600 3 500 3 500 3 400 2 500 2 300 2 000 1 800 1 700 1 600 1 600 (7 200–8 500) (7 900–9 000) (8 500–9 500) (8 700–9 700) (8 400–9 100) (8 400–9 100) (8 300–9 000) (950–1 600) (1 300–1 900) (1 700–2 400) (2 000–2 700) (2 100–2 500) (2 100–2 500) (2 100–2 500) (370–490) (360–410) (320–370) (290–330) (260–300) (260–300) (260–300) (360–580) (470–590) (500–630) (530–670) (570–720) (580–740) (590–750) (350–380) (530–590) (600–680) (530–600) (400–450) (380–430) (340–390) (2 500–3 200) (2 800–3 400) (3 200–3 700) (3 300–3 900) (3 200–3 700) (3 200–3 700) (3 200–3 700) (2 100–2 900) (2 000–2 600) (1 800–2 300) (1 700–2 000) (1 500–1 800) (1 500–1 800) (1 500–1 800) RATEa 147 148 148 142 128 125 122 245 275 310 310 271 262 255 59 49 41 34 30 30 29 122 123 118 112 109 109 109 43 65 73 64 47 44 40 218 218 220 213 194 191 187 161 138 119 105 92 90 87 (136–160) (139–157) (139–156) (134–150) (123–133) (120–130) (117–127) (189–309) (226–329) (255–370) (263–361) (249–293) (242–284) (235–275) (51–68) (46–52) (38–43) (32–36) (28–32) (28–32) (27–31) (94–153) (109–137) (104–132) (99–126) (96–122) (97–122) (96–122) (41–45) (62–69) (69–78) (60–68) (44–50) (42–47) (38–43) (192–246) (198–239) (203–237) (197–229) (181–208) (177–204) (174–200) (135–189) (120–158) (106–133) (95–115) (84–100) (82–98) (80–95) SUMMARY BY WHO REGION MORTALITY (EXCLUDING HIV) YEAR Rates are per 100 000 population. Data for all years can be downloaded from www.who.int/tb/data GLOBAL TUBERCULOSIS REPORT 2013 149 7$%/($,QFLGHQFHQRWLILFDWLRQDQGFDVHGHWHFWLRQUDWHVDOOIRUPV ± INCIDENCE (INCLUDING HIV) Global Africa The Americas Eastern Mediterranean Europe South-East Asia Western Pacific a b YEAR POPULATION (MILLIONS) 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 5 298 5 718 6 102 6 489 6 890 6 972 7 054 503 577 655 744 847 870 893 727 783 841 892 942 951 961 378 429 480 533 593 605 617 849 863 870 882 899 902 905 1 310 1 435 1 560 1 682 1 790 1 812 1 833 1 532 1 630 1 697 1 756 1 820 1 833 1 846 NUMBER (THOUSANDS) 7 800 8 400 9 000 9 200 8 800 8 700 8 600 1 200 1 600 2 000 2 300 2 300 2 300 2 300 430 380 340 310 280 280 280 460 530 560 600 650 660 670 370 560 640 570 420 400 360 2 900 3 100 3 400 3 600 3 500 3 500 3 400 2 500 2 300 2 000 1 800 1 700 1 600 1 600 (7 200–8 500) (7 900–9 000) (8 500–9 500) (8 700–9 700) (8 400–9 100) (8 400–9 100) (8 300–9 000) (950–1 600) (1 300–1 900) (1 700–2 400) (2 000–2 700) (2 100–2 500) (2 100–2 500) (2 100–2 500) (370–490) (360–410) (320–370) (290–330) (260–300) (260–300) (260–300) (360–580) (470–590) (500–630) (530–670) (570–720) (580–740) (590–750) (350–380) (530–590) (600–680) (530–600) (400–450) (380–430) (340–390) (2 500–3 200) (2 800–3 400) (3 200–3 700) (3 300–3 900) (3 200–3 700) (3 200–3 700) (3 200–3 700) (2 100–2 900) (2 000–2 600) (1 800–2 300) (1 700–2 000) (1 500–1 800) (1 500–1 800) (1 500–1 800) INCIDENCE HIV-POSITIVE NUMBER (THOUSANDS) a RATE 147 148 148 142 128 125 122 245 275 310 310 271 262 255 59 49 41 34 30 30 29 122 123 118 112 109 109 109 43 65 73 64 47 44 40 218 218 220 213 194 191 187 161 138 119 105 92 90 87 (136–160) (139–157) (139–156) (134–150) (123–133) (120–130) (117–127) (189–309) (226–329) (255–370) (263–361) (249–293) (242–284) (235–275) (51–68) (46–52) (38–43) (32–36) (28–32) (28–32) (27–31) (94–153) (109–137) (104–132) (99–126) (96–122) (97–122) (96–122) (41–45) (62–69) (69–78) (60–68) (44–50) (42–47) (38–43) (192–246) (198–239) (203–237) (197–229) (181–208) (177–204) (174–200) (135–189) (120–158) (106–133) (95–115) (84–100) (82–98) (80–95) 280 620 1 100 1 300 1 100 1 100 1 100 230 460 780 960 880 850 830 17 31 32 34 33 33 31 0.91 2.8 5.9 8.6 11 11 11 1.8 3.4 6.7 17 20 19 19 22 110 210 220 180 170 170 1.8 8.6 17 24 24 24 24 a RATE (230–320) 5.2 (4.4–6.1) (560–680) 11 (9.8–12) (960–1 200) 17 (16–19) (1 200–1 400) 20 (18–21) (1 100–1 200) 17 (15–18) (1 000–1 200) 16 (15–17) (1 000–1 200) 15 (14–16) (190–280) 46 (38–56) (410–520) 80 (71–91) (690–880) 119 (105–134) (850–1 100) 130 (115–145) (800–950) 103 (94–113) (780–930) 98 (89–107) (760–910) 93 (85–102) (14–20) 2.3 (2.0–2.7) (28–33) 3.9 (3.6–4.3) (30–35) 3.8 (3.5–4.2) (31–37) 3.8 (3.5–4.1) (30–36) 3.5 (3.1–3.8) (30–36) 3.5 (3.1–3.8) (28–34) 3.3 (3.0–3.6) (0.77–1.1) 0.2 (0.20–0.28) (2.5–3.2) 0.7 (0.59–0.74) (5.3–6.6) 1.2 (1.1–1.4) (7.6–9.6) 1.6 (1.4–1.8) (9.9–12) 1.9 (1.7–2.1) (9.7–12) 1.8 (1.6–1.9) (10–12) 1.8 (1.6–2.0) (1.8–1.9) 0.2 (0.21–0.23) (3.3–3.6) 0.4 (0.38–0.42) (6.2–7.1) 0.8 (0.71–0.82) (15–18) 1.9 (1.7–2.0) (18–21) 2.2 (2.0–2.4) (18–21) 2.1 (2.0–2.3) (17–21) 2.1 (1.9–2.3) (19–26) 1.7 (1.5–2.0) (96–120) 7.5 (6.7–8.4) (190–230) 13 (12–15) (200–240) 13 (12–14) (160–190) 9.9 (9.1–11) (160–180) 9.4 (8.7–10) (160–180) 9.2 (8.5–10) (1.5–2.1) 0.1 (0.10–0.14) (7.4–9.9) 0.5 (0.45–0.61) (15–19) 1 (0.90–1.1) (21–27) 1.4 (1.2–1.5) (22–27) 1.3 (1.2–1.5) (22–27) 1.3 (1.2–1.5) (21–27) 1.3 (1.1–1.5) NOTIFIED NEW AND RELAPSE NUMBER 3 740 222 3 400 278 3 748 455 5 148 342 5 792 075 5 833 253 5 776 838 418 520 504 377 794 464 1 188 876 1 380 530 1 386 327 1 344 122 231 215 258 232 238 636 230 124 214 930 221 625 219 349 234 620 121 745 141 748 287 178 412 913 415 719 420 769 242 429 289 874 373 094 368 624 328 254 312 588 286 765 1 719 365 1 401 096 1 414 228 1 789 388 2 124 237 2 142 573 2 130 120 894 073 824 954 786 285 1 284 152 1 331 211 1 354 421 1 375 713 b CASE DETECTION a RATE PERCENT 71 59 61 79 84 84 82 83 87 121 160 163 159 151 32 33 28 26 23 23 23 62 28 30 54 70 69 68 29 34 43 42 37 35 32 131 98 91 106 119 118 116 58 51 46 73 73 74 75 48 40 42 56 66 67 67 34 32 39 52 60 61 59 54 67 70 75 76 78 79 51 23 25 48 64 63 63 66 51 59 65 77 78 79 60 45 41 50 61 62 62 36 37 39 70 80 83 85 Rates are per 100 000 population. NOTIFIED NEW AND RELAPSE includes cases for which the treatment history is unknown. 150 GLOBAL TUBERCULOSIS REPORT 2013 Data for all years can be downloaded from www.who.int/tb/data (44–52) (38–43) (39–44) (53–59) (63–69) (64–70) (64–70) (27–44) (27–39) (33–48) (44–61) (56–65) (56–66) (55–64) (47–63) (63–72) (65–75) (71–81) (71–82) (73–84) (74–85) (40–66) (21–26) (22–28) (43–54) (57–72) (56–71) (56–71) (63–69) (49–54) (55–62) (61–70) (73–83) (73–83) (74–84) (53–68) (41–49) (38–45) (46–54) (57–66) (58–67) (58–67) (31–43) (32–42) (35–44) (63–77) (73–87) (76–90) (78–93) 7$%/($&DVHQRWLILFDWLRQV ± YEAR Global • 71 82 • • 83 151 • • 32 23 • • 62 68 • Africa The Americas Eastern Mediterranean Europe • 29 32 • • 131 116 • • 58 75 • South-East Asia Western Pacific a b 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 NEW AND RELAPSEb 3 740 222 3 400 278 3 748 455 5 148 342 5 792 075 5 833 253 5 776 838 418 520 504 377 794 464 1 188 876 1 380 530 1 386 327 1 344 122 231 215 258 232 238 636 230 124 214 930 221 625 219 349 234 620 121 745 141 748 287 178 412 913 415 719 420 769 242 429 289 874 373 094 368 624 328 254 312 588 286 765 1 719 365 1 401 096 1 414 228 1 789 388 2 124 237 2 142 573 2 130 120 894 073 824 954 786 285 1 284 152 1 331 211 1 354 421 1 375 713 NEW CASES % SMEARRE-TREAT EXCL. TOTAL SMEAR- SMEAR-NEGATIVE/ EXTRAHISTORY POS AMONG OTHER RELAPSE POSITIVE UNKNOWN PULMONARY RELAPSE RETREAT UNKNOWN NEW PULM 30 046 1 175 290 1 541 607 2 413 708 2 655 557 2 630 564 2 563 744 24 064 212 910 368 750 550 004 601 149 606 085 600 355 1 542 138 932 131 294 124 840 116 994 122 010 122 730 1 587 46 851 60 959 113 765 168 627 170 748 173 963 0 104 444 94 442 96 121 91 324 85 551 80 453 2 769 357 882 510 053 857 371 1 047 013 1 067 367 1 065 852 84 314 271 376 109 671 607 630 450 578 803 520 391 22 393 1 811 850 1 615 263 1 722 281 2 002 463 2 037 926 2 084 246 6 137 191 477 222 230 364 785 477 516 467 022 446 213 516 72 312 60 392 56 056 52 265 51 165 50 338 12 394 51 823 34 289 102 274 137 301 135 388 143 869 0 146 592 208 147 157 237 145 140 136 456 129 293 3 241 939 945 741 471 594 185 615 463 598 800 586 455 105 409 701 348 734 447 744 574 778 649 095 728 078 4 237 262 728 399 677 686 525 806 373 817 668 813 960 2 067 72 689 141 255 208 979 247 020 240 839 234 707 723 32 991 32 037 33 285 32 240 34 048 34 496 754 33 382 40 754 64 612 92 070 93 605 90 943 0 29 866 35 081 49 747 40 951 46 012 43 134 656 76 865 120 708 242 332 328 421 333 993 338 303 37 16 935 29 842 87 570 65 671 69 171 72 377 0 5 37 8 111 12 870 12 164 9 689 0 0 0 2 941 561 1 073 977 0 5 37 3 685 2 133 1 502 1 636 0 0 0 12 633 623 702 0 0 0 0 8 008 3 381 83 0 0 0 1 439 1 508 2 878 3 004 0 0 0 34 27 2 707 3 287 734 59 240 115 334 259 937 285 966 284 815 288 119 554 15 133 19 173 60 092 53 967 52 357 60 085 180 1 723 10 834 10 152 10 413 10 087 10 100 0 2 407 5 568 6 495 11 203 11 223 11 208 0 7 927 21 607 22 248 24 304 24 628 25 133 0 5 546 27 095 93 859 130 714 135 650 131 245 0 26 504 31 057 67 091 55 365 50 870 50 348 49 0 236 107 406 355 418 071 413 363 393 437 49 0 68 118 66 449 94 506 74 545 67 960 0 0 14 344 12 481 12 133 11 856 13 879 0 0 0 5 334 8 713 10 102 10 020 0 0 19 127 64 831 60 736 67 986 65 121 0 0 80 444 158 215 208 542 215 554 201 335 0 0 54 074 99 045 33 441 33 320 35 122 783 59 240 351 441 666 292 704 037 698 178 681 556 603 15 133 87 291 126 541 148 473 126 902 128 045 180 1 723 25 178 22 633 22 546 21 943 23 979 0 2 407 5 568 11 829 19 916 21 325 21 228 0 7 927 40 734 87 079 85 040 92 614 90 254 0 5 546 107 539 252 074 339 256 351 204 332 580 0 26 504 85 131 166 136 88 806 84 190 85 470 29 44 229 18 172 28 846 50 116 17 080 0 0 0 2 075 317 18 951 1 785 29 44 56 2 106 885 2 813 49 0 0 0 20 3 079 4 132 84 0 0 173 3 663 18 527 16 560 8 669 0 0 0 202 1 118 3 885 5 261 0 0 0 10 106 4 920 3 775 1 232 57 39 49 58 57 56 55 80 53 62 60 56 56 57 75 66 68 69 69 70 71 11 47 64 53 55 56 55 SUMMARY BY WHO REGION NEW AND RELAPSE NOTIFICATION RATEa 1990–2012 42 31 38 39 39 38 46 28 41 59 63 64 65 44 43 52 60 52 47 42 Rates are per 100 000 population. NEW AND RELAPSE includes cases for which the treatment history is unknown. Data for all years can be downloaded from www.who.int/tb/data GLOBAL TUBERCULOSIS REPORT 2013 151 7$%/($7UHDWPHQWRXWFRPHVQHZVPHDUSRVLWLYHFDVHV ± % OF COHORT TREATMENT SUCCESS (%)a 1995–2011 Global • 57 87 • • 60 82 • • 50 78 • • 79 88 • • 67 66 • • 33 89 • • 80 94 • Africa The Americas Eastern Mediterranean Europe South-East Asia Western Pacific YEAR 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 NUMBER NOTIFIED 1 175 290 1 541 607 2 413 708 2 662 588 2 655 557 2 630 564 212 910 368 750 550 004 607 254 601 149 606 085 138 932 131 294 124 840 110 614 116 994 122 010 46 851 60 959 113 765 168 013 168 627 170 748 104 444 94 442 96 121 100 493 91 324 85 551 357 882 510 053 857 371 1 028 656 1 047 013 1 067 367 314 271 376 109 671 607 647 558 630 450 578 803 SIZE OF COHORT 1 000 581 1 452 991 2 396 387 2 664 704 2 661 653 2 610 821 177 567 364 804 563 750 605 932 598 985 578 920 128 531 110 642 118 840 122 534 126 450 126 859 46 318 63 749 113 742 167 317 169 872 170 903 33 823 41 480 81 410 105 441 98 689 106 626 318 410 512 286 855 962 1 022 380 1 045 179 1 064 879 295 932 360 030 662 683 641 100 622 478 562 634 COHORT AS % NOTIFIED CURED COMPLETED 85 94 99 100 100 99 83 99 102 100 100 96 93 84 95 111 108 104 99 105 100 100 101 100 32 44 85 105 108 125 89 100 100 99 100 100 94 96 99 99 99 97 40 60 77 80 80 80 46 59 62 70 72 72 37 60 55 53 53 54 60 69 72 74 74 74 58 47 59 56 54 51 9 44 83 85 85 85 67 85 89 90 90 91 17 9 7 7 7 7 14 12 13 10 9 10 14 17 24 23 22 23 19 12 11 14 14 14 10 28 13 13 13 15 23 6 4 3 4 4 13 5 3 3 3 3 DIED 3 4 4 4 4 4 6 7 7 5 5 5 3 5 5 5 5 5 2 4 3 3 2 2 6 5 8 8 8 8 1 2 4 4 4 4 2 2 2 2 2 2 FAILED DEFAULTED NOT EVALUATED 1 1 2 2 2 2 2 1 1 1 1 1 1 1 1 1 1 2 3 2 1 1 1 1 6 6 7 12 12 8 0 1 2 2 2 2 1 1 1 1 1 1 5 7 5 4 4 4 12 11 9 6 6 6 6 8 7 8 8 7 13 8 8 5 5 5 4 6 7 6 6 6 2 7 6 5 5 5 4 2 1 1 1 1 34 19 4 4 3 4 20 10 7 7 6 6 39 11 9 11 11 9 4 6 5 3 3 4 16 7 5 5 7 12 64 40 1 1 1 1 13 4 3 3 3 2 7$%/($7UHDWPHQWRXWFRPHVUHWUHDWPHQWFDVHV ± % OF COHORT TREATMENT SUCCESS (%)a 1995–2011 Global • 86 72 • • 69 68 • • 72 51 • • 75 74 • • 40 47 • • 68 75 • • 90 86 • Africa The Americas Eastern Mediterranean Europe South-East Asia Western Pacific a YEAR NUMBER NOTIFIED SIZE OF COHORT COHORT AS % NOTIFIED CURED COMPLETED DIED FAILED DEFAULTED NOT EVALUATED 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 59 240 351 441 666 292 673 854 704 037 698 178 15 133 87 291 126 541 144 320 148 473 126 902 1 723 25 178 22 633 21 492 22 546 21 943 2 407 5 568 11 829 17 964 19 916 21 325 7 927 40 734 87 079 67 190 85 040 92 614 5 546 107 539 252 074 331 424 339 256 351 204 26 504 85 131 166 136 91 464 88 806 84 190 71 395 188 509 546 182 594 019 613 895 601 904 5 756 44 147 114 838 94 342 113 405 85 278 1 104 15 302 18 603 19 158 17 499 20 228 1 860 4 217 12 860 16 332 18 326 22 191 480 10 739 39 497 58 966 58 698 58 831 3 271 59 337 254 378 332 286 338 748 350 251 58 924 54 767 106 006 72 935 67 219 65 125 121 54 82 88 87 86 38 51 91 65 76 67 64 61 82 89 78 92 77 76 109 91 92 104 6 26 45 88 69 64 59 55 101 100 100 100 222 64 64 80 76 77 82 60 51 49 47 48 57 47 35 50 41 53 61 47 38 29 26 27 61 51 60 56 54 52 20 39 32 27 25 24 62 57 49 48 47 45 88 83 81 79 79 80 4 10 19 23 22 24 12 11 27 20 13 15 11 8 16 22 23 24 14 11 15 21 21 22 20 19 18 22 25 23 6 14 22 27 28 30 2 3 6 7 7 6 3 6 7 7 7 7 9 9 11 9 6 7 6 5 6 8 7 8 3 6 5 4 4 4 11 9 11 11 11 10 4 6 7 7 7 7 3 2 3 3 3 3 3 4 4 6 5 5 3 3 3 3 3 3 4 3 2 3 2 3 4 7 4 3 3 3 8 14 13 22 16 15 5 5 5 4 4 4 3 2 3 2 2 3 3 11 12 10 10 10 12 16 13 9 7 9 11 12 15 19 20 20 12 15 10 10 10 10 32 11 14 11 10 10 15 15 15 12 12 11 1 1 2 2 2 2 4 10 6 5 10 7 6 14 12 10 31 12 8 25 21 21 21 18 5 11 6 6 8 8 8 8 10 7 13 18 8 3 2 2 2 3 3 9 6 7 7 6 TREATMENT SUCCESS = percent cured + percent completed then rounded to the nearest digit. 152 GLOBAL TUBERCULOSIS REPORT 2013 Data for all years can be downloaded from www.who.int/tb/data 7$%/($+,9WHVWLQJDQGSURYLVLRQRI&37$57DQG,37– Global •8 46 • • 11 74 • • 35 57 • •1 14 • • 40 60 • •2 39 • •2 32 • Africa The Americas Eastern Mediterranean Europe South-East Asia Western Pacific % OF TB NUMBER OF TB PATIENTS WITH PATIENTS WITH KNOWN HIV KNOWN HIV STATUS STATUS 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 8.3 34 40 46 11 60 69 74 35 53 56 57 0.88 11 11 14 40 55 57 60 1.6 23 33 39 2.4 20 25 32 463 027 2 080 846 2 526 072 2 808 221 140 713 888 765 1 013 342 1 040 262 84 032 121 421 129 613 132 943 2 582 44 596 48 271 58 498 171 248 212 727 215 256 212 880 31 847 546 350 767 813 909 026 32 605 266 987 351 777 454 612 PATIENTS NOTIFIED (NEW AND RETREAT) 5 554 697 6 210 146 6 246 616 6 170 275 1 255 325 1 475 036 1 460 872 1 412 082 242 605 227 063 233 481 233 228 292 512 421 626 425 821 430 789 433 455 388 990 380 574 351 886 1 947 603 2 332 779 2 358 127 2 331 455 1 383 197 1 364 652 1 387 741 1 410 835 NUMBER OF HIV-POSITIVE TB PATIENTS % OF TESTED TB PATIENTS HIV-POSITIVE 103 683 493 186 569 074 549 769 73 332 394 332 465 647 443 558 14 232 19 615 20 497 20 798 330 1 360 1 738 2 036 6 543 12 858 11 790 13 103 7 025 52 519 55 608 56 093 2 221 12 502 13 794 14 181 22 24 23 20 52 44 46 43 17 16 16 16 13 3 3.6 3.5 2.8 5.9 5.3 6.2 22 9.6 7.2 6.2 6.8 4.6 3.9 3.1 % OF HIV% OF HIVNUMBER OF POSITIVE TB POSITIVE TB HIV-POSITIVE PATIENTS ON PATIENTS ON PEOPLE CPT ART PROVIDED IPT 76 81 82 79 78 81 82 79 10 50 41 63 18 50 60 69 25 58 63 71 50 86 88 89 31 55 71 79 35 46 49 57 29 44 47 55 81 63 69 77 16 44 31 49 16 61 58 62 31 56 58 61 33 41 48 56 25 938 204 802 446 598 518 670 22 211 182 524 438 121 473 214 3 727 12 906 1 705 18 710 0 253 52 243 0 6 575 4 565 17 938 0 581 368 8 0 1 963 1 787 8 557 SUMMARY BY WHO REGION % OF TB PATIENTS WITH YEAR KNOWN HIV STATUS 2005–2012 7$%/($7HVWLQJIRU0'57%DQGQXPEHURIFRQILUPHGFDVHVRI0'57%± YEAR TOTAL CONFIRMED CASES OF a MDR-TB Global Africa The Americas Eastern Mediterranean Europe South-East Asia Western Pacific a b 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 11988 54887 61907 85085 2445 9340 12384 18146 4427 2661 3474 2967 350 873 841 2249 4347 33776 34199 36772 68 3942 6615 19202 351 4295 4394 5749 NEW PULMONARY CASES ESTIMATED CASES OF MDR-TB AMONG NOTIFIED ESTIMATED CASES OF MDR-TB AMONG NOTIFIED 310 000 (230 000–380 000) 170 000 (98 000–240 000) 38 000 (14 000–62 000) 24 000 (2 100–46 000) 7 100 (4 600–9 600) 3 800 (2 400–5 200) 18 000 (0–42 000) 11 000 (320–36 000) 74 000 (60 000–88 000) 33 000 (20 000–46 000) 90 000 (71 000–110 000) 36 000 (26 000–46 000) 78 000 (60 000–95 000) 59 000 (41 000–76 000) NUMBER OF b BACT+VE TESTED FOR MDR-TB 72870 118835 133064 153626 1826 2732 1311 2565 14568 11309 13334 29869 1442 2397 2264 1990 34527 89005 89438 92580 661 1073 1204 1352 19846 12319 25513 25270 PREVIOUSLY TREATED CASES % OF ESTIMATED CASES OF MDR-TB AMONG NOTIFIED b BACT+VE TESTED FOR MDR-TB 2.9 4 4.6 5.7 0.32 0.36 0.19 0.39 11 8.6 10 23 1.3 1.4 1.2 1.1 27 68 67 76 <0.1 0.1 0.1 0.13 2.9 1.7 4.2 4.6 140 000 (91 000–190 000) 14 000 (5 600–22 000) 3 200 (1 100–5 300) 6 900 (2 400–11 000) 41 000 (35 000–46 000) 54 000 (37 000–70 000) 19 000 (15 000–23 000) NUMBER OF % OF NOTIFIED NOTIFIED TESTED FOR TESTED FOR MDR-TB MDR-TB 24002 3.6 47315 6.7 48124 6.9 60589 8.9 3922 3.1 4294 2.9 3707 2.9 4118 3.2 11003 49 4234 19 4234 19 5565 23 94 0.79 1257 6.3 1466 6.9 1617 7.6 7024 8.1 34212 40 31646 34 38268 42 420 0.17 1264 0.37 1935 0.55 2292 0.69 1539 0.93 2054 2.3 5136 6.1 8729 10 TOTAL CONFIRMED CASES OF MDR-TB includes cases with unknown previous treatment history (i.e. not included under NEW CASES or PREVIOUSLY TREATED CASES). BACT+VE = bacteriologically positive cases. Data for all years can be downloaded from www.who.int/tb/data GLOBAL TUBERCULOSIS REPORT 2013 153 7$%/($1HZVPHDUSRVLWLYHFDVHQRWLILFDWLRQE\DJHDQGVH[ ± MALE Global Africa The Americas Eastern Mediterranean Europe South-East Asia Western Pacific 154 FEMALE YEAR 0–14 15–24 25–34 35–44 45–54 55–64 65+ UNKNOWN 0–14 15–24 25–34 35–44 45–54 55–64 65+ UNKNOWN 1995 2000 2005 2010 2011 2012 1995 2000 2005 2010 2011 2012 1995 2000 2005 2010 2011 2012 1995 2000 2005 2010 2011 2012 1995 2000 2005 2010 2011 2012 1995 2000 2005 2010 2011 2012 1995 2000 2005 2010 2011 2012 7 491 12 387 18 415 20 239 19 701 17 046 2 910 3 625 7 635 8 393 8 551 6 032 437 3 464 1 520 1 050 1 103 935 2 010 1 339 1 546 2 316 1 924 1 999 553 201 299 156 164 138 165 2 453 5 064 6 737 6 490 6 581 1 416 1 305 2 351 1 587 1 469 1 361 48 816 115 250 242 356 268 884 265 503 246 030 16 754 29 522 54 066 57 146 59 072 51 158 2 888 18 564 16 410 11 461 12 436 12 125 6 796 8 135 13 558 19 526 19 630 20 119 3 588 4 636 6 170 7 319 6 536 5 997 3 179 30 093 94 638 114 806 114 254 111 501 15 611 24 300 57 514 58 626 53 575 45 130 76 799 172 896 329 720 345 937 349 803 330 650 28 172 47 654 94 388 98 636 105 549 96 915 3 443 21 869 16 671 14 267 15 023 14 784 8 673 9 002 14 609 19 993 20 303 20 411 7 046 8 322 9 151 13 259 13 704 13 038 6 467 45 720 120 560 136 683 136 142 133 040 22 998 40 329 74 341 63 099 59 082 52 462 65 678 156 274 312 526 336 981 333 792 321 408 20 240 34 435 71 072 78 660 81 247 79 312 3 157 19 787 14 369 11 332 11 704 11 278 5 475 6 525 10 798 14 908 14 984 15 178 10 157 9 862 9 150 12 447 13 498 13 394 6 508 47 107 122 256 142 080 141 636 140 542 20 141 38 558 84 881 77 554 70 723 61 704 49 514 121 277 261 233 298 715 300 666 290 214 12 017 17 923 40 974 48 543 49 967 46 870 2 448 15 138 12 340 10 627 11 234 10 716 3 731 4 409 8 729 13 086 13 857 14 006 7 625 8 065 8 704 12 270 12 966 12 301 5 241 38 058 107 228 132 411 135 592 136 569 18 452 37 684 83 258 81 778 77 050 69 752 41 756 82 844 184 836 227 530 229 756 225 684 7 008 8 970 18 931 24 094 24 393 23 665 1 866 9 899 7 801 7 433 7 709 7 596 3 732 2 990 6 581 10 596 11 049 11 333 5 716 4 313 4 443 6 916 7 569 7 624 4 682 25 080 74 084 101 728 106 420 108 866 18 752 31 592 72 996 76 763 72 616 66 600 34 776 75 156 166 858 186 815 183 782 177 736 4 104 5 751 12 143 14 478 14 732 14 186 2 251 9 717 7 951 7 084 7 198 6 989 2 604 3 036 5 595 9 521 9 871 10 059 4 842 3 321 4 089 4 125 4 329 4 113 3 523 16 208 45 533 67 131 72 264 72 554 17 452 37 123 91 547 84 476 75 388 69 835 0 0 42 7 502 579 268 0 0 0 17 516 31 0 0 0 59 56 67 0 0 0 0 0 160 0 0 42 7 423 7 5 0 0 0 0 0 0 0 0 0 3 0 5 7 730 14 749 26 178 28 825 28 133 24 834 3 167 4 315 10 023 10 287 10 632 8 003 431 3 535 1 718 1 137 1 241 1 044 1 881 1 711 2 766 4 377 3 839 3 642 548 290 422 301 257 224 250 3 222 8 591 10 923 10 654 10 535 1 453 1 676 2 658 1 800 1 510 1 386 41 378 94 641 199 700 210 729 209 821 197 407 15 873 29 530 57 115 55 537 57 027 48 828 2 293 15 305 12 405 8 405 8 517 8 615 5 035 6 710 13 529 21 108 21 322 22 258 2 906 3 506 4 667 4 958 4 734 4 258 2 187 21 518 71 923 84 006 85 376 85 726 13 084 18 072 40 061 36 715 32 845 27 722 50 102 110 306 220 530 225 986 224 552 210 454 19 005 35 386 75 056 76 051 76 968 67 255 2 434 14 961 11 563 8 496 8 766 8 561 5 797 5 780 12 098 17 151 17 214 17 341 3 636 4 405 5 101 6 559 6 767 6 336 2 834 25 653 76 779 84 704 84 383 82 947 16 396 24 121 39 933 33 025 30 454 28 014 32 741 74 705 153 503 163 260 162 884 153 967 11 339 20 037 43 213 47 070 47 873 43 481 1 654 10 323 7 891 5 818 5 875 5 710 3 679 3 922 8 386 12 183 12 380 12 564 2 594 2 945 3 161 4 218 4 507 4 387 2 404 19 241 54 000 63 272 64 868 64 170 11 071 18 237 36 852 30 699 27 381 23 655 22 688 49 823 106 029 118 565 119 644 115 659 6 643 9 402 22 855 26 299 26 401 23 378 1 109 7 294 5 933 4 880 4 973 5 023 3 047 2 851 6 245 9 776 10 060 10 187 1 549 1 798 2 242 3 051 3 195 2 986 2 003 13 019 37 709 48 470 50 920 52 118 8 337 15 459 31 045 26 089 24 095 21 967 17 816 33 696 72 022 86 264 87 668 86 968 3 655 4 581 11 047 13 522 13 543 12 683 912 5 038 3 788 3 467 3 690 3 760 2 742 2 039 4 383 7 532 7 770 8 082 1 560 1 243 1 336 2 033 2 292 2 125 1 866 8 142 24 289 34 052 36 755 38 516 7 081 12 653 27 179 25 658 23 618 21 802 16 686 33 829 65 717 75 368 74 004 74 189 1 734 2 578 7 163 8 685 8 843 8 642 1 311 5 894 4 751 4 068 4 243 4 157 1 902 1 893 3 399 7 032 6 432 6 784 3 289 2 490 3 176 3 398 3 693 3 528 1 480 5 468 12 975 20 004 21 593 22 187 6 970 15 506 34 253 32 181 29 200 28 891 0 0 15 2 601 313 172 0 0 0 9 301 37 0 0 0 22 9 30 0 0 0 0 0 20 0 0 15 2 567 3 3 0 0 0 0 0 0 0 0 0 3 0 82 GLOBAL TUBERCULOSIS REPORT 2013 Data for all years can be downloaded from www.who.int/tb/data MALE:FEMALE RATIO 1.7 1.8 1.8 1.9 1.9 1.9 1.5 1.4 1.3 1.4 1.4 1.5 1.6 1.6 1.6 1.7 1.8 1.7 1.4 1.4 1.2 1.1 1.2 1.2 2.5 2.3 2.1 2.4 2.3 2.4 2.3 2.1 2.0 2.0 2.0 2.0 1.8 2.0 2.2 2.4 2.4 2.4 #(4+%#04')+10 Table A4.1 Estimates of the burden of disease caused by TB, 1990–2012 157 6CDNG# +PEKFGPEGPQVKßECVKQPCPFECUGFGVGEVKQPTCVGUCNNHQTOU¿ 6CDNG# %CUGPQVKßECVKQPU¿ Table A4.4 Treatment outcomes, new smear-positive cases, 1995–2011 166 Table A4.5 Treatment outcomes, retreatment cases, 1995–2011 169 6CDNG# *+8VGUVKPICPFRTQXKUKQPQH%26#46CPF+26¿ 6CDNG# 6GUVKPIHQT/&46$CPFPWODGTQHEQPßTOGFECUGUQH/&46$¿ 6CDNG# 0GYUOGCTRQUKVKXGECUGPQVKßECVKQPD[CIGCPFUGZ¿ Table A4.9 Laboratories, NTP services, drug management and infection control, 2012 179 6CDNG# /GCUWTGFRGTEGPVCIGQH6$ECUGUYKVJ/&46$OQUVTGEGPV[GCTCXCKNCDNG Estimates of mortality, prevalence and incidence Estimated values are shown as best estimates followed by lower and upper bounds. The lower and upper bounds are defined as the 2.5th and 97.5th centiles of outcome distributions produced in simulations. See ANNEX 1 for further details. Estimated numbers are shown rounded to two significant figures. Estimated rates are shown rounded to three significant figures unless the value is under 100, in which case rates are shown rounded to two significant figures. Estimates for all years are recalculated as new information becomes available and techniques are refined, so they may differ from those published in previous reports in this series. The main updates implemented in this report are explained in Box 2.1 of Chapter 2. Estimates published in previous global TB control reports should no longer be used. Data source Data shown in this annex are taken from the WHO global TB database on 1 October 2013. Data shown in the main part of the report were taken from the database in July 2013. As a result, data in this annex may differ slightly from those in the main part of the report. Data for all years can be downloaded from www.who.int/tb/data. 156 GLOBAL TUBERCULOSIS REPORT 2013 Data for all years can be downloaded from www.who.int/tb/data 7$%/($(VWLPDWHVRIWKHEXUGHQRIGLVHDVHFDXVHGE\7% ± Algeria Angola Benin Botswana Burkina Faso Burundi Cameroon Cape Verde Central African Republic Chad Comoros Congo Côte d'Ivoire Democratic Republic of the Congo Equatorial Guinea Eritrea a 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 POPULATION (MILLIONS) 26 29 32 34 37 38 38 10 12 14 17 20 20 21 5 6 7 8 10 10 10 1 2 2 2 2 2 2 9 10 12 13 16 16 16 6 6 7 8 9 10 10 12 14 16 18 21 21 22 <1 <1 <1 <1 <1 <1 <1 3 3 4 4 4 4 5 6 7 8 10 12 12 12 <1 <1 <1 <1 <1 <1 <1 2 3 3 4 4 4 4 12 14 16 17 19 19 20 35 42 47 54 62 64 66 <1 <1 <1 <1 <1 <1 <1 3 3 4 5 6 6 6 NUMBER (THOUSANDS) 2.8 2.9 4.4 5 5.3 5.4 5.6 4 6.1 5.8 4.4 6.6 7.6 8.7 0.97 0.95 0.95 0.87 0.88 0.91 0.94 1.3 1.3 0.88 0.66 0.48 0.45 0.42 1.2 1.4 1.5 1.5 1.4 1.4 1.4 1.3 3 2.6 2.2 1.8 1.8 1.8 2.3 5.8 8.1 7.3 6.6 6.3 6.4 0.13 0.14 0.15 0.15 0.13 0.12 0.11 3.6 5.1 5.2 3.9 2.6 2.4 2.2 0.86 1.5 2 2.3 2.3 2.2 2.3 0.043 0.038 0.037 0.045 0.045 0.046 0.045 0.7 0.83 1.1 1.7 1.8 1.8 1.8 4.8 8.2 9 6.6 4.7 4.7 4.4 26 28 29 29 33 35 36 0 0 0 0 0 0 0 0.39 0.33 0.3 0.29 0.28 0.28 0.28 (0.970–5.5) (0.980–5.9) (1.5–8.8) (1.7–9.9) (1.8–11) (1.9–11) (1.9–11) (1.0–8.9) (2.3–12) (2.4–11) (1.7–8.1) (3.0–12) (3.5–13) (3.9–15) (0.390–1.8) (0.390–1.7) (0.400–1.7) (0.380–1.6) (0.390–1.6) (0.400–1.6) (0.420–1.7) (0.095–4.2) (0.076–4.4) (0.046–2.9) (0.190–1.4) (0.120–1.1) (0.120–1.0) (0.110–0.920) (0.470–2.3) (0.540–2.6) (0.580–2.8) (0.610–2.7) (0.630–2.5) (0.620–2.5) (0.600–2.5) (0.570–2.3) (1.2–5.6) (1.1–4.9) (0.960–4.0) (0.840–3.2) (0.840–3.2) (0.790–3.2) (0.980–4.1) (2.2–11) (3.1–16) (3.0–14) (2.8–12) (2.7–11) (2.7–12) (0.034–0.290) (0.055–0.270) (0.057–0.290) (0.057–0.280) (0.051–0.240) (0.049–0.220) (0.047–0.210) (1.3–6.9) (1.9–9.9) (1.9–10) (1.5–7.5) (1.0–4.8) (0.980–4.4) (0.840–4.3) (0.370–1.5) (0.610–2.9) (0.800–3.7) (0.940–4.2) (1.0–4.1) (0.960–3.9) (0.980–4.1) (0.018–0.077) (0.017–0.069) (0.016–0.065) (0.019–0.083) (0.019–0.082) (0.019–0.083) (0.019–0.084) (0.220–1.4) (0.340–1.5) (0.500–2.0) (0.730–3.0) (0.790–3.3) (0.800–3.3) (0.780–3.4) (1.9–9.0) (3.2–16) (3.6–17) (2.8–12) (2.1–8.2) (2.2–8.3) (1.8–8.0) (9.9–49) (11–53) (12–53) (13–52) (15–59) (15–62) (16–64) (0–0.063) (0–0.087) (0–0.086) (0–0.058) (0–0.058) (0–0.053) (0–0.054) (0.260–0.540) (0.220–0.460) (0.200–0.420) (0.190–0.400) (0.190–0.390) (0.190–0.390) (0.190–0.400) a RATE 11 9.9 14 15 14 14 15 39 50 42 26 34 38 42 19 16 14 11 9.3 9.3 9.4 97 85 50 35 24 23 21 14 14 13 11 9.2 8.8 8.5 23 48 40 28 20 19 18 19 42 51 40 32 30 29 37 36 34 31 26 25 23 122 156 143 99 59 54 50 14 22 24 23 20 18 18 10 8.3 6.9 7.6 6.6 6.5 6.3 29 31 36 47 44 44 42 40 58 56 38 25 24 22 74 67 61 54 54 54 54 0 0 0 0 0 0 0 12 9.7 7.7 5.9 4.9 4.7 4.6 (3.7–21) (3.4–20) (4.9–28) (5.1–29) (5.0–28) (5.0–29) (5.1–29) (9.9–87) (19–96) (17–77) (11–49) (16–60) (17–66) (19–73) (7.9–36) (6.6–29) (5.8–25) (4.7–19) (4.1–16) (4.1–17) (4.2–17) (6.9–302) (4.8–276) (2.6–165) (10–76) (6.0–56) (5.9–51) (5.5–46) (5.3–26) (5.3–26) (5.0–24) (4.5–20) (4.0–16) (3.9–16) (3.7–15) (10–40) (19–90) (16–73) (12–51) (9.1–35) (8.8–33) (8.0–32) (8.1–34) (16–80) (19–98) (16–75) (14–58) (13–54) (12–54) (9.8–81) (14–68) (13–65) (12–59) (11–49) (10–46) (9.5–42) (45–236) (57–303) (53–277) (37–190) (24–110) (22–99) (19–95) (6.2–26) (8.8–41) (9.7–45) (9.4–42) (8.5–35) (8.0–33) (7.9–33) (4.4–19) (3.6–15) (3.0–12) (3.2–14) (2.8–12) (2.8–12) (2.6–12) (9.4–61) (13–56) (16–63) (21–85) (19–80) (19–78) (18–77) (16–74) (23–109) (22–105) (16–69) (11–43) (11–43) (9.1–41) (28–140) (27–126) (25–112) (24–97) (24–96) (24–97) (24–97) (0–17) (0–20) (0–17) (0–9.7) (0–8.3) (0–7.4) (0–7.4) (7.9–17) (6.4–14) (5.1–11) (3.9–8.3) (3.2–6.9) (3.1–6.6) (3.0–6.5) PREVALENCE (INCLUDING HIV) NUMBER (THOUSANDS) 29 32 47 53 56 57 59 39 55 59 57 80 90 99 9.7 8.9 9.3 9.2 10 11 11 13 15 13 11 8.1 7.5 6.9 12 12 13 13 14 14 14 15 32 27 22 20 20 20 24 56 80 78 76 68 69 1.2 1.3 1.4 1.4 1.3 1.2 1.2 40 55 54 40 28 26 24 9.4 16 21 24 28 28 28 0.38 0.35 0.34 0.4 0.42 0.45 0.44 7.7 9.6 14 21 23 23 23 48 78 83 64 49 51 45 240 270 290 300 350 360 380 0.38 0.42 0.67 0.81 1.2 1.2 1.2 16 12 7.6 9.1 9.6 9.5 9.3 (13–53) (13–59) (20–85) (23–95) (24–100) (25–100) (25–110) (14–76) (27–93) (29–99) (22–110) (35–140) (42–160) (48–170) (4.7–17) (4.3–15) (4.6–16) (4.6–15) (5.0–17) (5.3–18) (5.6–18) (1.9–33) (2.6–37) (3.4–28) (5.2–19) (3.6–14) (3.4–13) (3.1–12) (5.4–20) (5.7–21) (6.0–22) (6.6–22) (7.1–23) (7.2–23) (6.9–22) (7.8–24) (16–53) (14–45) (12–37) (11–33) (11–33) (10–32) (12–39) (26–98) (36–140) (36–140) (36–130) (32–120) (33–120) (0.440–2.3) (0.640–2.2) (0.670–2.3) (0.680–2.3) (0.630–2.1) (0.610–2.0) (0.590–2.0) (17–72) (23–100) (23–99) (17–71) (13–47) (12–44) (11–40) (4.7–16) (7.7–27) (10–36) (12–41) (14–47) (14–46) (14–46) (0.180–0.660) (0.170–0.600) (0.160–0.580) (0.200–0.680) (0.210–0.710) (0.230–0.740) (0.220–0.740) (2.6–16) (4.6–16) (6.9–24) (9.8–35) (11–39) (11–40) (11–40) (23–80) (38–130) (40–140) (33–100) (25–80) (26–83) (23–75) (110–420) (130–470) (140–480) (150–500) (180–560) (190–590) (200–620) (0.150–0.720) (0.160–0.820) (0.300–1.2) (0.350–1.5) (0.520–2.0) (0.560–2.2) (0.510–2.2) (6.5–29) (4.1–25) (1.9–17) (3.2–18) (3.6–18) (3.6–18) (3.5–18) INCIDENCE (INCLUDING HIV) a RATE 112 110 148 156 151 152 152 378 458 421 347 411 447 474 195 149 134 113 107 109 110 915 925 720 579 411 380 343 132 121 108 97 89 88 82 263 510 408 289 219 214 199 195 404 504 432 366 320 319 340 326 311 288 257 248 237 1 360 1 680 1 500 1 000 637 579 520 157 228 252 243 237 229 221 93 75 64 67 62 64 62 323 352 455 580 557 548 530 394 551 513 366 258 262 228 695 654 611 558 555 568 576 101 96 130 135 166 174 164 484 362 194 187 167 160 152 (49–202) (46–203) (64–267) (67–281) (65–273) (65–274) (66–274) (137–738) (225–772) (207–709) (132–663) (181–731) (209–772) (230–804) (93–333) (72–253) (66–225) (56–189) (53–179) (54–182) (55–184) (135–2 410) (166–2 310) (194–1 580) (276–991) (185–727) (172–668) (157–600) (61–230) (57–209) (52–186) (49–161) (46–147) (45–145) (42–136) (140–425) (251–858) (207–675) (151–471) (116–354) (114–345) (106–322) (98–325) (186–704) (227–889) (201–750) (174–629) (152–549) (153–544) (125–660) (161–549) (152–526) (142–485) (129–427) (124–414) (119–395) (583–2 460) (704–3 070) (631–2 720) (438–1 790) (304–1 090) (279–987) (251–884) (78–264) (111–388) (122–429) (119–412) (118–397) (114–383) (109–372) (45–159) (36–129) (30–111) (33–114) (31–103) (32–105) (31–103) (108–654) (168–601) (222–770) (276–994) (265–955) (262–938) (250–913) (193–664) (265–940) (249–870) (187–604) (133–424) (135–430) (115–380) (327–1 200) (318–1 110) (308–1 020) (285–920) (288–908) (297–923) (301–938) (39–193) (35–187) (58–231) (58–243) (75–294) (79–305) (69–299) (198–894) (121–731) (49–436) (67–368) (63–319) (60–307) (56–294) NUMBER (THOUSANDS) 17 20 28 31 33 34 34 21 27 35 46 59 62 66 6.4 6 6 6 6.5 6.8 7 7.4 14 16 14 9.9 9 8.2 7.6 8.3 8.2 8.4 9 9.1 9 9.1 20 19 15 13 13 13 14 29 49 57 56 51 52 0.62 0.67 0.71 0.73 0.71 0.71 0.71 25 39 39 27 19 18 17 5.6 9 13 15 18 18 19 0.22 0.21 0.21 0.22 0.23 0.24 0.25 4 6.7 11 15 16 16 17 29 54 60 46 36 37 34 110 140 150 180 200 210 210 0.3 0.35 0.52 0.66 0.94 1 1 8 6.7 6.2 5.9 5.8 5.7 5.7 (13–22) (15–26) (20–36) (23–41) (24–44) (25–44) (25–45) (13–31) (22–33) (28–42) (37–54) (50–69) (53–73) (55–77) (5.3–7.6) (4.9–7.1) (4.9–7.1) (5.0–7.2) (5.4–7.8) (5.6–8.1) (5.8–8.3) (2.9–14) (8.8–19) (13–20) (13–15) (8.8–11) (8.1–10) (7.3–9.1) (6.5–8.9) (7.0–9.6) (7.0–9.6) (7.1–9.8) (7.6–10) (7.7–11) (7.6–10) (8.0–10) (18–23) (17–22) (14–17) (12–15) (12–15) (11–14) (11–16) (24–34) (41–59) (47–68) (47–67) (42–61) (43–61) (0.380–0.910) (0.550–0.800) (0.580–0.850) (0.600–0.880) (0.590–0.850) (0.590–0.850) (0.590–0.850) (21–30) (32–47) (32–46) (23–33) (16–22) (15–21) (14–20) (4.7–6.7) (7.4–11) (10–15) (12–18) (15–21) (15–22) (16–22) (0.180–0.270) (0.180–0.250) (0.170–0.250) (0.180–0.260) (0.190–0.270) (0.200–0.290) (0.200–0.290) (2.5–5.9) (5.4–8.0) (9.3–13) (12–18) (13–19) (13–20) (14–20) (25–33) (47–62) (52–68) (40–53) (31–41) (32–42) (30–39) (92–140) (110–160) (130–180) (150–200) (180–230) (180–240) (190–250) (0.260–0.340) (0.310–0.400) (0.460–0.590) (0.580–0.750) (0.830–1.1) (0.890–1.1) (0.900–1.2) (5.3–11) (4.5–9.5) (4.1–8.7) (3.9–8.2) (3.8–8.1) (3.8–8.1) (3.8–8.0) RATEa 66 68 87 93 90 90 89 205 226 250 276 304 310 316 128 100 86 74 69 70 70 533 855 918 733 503 455 408 87 82 71 62 58 57 54 162 321 288 198 144 139 130 112 206 310 312 274 243 238 175 168 160 153 147 145 144 861 1 200 1 070 690 433 400 367 95 128 151 150 151 151 151 54 46 39 36 33 34 34 169 245 353 425 391 387 381 238 379 369 267 190 191 172 327 327 327 327 327 327 327 80 80 101 110 135 142 139 243 198 157 121 100 97 93 (48–86) (50–89) (64–114) (68–121) (66–118) (66–117) (65–117) (127–303) (185–272) (204–300) (227–329) (256–355) (261–362) (266–369) (106–152) (82–118) (71–102) (61–88) (57–82) (58–83) (58–83) (212–997) (553–1 220) (736–1 120) (667–802) (449–560) (406–507) (364–454) (73–101) (70–95) (60–83) (53–73) (49–67) (48–66) (46–63) (143–183) (283–362) (254–325) (174–223) (127–163) (122–157) (114–147) (92–133) (170–246) (255–369) (258–372) (226–327) (200–290) (197–283) (108–259) (137–201) (131–193) (125–184) (121–175) (120–173) (119–172) (710–1 030) (988–1 430) (884–1 280) (569–822) (357–515) (330–477) (302–438) (78–112) (106–153) (125–180) (124–178) (125–179) (125–179) (125–180) (44–64) (38–55) (32–46) (30–43) (28–40) (28–41) (28–41) (104–250) (200–294) (298–412) (347–510) (320–470) (317–465) (311–458) (206–272) (329–433) (320–422) (232–306) (165–217) (165–218) (149–198) (262–398) (268–392) (273–385) (279–379) (282–375) (282–375) (282–375) (70–91) (70–90) (88–114) (96–124) (119–153) (124–161) (122–158) (162–341) (132–278) (104–220) (80–169) (67–140) (64–136) (62–131) AFRICAN REGION MORTALITY (EXCLUDING HIV) YEAR Rates are per 100 000 population. Data for all years can be downloaded from www.who.int/tb/data GLOBAL TUBERCULOSIS REPORT 2013 157 7$%/($(VWLPDWHVRIWKHEXUGHQRIGLVHDVHFDXVHGE\7% ± MORTALITY (EXCLUDING HIV) YEAR Ethiopia Gabon Gambia Ghana Guinea Guinea-Bissau Kenya Lesotho Liberia Madagascar Malawi Mali Mauritania Mauritius Mozambique Namibia a 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 POPULATION (MILLIONS) 48 57 66 76 87 89 92 <1 1 1 1 2 2 2 <1 1 1 1 2 2 2 15 17 19 21 24 25 25 6 8 9 10 11 11 11 1 1 1 1 2 2 2 23 27 31 36 41 42 43 2 2 2 2 2 2 2 2 2 3 3 4 4 4 12 13 16 18 21 22 22 9 10 11 13 15 15 16 8 9 10 12 14 14 15 2 2 3 3 4 4 4 1 1 1 1 1 1 1 14 16 18 21 24 25 25 1 2 2 2 2 2 2 NUMBER (THOUSANDS) 23 27 27 22 17 16 16 0.39 0.62 0.99 1.1 0.8 0.73 0.72 0.33 0.4 0.44 0.57 0.78 0.84 0.91 5.3 5.4 5.1 4 2.5 2.1 1.7 3.7 4.2 3.9 3.3 2.8 2.6 2.6 0.21 0.26 0.36 0.32 0.43 0.46 0.49 7.1 4.5 5.9 8.1 8.2 8.9 9.5 0.35 0.34 0.29 0.2 0.27 0.34 0.34 0.62 1.1 1.6 1.6 1.9 1.9 1.9 13 11 11 10 10 10 10 3.8 3.7 3.2 2.3 1.8 1.5 1.4 1.2 1.2 1.2 1.3 1.3 1.3 1.3 0.38 0.92 1.5 2.3 3.2 3.4 3.5 0.027 0.013 <0.01 0.013 0.012 0.019 0.012 13 16 14 12 12 13 13 0.074 0.15 0.46 0.46 0.34 0.32 0.32 (14–35) (16–41) (16–41) (13–33) (12–23) (12–21) (12–21) (0.160–0.710) (0.250–1.2) (0.390–1.9) (0.430–2.0) (0.340–1.4) (0.320–1.3) (0.300–1.3) (0.087–0.730) (0.160–0.740) (0.180–0.810) (0.230–1.1) (0.300–1.5) (0.330–1.6) (0.360–1.7) (0.880–14) (1.1–13) (1.2–12) (1.3–8.3) (1.2–4.4) (1.0–3.6) (0.880–2.9) (1.4–7.2) (1.6–8.1) (1.5–7.3) (1.4–6.1) (1.2–5.0) (1.2–4.7) (1.1–4.8) (0.051–0.480) (0.100–0.470) (0.130–0.690) (0.110–0.660) (0.150–0.860) (0.150–0.920) (0.160–0.990) (2.8–13) (2.0–7.9) (2.8–10) (4.3–13) (5.1–12) (5.3–14) (5.4–15) (0.100–0.730) (0.110–0.680) (<0.01–1.1) (0–1.6) (<0.01–1.3) (<0.01–1.4) (<0.01–1.4) (0.130–1.5) (0.400–2.0) (0.580–3.0) (0.630–3.1) (0.790–3.5) (0.810–3.5) (0.830–3.5) (4.9–25) (4.4–21) (4.4–20) (4.3–19) (4.3–18) (4.4–18) (4.3–19) (0.700–9.5) (0.760–8.9) (0.360–9.0) (0.130–7.4) (0.680–3.5) (0.560–3.0) (0.570–2.7) (0.510–2.1) (0.540–2.2) (0.560–2.2) (0.600–2.2) (0.620–2.2) (0.630–2.2) (0.630–2.3) (0.015–1.3) (0.390–1.7) (0.610–2.9) (0.880–4.4) (1.2–6.1) (1.2–6.5) (1.3–6.9) (0.026–0.028) (0.012–0.013) (<0.01–<0.01) (0.013–0.014) (0.011–0.012) (0.019–0.019) (0.012–0.012) (0.360–48) (1.0–52) (0.430–49) (0.360–44) (0.890–38) (0.890–40) (0.980–41) (0.058–0.091) (0.110–0.180) (0.360–0.580) (0.350–0.580) (0.270–0.410) (0.250–0.390) (0.260–0.400) PREVALENCE (INCLUDING HIV) NUMBER (THOUSANDS) RATEa 49 48 41 29 20 18 18 41 57 81 78 51 46 44 36 38 36 39 46 49 51 36 32 27 19 10 8.6 6.9 62 54 44 34 25 24 23 21 22 28 23 27 28 29 30 16 19 23 20 21 22 22 19 16 10 14 17 17 29 51 54 50 48 47 46 114 82 69 56 48 47 46 40 37 28 18 12 9.9 9 15 13 12 11 9.3 9.1 9 19 39 57 73 88 91 93 2.5 1.1 0.68 1.1 0.94 1.5 0.97 98 101 75 58 51 51 53 5.2 8.8 24 23 15 14 14 (29–73) (28–72) (25–63) (17–44) (14–26) (14–24) (13–23) (17–74) (23–107) (32–152) (32–145) (22–93) (20–83) (18–81) (9.4–80) (15–70) (15–66) (16–74) (18–87) (19–92) (20–96) (6.0–93) (6.3–79) (6.3–62) (5.9–39) (5.0–18) (4.2–15) (3.5–11) (23–119) (21–103) (17–83) (14–63) (11–46) (10–42) (9.8–42) (5.0–47) (9.2–41) (11–54) (7.5–46) (9.4–54) (9.5–57) (9.8–59) (12–57) (7.4–29) (9.0–32) (12–36) (12–30) (13–32) (13–34) (6.5–46) (6.5–39) (0.38–58) (0–82) (<0.1–66) (0.20–67) (0.18–68) (6.0–71) (19–97) (20–104) (19–94) (20–88) (20–86) (20–84) (43–220) (33–154) (28–127) (24–103) (21–88) (20–85) (19–84) (7.4–101) (7.6–90) (3.2–80) (1.0–57) (4.5–23) (3.6–19) (3.6–17) (6.4–26) (6.0–24) (5.5–21) (5.0–19) (4.4–16) (4.4–16) (4.3–15) (0.76–65) (17–71) (23–106) (28–140) (33–170) (34–175) (34–181) (2.4–2.6) (1.1–1.2) (0.67–0.70) (1.1–1.1) (0.93–0.95) (1.5–1.6) (0.96–0.98) (2.6–357) (6.4–323) (2.3–270) (1.7–208) (3.7–160) (3.6–161) (3.9–163) (4.1–6.4) (6.9–11) (19–31) (17–28) (12–19) (11–18) (11–18) 200 270 280 250 220 210 210 4 6.4 11 13 10 9.8 9.2 3.2 4 4.6 5.8 7.7 8.2 8.8 47 50 48 40 29 26 23 33 40 38 33 33 32 31 2.4 2.9 3.7 3.8 4.8 5 5.2 64 54 85 120 130 130 130 4.3 5.7 7.2 7.9 8.5 8.9 8.7 6.7 9.4 14 16 20 20 21 110 98 96 95 97 98 99 39 43 41 34 27 24 22 11 12 12 12 13 13 14 5.7 9.7 15 20 27 29 30 0.58 0.57 0.54 0.52 0.5 0.49 0.48 120 140 130 120 130 130 140 11 13 27 23 18 15 16 (140–290) (200–370) (210–370) (190–320) (170–270) (170–260) (170–250) (2.0–6.6) (3.1–11) (5.2–19) (6.0–21) (5.0–17) (4.7–17) (4.3–16) (1.2–6.2) (2.0–6.6) (2.3–7.7) (2.9–9.7) (3.8–13) (4.1–14) (4.4–15) (12–110) (15–110) (17–96) (17–72) (15–48) (13–44) (11–41) (15–58) (19–68) (18–64) (16–57) (16–54) (16–54) (16–53) (0.860–4.8) (1.4–5.0) (1.8–6.2) (1.7–6.6) (2.3–8.1) (2.4–8.5) (2.5–8.9) (32–110) (29–85) (46–140) (65–200) (65–200) (68–210) (71–210) (1.6–8.2) (2.4–10) (2.4–15) (1.3–20) (2.5–18) (2.8–18) (2.7–18) (2.2–14) (4.6–16) (6.7–24) (7.7–26) (9.8–33) (10–34) (10–35) (50–190) (48–170) (47–160) (48–160) (49–160) (50–160) (50–160) (12–80) (16–81) (13–85) (10–72) (14–45) (12–40) (11–36) (6.0–18) (6.5–18) (6.7–19) (7.0–20) (7.3–21) (7.4–21) (7.6–22) (1.1–14) (4.7–17) (7.3–24) (9.9–35) (13–47) (13–50) (14–52) (0.220–1.1) (0.290–0.950) (0.270–0.910) (0.260–0.870) (0.250–0.830) (0.250–0.820) (0.240–0.810) (7.5–370) (17–400) (10–390) (12–350) (25–320) (26–330) (28–340) (5.1–18) (5.7–23) (9.8–53) (6.5–51) (6.3–36) (5.3–31) (6.1–29) RATEa 426 480 429 331 250 237 224 419 592 898 908 663 612 563 350 372 373 404 455 472 490 320 301 257 188 121 106 92 556 505 429 350 299 287 274 237 256 290 264 300 306 312 272 196 273 345 306 305 299 267 323 387 409 425 439 424 321 453 482 475 493 494 495 946 729 609 522 461 452 442 412 427 365 262 182 156 140 138 131 117 105 94 94 92 283 417 536 651 756 775 794 55 51 46 43 41 40 39 863 897 701 576 541 544 553 751 770 1 430 1 160 834 699 688 (285–594) (342–642) (318–556) (250–422) (199–307) (191–288) (180–272) (210–699) (289–1 000) (426–1 540) (434–1 550) (323–1 120) (295–1 040) (265–971) (129–679) (186–622) (184–628) (200–677) (227–762) (236–788) (245–819) (81–722) (91–634) (89–510) (81–338) (62–199) (52–179) (41–162) (257–968) (237–873) (205–734) (171–590) (149–500) (143–481) (136–459) (84–469) (120–442) (142–490) (121–462) (144–513) (145–525) (148–537) (138–452) (108–311) (147–437) (183–559) (159–500) (163–491) (164–475) (99–515) (134–593) (129–784) (65–1 060) (126–903) (139–905) (130–888) (102–661) (220–769) (231–822) (234–798) (247–822) (245–827) (244–832) (434–1 650) (356–1 230) (300–1 020) (261–870) (233–767) (228–749) (222–735) (131–849) (165–810) (118–749) (77–556) (95–298) (80–256) (72–229) (75–221) (73–206) (65–184) (58–164) (52–149) (52–148) (51–146) (53–703) (202–707) (268–895) (315–1 110) (357–1 300) (364–1 340) (373–1 370) (21–105) (25–85) (23–76) (22–72) (20–68) (20–66) (20–65) (56–2 730) (104–2 520) (56–2 130) (59–1 660) (105–1 320) (106–1 330) (111–1 340) (358–1 280) (344–1 360) (517–2 790) (321–2 510) (291–1 660) (241–1 390) (271–1 300) INCIDENCE (INCLUDING HIV) NUMBER (THOUSANDS) 180 240 280 260 230 230 230 2.1 3.4 6.5 8.1 7.4 7.2 7 1.7 2.2 2.8 3.6 4.6 4.8 5.1 23 28 29 25 21 20 18 15 20 20 20 20 20 20 1.6 2 2.4 3 3.7 3.9 4 33 46 89 130 120 120 120 2.9 5.7 10 12 13 13 13 4.2 4.6 7 8.7 12 12 13 45 45 46 48 51 52 52 31 46 53 46 33 30 26 6 7.2 7.9 8.3 8.8 8.9 9 4.6 5.9 7.5 9.6 12 13 13 0.29 0.29 0.29 0.28 0.27 0.26 0.26 54 76 94 110 130 130 140 5.4 9.5 27 28 19 16 15 (100–270) (140–360) (170–420) (150–390) (170–310) (170–300) (170–290) (1.7–2.5) (2.8–4.1) (5.3–7.7) (6.7–9.6) (6.1–8.8) (5.9–8.6) (5.8–8.3) (1.0–2.5) (1.8–2.6) (2.3–3.3) (2.9–4.3) (3.8–5.5) (4.0–5.7) (4.2–6.0) (10–40) (16–44) (18–41) (19–33) (18–24) (17–22) (16–21) (12–18) (16–23) (17–24) (17–24) (17–24) (17–24) (17–24) (1.1–2.2) (1.6–2.4) (2.0–2.9) (2.5–3.6) (3.0–4.4) (3.2–4.6) (3.3–4.8) (28–37) (43–50) (84–95) (120–140) (120–130) (120–130) (110–120) (2.2–3.8) (5.0–6.4) (9.0–12) (10–14) (11–14) (11–15) (11–15) (2.6–6.2) (3.7–5.5) (5.7–8.4) (7.1–10) (9.6–14) (10–15) (11–15) (37–54) (37–54) (38–55) (39–57) (42–61) (43–62) (43–62) (22–41) (38–55) (44–63) (38–54) (31–35) (27–32) (24–28) (5.8–6.3) (6.9–7.6) (7.6–8.3) (7.9–8.7) (8.4–9.2) (8.5–9.3) (8.5–9.4) (2.8–6.8) (4.8–7.0) (6.1–9.0) (7.9–12) (10–15) (10–15) (11–16) (0.180–0.430) (0.240–0.350) (0.240–0.350) (0.230–0.330) (0.220–0.320) (0.220–0.310) (0.210–0.310) (8.5–140) (24–160) (41–170) (63–170) (90–180) (93–180) (96–190) (4.3–6.6) (7.5–12) (21–33) (22–35) (15–23) (13–20) (12–18) RATEa 367 419 421 342 269 258 247 221 315 527 586 475 450 428 185 204 225 248 273 279 284 155 167 152 119 86 79 72 248 249 234 211 188 183 178 158 174 192 211 233 238 242 139 169 286 359 298 288 272 184 323 553 639 633 632 630 199 219 242 266 293 299 304 391 335 293 262 242 238 234 326 462 467 354 219 191 163 76 80 77 69 63 62 60 228 251 277 305 337 344 350 28 26 24 23 22 21 21 401 478 513 524 544 548 552 379 575 1 410 1 390 867 723 655 Rates are per 100 000 population. GLOBAL TUBERCULOSIS REPORT 2013 Data for all years can be downloaded from www.who.int/tb/data (218–553) (249–633) (251–636) (203–516) (191–359) (191–335) (183–321) (182–263) (260–375) (435–627) (484–698) (392–566) (372–536) (354–510) (114–273) (167–245) (184–271) (203–298) (226–325) (230–331) (234–337) (69–275) (93–263) (97–220) (88–154) (75–97) (69–89) (63–82) (204–295) (205–297) (193–279) (173–251) (155–224) (151–219) (146–213) (108–217) (142–209) (157–230) (173–254) (192–278) (196–283) (200–289) (121–159) (155–184) (267–305) (339–380) (286–311) (276–300) (261–283) (135–240) (283–367) (484–626) (535–752) (553–719) (551–717) (550–716) (123–293) (179–263) (197–290) (218–320) (242–349) (247–356) (251–362) (322–466) (276–400) (241–349) (216–313) (199–288) (196–284) (193–280) (230–438) (383–548) (387–554) (292–421) (203–236) (177–206) (151–176) (72–80) (76–84) (74–81) (66–73) (60–66) (59–65) (57–63) (140–336) (205–302) (226–333) (250–367) (277–402) (283–410) (288–418) (17–41) (21–31) (20–29) (19–28) (18–26) (18–25) (17–25) (62–1 050) (153–985) (227–914) (298–811) (377–741) (380–747) (383–753) (300–468) (456–709) (1 110–1 730) (1 100–1 720) (686–1 070) (573–891) (524–800) 7$%/($(VWLPDWHVRIWKHEXUGHQRIGLVHDVHFDXVHGE\7% ± Niger Nigeria Rwanda Sao Tome and Principe Senegal Seychelles Sierra Leone South Africa Swaziland Togo Uganda United Republic of Tanzania Zambia Zimbabwe a 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 POPULATION (MILLIONS) 8 9 11 13 16 17 17 96 108 123 140 160 164 169 7 6 8 9 11 11 11 <1 <1 <1 <1 <1 <1 <1 8 9 10 11 13 13 14 <1 <1 <1 <1 <1 <1 <1 4 4 4 5 6 6 6 37 41 45 48 51 52 52 <1 <1 1 1 1 1 1 4 4 5 6 6 6 7 18 21 24 29 34 35 36 25 30 34 39 45 46 48 8 9 10 11 13 14 14 10 12 13 13 13 13 14 NUMBER (THOUSANDS) 7.7 6.8 5 3.7 2.9 2.8 2.8 34 40 47 46 34 30 27 2.7 4.4 4.1 2 1.3 1.2 1.2 0.031 0.034 0.018 0.012 0.024 0.027 0.03 1.8 2.2 2.6 2.5 2.5 2.6 2.7 <0.01 <0.01 <0.01 <0.01 <0.01 <0.01 <0.01 2.4 2 2.4 5.9 8.2 8.3 8.5 16 15 20 25 26 28 31 0.31 0.27 0.37 0.32 0.46 0.67 0.78 0.23 0.37 0.59 0.58 0.54 0.56 0.58 8.7 8.3 8.5 7.6 5.5 5.1 4.7 9.9 6.4 5.8 5.7 6.2 6.1 6.1 4.9 3.9 3.1 2.2 3.2 3.4 3.9 3.5 1.9 2.1 3.6 4 4.6 4.6 (2.9–15) (2.5–13) (2.0–9.5) (1.5–6.8) (1.3–5.2) (1.2–5.0) (1.2–5.1) (0.019–180) (0.250–170) (0.077–230) (0.084–220) (3.1–100) (2.0–93) (1.6–86) (1.1–5.1) (1.7–8.4) (1.6–7.7) (0.880–3.7) (0.610–2.3) (0.580–2.1) (0.530–2.1) (<0.01–0.070) (0.013–0.064) (<0.01–0.032) (<0.01–0.023) (0.010–0.045) (0.011–0.050) (0.012–0.055) (0.800–3.3) (0.980–4.0) (1.1–4.7) (1.1–4.4) (1.1–4.5) (1.2–4.7) (1.2–4.8) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (0.730–5.2) (0.730–3.9) (0.860–4.8) (2.2–11) (3.1–16) (3.1–16) (3.2–16) (4.2–34) (5.6–28) (4.0–48) (2.0–75) (2.2–80) (2.9–83) (3.7–86) (0.051–0.800) (0.065–0.620) (<0.01–1.4) (<0.01–2.0) (<0.01–2.3) (0.015–2.5) (0.031–2.7) (0.100–0.410) (0.160–0.670) (0.250–1.1) (0.250–1.0) (0.230–0.970) (0.240–1.0) (0.250–1.0) (<0.01–48) (<0.01–46) (0.055–37) (0.660–23) (1.0–14) (0.960–13) (0.820–12) (3.8–19) (2.2–13) (1.9–12) (2.7–9.8) (3.3–10) (3.3–9.8) (3.2–9.9) (1.5–10) (1.1–8.3) (0.940–6.5) (0.450–5.4) (0.970–6.8) (1.1–7.0) (1.4–7.7) (0.068–13) (0–15) (0–16) (<0.01–18) (0.037–17) (0.140–17) (0.160–16) RATEa 99 74 46 28 18 17 16 35 37 38 33 22 18 16 37 78 49 22 12 11 10 27 26 13 7.6 14 15 16 24 26 26 22 20 20 20 2 2 2 2.5 1.8 1.8 1.8 61 51 59 116 142 142 143 42 35 44 51 51 55 59 36 28 34 29 39 56 63 6.1 8.7 12 10 8.5 8.6 8.7 50 40 35 26 16 15 13 39 21 17 15 14 13 13 63 44 31 19 24 25 28 33 16 17 28 31 35 33 (37–191) (28–143) (18–86) (12–51) (8.0–33) (7.4–30) (6.8–30) (<0.1–183) (0.23–161) (<0.1–185) (<0.1–159) (2.0–64) (1.2–57) (0.92–51) (15–70) (30–149) (19–91) (9.3–39) (5.7–21) (5.2–19) (4.6–18) (7.1–59) (10–49) (5.3–23) (2.8–15) (5.7–25) (6.1–27) (6.4–29) (11–44) (11–46) (12–48) (9.6–39) (8.7–35) (8.7–35) (8.8–35) (1.9–2.0) (1.9–2.0) (1.9–2.0) (2.4–2.7) (1.8–1.9) (1.8–1.9) (1.8–1.9) (18–128) (18–99) (21–116) (43–223) (54–273) (53–274) (53–275) (11–93) (14–68) (8.9–107) (4.1–156) (4.3–155) (5.6–159) (7.0–164) (5.9–93) (6.8–64) (0.74–129) (0–177) (<0.1–196) (1.3–208) (2.5–219) (2.7–11) (3.8–16) (5.0–22) (4.5–19) (3.7–15) (3.8–15) (3.8–15) (<0.1–273) (<0.1–223) (0.23–151) (2.3–79) (3.0–40) (2.7–36) (2.3–33) (15–74) (7.3–43) (5.6–35) (6.9–25) (7.4–22) (7.1–21) (6.8–21) (19–132) (13–93) (9.4–64) (3.9–47) (7.4–51) (8.0–52) (9.8–55) (0.65–128) (0–125) (0–129) (<0.1–146) (0.28–129) (1.1–125) (1.2–117) PREVALENCE (INCLUDING HIV) NUMBER (THOUSANDS) 65 57 44 34 30 29 28 290 340 400 420 330 300 270 26 37 35 21 15 14 13 0.3 0.32 0.22 0.2 0.26 0.28 0.3 19 23 27 26 28 29 30 0.035 0.059 0.045 0.053 0.048 0.039 0.036 21 18 22 53 74 76 78 170 180 250 360 410 430 450 3.4 3.4 6.1 7.4 9 11 11 2.7 4 5.6 5.9 6.2 6.6 6.9 86 89 92 88 70 68 64 94 76 80 82 86 85 84 52 53 53 47 51 52 55 34 34 49 60 57 61 59 (30–110) (26–99) (21–75) (17–57) (15–50) (14–49) (14–48) (0.550–1 400) (4.9–1 300) (2.6–1 700) (4.2–1 700) (62–830) (49–760) (43–710) (13–44) (17–64) (17–59) (11–35) (7.9–24) (7.2–22) (7.0–21) (0.110–0.590) (0.160–0.530) (0.093–0.410) (0.070–0.390) (0.130–0.450) (0.140–0.470) (0.150–0.500) (9.4–31) (12–39) (14–45) (13–44) (14–47) (14–49) (15–50) (<0.01–0.091) (0.028–0.100) (0.021–0.080) (0.026–0.091) (0.023–0.082) (0.016–0.071) (0.013–0.072) (7.8–39) (8.3–31) (10–39) (25–90) (36–130) (37–130) (37–130) (64–340) (81–310) (100–480) (110–750) (140–840) (150–860) (160–880) (1.0–7.3) (1.4–6.3) (1.5–14) (1.1–19) (1.5–23) (2.6–24) (2.9–25) (1.3–4.6) (2.0–6.6) (2.7–9.4) (2.9–10) (3.0–11) (3.2–11) (3.4–12) (0.490–370) (0.760–370) (6.1–290) (22–200) (27–130) (26–130) (24–120) (47–160) (37–130) (38–140) (43–130) (46–140) (45–140) (45–140) (24–91) (26–90) (26–89) (20–83) (25–87) (25–87) (28–90) (2.4–110) (0.860–130) (3.9–150) (7.0–170) (9.1–150) (12–150) (13–140) RATEa 839 620 396 261 187 176 166 302 311 326 298 210 181 161 356 655 417 228 136 121 114 258 244 159 128 149 154 159 249 269 273 234 217 217 219 50 79 57 61 52 42 39 507 454 537 1 030 1 290 1 290 1 300 475 427 568 748 803 831 857 397 357 573 666 751 870 907 71 92 114 107 99 102 104 492 429 380 305 207 192 175 368 254 234 211 190 183 176 665 605 524 406 387 379 388 323 295 389 473 438 458 433 (388–1 460) (283–1 080) (189–678) (130–436) (94–312) (88–294) (83–277) (0.58–1 440) (4.5–1 230) (2.1–1 400) (3.0–1 220) (39–521) (30–464) (25–420) (173–603) (305–1 130) (205–701) (120–370) (73–219) (65–196) (61–183) (96–499) (122–408) (67–291) (46–253) (72–252) (76–258) (80–264) (125–414) (135–448) (137–453) (116–393) (106–366) (106–366) (108–368) (7.7–131) (37–135) (26–100) (29–104) (25–90) (17–78) (14–78) (194–968) (211–788) (245–940) (491–1 750) (624–2 180) (625–2 200) (626–2 220) (173–925) (195–747) (225–1 070) (234–1 560) (266–1 630) (289–1 650) (305–1 680) (116–847) (149–653) (145–1 290) (104–1 730) (130–1 900) (213–1 970) (232–2 030) (34–122) (46–155) (56–193) (52–181) (47–169) (49–174) (51–176) (2.8–2 140) (3.6–1 800) (25–1 200) (76–689) (80–392) (74–366) (67–334) (185–611) (123–430) (113–399) (111–341) (102–306) (97–295) (95–283) (308–1 160) (299–1 020) (256–885) (177–727) (186–659) (185–640) (197–642) (23–1 000) (7.4–1 090) (31–1 180) (55–1 320) (70–1 140) (93–1 110) (92–1 030) INCIDENCE (INCLUDING HIV) NUMBER (THOUSANDS) 28 25 21 19 18 18 18 120 150 210 240 210 190 180 21 29 27 17 11 11 9.8 0.16 0.16 0.16 0.16 0.17 0.17 0.17 10 13 15 16 18 18 19 0.03 0.03 0.029 0.029 0.028 0.028 0.027 8.4 8.3 11 26 38 39 40 110 130 260 450 500 520 530 2.3 3.2 8.5 13 15 16 17 1.8 2.5 3.5 4.2 4.6 4.7 4.9 110 110 100 87 71 68 65 58 68 80 83 80 78 79 56 70 72 65 61 61 60 31 56 91 100 83 81 77 (23–33) (20–29) (17–25) (15–22) (15–21) (15–21) (15–21) (1.3–500) (8.0–490) (15–660) (33–660) (100–360) (91–340) (85–310) (19–23) (26–32) (24–30) (15–19) (10–13) (9.4–12) (8.8–11) (0.098–0.230) (0.130–0.190) (0.130–0.190) (0.140–0.190) (0.140–0.200) (0.140–0.210) (0.140–0.210) (8.5–12) (11–16) (13–18) (13–19) (15–21) (15–22) (16–22) (0.019–0.044) (0.025–0.036) (0.024–0.035) (0.024–0.035) (0.023–0.033) (0.023–0.033) (0.023–0.033) (5.2–12) (6.4–11) (8.1–14) (21–31) (31–45) (32–47) (32–49) (76–150) (110–160) (210–310) (360–540) (420–600) (430–610) (430–630) (1.4–3.4) (2.7–3.9) (7.0–10) (10–15) (13–18) (13–19) (14–20) (1.5–2.1) (2.0–3.0) (2.9–4.2) (3.5–5.1) (3.8–5.5) (3.9–5.6) (4.0–5.8) (57–180) (62–180) (63–150) (63–120) (57–86) (55–82) (53–79) (49–67) (58–78) (70–91) (76–89) (75–85) (74–83) (74–84) (49–63) (64–76) (67–77) (59–71) (55–67) (55–67) (54–66) (17–50) (39–77) (72–110) (81–130) (64–100) (62–100) (60–97) RATEa 358 270 191 142 113 108 104 128 139 172 175 133 118 108 290 513 325 181 106 94 86 135 124 114 105 96 94 93 138 153 155 142 137 136 137 43 40 37 33 31 30 30 207 212 264 503 660 668 674 301 317 576 925 981 993 1 000 267 337 803 1 150 1 290 1 320 1 350 47 58 72 77 73 73 73 624 542 427 304 209 193 179 226 226 236 213 177 169 165 710 788 713 566 462 444 427 296 483 726 799 633 603 562 (295–426) (223–321) (157–227) (118–170) (94–135) (90–129) (86–124) (1.3–526) (7.4–456) (12–536) (23–476) (64–225) (55–204) (50–186) (259–323) (458–571) (290–362) (162–202) (94–118) (84–105) (77–96) (83–199) (102–149) (93–137) (88–123) (79–115) (78–113) (76–111) (114–164) (126–183) (128–184) (117–169) (113–163) (112–162) (113–163) (27–64) (33–48) (30–44) (27–40) (25–37) (25–36) (24–35) (128–305) (162–269) (196–341) (410–605) (540–791) (542–807) (540–821) (206–413) (259–381) (471–691) (756–1 110) (809–1 170) (819–1 180) (827–1 190) (165–394) (275–405) (657–964) (938–1 380) (1 060–1 530) (1 090–1 570) (1 110–1 610) (39–56) (48–69) (59–86) (63–91) (60–87) (60–87) (60–87) (328–1 010) (297–860) (259–636) (220–402) (169–253) (156–234) (145–216) (193–261) (193–261) (207–268) (197–229) (166–189) (159–180) (154–175) (624–801) (719–861) (661–767) (519–615) (418–509) (401–489) (385–470) (159–476) (335–658) (573–897) (634–984) (489–795) (466–757) (434–706) AFRICAN REGION MORTALITY (EXCLUDING HIV) YEAR Rates are per 100 000 population. Data for all years can be downloaded from www.who.int/tb/data GLOBAL TUBERCULOSIS REPORT 2013 159 7$%/($,QFLGHQFHQRWLILFDWLRQDQGFDVHGHWHFWLRQUDWHVDOOIRUPV ± INCIDENCE (INCLUDING HIV) YEAR Algeria Angola Benin Botswana Burkina Faso Burundi Cameroon Cape Verde Central African Republic Chad Comoros Congo Côte d'Ivoire Democratic Republic of the Congo Equatorial Guinea Eritrea a b 160 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 POPULATION (MILLIONS) 26 29 32 34 37 38 38 10 12 14 17 20 20 21 5 6 7 8 10 10 10 1 2 2 2 2 2 2 9 10 12 13 16 16 16 6 6 7 8 9 10 10 12 14 16 18 21 21 22 <1 <1 <1 <1 <1 <1 <1 3 3 4 4 4 4 5 6 7 8 10 12 12 12 <1 <1 <1 <1 <1 <1 <1 2 3 3 4 4 4 4 12 14 16 17 19 19 20 35 42 47 54 62 64 66 <1 <1 <1 <1 <1 <1 <1 3 3 4 5 6 6 6 NUMBER (THOUSANDS) 17 20 28 31 33 34 34 21 27 35 46 59 62 66 6.4 6 6 6 6.5 6.8 7 7.4 14 16 14 9.9 9 8.2 7.6 8.3 8.2 8.4 9 9.1 9 9.1 20 19 15 13 13 13 14 29 49 57 56 51 52 0.62 0.67 0.71 0.73 0.71 0.71 0.71 25 39 39 27 19 18 17 5.6 9 13 15 18 18 19 0.22 0.21 0.21 0.22 0.23 0.24 0.25 4 6.7 11 15 16 16 17 29 54 60 46 36 37 34 110 140 150 180 200 210 210 0.3 0.35 0.52 0.66 0.94 1 1 8 6.7 6.2 5.9 5.8 5.7 5.7 (13–22) (15–26) (20–36) (23–41) (24–44) (25–44) (25–45) (13–31) (22–33) (28–42) (37–54) (50–69) (53–73) (55–77) (5.3–7.6) (4.9–7.1) (4.9–7.1) (5.0–7.2) (5.4–7.8) (5.6–8.1) (5.8–8.3) (2.9–14) (8.8–19) (13–20) (13–15) (8.8–11) (8.1–10) (7.3–9.1) (6.5–8.9) (7.0–9.6) (7.0–9.6) (7.1–9.8) (7.6–10) (7.7–11) (7.6–10) (8.0–10) (18–23) (17–22) (14–17) (12–15) (12–15) (11–14) (11–16) (24–34) (41–59) (47–68) (47–67) (42–61) (43–61) (0.380–0.910) (0.550–0.800) (0.580–0.850) (0.600–0.880) (0.590–0.850) (0.590–0.850) (0.590–0.850) (21–30) (32–47) (32–46) (23–33) (16–22) (15–21) (14–20) (4.7–6.7) (7.4–11) (10–15) (12–18) (15–21) (15–22) (16–22) (0.180–0.270) (0.180–0.250) (0.170–0.250) (0.180–0.260) (0.190–0.270) (0.200–0.290) (0.200–0.290) (2.5–5.9) (5.4–8.0) (9.3–13) (12–18) (13–19) (13–20) (14–20) (25–33) (47–62) (52–68) (40–53) (31–41) (32–42) (30–39) (92–140) (110–160) (130–180) (150–200) (180–230) (180–240) (190–250) (0.260–0.340) (0.310–0.400) (0.460–0.590) (0.580–0.750) (0.830–1.1) (0.890–1.1) (0.900–1.2) (5.3–11) (4.5–9.5) (4.1–8.7) (3.9–8.2) (3.8–8.1) (3.8–8.1) (3.8–8.0) RATEa 66 68 87 93 90 90 89 205 226 250 276 304 310 316 128 100 86 74 69 70 70 533 855 918 733 503 455 408 87 82 71 62 58 57 54 162 321 288 198 144 139 130 112 206 310 312 274 243 238 175 168 160 153 147 145 144 861 1 200 1 070 690 433 400 367 95 128 151 150 151 151 151 54 46 39 36 33 34 34 169 245 353 425 391 387 381 238 379 369 267 190 191 172 327 327 327 327 327 327 327 80 80 101 110 135 142 139 243 198 157 121 100 97 93 (48–86) (50–89) (64–114) (68–121) (66–118) (66–117) (65–117) (127–303) (185–272) (204–300) (227–329) (256–355) (261–362) (266–369) (106–152) (82–118) (71–102) (61–88) (57–82) (58–83) (58–83) (212–997) (553–1 220) (736–1 120) (667–802) (449–560) (406–507) (364–454) (73–101) (70–95) (60–83) (53–73) (49–67) (48–66) (46–63) (143–183) (283–362) (254–325) (174–223) (127–163) (122–157) (114–147) (92–133) (170–246) (255–369) (258–372) (226–327) (200–290) (197–283) (108–259) (137–201) (131–193) (125–184) (121–175) (120–173) (119–172) (710–1 030) (988–1 430) (884–1 280) (569–822) (357–515) (330–477) (302–438) (78–112) (106–153) (125–180) (124–178) (125–179) (125–179) (125–180) (44–64) (38–55) (32–46) (30–43) (28–40) (28–41) (28–41) (104–250) (200–294) (298–412) (347–510) (320–470) (317–465) (311–458) (206–272) (329–433) (320–422) (232–306) (165–217) (165–218) (149–198) (262–398) (268–392) (273–385) (279–379) (282–375) (282–375) (282–375) (70–91) (70–90) (88–114) (96–124) (119–153) (124–161) (122–158) (162–341) (132–278) (104–220) (80–169) (67–140) (64–136) (62–131) INCIDENCE HIV-POSITIVE NUMBER (THOUSANDS) RATEa <0.01 <0.01 0.025 0.057 0.08 0.085 0.086 0.51 1.3 2.5 4 5.3 5.3 5.5 2.1 1.9 1.5 1.2 0.99 1 1 1.5 7.2 11 9.3 6.3 5.7 5.1 2.9 3.3 2.8 2.3 1.8 1.7 1.6 1.6 6.7 7.4 4.8 3 2.8 2.5 0.71 5.5 17 22 21 19 19 0.039 0.057 0.071 0.074 0.067 0.068 0.071 9.8 18 18 11 6.3 5.8 5.3 0.69 1.8 3.1 3.7 3.6 3.8 4.1 (<0.01–<0.01) (<0.01–<0.01) (0.018–0.032) (0.042–0.074) (0.059–0.10) (0.062–0.11) (0.063–0.11) (0.31–0.75) (1.1–1.5) (2.0–3.0) (3.3–4.8) (4.5–6.2) (4.5–6.2) (4.7–6.5) (1.7–2.4) (1.5–2.2) (1.3–1.8) (1.0–1.5) (0.82–1.2) (0.84–1.2) (0.84–1.2) (0.58–2.7) (4.7–10) (9.0–14) (8.4–10) (5.6–7.0) (5.1–6.3) (4.5–5.6) (2.5–3.4) (2.8–3.8) (2.4–3.3) (2.0–2.7) (1.5–2.1) (1.4–1.9) (1.3–1.8) (1.4–1.8) (5.9–7.5) (6.5–8.3) (4.3–5.5) (2.7–3.4) (2.4–3.1) (2.2–2.8) (0.58–0.84) (4.6–6.6) (14–20) (18–26) (18–25) (16–23) (16–23) (0.024–0.058) (0.046–0.069) (0.057–0.085) (0.060–0.089) (0.055–0.081) (0.055–0.081) (0.058–0.086) (8.1–12) (15–21) (15–21) (9.4–14) (5.2–7.5) (4.8–6.9) (4.4–6.4) (0.57–0.83) (1.5–2.2) (2.5–3.6) (3.1–4.4) (2.9–4.2) (3.2–4.6) (3.4–4.8) <0.1 <0.1 <0.1 0.2 0.2 0.2 0.2 4.9 11 18 24 27 26 27 41 31 22 15 10 10 10 105 456 638 494 321 285 253 33 32 25 17 11 10 9.5 28 107 110 62 33 29 25 5.8 40 105 121 103 91 88 11 14 16 15 14 14 14 336 549 492 287 145 131 118 12 26 37 37 30 32 33 (0–<0.1) (<0.1–<0.1) (<0.1–0.10) (0.12–0.22) (0.16–0.28) (0.16–0.29) (0.16–0.29) (3.0–7.2) (8.7–13) (14–21) (20–29) (23–32) (22–31) (22–31) (34–49) (26–37) (18–26) (12–18) (8.6–12) (8.6–12) (8.3–12) (42–196) (295–651) (511–777) (449–541) (286–357) (254–317) (226–281) (28–38) (27–37) (21–29) (15–20) (9.7–13) (8.9–12) (8.0–11) (25–31) (94–121) (97–124) (55–70) (29–37) (26–33) (22–28) (4.8–7.0) (33–47) (87–126) (100–145) (85–123) (75–109) (73–104) (6.8–16) (12–17) (13–19) (12–19) (11–17) (11–17) (12–17) (277–400) (453–654) (406–587) (237–342) (119–172) (108–156) (97–141) (9.7–14) (22–31) (31–44) (31–44) (25–36) (26–38) (27–39) <0.01 <0.01 0.01 0.94 2.1 3.2 3.8 3.4 3.5 3.6 8.3 21 25 17 9.4 9.5 8.8 8.1 12 14 16 16 17 16 0.014 0.028 0.062 0.11 0.18 0.2 0.2 0.15 0.4 0.97 1.1 0.8 0.79 0.73 (<0.01–<0.01) (<0.01–<0.01) (<0.01–0.012) (0.58–1.4) (1.7–2.5) (2.7–3.7) (3.1–4.6) (2.8–4.1) (2.8–4.2) (2.9–4.3) (7.2–9.5) (19–24) (22–28) (15–19) (8.2–11) (8.3–11) (7.6–10) (6.5–9.9) (9.7–14) (12–17) (14–19) (14–19) (14–19) (14–19) (0.012–0.016) (0.024–0.032) (0.054–0.071) (0.095–0.12) (0.16–0.21) (0.18–0.23) (0.17–0.23) (0.098–0.21) (0.27–0.56) (0.64–1.4) (0.72–1.5) (0.53–1.1) (0.53–1.1) (0.49–1.0) 0.1 0.5 1.4 40 76 102 108 83 82 83 68 151 154 98 50 49 44 23 28 30 30 26 26 25 3.7 6.3 12 18 26 29 27 4.5 12 25 22 14 13 12 (<0.1–0.13) (0.45–0.65) (1.2–1.7) (24–58) (62–91) (86–119) (88–130) (68–100) (67–98) (68–100) (59–78) (131–172) (134–177) (85–112) (43–57) (43–56) (38–51) (19–28) (23–34) (25–35) (25–34) (23–30) (22–30) (22–29) (3.2–4.2) (5.5–7.1) (11–14) (16–20) (23–30) (25–32) (24–31) (3.0–6.3) (7.8–16) (16–34) (15–31) (9.3–20) (8.9–19) (7.9–17) NOTIFIED NEW AND RELAPSEb CASE DETECTION NUMBER RATEa PERCENT 11 607 13 507 18 572 21 336 22 336 21 429 21 880 10 271 5 143 16 062 37 175 44 655 47 240 51 819 2 074 2 400 2 697 3 270 3 756 4 212 3 966 2 938 5 665 9 292 10 058 7 013 6 603 6 161 1 497 2 572 2 331 3 478 4 800 5 286 5 210 4 575 3 326 6 421 6 585 7 611 6 742 6 921 5 892 3 292 5 251 21 499 24 073 24 533 24 802 221 303 44 46 59 63 60 57 57 99 42 115 225 228 234 249 41 40 39 40 39 43 39 212 358 529 536 356 332 307 17 25 20 26 31 33 32 82 54 96 85 82 71 70 49 24 33 119 117 116 114 63 76 67 68 67 68 67 63 64 48 19 46 82 75 76 79 32 40 45 54 57 62 57 40 42 58 73 71 73 75 20 31 28 41 54 58 58 50 17 33 43 57 51 54 44 11 11 38 43 48 48 36 45 (52–92) (52–92) (52–92) (52–92) (51–91) (48–87) (49–87) (33–78) (16–23) (38–56) (68–99) (64–89) (65–90) (67–94) (27–39) (34–49) (38–55) (46–66) (48–69) (52–75) (48–68) (21–100) (29–65) (47–72) (67–80) (64–79) (66–82) (68–84) (17–23) (27–37) (24–33) (36–49) (46–63) (50–68) (50–69) (45–57) (15–19) (30–38) (38–49) (51–65) (45–58) (48–62) (37–53) (9.6–14) (8.9–13) (32–46) (36–52) (40–58) (40–58) (24–58) (38–55) 292 356 380 420 2 124 3 339 61 73 77 85 73 102 40 50 53 59 8.5 8.5 (33–49) (42–60) (45–65) (49–72) (7.1–10) (7.1–10) 3 210 6 643 5 611 8 084 2 591 3 186 81 153 126 179 44 46 12 35 32 49 46 36 (9.9–14) (30–43) (27–38) (41–59) (39–56) (30–43) 6 311 9 452 10 505 10 585 140 123 120 111 63 81 87 85 34 26 23 18 42 53 58 56 63 58 58 51 (35–51) (45–65) (48–70) (47–68) (53–76) (48–70) (49–71) (43–62) 117 120 591 3 615 9 239 9 853 10 150 10 975 11 303 7 841 11 988 15 094 19 681 22 708 22 476 23 762 21 131 42 819 61 024 97 075 114 170 110 132 108 984 260 306 17 17 25 133 296 278 247 260 261 65 84 94 113 120 116 120 61 102 130 180 184 172 166 70 69 49 49 15 54 84 66 63 67 68 27 22 25 42 63 61 69 19 31 40 55 56 53 51 87 87 (41–59) (41–59) (9.9–24) (45–66) (72–99) (55–80) (53–77) (56–82) (57–84) (24–31) (19–26) (22–29) (37–49) (55–73) (53–70) (61–81) (15–23) (26–38) (34–48) (47–64) (49–65) (46–61) (44–59) (77–99) (77–99) 820 883 118 123 87 (77–99) 87 (77–99) 3 699 21 453 6 652 3 585 2 870 3 049 3 143 113 630 169 74 50 51 51 46 320 110 61 50 53 55 Rates are per 100 000 population. NOTIFIED NEW AND RELAPSE includes cases for which the treatment history is unknown. GLOBAL TUBERCULOSIS REPORT 2013 Data for all years can be downloaded from www.who.int/tb/data (33–70) (230–480) (77–160) (44–92) (36–75) (38–80) (39–83) 7$%/($,QFLGHQFHQRWLILFDWLRQDQGFDVHGHWHFWLRQUDWHVDOOIRUPV ± Ethiopia Gabon Gambia Ghana Guinea Guinea-Bissau Kenya Lesotho Liberia Madagascar Malawi Mali Mauritania Mauritius Mozambique Namibia a b 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 POPULATION (MILLIONS) 48 57 66 76 87 89 92 <1 1 1 1 2 2 2 <1 1 1 1 2 2 2 15 17 19 21 24 25 25 6 8 9 10 11 11 11 1 1 1 1 2 2 2 23 27 31 36 41 42 43 2 2 2 2 2 2 2 2 2 3 3 4 4 4 12 13 16 18 21 22 22 9 10 11 13 15 15 16 8 9 10 12 14 14 15 2 2 3 3 4 4 4 1 1 1 1 1 1 1 14 16 18 21 24 25 25 1 2 2 2 2 2 2 NUMBER (THOUSANDS) 180 240 280 260 230 230 230 2.1 3.4 6.5 8.1 7.4 7.2 7 1.7 2.2 2.8 3.6 4.6 4.8 5.1 23 28 29 25 21 20 18 15 20 20 20 20 20 20 1.6 2 2.4 3 3.7 3.9 4 33 46 89 130 120 120 120 2.9 5.7 10 12 13 13 13 4.2 4.6 7 8.7 12 12 13 45 45 46 48 51 52 52 31 46 53 46 33 30 26 6 7.2 7.9 8.3 8.8 8.9 9 4.6 5.9 7.5 9.6 12 13 13 0.29 0.29 0.29 0.28 0.27 0.26 0.26 54 76 94 110 130 130 140 5.4 9.5 27 28 19 16 15 (100–270) (140–360) (170–420) (150–390) (170–310) (170–300) (170–290) (1.7–2.5) (2.8–4.1) (5.3–7.7) (6.7–9.6) (6.1–8.8) (5.9–8.6) (5.8–8.3) (1.0–2.5) (1.8–2.6) (2.3–3.3) (2.9–4.3) (3.8–5.5) (4.0–5.7) (4.2–6.0) (10–40) (16–44) (18–41) (19–33) (18–24) (17–22) (16–21) (12–18) (16–23) (17–24) (17–24) (17–24) (17–24) (17–24) (1.1–2.2) (1.6–2.4) (2.0–2.9) (2.5–3.6) (3.0–4.4) (3.2–4.6) (3.3–4.8) (28–37) (43–50) (84–95) (120–140) (120–130) (120–130) (110–120) (2.2–3.8) (5.0–6.4) (9.0–12) (10–14) (11–14) (11–15) (11–15) (2.6–6.2) (3.7–5.5) (5.7–8.4) (7.1–10) (9.6–14) (10–15) (11–15) (37–54) (37–54) (38–55) (39–57) (42–61) (43–62) (43–62) (22–41) (38–55) (44–63) (38–54) (31–35) (27–32) (24–28) (5.8–6.3) (6.9–7.6) (7.6–8.3) (7.9–8.7) (8.4–9.2) (8.5–9.3) (8.5–9.4) (2.8–6.8) (4.8–7.0) (6.1–9.0) (7.9–12) (10–15) (10–15) (11–16) (0.180–0.430) (0.240–0.350) (0.240–0.350) (0.230–0.330) (0.220–0.320) (0.220–0.310) (0.210–0.310) (8.5–140) (24–160) (41–170) (63–170) (90–180) (93–180) (96–190) (4.3–6.6) (7.5–12) (21–33) (22–35) (15–23) (13–20) (12–18) a RATE 367 419 421 342 269 258 247 221 315 527 586 475 450 428 185 204 225 248 273 279 284 155 167 152 119 86 79 72 248 249 234 211 188 183 178 158 174 192 211 233 238 242 139 169 286 359 298 288 272 184 323 553 639 633 632 630 199 219 242 266 293 299 304 391 335 293 262 242 238 234 326 462 467 354 219 191 163 76 80 77 69 63 62 60 228 251 277 305 337 344 350 28 26 24 23 22 21 21 401 478 513 524 544 548 552 379 575 1 410 1 390 867 723 655 (218–553) (249–633) (251–636) (203–516) (191–359) (191–335) (183–321) (182–263) (260–375) (435–627) (484–698) (392–566) (372–536) (354–510) (114–273) (167–245) (184–271) (203–298) (226–325) (230–331) (234–337) (69–275) (93–263) (97–220) (88–154) (75–97) (69–89) (63–82) (204–295) (205–297) (193–279) (173–251) (155–224) (151–219) (146–213) (108–217) (142–209) (157–230) (173–254) (192–278) (196–283) (200–289) (121–159) (155–184) (267–305) (339–380) (286–311) (276–300) (261–283) (135–240) (283–367) (484–626) (535–752) (553–719) (551–717) (550–716) (123–293) (179–263) (197–290) (218–320) (242–349) (247–356) (251–362) (322–466) (276–400) (241–349) (216–313) (199–288) (196–284) (193–280) (230–438) (383–548) (387–554) (292–421) (203–236) (177–206) (151–176) (72–80) (76–84) (74–81) (66–73) (60–66) (59–65) (57–63) (140–336) (205–302) (226–333) (250–367) (277–402) (283–410) (288–418) (17–41) (21–31) (20–29) (19–28) (18–26) (18–25) (17–25) (62–1 050) (153–985) (227–914) (298–811) (377–741) (380–747) (383–753) (300–468) (456–709) (1 110–1 730) (1 100–1 720) (686–1 070) (573–891) (524–800) INCIDENCE HIV-POSITIVE NUMBER (THOUSANDS) 11 36 61 54 30 27 23 0.12 0.47 1.6 2.5 2.1 2 1.9 0.023 0.071 0.2 0.47 0.78 0.77 0.76 1.7 4.2 5.9 5.4 3.7 3.3 2.8 1.1 2.8 4.1 4.5 3.8 3.7 3.7 0.08 0.23 0.55 1 1.3 1.4 1.6 3.6 19 47 64 51 49 45 0.083 2.2 7.6 10 9.7 9.5 9.9 0.095 0.31 0.8 1 0.91 0.83 0.76 0.34 0.55 0.73 0.77 0.7 0.67 0.64 13 29 37 33 21 19 16 0.59 1.2 1.6 1.6 1.3 1.3 1.2 0.05 0.1 0.17 0.27 0.44 0.5 0.57 <0.01 <0.01 0.011 0.017 0.016 0.015 0.014 0.84 15 41 61 78 81 83 0.48 2.8 15 19 11 8.7 7.3 (6.3–16) (22–55) (36–92) (32–81) (21–40) (20–35) (17–30) (0.096–0.14) (0.39–0.56) (1.3–1.9) (2.0–2.9) (1.7–2.5) (1.6–2.4) (1.5–2.2) (0.014–0.033) (0.058–0.085) (0.16–0.24) (0.38–0.56) (0.65–0.93) (0.64–0.91) (0.63–0.90) (0.74–2.9) (2.3–6.6) (3.8–8.6) (4.0–7.0) (3.2–4.2) (2.9–3.7) (2.4–3.1) (0.90–1.3) (2.3–3.3) (3.3–4.8) (3.7–5.4) (3.2–4.6) (3.1–4.5) (3.0–4.4) (0.054–0.11) (0.19–0.27) (0.45–0.66) (0.84–1.2) (1.1–1.5) (1.2–1.7) (1.3–1.9) (3.1–4.1) (18–21) (44–50) (60–67) (49–53) (47–51) (44–47) (0.061–0.11) (1.9–2.5) (6.6–8.6) (8.3–12) (8.5–11) (8.3–11) (8.7–11) (0.058–0.14) (0.25–0.38) (0.65–0.98) (0.83–1.3) (0.73–1.1) (0.67–1.0) (0.61–0.93) (0.28–0.40) (0.46–0.66) (0.60–0.87) (0.64–0.92) (0.57–0.83) (0.55–0.80) (0.53–0.77) (9.5–18) (24–34) (31–44) (27–39) (20–23) (18–21) (15–17) (0.56–0.62) (1.2–1.3) (1.6–1.7) (1.5–1.7) (1.3–1.4) (1.2–1.4) (1.2–1.3) (0.031–0.074) (0.083–0.12) (0.14–0.20) (0.22–0.32) (0.36–0.53) (0.41–0.60) (0.47–0.68) (<0.01–<0.01) (<0.01–<0.01) (<0.01–0.013) (0.014–0.021) (0.013–0.020) (0.013–0.018) (0.011–0.017) (0.13–2.2) (4.8–31) (18–74) (35–94) (54–110) (56–110) (58–110) (0.38–0.59) (2.2–3.4) (12–19) (15–23) (8.3–13) (6.9–11) (5.8–8.9) a RATE 22 64 93 71 35 30 25 12 44 132 178 136 125 115 2.5 6.7 16 33 47 44 42 11 25 31 25 15 13 11 18 35 46 47 35 33 32 7.8 20 43 73 81 88 94 15 70 151 177 124 116 105 5.2 125 408 517 483 467 485 4.5 15 28 32 23 20 18 2.9 4.1 4.6 4.2 3.3 3.1 2.9 143 291 329 256 142 125 100 7.4 14 16 13 9.4 8.9 8.2 2.5 4.4 6.3 8.4 12 14 15 <0.1 0.3 0.9 1.4 1.3 1.2 1.1 6.2 94 227 290 327 331 330 34 168 798 932 483 391 323 (13–33) (38–97) (55–140) (42–107) (25–46) (22–39) (19–33) (10–15) (36–52) (108–157) (146–212) (112–162) (103–149) (95–137) (1.5–3.6) (5.5–8.0) (13–19) (27–39) (39–56) (37–53) (35–50) (5.0–20) (14–39) (20–46) (19–33) (13–17) (12–15) (9.6–12) (15–22) (29–42) (38–55) (39–56) (29–42) (28–40) (27–39) (5.3–11) (16–24) (35–52) (59–87) (67–97) (73–105) (77–112) (13–17) (64–76) (141–161) (168–188) (119–129) (111–121) (101–109) (3.8–6.8) (109–142) (357–462) (433–608) (422–549) (408–531) (423–550) (2.8–6.7) (12–18) (22–34) (25–38) (18–28) (16–25) (15–22) (2.4–3.5) (3.4–4.9) (3.8–5.5) (3.5–5.0) (2.7–3.9) (2.6–3.7) (2.4–3.4) (101–192) (241–345) (273–391) (211–305) (132–153) (116–135) (93–108) (7.0–7.8) (13–14) (15–17) (13–14) (9.0–9.9) (8.5–9.4) (7.8–8.6) (1.5–3.7) (3.6–5.2) (5.1–7.5) (6.9–10) (10–15) (11–16) (12–18) (<0.1–<0.1) (0.24–0.35) (0.74–1.1) (1.2–1.7) (1.1–1.6) (1.0–1.5) (0.92–1.3) (0.97–16) (30–194) (100–404) (165–449) (227–446) (229–451) (228–450) (27–41) (133–207) (631–983) (738–1 150) (383–596) (310–482) (258–394) NOTIFIED NEW AND RELAPSE NUMBER a b CASE DETECTION RATE PERCENT 88 634 26 034 91 101 124 262 154 694 156 539 145 323 917 1 115 184 46 138 163 178 175 158 97 103 50 11 33 48 66 68 64 44 33 (33–85) (7.2–18) (22–55) (32–80) (49–93) (52–91) (49–87) (37–53) (28–40) 2 512 3 790 4 404 4 929 182 244 276 302 31 51 61 71 (26–38) (43–62) (52–74) (59–85) 1 023 1 553 2 031 1 989 2 302 2 333 6 407 8 636 10 933 12 124 14 607 15 389 14 753 1 988 3 523 5 440 6 863 11 038 11 359 11 407 1 163 1 613 1 273 1 774 2 183 2 063 1 939 11 788 28 142 64 159 102 680 99 272 97 320 92 987 2 525 5 181 9 746 10 802 11 674 11 561 10 776 96 126 141 118 133 130 44 52 58 57 60 62 58 33 45 62 72 101 102 100 114 142 100 125 138 127 117 50 103 205 287 243 232 215 158 295 525 561 581 570 525 47 56 57 43 48 46 28 31 38 48 70 79 81 13 18 27 34 54 55 56 73 81 52 59 59 53 48 36 61 72 80 81 80 79 86 91 95 88 92 90 83 (39–57) (47–69) (47–70) (36–52) (40–58) (39–56) (16–63) (20–55) (26–60) (37–64) (62–80) (70–90) (71–92) (11–16) (15–22) (22–32) (29–41) (45–66) (47–67) (47–68) (53–110) (68–100) (43–64) (49–72) (50–72) (45–65) (40–58) (32–41) (56–66) (67–77) (76–85) (78–85) (77–84) (76–83) (66–120) (81–100) (84–110) (75–100) (81–110) (79–100) (73–95) 1 393 1 500 3 432 6 597 7 906 8 093 6 261 21 616 67 52 105 167 194 193 54 161 31 21 39 57 65 64 14 48 (25–37) (18–26) (33–48) (48–69) (54–79) (53–77) (12–17) (40–58) 18 993 24 432 26 019 25 782 12 395 19 155 23 604 25 491 21 092 19 361 20 335 2 933 3 087 4 216 4 704 5 291 5 428 5 446 5 284 3 849 3 067 2 162 2 461 1 804 2 616 119 131 160 125 122 114 128 15 899 17 882 21 158 33 231 43 558 44 627 47 741 2 671 1 540 10 799 14 920 11 281 10 806 10 003 104 116 120 116 131 192 208 197 140 125 128 37 34 41 39 38 38 37 261 165 113 69 68 49 69 11 12 14 10 9.9 9.2 10 117 112 116 158 182 182 189 189 93 569 736 518 487 443 40 48 50 49 40 42 45 56 64 66 78 49 43 53 57 60 61 61 110 66 41 22 20 14 20 41 45 55 45 46 43 49 29 23 23 30 33 33 34 50 16 40 53 60 67 68 (33–48) (40–58) (42–61) (41–60) (30–57) (35–50) (38–54) (47–68) (59–69) (61–71) (73–85) (46–51) (41–45) (51–56) (54–60) (57–63) (58–64) (58–64) (78–190) (55–80) (34–50) (19–28) (17–25) (12–17) (16–24) (28–66) (37–55) (46–68) (37–55) (39–56) (36–53) (41–60) (11–190) (11–73) (13–51) (20–53) (25–48) (24–48) (25–50) (40–63) (13–20) (33–51) (43–67) (48–75) (55–85) (55–84) AFRICAN REGION INCIDENCE (INCLUDING HIV) YEAR Rates are per 100 000 population. NOTIFIED NEW AND RELAPSE includes cases for which the treatment history is unknown. Data for all years can be downloaded from www.who.int/tb/data GLOBAL TUBERCULOSIS REPORT 2013 161 7$%/($,QFLGHQFHQRWLILFDWLRQDQGFDVHGHWHFWLRQUDWHVDOOIRUPV ± INCIDENCE (INCLUDING HIV) YEAR Niger Nigeria Rwanda Sao Tome and Principe Senegal Seychelles Sierra Leone South Africa Swaziland Togo Uganda United Republic of Tanzania Zambia Zimbabwe 162 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 NUMBER (THOUSANDS) POPULATION (MILLIONS) 8 9 11 13 16 17 17 96 108 123 140 160 164 169 7 6 8 9 11 11 11 <1 <1 <1 <1 <1 <1 <1 8 9 10 11 13 13 14 <1 <1 <1 <1 <1 <1 <1 4 4 4 5 6 6 6 37 41 45 48 51 52 52 <1 <1 1 1 1 1 1 4 4 5 6 6 6 7 18 21 24 29 34 35 36 25 30 34 39 45 46 48 8 9 10 11 13 14 14 10 12 13 13 13 13 14 28 25 21 19 18 18 18 120 150 210 240 210 190 180 21 29 27 17 11 11 9.8 0.16 0.16 0.16 0.16 0.17 0.17 0.17 10 13 15 16 18 18 19 0.03 0.03 0.029 0.029 0.028 0.028 0.027 8.4 8.3 11 26 38 39 40 110 130 260 450 500 520 530 2.3 3.2 8.5 13 15 16 17 1.8 2.5 3.5 4.2 4.6 4.7 4.9 110 110 100 87 71 68 65 58 68 80 83 80 78 79 56 70 72 65 61 61 60 31 56 91 100 83 81 77 (23–33) (20–29) (17–25) (15–22) (15–21) (15–21) (15–21) (1.3–500) (8.0–490) (15–660) (33–660) (100–360) (91–340) (85–310) (19–23) (26–32) (24–30) (15–19) (10–13) (9.4–12) (8.8–11) (0.098–0.230) (0.130–0.190) (0.130–0.190) (0.140–0.190) (0.140–0.200) (0.140–0.210) (0.140–0.210) (8.5–12) (11–16) (13–18) (13–19) (15–21) (15–22) (16–22) (0.019–0.044) (0.025–0.036) (0.024–0.035) (0.024–0.035) (0.023–0.033) (0.023–0.033) (0.023–0.033) (5.2–12) (6.4–11) (8.1–14) (21–31) (31–45) (32–47) (32–49) (76–150) (110–160) (210–310) (360–540) (420–600) (430–610) (430–630) (1.4–3.4) (2.7–3.9) (7.0–10) (10–15) (13–18) (13–19) (14–20) (1.5–2.1) (2.0–3.0) (2.9–4.2) (3.5–5.1) (3.8–5.5) (3.9–5.6) (4.0–5.8) (57–180) (62–180) (63–150) (63–120) (57–86) (55–82) (53–79) (49–67) (58–78) (70–91) (76–89) (75–85) (74–83) (74–84) (49–63) (64–76) (67–77) (59–71) (55–67) (55–67) (54–66) (17–50) (39–77) (72–110) (81–130) (64–100) (62–100) (60–97) INCIDENCE HIV-POSITIVE NUMBER (THOUSANDS) a RATE 358 270 191 142 113 108 104 128 139 172 175 133 118 108 290 513 325 181 106 94 86 135 124 114 105 96 94 93 138 153 155 142 137 136 137 43 40 37 33 31 30 30 207 212 264 503 660 668 674 301 317 576 925 981 993 1 000 267 337 803 1 150 1 290 1 320 1 350 47 58 72 77 73 73 73 624 542 427 304 209 193 179 226 226 236 213 177 169 165 710 788 713 566 462 444 427 296 483 726 799 633 603 562 (295–426) (223–321) (157–227) (118–170) (94–135) (90–129) (86–124) (1.3–526) (7.4–456) (12–536) (23–476) (64–225) (55–204) (50–186) (259–323) (458–571) (290–362) (162–202) (94–118) (84–105) (77–96) (83–199) (102–149) (93–137) (88–123) (79–115) (78–113) (76–111) (114–164) (126–183) (128–184) (117–169) (113–163) (112–162) (113–163) (27–64) (33–48) (30–44) (27–40) (25–37) (25–36) (24–35) (128–305) (162–269) (196–341) (410–605) (540–791) (542–807) (540–821) (206–413) (259–381) (471–691) (756–1 110) (809–1 170) (819–1 180) (827–1 190) (165–394) (275–405) (657–964) (938–1 380) (1 060–1 530) (1 090–1 570) (1 110–1 610) (39–56) (48–69) (59–86) (63–91) (60–87) (60–87) (60–87) (328–1 010) (297–860) (259–636) (220–402) (169–253) (156–234) (145–216) (193–261) (193–261) (207–268) (197–229) (166–189) (159–180) (154–175) (624–801) (719–861) (661–767) (519–615) (418–509) (401–489) (385–470) (159–476) (335–658) (573–897) (634–984) (489–795) (466–757) (434–706) RATE 1.1 1.7 2.1 2.2 1.9 1.9 1.9 2.2 16 46 64 53 49 46 11 15 13 7.5 3.7 3.3 2.9 <0.01 <0.01 <0.01 0.015 0.018 0.018 0.017 0.17 0.4 0.8 1.2 1.5 1.6 1.7 (0.91–1.3) 14 (12–17) (1.4–2.1) 19 (16–22) (1.7–2.5) 19 (16–23) (1.8–2.6) 16 (14–20) (1.6–2.3) 12 (9.8–14) (1.6–2.3) 11 (9.5–14) (1.5–2.2) 11 (8.9–13) (0.023–9.1) 2.3 (<0.1–9.5) (0.84–52) 15 (0.78–48) (3.3–140) 38 (2.7–118) (8.6–170) 46 (6.2–125) (26–91) 33 (16–57) (23–85) 30 (14–52) (21–80) 27 (13–47) (9.5–12) 148 (132–165) (13–16) 260 (232–290) (12–15) 157 (140–175) (6.7–8.3) 79 (71–88) (3.3–4.1) 34 (31–38) (3.0–3.7) 30 (26–33) (2.6–3.2) 25 (22–28) (<0.01–<0.01) 2 (1.2–2.9) (<0.01–<0.01) 3.8 (3.1–4.6) (<0.01–0.010) 6.2 (5.0–7.4) (0.012–0.017) 9.6 (8.0–11) (0.015–0.021) 9.9 (8.1–12) (0.014–0.021) 9.6 (7.9–11) (0.014–0.021) 9.2 (7.5–11) (0.14–0.20) 2.2 (1.8–2.6) (0.33–0.48) 4.6 (3.8–5.5) (0.66–0.96) 8.1 (6.7–9.7) (1.0–1.4) 11 (8.9–13) (1.3–1.8) 12 (9.7–14) (1.3–1.9) 12 (9.6–14) (1.4–2.0) 12 (9.9–14) <0.01 <0.01 <0.01 0.011 0.087 0.45 2.3 4.2 4.3 3.9 2.5 25 140 300 330 330 330 0.38 1.6 6.3 11 13 12 13 0.18 0.44 0.89 1.2 1.2 1.2 1.2 79 81 68 50 38 36 35 14 31 41 40 33 31 32 35 49 52 47 39 38 35 18 46 79 83 63 58 55 (<0.01–<0.01) 1.8 (<0.01–0.011) 5.8 (<0.01–<0.01) 2.7 (<0.01–0.016) 0.3 (0.067–0.11) 2.2 (0.33–0.58) 11 (1.9–2.7) 44 (3.4–5.0) 73 (3.5–5.2) 73 (3.2–4.8) 66 (1.7–3.4) 6.7 (21–30) 61 (110–170) 311 (250–360) 622 (270–390) 640 (270–390) 635 (270–390) 631 (0.23–0.56) 44 (1.3–1.9) 161 (5.2–7.6) 595 (8.7–13) 962 (11–15) 1 070 (10–15) 1 020 (11–15) 1 040 (0.15–0.21) 4.7 (0.37–0.53) 10 (0.73–1.1) 18 (1.0–1.5) 22 (0.99–1.4) 19 (0.97–1.4) 18 (0.98–1.4) 18 (41–130) 449 (44–130) 390 (41–100) 280 (36–66) 173 (31–46) 113 (29–44) 102 (28–42) 95 (12–16) 56 (26–36) 103 (36–46) 121 (37–43) 104 (31–35) 72 (29–33) 68 (30–34) 68 (31–40) 449 (45–54) 559 (48–56) 513 (43–51) 409 (35–43) 292 (34–42) 277 (32–39) 251 (9.5–29) 170 (32–62) 392 (62–97) 629 (66–100) 657 (48–79) 480 (45–73) 433 (42–69) 399 a Rates are per 100 000 population. b NOTIFIED NEW AND RELAPSE includes cases for which the treatment history is unknown. GLOBAL TUBERCULOSIS REPORT 2013 a (<0.1–8.0) (1.6–12) (<0.1–10) (0.17–0.40) (1.7–2.8) (8.0–14) (36–53) (60–87) (59–88) (53–81) (4.6–9.2) (50–73) (254–374) (508–746) (528–763) (524–756) (521–752) (27–64) (132–194) (486–714) (787–1 150) (882–1 270) (844–1 220) (856–1 240) (3.8–5.6) (8.5–12) (15–22) (18–26) (16–23) (15–22) (15–21) (236–729) (214–619) (170–417) (125–228) (91–137) (83–124) (77–115) (47–64) (88–119) (106–137) (96–112) (68–77) (63–72) (64–72) (395–507) (510–611) (475–551) (375–445) (264–322) (250–305) (226–276) (91–273) (272–535) (496–777) (521–809) (371–603) (335–543) (308–501) NOTIFIED NEW AND RELAPSE NUMBER a RATE b CASE DETECTION PERCENT 5 200 1 980 4 701 7 873 10 130 10 510 10 989 20 122 13 423 25 821 63 990 84 121 86 778 92 818 6 387 3 054 6 093 7 220 6 703 6 623 6 091 17 67 22 43 60 64 64 64 21 12 21 46 53 53 55 89 54 73 77 62 59 53 14 19 8 22 42 56 59 62 16 8.9 12 26 40 45 51 30 11 22 42 59 63 62 11 (16–23) (6.7–9.7) (19–27) (35–51) (47–68) (49–71) (52–75) (4.0–1 600) (2.7–170) (3.9–170) (9.6–200) (23–82) (26–95) (29–110) (27–34) (9.4–12) (20–25) (38–47) (53–66) (57–71) (56–69) (7.3–17) 97 136 121 136 115 4 977 7 561 8 508 9 765 11 061 11 022 12 265 41 8 20 14 17 21 20 632 1 955 3 760 6 737 12 859 12 734 13 074 80 400 73 917 151 239 270 178 354 786 362 453 323 664 70 88 68 74 61 66 87 86 87 85 83 89 59 11 25 16 19 23 22 16 50 91 132 224 217 219 219 178 337 560 690 698 618 61 84 71 79 66 48 57 56 61 63 61 65 140 27 69 48 61 76 73 7.5 23 34 26 34 32 32 73 56 59 61 70 70 62 (51–75) (72–100) (59–86) (66–96) (55–80) (40–58) (47–69) (47–68) (51–74) (52–76) (51–74) (55–79) (92–220) (22–33) (57–84) (40–59) (51–74) (64–92) (61–88) (5.1–12) (19–31) (27–46) (22–32) (28–41) (27–40) (27–40) (53–110) (47–69) (49–72) (50–74) (59–85) (59–85) (52–75) 2 050 5 877 8 705 10 101 8 337 7 165 1 324 1 520 1 409 2 541 2 791 2 888 2 843 14 740 25 316 30 372 41 040 42 885 46 306 44 663 22 249 39 847 54 442 61 022 61 098 59 357 62 178 16 863 35 958 49 806 49 576 44 154 43 583 40 726 9 132 30 831 50 855 50 454 44 209 38 404 35 760 213 552 788 847 688 582 35 35 29 46 44 45 43 84 122 125 143 126 132 123 87 133 160 157 136 128 130 215 407 493 432 334 320 289 87 265 407 397 338 287 261 63 69 69 66 52 43 74 61 40 60 61 61 59 13 23 29 47 60 68 69 39 59 68 74 77 76 79 30 52 69 76 72 72 68 29 55 56 50 53 48 46 (53–77) (57–84) (57–84) (55–80) (44–63) (36–52) (62–90) (51–74) (34–49) (50–73) (51–74) (51–74) (49–71) (8.3–26) (14–41) (20–48) (36–65) (50–75) (56–84) (57–85) (33–45) (51–69) (60–77) (69–80) (72–82) (71–81) (74–84) (27–34) (47–57) (64–75) (70–83) (66–80) (65–80) (62–75) (18–55) (40–79) (45–71) (40–63) (43–69) (38–62) (37–60) Data for all years can be downloaded from www.who.int/tb/data 7$%/($&DVHQRWLILFDWLRQV ± YEAR Algeria • 44 57 • Angola • 99 249 • Benin • 41 39 • Botswana • 212 307 • Burkina Faso • 17 32 • Burundi • 82 70 • Cameroon • 49 114 • Cape Verde • 63 85 • Central African Republic • 73 179 • Chad • 44 85 • Comoros • 34 17 • Congo • 25 261 • Côte d'Ivoire • 65 120 • Democratic Republic of the Congo • 61 166 • Equatorial Guinea • 70 a b 0• 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 NEW AND b RELAPSE 11 607 13 507 18 572 21 336 22 336 21 429 21 880 10 271 5 143 16 062 37 175 44 655 47 240 51 819 2 074 2 400 2 697 3 270 3 756 4 212 3 966 2 938 5 665 9 292 10 058 7 013 6 603 6 161 1 497 2 572 2 331 3 478 4 800 5 286 5 210 4 575 3 326 6 421 6 585 7 611 6 742 6 921 5 892 3 292 5 251 21 499 24 073 24 533 24 802 221 303 292 356 380 420 2 124 3 339 NEW CASES % SMEARSMEAR- SMEAR-NEGATIVE/ EXTRARE-TREAT EXCL. TOTAL HISTORY POS AMONG OTHER RELAPSE NEW PULM POSITIVE UNKNOWN PULMONARY RELAPSE RETREAT UNKNOWN 5 735 8 328 8 654 8 299 7 790 7 510 2 256 2 019 1 651 1 770 1 753 1 702 5 065 7 758 10 216 11 770 11 444 12 294 3 804 9 053 20 410 21 146 21 703 21 124 1 410 1 839 2 277 2 739 2 973 3 331 3 171 1 631 5 367 12 467 17 285 18 380 23 056 310 281 130 96 296 329 305 266 1 102 2 569 3 780 4 399 4 776 182 212 199 285 367 398 316 1 903 3 091 3 170 3 295 2 669 2 426 2 885 4 789 5 166 2 055 1 983 2 208 1 028 1 545 2 290 3 041 3 450 3 583 267 0 0 0 451 467 548 497 442 374 0 0 0 134 540 1 729 2 444 2 758 2 863 172 68 91 150 120 154 174 720 1 231 1 220 1 210 1 213 1 151 195 196 367 736 692 662 1 121 3 159 3 262 4 590 4 060 4 075 80 165 194 168 202 451 547 713 691 610 576 0 0 0 189 187 85 108 109 134 540 2 871 7 776 4 444 4 470 221 68 280 337 205 262 283 0 0 0 147 181 502 453 738 376 1 058 46 619 130 62 147 1 239 548 1 072 868 438 0 0 0 195 502 571 729 742 617 90 77 175 154 45 88 160 217 227 194 90 167 335 257 195 45 178 327 552 484 389 0 0 0 0 0 908 1 489 1 160 963 799 746 1 116 1 568 2 089 1 826 1 649 1 887 0 0 8 5 3 181 205 74 224 229 210 20 42 108 86 95 181 225 116 332 315 305 0 0 0 0 0 2 896 3 960 13 001 14 464 14 927 15 016 142 625 5 021 5 437 4 941 5 204 18 415 2 461 3 157 3 597 3 524 0 0 0 0 236 251 1 016 1 015 1 068 1 058 574 479 593 558 236 251 1 590 1 494 1 661 1 616 0 0 0 0 111 150 12 135 186 182 189 93 98 127 151 43 54 54 66 13 9 10 5 34 27 27 19 0 0 1 142 5 332 1 686 1 607 49 30 0 21 18 17 14 0 0 0 0 0 0 30 0 0 1 794 964 393 3 210 6 643 5 611 8 084 2 591 3 186 2 153 3 638 3 479 4 641 608 1 598 964 1 752 286 1 079 876 1 356 2 002 518 463 203 6 311 9 452 10 505 10 585 140 123 120 111 2 516 3 833 4 434 3 849 2 419 3 746 4 211 4 809 1 055 1 217 1 033 1 113 193 249 180 321 463 578 634 194 245 269 215 515 708 847 849 0 0 0 103 87 79 10 14 14 7 15 16 0 7 4 2 1 1 7 5 3 0 117 120 591 3 615 9 239 9 853 10 150 10 975 11 303 7 841 11 988 15 094 19 681 22 708 22 476 23 762 21 131 42 819 61 024 97 075 114 170 110 132 108 984 260 306 62 71 13 24 28 23 9 2 2 2 11 4 2 013 4 218 3 640 3 568 3 716 3 984 849 2 016 3 249 3 545 3 930 3 937 675 2 810 2 665 2 692 2 990 3 110 0 0 78 169 299 345 339 272 650 108 171 168 209 78 819 407 516 507 481 0 0 8 254 10 276 12 496 14 131 14 416 14 660 1 508 1 616 2 315 2 381 2 316 2 818 1 577 2 756 4 235 5 179 4 729 5 344 0 0 0 0 0 649 446 635 1 017 1 015 940 447 345 502 444 460 649 893 980 1 519 1 459 1 400 0 0 0 0 0 20 914 36 513 65 040 73 653 71 321 71 124 7 953 8 089 9 959 14 039 13 471 13 214 9 112 13 785 18 494 22 340 21 579 20 669 2 891 2 637 3 582 4 138 3 761 3 977 2 483 4 466 4 158 3 515 2 891 2 637 6 065 8 604 7 919 7 492 219 45 41 579 611 98 118 109 131 820 883 188 0 0 24 60 163 304 232 335 5 0 188 128 117 113 199 34 23 0 0 0 203 1 0 0 291 421 345 534 0 0 1 33 30 67 53 0 0 – 72 80 84 82 82 82 – 70 63 62 55 54 48 82 87 95 97 91 91 91 – 40 39 38 62 57 52 – 84 89 86 81 83 84 – 55 68 74 83 84 85 – 95 86 72 73 75 74 – 43 – 59 65 59 56 – 65 – 78 69 78 73 – 79 – 51 51 51 44 – 91 86 85 – 83 75 – 70 68 53 50 49 50 – 85 86 84 86 86 84 – 72 82 87 84 84 84 – 83 – – 86 84 – AFRICAN REGION NEW AND RELAPSE NOTIFICATION RATEa 1990–2012 Rates are per 100 000 population. NEW AND RELAPSE includes cases for which the treatment history is unknown. Data for all years can be downloaded from www.who.int/tb/data GLOBAL TUBERCULOSIS REPORT 2013 163 7$%/($&DVHQRWLILFDWLRQV ± NEW AND RELAPSE NOTIFICATION RATEa 1990–2012 YEAR Eritrea • 113 51 • Ethiopia • 184 158 • Gabon • 97 302 • Gambia •0 130 • Ghana • 44 58 • Guinea • 33 100 • Guinea-Bissau • 114 117 • Kenya • 50 215 • Lesotho • 158 525 • Liberia •0 193 • Madagascar • 54 116 • Malawi • 131 128 • Mali • 37 37 • Mauritania • 261 69 • Mauritius • 11 164 10 • 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 NEW AND b RELAPSE 3 699 21 453 6 652 3 585 2 870 3 049 3 143 88 634 26 034 91 101 124 262 154 694 156 539 145 323 917 1 115 NEW CASES % SMEARRE-TREAT EXCL. TOTAL SMEAR- SMEAR-NEGATIVE/ EXTRAHISTORY POS AMONG OTHER RELAPSE NEW PULM POSITIVE UNKNOWN PULMONARY RELAPSE RETREAT UNKNOWN 590 687 832 835 779 18 205 5 332 1 764 1 115 1 163 1 154 3 248 683 1 001 836 888 1 093 9 040 30 510 38 525 46 634 49 594 47 236 8 888 30 565 39 816 54 979 55 497 49 413 7 763 28 907 43 675 50 417 49 305 46 854 0 60 0 47 97 87 103 117 20 27 121 44 111 67 124 208 147 228 36 0 0 0 0 0 0 343 1 119 2 246 2 664 2 143 1 820 1 658 873 2 234 2 478 2 269 343 2 777 3 119 4 898 4 621 4 089 0 0 486 517 68 44 2 512 3 790 4 404 4 929 1 042 1 560 1 740 1 745 1 071 1 366 1 959 2 353 241 379 384 414 0 0 0 158 168 321 175 99 390 512 486 257 558 833 661 1 023 1 553 2 031 1 989 2 302 2 333 6 407 8 636 10 933 12 124 14 607 15 389 14 753 1 988 3 523 5 440 6 863 11 038 11 359 11 407 1 163 1 613 1 273 1 774 2 183 2 063 1 939 11 788 28 142 64 159 102 680 99 272 97 320 92 987 2 525 5 181 9 746 10 802 11 674 11 561 10 776 778 919 1 127 1 344 1 375 1 429 171 515 749 462 673 643 68 99 78 143 199 169 0 0 4 0 6 20 77 40 51 92 33 89 41 31 54 6 53 166 81 82 146 2 638 7 316 7 505 7 656 7 616 7 097 1 225 2 500 3 068 5 068 5 875 5 979 109 615 1 019 1 400 1 471 1 301 159 502 532 483 427 376 538 451 454 159 502 532 1 021 878 830 2 263 3 920 5 479 7 041 6 934 6 653 527 430 524 1 472 1 446 1 510 620 938 629 2 077 2 284 2 434 86 273 321 55 152 231 362 422 489 294 227 286 247 234 55 446 458 648 669 723 0 956 526 1 132 1 409 1 230 1 324 6 800 13 934 28 773 40 389 36 260 37 085 36 937 714 600 522 636 644 521 19 57 24 22 63 43 0 0 0 0 59 90 96 116 126 51 42 76 7 11 59 90 138 192 133 62 0 0 0 0 9 676 24 143 43 772 41 962 39 810 36 697 3 468 9 118 15 265 17 382 17 069 15 934 0 0 0 1 064 1 773 3 254 3 668 3 356 3 419 704 5 721 6 811 6 661 6 162 1 064 2 477 8 975 10 479 10 017 9 581 0 0 0 1 361 3 041 4 280 3 600 3 666 3 298 2 685 2 838 4 063 5 331 5 296 5 142 653 2 520 2 020 2 222 2 095 1 877 147 385 439 521 504 459 1 096 602 1 464 1 224 1 195 147 1 481 1 041 1 985 1 728 1 654 1 393 1 500 3 432 6 597 7 906 8 093 6 261 21 616 1 154 1 021 2 167 3 750 4 261 4 342 119 285 575 1 385 1 967 1 946 120 187 657 1 363 1 612 1 749 7 33 99 66 56 25 24 71 59 39 32 57 170 125 95 8 026 987 2 219 18 993 24 432 26 019 25 782 12 395 19 155 23 604 25 491 21 092 19 361 20 335 2 933 3 087 4 216 4 704 5 291 5 428 5 446 5 284 3 849 3 067 2 162 2 461 1 804 2 616 119 131 160 125 122 114 128 13 056 16 795 17 927 17 206 4 301 6 285 8 260 8 443 7 240 7 003 6 951 1 287 1 657 1 726 1 804 5 827 7 054 8 846 10 132 8 245 6 612 6 550 3 634 4 545 4 851 4 964 1 885 5 257 5 734 5 823 4 857 5 076 4 886 482 674 703 427 0 2 119 1 444 1 493 128 1 498 2 109 2 218 1 946 382 551 764 3 212 2 194 2 163 822 1 866 2 527 3 530 3 686 3 777 3 724 609 797 482 481 491 487 459 653 492 926 984 1 081 180 157 145 156 153 239 380 355 321 310 2 074 1 583 1 155 1 422 1 009 1 522 800 687 454 390 222 354 455 580 403 524 458 628 28 0 113 115 110 105 100 118 8 14 4 5 3 3 12 23 8 6 8 5 0 0 0 a Rates are per 100 000 population. b NEW AND RELAPSE includes cases for which the treatment history is unknown. GLOBAL TUBERCULOSIS REPORT 2013 0 0 0 0 44 596 0 0 0 0 0 1 016 1 435 1 515 1 519 382 551 764 1 093 750 670 694 0 0 0 0 0 0 0 0 596 0 153 239 200 198 176 154 0 0 0 0 520 580 150 125 87 112 358 56 28 16 20 520 938 206 153 103 132 0 0 0 2 8 3 6 3 2 4 2 1 2 2 2 12 5 7 5 4 0 317 0 242 0 0 289 1 254 Data for all years can be downloaded from www.who.int/tb/data 0 0 0 0 – – 10 28 43 42 40 – 50 50 49 46 47 49 – 48 – 49 53 47 43 – 82 64 60 74 67 69 – 68 75 71 60 56 54 – 81 90 91 83 83 82 – 57 47 68 69 66 72 100 59 54 48 46 48 50 – 34 52 51 40 41 39 – 91 78 79 73 68 69 – 89 – 91 91 91 91 42 47 48 45 47 51 51 – 75 76 88 88 88 88 – 72 70 72 78 82 81 – 93 89 96 95 97 98 7$%/($&DVHQRWLILFDWLRQV ± a YEAR Mozambique • 117 189 • Namibia • 189 443 • Niger • 67 64 • Nigeria • 21 55 • Rwanda • 89 53 • Sao Tome and Principe • 14 61 • Senegal • 66 89 • Seychelles • 59 22 • Sierra Leone • 16 219 • South Africa • 219 618 • Swaziland •0 582 • Togo • 35 43 • Uganda • 84 123 • United Republic of Tanzania • 87 130 • Zambia • 215 289 • Zimbabwe • 87 a b 261 • 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 NEW AND b RELAPSE 15 899 17 882 21 158 33 231 43 558 44 627 47 741 2 671 1 540 10 799 14 920 11 281 10 806 10 003 5 200 1 980 4 701 7 873 10 130 10 510 10 989 20 122 13 423 25 821 63 990 84 121 86 778 92 818 6 387 3 054 6 093 7 220 6 703 6 623 6 091 17 97 136 121 136 115 4 977 7 561 8 508 9 765 11 061 11 022 12 265 41 8 20 14 17 21 20 632 1 955 3 760 6 737 12 859 12 734 13 074 80 400 73 917 151 239 270 178 354 786 362 453 323 664 2 050 5 877 8 705 10 101 8 337 7 165 1 324 1 520 1 409 2 541 2 791 2 888 2 843 14 740 25 316 30 372 41 040 42 885 46 306 44 663 22 249 39 847 54 442 61 022 61 098 59 357 62 178 16 863 35 958 49 806 49 576 44 154 43 583 40 726 9 132 30 831 50 855 50 454 44 209 38 404 35 760 NEW CASES % SMEARRE-TREAT EXCL. TOTAL SMEAR- SMEAR-NEGATIVE/ EXTRAHISTORY POS AMONG OTHER RELAPSE NEW PULM POSITIVE UNKNOWN PULMONARY RELAPSE RETREAT UNKNOWN 10 566 13 257 17 877 20 097 19 537 20 951 5 054 4 037 9 184 16 408 18 159 19 797 1 363 2 262 4 771 5 621 5 504 5 542 697 4 012 5 222 4 464 4 503 4 333 507 4 724 4 455 3 309 3 034 2 473 248 1 459 1 907 2 330 2 039 2 063 1 492 3 045 5 050 6 283 6 604 6 848 116 699 1 193 1 730 1 856 1 989 372 702 1 227 1 492 1 489 1 689 9 476 17 423 35 048 45 416 47 436 52 901 3 364 6 613 22 705 32 616 33 034 32 972 280 1 069 2 836 3 422 3 793 4 432 1 840 3 681 4 166 3 785 3 811 3 571 676 845 859 1 072 1 017 858 338 1 289 1 727 1 577 1 300 1 247 30 49 47 53 59 56 75 63 49 37 7 1 10 28 16 5 421 5 823 6 722 7 688 7 765 8 448 1 073 1 370 1 557 1 470 1 389 1 755 504 800 921 1 404 1 315 1 524 6 11 8 9 2 9 2 7 3 8 13 8 1 2 1 0 6 2 1 454 2 472 4 370 6 898 7 435 8 031 339 821 1 679 4 919 4 358 4 241 121 400 551 831 775 570 23 112 75 967 125 460 132 107 129 770 119 898 74 399 16 392 76 680 151 772 148 266 134 631 10 636 17 486 39 739 52 095 47 285 42 467 660 1 823 2 187 3 011 2 408 2 548 687 3 198 4 106 5 064 4 228 3 111 219 583 1 458 1 631 1 395 1 209 887 984 1 798 2 096 2 087 2 112 304 91 170 164 205 168 236 287 484 397 475 444 13 631 17 246 20 559 23 456 25 614 24 916 11 553 19 955 24 049 25 264 24 769 24 115 25 138 5 912 9 003 15 040 13 567 14 389 13 270 2 070 2 618 3 780 4 571 5 001 5 143 12 362 17 624 20 810 21 184 20 438 21 393 6 195 10 997 13 094 13 715 13 725 14 595 10 038 12 927 14 857 12 639 12 046 12 645 3 268 25 222 24 327 20 412 20 004 17 050 656 10 202 8 587 9 255 9 908 9 174 8 965 14 392 13 155 11 654 12 596 12 163 10 934 27 626 29 074 25 157 19 172 17 316 5 040 8 837 6 721 6 061 5 192 4 912 899 917 1 399 1 432 1 427 1 451 546 487 2 616 2 825 3 086 899 1 463 1 886 4 048 4 252 4 537 88 604 849 1 178 1 230 1 134 930 974 1 344 1 132 1 142 88 1 534 1 823 2 522 2 362 2 276 255 403 452 376 347 351 215 204 218 255 754 667 580 565 303 716 2 009 2 667 2 515 2 513 1 640 2 858 6 326 6 272 5 035 303 2 356 4 867 8 993 8 787 7 548 242 203 200 278 371 269 253 212 96 460 362 161 117 200 374 831 631 414 329 0 0 0 0 0 0 4 11 1 6 3 16 1 10 12 4 27 2 16 15 0 0 0 0 0 0 563 515 565 499 553 538 541 355 530 566 554 563 1 056 920 1 029 1 119 1 092 0 0 0 0 0 0 0 0 0 2 0 0 1 0 0 0 1 0 0 2 0 0 2 0 0 0 41 67 137 211 166 232 374 193 336 209 280 41 441 330 547 375 512 0 0 0 2 487 0 173 116 0 0 0 97 0 0 0 0 0 28 299 18 812 18 394 26 668 179 56 202 32 289 41 768 27 521 25 918 179 56 202 60 588 60 580 45 915 52 586 0 0 489 273 311 395 306 297 976 159 1 045 843 574 489 1 249 470 1 440 1 149 871 0 0 0 93 47 85 134 121 119 86 94 106 92 69 93 133 179 240 213 188 0 955 1 505 1 661 1 291 1 302 1 334 0 769 2 661 2 712 2 548 955 1 505 2 430 3 952 4 014 3 882 0 0 1 335 1 772 1 854 1 430 1 079 1 052 3 178 2 355 1 791 1 714 1 335 1 772 5 032 3 785 2 870 2 766 243 1 455 1 805 1 848 1 625 1 857 3 691 4 462 5 011 4 551 243 1 455 5 496 6 310 6 636 6 408 4 437 3 348 2 901 2 960 5 941 4 685 4 345 4 329 0 0 0 737 0 0 0 0 1 504 1 337 1 444 1 369 0 0 0 0 0 0 185 0 1 392 0 0 0 0 18 738 0 643 0 0 4 0 0 0 0 0 0 0 0 737 0 0 0 – 68 77 66 55 52 51 – 58 46 54 57 60 64 – 93 81 81 78 78 77 – 74 72 61 58 59 62 – 73 81 83 78 79 81 – – 35 40 43 52 61 – 83 81 81 84 85 83 – 75 61 73 53 13 53 – 81 75 72 58 63 65 – 24 82 62 47 47 47 – 49 36 35 37 36 45 – 74 92 91 93 91 93 – 70 66 58 63 64 65 100 62 58 55 54 54 54 – 75 34 38 38 38 43 – 45 34 31 32 40 41 AFRICAN REGION NEW AND RELAPSE NOTIFICATION RATE 1990–2012 Rates are per 100 000 population. NEW AND RELAPSE includes cases for which the treatment history is unknown. Data for all years can be downloaded from www.who.int/tb/data GLOBAL TUBERCULOSIS REPORT 2013 165 7$%/($7UHDWPHQWRXWFRPHVQHZVPHDUSRVLWLYHFDVHV ± % OF COHORT a TREATMENT SUCCESS (%) 1995–2011 Algeria •0 92 • Angola •0 55 • • 71 90 • • 67 81 • • 25 78 • • 45 92 • • 53 80 • Benin Botswana Burkina Faso Burundi Cameroon Cape Verde •0 77 • Central African Republic • 37 68 • Chad • 47 68 • • 90 25 • Comoros Congo •0 71 • • 68 78 • • 74 87 • • 89 0• Côte d'Ivoire Democratic Republic of the Congo Equatorial Guinea Eritrea •0 87 • • 61 90 • Ethiopia Gabon • 86 a 166 51 • YEAR 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 NUMBER NOTIFIED 5 735 8 328 8 654 8 402 8 299 7 790 3 804 9 053 20 410 22 488 21 146 21 703 1 839 2 277 2 739 2 960 2 973 3 331 1 903 3 091 3 170 3 144 3 295 2 669 1 028 1 545 2 290 3 061 3 041 3 450 1 121 3 159 3 262 3 974 4 590 4 060 2 896 3 960 13 001 14 635 14 464 14 927 111 135 172 186 182 1 794 2 153 5 132 3 638 3 479 2 002 2 516 3 820 3 833 4 434 103 87 79 76 62 2 013 4 218 3 640 3 433 3 568 3 716 8 254 10 276 12 496 14 300 14 131 14 416 20 914 36 513 65 040 73 078 73 653 71 321 219 SIZE OF COHORT 8 328 8 379 8 438 7 894 7 364 6 392 20 113 21 627 21 145 21 703 1 839 2 277 2 766 2 963 2 987 3 324 2 060 3 991 3 335 3 492 3 314 3 107 1 200 1 574 2 290 3 061 3 057 3 442 1 798 3 465 3 424 3 974 4 590 4 060 2 740 3 164 13 169 14 428 14 464 14 927 14 135 182 692 1 366 3 217 5 132 3 569 3 205 529 3 820 3 780 4 430 113 85 70 87 4 3 114 4 121 3 634 3 447 3 716 7 221 10 631 12 496 14 300 14 131 14 416 16 247 36 123 65 066 72 367 73 448 71 321 219 490 579 611 490 590 590 687 802 832 835 9 040 30 510 38 525 44 396 46 634 49 594 486 765 688 804 804 835 5 087 29 662 39 430 44 807 46 634 41 351 249 1 042 1 244 1 560 1 740 1 165 1 163 1 671 1 654 COHORT AS % NOTIFIED – 100 97 100 95 95 – 71 99 96 100 100 100 100 101 100 100 100 108 129 105 111 101 116 117 102 100 100 101 100 160 110 105 100 100 100 95 80 101 99 100 100 – – 100 – – 100 39 – 149 100 98 92 26 – – 100 99 100 110 98 89 – – 6 – 74 113 106 97 100 87 103 100 100 100 100 78 99 100 99 100 100 100 – – 100 102 – – 130 100 100 97 100 56 97 102 101 100 83 51 – 112 93 107 95 DIED FAILED DEFAULTED COMPLETED 80 74 81 79 81 7 13 10 10 11 1 2 2 2 2 2 0 1 1 0 5 3 3 4 4 5 8 3 4 2 68 45 47 30 36 50 57 74 82 84 84 13 22 37 57 50 36 22 53 66 72 74 74 25 42 52 83 87 88 45 67 66 65 64 67 28 25 18 19 21 20 13 9 7 6 54 55 33 22 32 46 2 7 5 4 3 4 20 39 27 7 4 4 8 10 7 13 14 13 3 3 4 8 7 6 6 7 5 5 6 5 6 7 5 5 6 5 13 14 10 9 9 3 4 4 3 4 4 7 7 6 6 6 6 2 3 2 1 2 1 2 2 2 2 3 1 0 1 3 2 2 1 2 7 9 7 6 0 0 0 1 1 1 1 2 1 1 1 1 26 19 18 8 13 17 11 3 1 1 1 12 7 8 4 3 3 3 16 6 4 6 6 14 13 17 5 3 3 35 13 14 10 10 9 2 3 5 35 23 5 3 1 0 1 0 15 10 15 9 8 9 67 9 1 2 1 1 38 1 1 0 0 0 4 1 5 5 5 4 64 56 0 8 7 3 0 2 0 19 29 12 55 16 36 38 33 45 44 17 23 21 21 28 20 23 23 30 4 7 0 6 3 6 4 6 0 0 3 2 1 1 1 1 9 53 34 8 13 19 18 43 10 3 5 19 30 7 10 3 55 39 45 90 91 91 22 28 23 0 2 0 4 4 4 4 4 3 2 2 1 0 4 4 15 21 19 6 0 0 3 5 8 0 0 1 91 25 0 3 75 2 1 2 0 57 24 66 63 59 63 47 62 69 66 69 55 69 80 85 86 82 89 12 4 12 13 12 6 10 11 10 12 9 20 8 5 3 4 5 0 4 0 1 2 2 4 5 8 8 7 7 5 6 6 4 4 4 3 0 1 0 1 2 1 2 2 3 2 2 1 1 1 1 1 1 0 22 13 13 12 11 17 16 10 7 8 9 10 8 4 3 3 4 8 5 58 7 8 14 9 20 6 4 5 3 9 7 4 4 3 5 0 47 50 19 20 3 5 1 1 16 17 14 7 64 83 83 81 83 56 63 64 65 66 70 63 12 5 2 4 4 5 17 14 19 17 19 22 8 7 5 7 4 5 6 5 3 3 3 1 1 1 3 3 4 2 1 1 1 1 1 2 9 2 2 1 1 13 9 4 3 3 2 9 6 1 5 5 5 19 4 12 10 10 4 2 35 37 34 26 12 18 29 25 10 1 2 2 1 1 3 1 42 25 26 36 1 18 6 11 TREATMENT SUCCESS = percent cured + percent completed then rounded to the nearest digit. GLOBAL TUBERCULOSIS REPORT 2013 NOT EVALUATED CURED Data for all years can be downloaded from www.who.int/tb/data 7$%/($7UHDWPHQWRXWFRPHVQHZVPHDUSRVLWLYHFDVHV ± % OF COHORT Gambia • 76 88 • • 54 86 • • 78 82 • Ghana Guinea Guinea-Bissau • 65 73 • • 75 88 • Kenya Lesotho • 47 74 • Liberia • 79 86 • Madagascar • 55 83 • • 71 85 • Malawi Mali • 59 68 • Mauritania •0 73 • Mauritius •0 90 • • 39 0• Mozambique Namibia •0 84 • Niger •0 80 • • 49 85 • Nigeria Rwanda •0 89 • Sao Tome and Principe •0 a 72 • YEAR 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 NUMBER NOTIFIED 778 919 1 127 1 313 1 344 1 375 2 638 7 316 7 505 8 255 7 656 7 616 2 263 3 920 5 479 5 377 7 041 6 934 956 526 1 132 1 310 1 409 1 230 13 934 28 773 40 389 37 402 36 260 37 085 1 361 3 041 4 280 3 976 3 600 3 666 1 154 1 021 2 167 3 796 3 750 4 261 8 026 13 056 15 729 16 795 17 927 6 285 8 260 8 443 7 623 7 240 7 003 1 866 2 527 3 530 5 163 3 686 3 777 2 074 1 583 1 155 1 555 1 422 1 009 113 115 110 98 105 100 10 566 13 257 17 877 19 579 20 097 19 537 697 4 012 5 222 4 608 4 464 4 503 1 492 3 045 5 050 6 347 6 283 6 604 9 476 17 423 35 048 44 863 45 416 47 436 1 840 3 681 4 166 4 184 3 785 3 811 30 49 52 47 53 SIZE OF COHORT COHORT AS % NOTIFIED 686 88 – 100 99 100 100 14 100 101 100 100 100 100 100 106 104 103 74 100 – 103 114 90 106 46 99 100 100 100 99 131 – 129 102 107 100 138 90 100 100 – 90 113 – 117 100 100 98 100 100 100 100 100 100 69 – 100 86 102 100 – – 152 101 100 144 – 139 100 100 100 100 100 100 100 100 100 – – 100 100 102 102 100 – 105 100 99 100 100 100 94 100 100 100 100 – 103 100 100 101 100 – 323 100 96 96 100 1 127 1 296 1 344 1 375 361 7 316 7 584 8 255 7 656 7 623 2 263 3 920 5 811 5 597 7 250 5 152 959 1 167 1 498 1 271 1 308 6 470 28 376 40 436 37 402 36 260 36 717 1 788 5 542 4 070 3 852 3 666 1 595 924 2 167 3 796 3 853 9 101 10 506 15 298 15 709 16 789 17 602 6 293 8 296 8 443 7 624 7 240 7 012 1 290 3 530 4 454 3 778 3 777 1 761 1 563 1 422 1 450 160 110 98 105 100 10 566 13 296 17 877 19 579 20 097 4 012 5 222 4 702 4 538 4 502 3 193 5 050 6 313 6 266 6 604 9 476 16 372 35 080 44 863 45 416 47 436 3 776 4 175 4 165 3 806 3 811 97 49 50 45 53 CURED COMPLETED DIED FAILED DEFAULTED NOT EVALUATED 69 7 5 1 13 5 81 88 86 86 41 45 68 79 76 75 62 59 65 72 76 76 42 6 1 2 2 13 5 5 8 10 11 17 9 7 6 4 6 23 7 6 5 6 11 6 9 7 7 8 6 7 6 5 4 4 6 1 1 1 2 2 3 2 1 1 1 2 1 2 2 2 2 0 3 2 3 2 11 14 11 3 3 3 9 15 10 7 6 7 23 2 1 3 2 22 27 5 3 3 2 5 9 10 8 9 5 6 51 51 54 60 60 66 71 78 81 83 32 18 17 18 14 14 14 11 8 6 5 14 12 6 6 6 9 5 5 4 3 3 7 1 1 0 0 1 0 0 1 1 1 0 11 21 14 13 9 9 8 6 5 4 9 7 5 7 7 7 6 5 4 4 3 36 73 11 10 11 1 2 2 2 5 6 0 1 4 5 8 6 12 10 12 9 14 12 12 7 0 3 8 3 59 58 63 79 71 60 57 9 16 26 8 11 10 11 5 2 3 5 64 47 61 67 78 78 79 65 70 72 87 86 81 41 22 8 9 7 3 4 4 6 3 2 2 2 4 18 4 6 7 6 4 4 4 19 19 15 7 7 7 5 1 2 1 1 1 1 1 1 1 1 1 1 2 0 6 16 17 13 9 9 8 0 4 3 2 2 2 22 4 20 5 5 5 4 4 10 3 7 1 2 4 14 69 66 76 55 6 12 0 13 11 10 8 7 4 4 3 3 7 7 9 7 3 2 4 15 44 51 55 57 11 12 14 16 2 3 2 2 1 1 1 0 19 10 13 16 24 23 15 9 0 86 88 90 90 34 73 78 84 83 92 2 3 4 4 5 3 10 12 9 8 2 0 0 0 5 2 1 1 2 0 1 0 1 1 1 1 1 3 6 4 5 5 9 11 5 3 4 0 5 4 0 0 48 3 2 2 1 41 59 74 74 74 15 16 11 11 10 6 7 5 5 5 2 2 4 4 5 15 10 4 3 5 21 7 2 2 0 42 49 66 69 66 34 65 50 73 73 77 22 25 13 13 15 15 14 25 10 10 9 8 5 7 7 5 5 6 9 5 5 5 4 2 2 2 3 2 2 4 1 1 1 12 14 7 6 9 9 11 11 8 8 7 11 5 5 3 3 35 2 1 4 2 2 52 73 77 80 84 9 10 8 8 5 6 6 5 5 5 1 2 4 4 4 4 3 3 2 2 28 6 3 1 1 52 98 98 20 45 27 0 0 58 26 9 2 0 9 4 5 0 2 0 19 7 0 0 13 6 0 0 0 0 0 AFRICAN REGION TREATMENT SUCCESS (%)a 1995–2011 TREATMENT SUCCESS = percent cured + percent completed then rounded to the nearest digit. Data for all years can be downloaded from www.who.int/tb/data GLOBAL TUBERCULOSIS REPORT 2013 167 7$%/($7UHDWPHQWRXWFRPHVQHZVPHDUSRVLWLYHFDVHV ± % OF COHORT TREATMENT SUCCESS (%)a 1995–2011 Senegal • 44 85 • • 89 67 • • 69 88 • • 58 79 • Seychelles Sierra Leone South Africa Swaziland •0 73 • Togo • 60 85 • • 44 77 • • 73 88 • • 70 88 • • 53 81 • Uganda United Republic of Tanzania Zambia Zimbabwe a YEAR 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 NUMBER NOTIFIED 5 421 5 823 6 722 7 883 7 688 7 765 6 11 8 11 9 2 1 454 2 472 4 370 6 092 6 898 7 435 23 112 75 967 125 460 139 468 132 107 129 770 660 1 823 2 187 3 498 3 011 2 408 887 984 1 798 2 267 2 096 2 087 13 631 17 246 20 559 23 113 23 456 25 614 19 955 24 049 25 264 24 895 24 769 24 115 10 038 12 927 14 857 12 995 12 639 12 046 8 965 14 392 13 155 10 195 11 654 12 596 SIZE OF COHORT COHORT AS % NOTIFIED 5 421 5 823 6 722 7 883 7 855 7 898 9 11 100 100 100 100 102 102 150 100 – 100 78 450 90 93 100 100 100 99 122 114 107 100 102 102 – – 100 100 100 104 97 – 100 100 100 99 112 80 100 100 100 100 100 99 100 100 98 100 59 54 100 100 100 106 108 100 98 100 100 100 11 7 9 1 315 2 296 4 370 6 083 6 897 7 351 28 209 86 276 134 782 139 458 134 250 132 867 2 187 3 498 3 011 2 499 856 1 796 2 267 2 096 2 075 15 301 13 874 20 559 23 113 23 456 25 614 19 955 23 923 25 324 24 895 24 373 24 218 5 957 7 014 14 857 12 995 12 639 12 711 9 702 14 392 12 860 10 195 11 654 12 596 CURED COMPLETED DIED FAILED DEFAULTED NOT EVALUATED 35 43 70 81 81 82 89 82 9 9 6 3 4 3 0 0 4 3 4 4 4 3 11 0 6 1 2 2 2 2 0 0 16 21 11 5 6 7 0 9 31 22 8 5 4 3 0 9 55 100 56 55 70 77 68 77 79 40 54 58 67 73 74 9 0 11 15 7 8 10 9 9 18 9 13 6 6 5 18 0 0 5 6 6 6 4 3 4 6 7 7 6 6 0 0 0 7 2 1 1 1 1 4 1 2 2 2 2 0 0 11 16 13 6 11 6 6 15 13 10 7 7 6 18 0 22 2 2 2 4 3 2 19 17 10 12 6 7 22 51 51 48 42 20 19 22 25 18 6 10 11 8 9 2 7 9 8 3 5 7 6 5 17 45 7 2 5 11 66 77 81 81 26 33 32 30 35 39 69 72 79 82 84 80 47 48 76 85 83 82 32 61 59 70 72 73 5 4 3 3 18 30 41 38 36 38 5 6 4 6 6 7 23 19 8 6 6 5 21 8 9 9 10 8 12 10 8 7 7 7 6 5 5 5 9 10 9 5 5 4 7 7 8 6 6 4 10 12 12 8 8 8 4 4 3 2 1 0 0 1 1 1 1 0 0 0 0 0 2 6 1 1 1 1 0 0 2 1 1 1 11 3 4 5 13 17 16 12 11 12 6 6 4 2 2 2 14 6 2 3 3 3 10 7 7 7 5 4 2 2 1 1 36 12 5 16 13 5 11 5 4 5 3 6 8 14 5 0 1 4 26 13 12 6 5 6 TREATMENT SUCCESS = percent cured + percent completed then rounded to the nearest digit. GLOBAL TUBERCULOSIS REPORT 2013 Data for all years can be downloaded from www.who.int/tb/data 7$%/($7UHDWPHQWRXWFRPHVUHWUHDWPHQWFDVHV ± Algeria •0 80 • Angola •0 0• Benin • 67 84 • Botswana •0 70 • • 77 75 • • 46 85 • Burkina Faso Burundi Cameroon •0 70 • Cape Verde •0 37 • Central African Republic •0 55 • Chad • 48 60 • • 43 0• Comoros Congo •0 51 • Côte d'Ivoire •0 67 • Democratic Republic of the Congo • 72 74 • • 83 0• Equatorial Guinea Eritrea •0 69 • • 79 78 • Ethiopia Gabon •0 a 40 • YEAR 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 NUMBER NOTIFIED 451 547 713 612 691 610 134 540 2 871 3 863 7 776 4 444 68 280 337 271 205 262 147 1 239 548 1 122 1 072 868 45 178 327 608 552 484 181 225 116 238 332 315 236 251 1 590 1 569 1 494 1 661 30 34 33 27 27 188 291 629 421 345 203 515 676 708 847 7 5 3 6 SIZE OF COHORT 512 713 553 598 588 1 613 3 044 2 272 4 444 139 282 341 270 203 262 395 219 1 126 1 027 998 26 166 272 509 475 481 265 92 238 332 315 347 1 611 1 516 1 489 1 661 34 27 353 291 629 284 275 92 676 704 847 7 5 5 5 11 78 819 407 451 516 507 649 893 980 1 436 1 519 1 459 2 891 2 637 6 065 8 666 8 604 7 919 1 44 67 53 67 124 207 208 147 343 2 777 3 119 3 544 4 898 4 621 44 257 655 558 833 187 477 418 235 528 507 980 1 436 1 519 1 459 1 202 5 448 7 193 5 583 4 572 6 44 41 157 120 147 193 1 556 3 116 2 942 3 934 1 796 150 611 147 200 COHORT AS % NOTIFIED – 94 100 90 87 96 – – 56 79 29 100 204 101 101 100 99 100 – 32 40 100 96 115 58 93 83 84 86 99 146 41 – 100 100 100 – 138 101 97 100 100 – – 100 – – 100 – – 100 100 67 80 45 – – 100 99 100 100 100 167 – – – – 23 117 93 46 104 – 57 100 100 100 100 42 – 90 83 65 58 600 – – 100 61 – – – – 76 58 100 56 56 100 83 80 39 – – 58 93 26 24 DEFAULTED NOT EVALUATED 4 1 2 2 4 5 6 5 5 11 10 19 5 6 3 5 5 8 0 9 5 10 11 6 8 17 4 4 0 4 1 3 6 6 5 26 21 16 0 19 11 6 1 1 1 4 3 7 100 1 0 1 1 1 1 54 28 43 46 55 12 4 4 5 4 4 21 13 8 11 13 14 11 8 13 6 9 9 10 6 15 1 5 4 3 3 12 5 10 8 8 8 2 3 11 12 8 7 6 0 15 6 5 6 6 28 17 6 11 10 10 10 4 7 4 3 1 1 18 1 81 78 80 3 4 4 6 7 6 3 5 5 4 6 4 2 0 0 50 49 51 55 54 10 7 18 16 16 9 6 9 9 9 5 3 2 3 3 26 16 13 12 12 2 19 7 6 6 41 15 0 0 24 21 CURED COMPLETED DIED 61 48 72 69 65 16 24 12 14 15 5 2 4 4 3 23 45 42 48 61 60 70 76 80 24 21 23 0 19 21 21 11 9 4 21 33 22 20 15 65 57 71 70 72 70 25 50 FAILED 22 15 4 4 11 44 33 53 19 35 33 29 16 30 12 24 21 18 1 9 5 7 11 5 4 0 2 4 4 2 39 8 8 25 20 40 8 1 53 6 11 4 49 38 29 43 100 100 21 35 31 0 0 0 4 4 4 29 0 0 3 2 1 0 0 0 15 18 27 29 0 0 8 3 7 0 0 0 80 0 0 20 0 0 49 12 59 40 51 13 2 22 17 0 3 0 2 3 5 3 0 1 2 4 28 3 14 21 10 4 83 2 18 31 45 43 50 51 56 56 10 14 14 14 11 16 8 8 13 12 10 8 9 7 11 8 8 2 21 13 9 11 12 12 7 15 3 3 3 6 71 54 72 68 83 4 23 5 5 0 10 8 7 8 0 4 2 3 2 17 6 4 6 5 0 5 8 8 12 0 36 32 14 15 14 22 2 0 16 27 18 5 70 81 67 71 60 41 47 56 57 12 8 3 8 11 15 21 27 21 7 9 7 3 10 9 5 4 4 6 2 10 5 4 2 2 3 0 2 1 1 8 8 5 3 5 3 3 0 13 5 7 28 23 6 15 18 12 32 18 12 67 33 21 5 2 3 2 3 1 3 2 60 17 26 30 3 1 2 26 AFRICAN REGION % OF COHORT a TREATMENT SUCCESS (%) 1995–2011 TREATMENT SUCCESS = percent cured + percent completed then rounded to the nearest digit. Data for all years can be downloaded from www.who.int/tb/data GLOBAL TUBERCULOSIS REPORT 2013 169 7$%/($7UHDWPHQWRXWFRPHVUHWUHDWPHQWFDVHV ± % OF COHORT TREATMENT SUCCESS (%)a 1995–2011 Gambia • 69 78 • Ghana • 74 77 • • 67 64 • Guinea Guinea-Bissau •0 68 • • 72 82 • Kenya Lesotho •0 58 • Liberia •0 82 • Madagascar •0 80 • • 69 82 • Malawi Mali •0 69 • •0 53 • Mauritania Mauritius •0 80 • Mozambique •0 0• Namibia •0 80 • Niger •0 76 • Nigeria •0 82 • Rwanda •0 80 • Sao Tome and Principe •0 a 170 31 • YEAR 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 NUMBER NOTIFIED 6 53 166 99 81 82 159 502 532 860 1 021 878 55 446 458 589 648 669 59 90 138 76 192 133 1 064 2 477 8 975 10 711 10 479 10 017 147 1 481 1 041 1 970 1 985 1 728 32 57 123 170 125 596 1 498 2 089 2 109 2 218 551 764 3 212 2 470 2 194 2 163 153 239 380 425 355 321 520 938 206 182 153 103 2 12 5 5 7 5 899 1 463 1 886 3 630 4 048 4 252 88 1 534 1 823 2 558 2 522 2 362 255 754 690 667 580 303 2 356 4 867 8 151 8 993 8 787 200 374 831 475 631 414 4 27 3 2 16 SIZE OF COHORT 45 100 81 86 47 540 717 1 021 878 112 299 458 111 121 146 89 140 47 879 1 964 3 794 4 859 4 333 7 235 597 1 931 2 091 1 728 41 57 123 125 1 825 2 073 1 800 1 843 492 797 1 093 788 750 670 379 390 345 321 182 153 133 2 5 5 7 5 1 594 1 855 604 2 009 1 546 2 548 2 361 667 661 580 1 848 3 662 8 151 8 993 8 787 296 506 448 446 415 0 3 12 16 COHORT AS % NOTIFIED 750 – – 101 100 105 30 – 102 83 100 100 204 67 100 – 17 18 – – 106 117 73 35 83 79 42 45 41 72 – – 57 98 105 100 – 128 100 100 – 100 – – 122 99 85 83 89 104 34 32 34 31 – – 100 92 97 100 – – – 100 100 129 – 17 100 100 100 100 – 109 98 – – – – 39 110 60 101 100 – – – 97 99 100 – 78 75 100 100 100 – 79 61 94 71 100 – – 0 100 600 100 CURED COMPLETED DIED FAILED DEFAULTED 69 0 11 2 11 7 67 30 74 68 5 6 3 6 17 6 13 6 2 1 3 9 7 0 3 9 2 57 2 2 40 50 38 40 44 63 45 8 26 39 38 23 8 16 6 10 12 12 3 5 10 3 2 2 3 9 3 7 11 3 2 4 13 8 13 32 10 7 5 8 13 11 55 56 14 7 8 8 5 3 13 16 6 9 44 30 23 47 61 65 68 70 73 77 34 34 31 21 11 11 9 8 6 5 8 2 10 13 9 2 10 8 6 4 0 0 0 2 1 8 1 4 3 4 8 29 27 9 10 10 7 7 8 7 7 4 9 9 8 4 5 4 4 3 20 16 17 71 42 42 41 11 17 16 18 2 2 2 2 2 4 8 10 14 15 16 12 39 75 70 22 9 15 12 2 8 7 4 20 9 2 0 5 0 72 10 4 12 2 0 65 62 71 75 65 61 74 83 77 79 7 11 3 4 4 5 1 2 1 3 7 7 8 7 22 23 19 9 10 10 2 2 2 1 2 1 1 2 3 1 12 8 9 8 1 6 3 2 1 3 6 10 8 4 6 3 3 1 9 5 67 67 87 64 6 8 12 5 10 9 1 7 5 6 0 4 10 7 0 4 3 3 0 15 48 46 43 13 13 10 3 5 10 1 2 2 20 15 17 14 20 19 0 60 60 86 80 0 20 0 0 0 50 50 20 0 0 0 0 0 0 20 20 14 20 0 0 0 0 0 69 69 3 1 11 15 4 2 11 10 2 3 41 24 58 63 67 14 29 15 15 13 8 11 9 6 5 6 3 9 10 9 13 13 6 5 5 17 22 3 2 0 64 64 62 12 11 14 9 10 6 4 3 5 5 5 10 6 7 4 58 48 48 43 42 13 18 33 39 40 7 2 6 4 4 7 11 2 4 4 11 20 7 7 6 4 1 4 3 4 49 56 62 65 72 5 9 10 9 8 14 15 11 9 10 1 3 7 6 7 5 4 4 4 2 25 13 6 6 1 33 0 0 33 50 31 0 8 6 33 17 38 0 8 25 0 17 0 TREATMENT SUCCESS = percent cured + percent completed then rounded to the nearest digit. GLOBAL TUBERCULOSIS REPORT 2013 NOT EVALUATED Data for all years can be downloaded from www.who.int/tb/data 7$%/($7UHDWPHQWRXWFRPHVUHWUHDWPHQWFDVHV ± Senegal • 56 68 • •0 0• Seychelles Sierra Leone • 87 70 • South Africa •0 66 • Swaziland •0 59 • Togo • 33 78 • Uganda •0 71 • • 76 82 • United Republic of Tanzania Zambia •0 0• Zimbabwe •0 a 78 • YEAR 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 NUMBER NOTIFIED SIZE OF COHORT COHORT AS % NOTIFIED 563 1 056 920 1 112 1 029 1 119 0 0 2 0 0 0 41 441 330 467 547 375 179 56 202 60 588 65 916 60 580 45 915 489 1 249 470 1 474 1 440 1 149 93 133 179 214 240 213 955 1 505 2 430 4 014 3 952 4 014 1 335 1 772 5 032 4 217 3 785 2 870 243 1 455 5 496 2 485 6 310 6 636 737 634 931 920 889 1 029 914 113 88 100 80 100 82 – – – – – – 168 – 99 100 99 97 – 44 107 52 100 68 – – 237 100 31 100 100 – 72 111 100 99 – 80 – 71 70 70 109 189 101 100 98 102 – 61 100 219 – – – – 79 26 35 41 5 941 4 685 4 685 4 345 0 0 0 69 328 466 543 362 24 847 64 923 34 122 60 580 31 168 1 113 1 474 446 1 151 93 128 237 240 210 1 209 2 856 2 764 2 814 1 455 3 356 5 067 4 217 3 714 2 936 894 5 496 5 444 1 063 4 667 1 203 1 629 1 772 CURED COMPLETED 45 40 58 67 56 64 11 8 5 4 4 4 DIED 5 4 8 7 6 5 FAILED DEFAULTED NOT EVALUATED 10 3 5 5 3 3 25 23 13 10 7 14 4 23 11 8 24 9 72 14 3 4 4 1 68 56 65 63 7 13 11 7 6 10 5 6 3 3 2 3 15 15 15 15 1 4 2 5 43 29 53 31 59 8 29 8 4 7 8 11 10 5 9 3 2 3 2 3 19 16 12 7 12 19 13 15 52 10 7 14 32 12 16 21 41 18 46 17 11 17 17 15 5 3 9 21 8 4 5 10 7 5 19 54 8 6 13 38 73 68 78 75 2 3 4 3 14 18 6 8 4 3 4 4 7 4 8 8 0 5 1 1 34 30 13 0 13 10 31 31 38 66 49 37 34 37 38 39 34 33 10 24 39 49 47 43 7 8 8 11 14 13 8 9 7 1 1 2 1 1 1 1 1 1 15 12 14 8 6 4 3 3 3 7 13 5 4 6 6 5 4 7 52 24 33 15 60 53 11 9 9 4 1 1 5 3 4 12 4 0 51 13 72 63 63 14 46 8 11 15 17 16 11 13 11 1 0 0 3 4 8 13 5 5 4 9 11 4 5 3 AFRICAN REGION % OF COHORT TREATMENT SUCCESS (%)a 1995–2011 TREATMENT SUCCESS = percent cured + percent completed then rounded to the nearest digit. Data for all years can be downloaded from www.who.int/tb/data GLOBAL TUBERCULOSIS REPORT 2013 171 7$%/($+,9WHVWLQJDQGSURYLVLRQRI&37$57DQG,37– % OF TB PATIENTS WITH KNOWN HIV STATUS YEAR 2005–2012 Algeria – – Angola – 23 • Benin • 15 98 • Botswana • 23 95 • • 33 84 • Burkina Faso Burundi – 82 • Cameroon •0 82 • • 98 89 • Cape Verde Central African Republic – 46 • – 44 • Chad Comoros • 100 3• Congo – 17 • • 20 85 • •2 31 • Côte d'Ivoire Democratic Republic of the Congo Equatorial Guinea – – Eritrea – 59 • Ethiopia •3 65 • •7 100 • Gabon Gambia – 78 • •7 78 • – 65 • Ghana Guinea Guinea-Bissau • 11 68 • • 14 94 • •1 88 • Kenya Lesotho Liberia •3 70 • •9 54 • Madagascar 172 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 % OF TB NUMBER OF TB PATIENTS WITH PATIENTS WITH KNOWN HIV KNOWN HIV STATUS STATUS 4.9 10 23 15 98 99 98 23 81 97 95 33 93 89 84 2 434 5 107 12 022 503 3 774 4 259 4 006 2 291 6 147 6 545 5 940 1 213 4 761 4 944 4 567 71 71 82 0 78 81 82 98 5 511 4 817 5 734 0 19 117 20 280 20 810 298 90 89 352 378 39 33 46 2 638 1 890 3 839 39 38 44 100 3.4 3.3 3 801 4 124 4 766 112 119 4 4 40 20 17 20 73 80 85 1.9 24 27 31 92 100 21 501 22 530 21 597 22 082 38 317 49 987 48 926 53 426 3 457 3 841 4 320 4 075 10 104 7 632 6 733 6 223 3 645 5 135 5 543 5 405 6 627 7 719 6 828 7 016 22 073 24 552 25 126 25 360 305 365 390 425 3 338 6 760 5 724 8 283 6 505 9 697 10 774 10 800 112 NUMBER OF HIV-POSITIVE TB PATIENTS % OF TESTED TB PATIENTS HIV-POSITIVE NUMBER OF % OF HIV% OF HIVPOSITIVE TB POSITIVE TB HIV-POSITIVE PEOPLE PATIENTS ON PATIENTS ON PROVIDED IPT ART CPT 1 620 789 1 149 57 592 727 637 1 829 4 018 4 129 3 759 559 839 829 671 67 15 9.6 11 16 17 16 80 65 63 63 46 18 17 15 43 100 100 43 100 100 97 98 57 74 79 62 90 68 98 97 96 43 53 65 32 60 70 75 1 260 1 036 1 076 0 8 314 7 731 7 747 14 23 22 19 95 95 94 40 48 55 43 38 37 4.7 81 87 83 51 62 55 100 47 45 13 12 44 98 862 733 1 483 33 39 39 0 12 28 62 9.3 20 17 23 20 1.8 0 100 100 53 39 100 45 43 65 100 100 100 100 100 4 106 2 247 1 979 4 079 16 991 18 297 20 663 1 885 28 997 30 636 35 097 119 122 9 961 10 321 11 143 11 512 20 026 23 210 22 920 24 222 99 558 118 636 114 290 112 499 663 959 960 2 0 4 4 757 687 653 1 551 4 112 4 820 5 482 386 5 273 4 942 5 748 18 31 33 38 24 26 27 20 18 16 16 2.9 24 20 38 80 80 75 74 24 54 61 2.9 26 23 14 27 36 44 0.78 9.3 23 40 786 911 853 913 225 234 29 26 85 31 21 164 1 321 9 809 5 442 9 819 185 667 578 852 8.6 41 15 8.4 10 100 59 26 16 88 69 62 37 100 52 29 39 39 82 224 11 93 46 302 340 2 676 2 907 2 812 16 40 26 23 24 97 100 77 72 72 48 37 18 28 37 1 483 1 670 1 859 110 396 431 517 8 954 40 069 38 175 35 837 127 8 459 8 519 7 878 14 283 454 772 16 39 40 19 26 26 25 55 38 42 39 57 41 39 39 81 77 75 75 12 8 10 14 0.91 0.24 0.26 0.13 87 72 83 100 41 49 49 30 0 0 44 100 97 98 79 96 95 97 0 8.5 26 90 0 0 17 48 64 74 59 2.6 43 41 65 7.1 27 46 100 1 913 3 211 66 955 65 140 96 245 185 1 130 2 252 5 415 97 74 78 7 67 79 78 1 962 1 726 1 859 844 10 147 12 587 11 825 51 56 65 11 46 50 68 14 91 93 94 1.4 84 89 88 3.3 53 55 70 9 65 58 54 5 776 6 548 7 575 200 1 046 1 037 1 322 15 658 96 930 97 136 92 890 156 11 005 11 413 10 476 114 3 533 4 355 5 661 1 759 16 439 15 532 14 146 GLOBAL TUBERCULOSIS REPORT 2013 PATIENTS NOTIFIED (NEW AND RETREAT) 3 612 2 991 3 093 3 254 125 135 156 928 159 017 147 592 2 611 4 180 4 916 5 415 2 120 2 030 2 333 2 387 12 124 15 145 15 840 15 207 7 090 11 324 11 606 11 641 1 816 2 259 2 070 1 950 108 401 106 083 103 981 99 149 11 404 13 138 12 785 11 971 3 456 6 668 7 965 8 132 19 475 25 106 26 722 26 209 1 100 339 18 762 738 0 0 0 1 373 123 0 2 0 1 983 6 636 30 816 30 395 0 52 66 27 68 53 0 9.3 15 36 95 Data for all years can be downloaded from www.who.int/tb/data 0 0 16 403 7$%/($+,9WHVWLQJDQGSURYLVLRQRI&37$57DQG,37– Malawi • 44 93 • Mali – 28 • Mauritania •0 – Mauritius • 91 96 • – 94 • Mozambique Namibia • 16 89 • – 46 • • 10 84 • • 65 99 • Niger Nigeria Rwanda Sao Tome and Principe • 100 99 • – 78 • Senegal Seychelles – 100 • – 87 • • 22 84 • – 95 • Sierra Leone South Africa Swaziland Togo •0 91 • • 25 86 • •3 82 • •2 100 • •0 88 • Uganda United Republic of Tanzania Zambia Zimbabwe 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 NUMBER OF TB % OF TB PATIENTS WITH PATIENTS WITH KNOWN HIV KNOWN HIV STATUS STATUS 44 88 83 93 12 243 19 855 17 334 19 009 42 35 28 0.45 24 0.66 2 303 1 963 1 544 10 608 12 91 95 93 96 115 117 108 125 88 91 94 16 76 84 89 40 554 43 096 47 960 2 547 9 534 10 042 9 927 48 44 46 10 79 81 84 65 98 97 99 100 92 100 99 4 925 4 710 5 166 6 897 71 844 75 772 82 641 5 003 6 914 6 560 6 131 152 112 146 126 69 76 78 8 018 8 757 10 048 100 100 100 17 21 21 74 78 87 22 54 83 84 9 718 10 159 11 655 67 988 213 006 322 732 294 196 86 92 95 0 77 84 91 25 81 80 86 2.5 90 88 82 2 84 100 100 0 86 90 88 9 536 8 419 7 363 0 2 242 2 513 2 657 10 555 36 742 39 394 40 581 1 613 56 849 53 842 52 499 1 082 40 704 48 594 45 269 0 41 062 37 029 34 212 PATIENTS NOTIFIED (NEW AND RETREAT) 27 610 22 536 20 854 20 463 4 884 5 448 5 573 5 602 2 218 2 489 1 820 2 636 127 123 116 130 33 718 46 174 47 452 50 827 15 894 12 625 11 938 11 145 8 224 10 345 10 714 11 207 66 848 90 447 93 050 97 853 7 680 7 065 6 784 6 208 152 122 146 127 10 120 11 591 11 588 12 819 14 17 21 21 6 930 13 195 12 943 13 354 302 467 396 554 389 974 349 582 8 864 11 146 9 180 7 739 2 635 2 897 2 980 2 912 41 809 45 546 49 018 47 211 64 200 63 453 61 148 63 892 53 267 48 616 48 594 45 277 54 891 47 557 41 305 38 720 NUMBER OF HIV-POSITIVE TB PATIENTS % OF TESTED TB PATIENTS HIV-POSITIVE % OF HIV% OF HIVNUMBER OF POSITIVE TB POSITIVE TB HIV-POSITIVE PATIENTS ON PATIENTS ON PEOPLE CPT ART PROVIDED IPT 8 447 12 476 10 341 11 296 69 63 60 59 92 94 89 88 49 46 60 81 416 404 425 0 90 12 18 21 28 0 15 100 75 72 42 52 69 100 0 61 100 0 2 8 8 10 1.7 6.8 7.4 8 100 100 100 100 50 75 62 90 24 574 26 538 27 979 1 465 5 227 4 990 4 688 152 405 334 431 1 241 17 736 19 553 19 342 2 276 2 199 1 855 1 601 5 13 15 18 61 62 58 58 55 50 47 97 91 98 25 29 55 13 164 17 064 17 317 93 98 99 43 37 6.6 31 44 54 72 34 0 4.8 16 13 989 14 428 11 906 59 68 80 15 97 97 99 0 92 100 100 33 43 56 13 72 75 1 750 1 107 2 257 0 54 100 100 37 48 64 100 100 100 100 8.2 7.1 8.3 18 25 26 23 45 32 28 26 3.3 12 10 14 776 877 882 2 1 4 3 9.7 10 8.8 5.9 19 14 85 85 90 100 100 75 67 976 902 1 343 35 299 128 457 211 128 190 093 10 8.9 12 52 60 65 65 6.4 25 26 100 74 77 74 19 28 69 33 54 46 54 7 788 6 480 5 666 0 632 667 625 7 523 19 836 20 725 20 376 841 21 662 20 632 20 269 614 26 571 26 737 24 309 0 31 849 27 562 23 957 82 77 77 93 95 98 35 51 66 28 27 24 71 54 53 50 52 38 38 39 57 65 55 54 72 77 87 25 90 93 94 61 92 95 96 75 87 93 49 67 76 10 24 32 49 22 35 38 54 68 48 53 60 78 74 70 88 94 26 45 60 18 Data for all years can be downloaded from www.who.int/tb/data 20 542 AFRICAN REGION % OF TB PATIENTS WITH KNOWN HIV STATUS YEAR 2005–2012 0 0 0 426 0 0 1 062 1 466 146 247 372 994 369 747 1 934 0 0 GLOBAL TUBERCULOSIS REPORT 2013 173 7$%/($7HVWLQJIRU0'57%DQGQXPEHURIFRQILUPHGFDVHVRI0'57%± YEAR TOTAL CONFIRMED CASES OF a MDR-TB Algeria Angola Benin Botswana Burkina Faso Burundi Cameroon Cape Verde Central African Republic Chad Comoros Congo Côte d'Ivoire Democratic Republic of the Congo Equatorial Guinea Eritrea Ethiopia Gabon Gambia Ghana Guinea Guinea-Bissau Kenya Lesotho Liberia Madagascar 174 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 NEW PULMONARY CASES ESTIMATED CASES OF MDR-TB AMONG NOTIFIED ESTIMATED CASES OF MDR-TB AMONG NOTIFIED 74 56 180 (69–290) 3 40 45 28 15 20 25 106 46 53 3 31 42 38 24 6 24 35 63 153 0 0 0 NUMBER OF b BACT+VE TESTED FOR MDR-TB 809 130 (56–250) 29 1 700 (780–2 500) 800 (44–1 500) 54 (26–83) 17 (2.1–70) 31 103 0 26 140 (94–190) 120 (70–160) 488 151 349 150 (71–240) 150 (27–280) 79 (4.4–150) 1 1 7 120 (0.48–240) 22 0 1 0 670 (140–1 200) 510 (2.0–1 000) 0 9.8 (4.0–16) 6.1 (0.34–12) 0 0 9 15 28 9 0 130 (36–220) 3 0 0 320 (150–490) 160 (8.8–300) 0 0 2.5 (0.92–4.0) 1.7 (0.10–3.2) 250 (43–450) 200 (0.79–400) 28 (0.72–160) 0 0 0 47 50 30 221 580 (270–890) 440 (190–850) 0 0 1 0 87 121 81 2 900 (670–5 100) 2 100 (8.4–4 200) 22 12 0 3 0 – 11 0 140 212 284 79 (38–120) 2 000 (1 200–2 900) – 35 (1.9–66) 1 600 (830–2 700) 42 73 469 0 0 0 0 0 1 4 7 20 20 31 78 69 170 (57–280) 100 (0.41–200) 9.9 (0–29) 9.9 (0.25–54) 390 (170–620) 240 (13–440) 250 (130–380) 47 (9.8–140) 45 (15–75) 33 (1.8–63) 2 6 44 112 166 225 2 800 (840–4 800) 1 800 (7.4–3 700) 117 64 46 170 (36–300) 77 (16–220) 3 9 10 0 0 215 5 8 0 0 6 0 50 92 78 5 0 130 (32–230) 170 (32–310) 110 (6.3–210) 94 (26–240) 60 9 7 PREVIOUSLY TREATED CASES % OF b BACT+VE TESTED FOR MDR-TB 9.1 – – – – – 0.13 – 1.1 3.5 0 0.78 – 11 4.5 14 – <0.1 <0.1 0.20 – 0.48 0 <0.1 – 0 – 0 – – 0 0 – 0.25 0 – – 0 0 0 – – – – – – – – 0 0 <0.1 0 – – <0.1 <0.1 – 0 – – – – – – – <0.1 0.15 0.99 – – – – – – – 0 0.62 – 0 0 3.9 <0.1 0.12 – – – – – 0 – 0.25 0.21 – – – 0.15 – 0 – – – 0.36 <0.1 <0.1 ESTIMATED CASES OF MDR-TB AMONG NOTIFIED 52 (6.5–170) 860 (330–1 400) 37 (23–55) 29 (11–47) 75 (29–120) 31 (11–52) 160 (57–270) 3.6 (1.4–5.9) 97 (37–190) 160 (63–260) 0.77 (0.30–1.2) 49 (17–81) 140 (49–240) 760 (260–1 300) – 44 (17–71) 480 (230–870) 67 (23–110) 0 (0–26) 160 (61–260) 200 (100–340) 12 (4.6–19) 980 (340–1 600) 94 (20–260) 18 (7.0–29) 76 (9.3–260) NUMBER OF % OF NOTIFIED NOTIFIED TESTED FOR TESTED FOR MDR-TB MDR-TB 164 23 – – – – – – 45 1.0 107 32 6 2.9 152 58 110 39 – 286 27 90 10 149 34 126 39 117 21 68 14 72 19 – 2 0.60 6 1.9 23 7.5 – 35 2.3 – 80 5.0 – – 0 0 0 0 – 0 0 56 16 – – 0 0 0 0 0 0 – – – – – – – – 0 0 72 4.7 29 2.0 365 26 – 100 1.2 160 2.0 95 1.3 – 0 0 – – – – – – – 510 10 139 3.0 180 4.4 – – – – – – – 0 0 2 0.38 21 2.1 61 6.9 44 5.3 34 7.4 26 4.0 26 3.9 – – – – – 1829 20 706 6.7 1195 12 1183 12 – – – 28 1.7 – 0 0 – – – 24 1.1 64 2.9 63 3.2 a TOTAL CONFIRMED CASES OF MDR-TB includes cases with unknown previous treatment history (i.e. not included under NEW CASES or PREVIOUSLY TREATED CASES). b BACT+VE = bacteriologically positive cases. GLOBAL TUBERCULOSIS REPORT 2013 Data for all years can be downloaded from www.who.int/tb/data 7$%/($7HVWLQJIRU0'57%DQGQXPEHURIFRQILUPHGFDVHVRI0'57%± a MDR-TB Malawi Mali Mauritania Mauritius Mozambique Namibia Niger Nigeria Rwanda Sao Tome and Principe Senegal Seychelles Sierra Leone South Africa Swaziland Togo Uganda United Republic of Tanzania Zambia Zimbabwe a b 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 9 40 26 27 2 12 10 12 11 35 8 1 0 2 1 0 115 165 283 266 214 192 210 39 18 35 21 95 107 35 90 76 58 0 4 8 38 50 27 0 0 0 NEW PULMONARY CASES ESTIMATED CASES OF MDR-TB AMONG NOTIFIED ESTIMATED CASES OF MDR-TB AMONG NOTIFIED 96 (45–150) 56 (18–130) 140 (60–210) 76 (4.2–140) 59 (26–92) 34 (1.9–64) 0 (0–0) 0 (0–3.6) 2 000 (1 300–2 700) 630 (510–750) 270 (110–420) 3 600 (2 700–4 500) 1 400 (900–2 000) NUMBER OF b BACT+VE TESTED FOR MDR-TB 871 102 0 0 0 23 161 3 1 114 105 100 121 113 80 206 205 260 (190–350) 160 (9.0–300) 2 500 (1 800–3 400) 0 1 0 27 12 11 57 171 240 (170–310) 180 (120–270) 15 (11–19) 1.7 (0.10–3.3) 2 16 220 (70–500) 41 14 25 0 (0–0) 0 (0–3.9) 0 14 220 (0–460) 100 (2.7–570) 400 (170–620) 8 2000 7386 10085 15419 326 332 280 2 4 2 46 93 71 89 10 34 68 42 80 17 118 149 8 100 (6 900–9 400) 4 600 (3 700–5 800) 148 730 (560–890) 430 (270–590) 77 (35–120) 41 (2.3–78) 1 000 (660–1 300) 500 (13–1 000) 620 (290–940) 930 (430–1 400) 540 (230–860) 500 (140–1 300) 86 0 358 316 196 276 201 83 639 98 (12–350) 570 (300–960) 0 360 PREVIOUSLY TREATED CASES % OF b BACT+VE TESTED FOR MDR-TB – 10 1.5 0 0 0 – 0.62 12 – 0.30 <0.1 100 100 100 100 0.63 0.39 1.1 0.98 – – – – – 0 <0.1 0 – <0.1 <0.1 <0.1 1.4 4.0 – – – – 1.9 27 – 0.53 0.18 0.30 – – 0 82 – – – – – – – – – 2.9 – – – – 4.1 0 – 1.5 1.2 0.79 0.60 0.44 0.34 2.5 – – – – – – 0 3.0 ESTIMATED CASES OF MDR-TB AMONG NOTIFIED 40 (27–57) 60 (23–96) 25 (9.8–41) 0 (0–2.4) 540 (0–1 100) 370 (290–470) 110 (42–180) 1 100 (770–1 500) 63 (51–76) 13 (7.1–15) 180 (76–340) 0 (0–1.7) 120 (26–280) 3 500 (2 800–4 300) 290 (250–340) 36 (14–58) 470 (260–750) 0 (0–160) 520 (260–900) 360 (76–970) NUMBER OF % OF NOTIFIED NOTIFIED TESTED FOR TESTED FOR MDR-TB MDR-TB 917 29 449 20 552 26 27 3.3 0 0 12 3.4 – 39 13 30 15 – 4 3.9 – 3 60 7 100 5 100 4 100 305 16 251 6.2 443 10 243 5.4 – – – – – 47 7.0 21 3.6 35 6.2 – 19 0.21 76 0.86 94 1.2 0 0 431 68 – – – – 2 12 8 53 – 66 6.4 97 8.7 113 10 – – 1 – 2 100 – – – – – – – – – 505 35 – – – – 83 39 2 1.1 – 356 9.0 360 9.0 748 19 405 8.0 246 6.5 17 0.59 108 3.9 – – – – – – 0 0 258 6.0 AFRICAN REGION YEAR TOTAL CONFIRMED CASES OF TOTAL CONFIRMED CASES OF MDR-TB includes cases with unknown previous treatment history (i.e. not included under NEW CASES or PREVIOUSLY TREATED CASES). BACT+VE = bacteriologically positive cases. Data for all years can be downloaded from www.who.int/tb/data GLOBAL TUBERCULOSIS REPORT 2013 175 7$%/($1HZVPHDUSRVLWLYHFDVHQRWLILFDWLRQE\DJHDQGVH[ ± MALE YEAR Algeria Angola Benin Botswana Burkina Faso Burundi Cameroon Cape Verde Central African Republic Chad Comoros Congo Côte d'Ivoire Democratic Republic of the Congo Equatorial Guinea Eritrea Ethiopia Gabon Gambia 176 1995 2000 2005 2010 2011 2012 1995 2000 2005 2010 2011 2012 1995 2000 2005 2010 2011 2012 1995 2000 2005 2010 2011 2012 1995 2000 2005 2010 2011 2012 1995 2000 2005 2010 2011 2012 1995 2000 2005 2010 2011 2012 1995 2000 2005 2010 2011 2012 1995 2000 2005 2010 2011 2012 1995 2000 2005 2010 2011 2012 1995 2000 2005 2010 2011 2012 1995 2000 2005 2010 2011 2012 1995 2000 2005 2010 2011 2012 1995 2000 2005 2010 2011 2012 1995 2000 2005 2010 2011 2012 1995 2000 2005 2010 2011 2012 1995 2000 2005 2010 2011 2012 1995 2000 2005 2010 2011 2012 1995 2000 2005 2010 2011 2012 FEMALE 0–14 15–24 25–34 35–44 45–54 55–64 65+ 59 53 52 42 29 386 186 520 448 501 390 14 19 21 18 21 23 927 1 309 1 203 1 147 1 102 724 999 2 549 2 900 3 000 2 804 186 277 306 314 320 314 1 516 1 841 1 669 1 513 1 467 562 1 003 2 797 3 584 3 792 3 627 352 428 595 631 650 595 610 919 825 881 857 346 912 1 918 2 415 2 386 2 529 306 327 396 443 497 524 491 473 513 483 464 224 482 1 255 1 424 1 395 1 427 176 213 270 267 353 329 234 314 392 345 354 155 312 665 691 680 732 101 103 135 164 210 179 299 426 397 347 349 14 194 461 355 455 424 92 74 87 85 107 121 25 27 45 36 40 4 12 18 20 22 25 5 185 260 256 220 207 67 91 181 231 265 277 128 605 563 590 464 394 133 274 430 620 708 769 238 488 506 477 354 333 124 252 370 493 582 631 224 267 272 239 206 190 62 133 273 328 375 423 73 135 135 137 110 79 48 68 144 224 262 250 32 96 97 107 94 75 29 65 113 173 196 198 19 34 56 37 45 20 41 134 106 114 108 352 481 484 447 208 518 1 472 1 497 1 580 1 597 591 773 743 801 569 842 2 482 2 750 2 931 2 900 525 651 620 667 323 584 1 766 1 996 2 139 2 182 372 570 504 461 287 284 1 035 1 314 1 283 1 304 111 270 235 233 204 130 463 559 625 658 55 157 98 103 164 75 289 329 361 375 0 22 23 26 9 2 8 0 0 38 17 29 162 43 36 356 35 34 206 31 24 120 3 8 40 3 2 18 29 78 70 73 40 379 362 502 1 136 633 576 799 160 468 467 660 26 251 269 360 35 135 119 158 15 63 59 92 25 76 92 68 0 0 0 194 382 469 405 18 18 12 535 850 951 842 13 7 9 409 666 764 634 9 14 6 229 379 418 376 7 9 4 123 173 184 210 8 3 2 82 99 121 88 4 4 4 0 16 10 9 265 13 15 409 9 8 221 5 4 73 2 6 44 5 6 15 41 58 46 41 435 453 563 989 672 705 716 2 092 424 462 519 1 344 203 222 276 759 77 80 113 283 55 76 72 130 128 159 189 163 373 485 1 321 1 707 1 579 1 439 8 1 346 1 751 1 743 1 743 1 572 4 048 6 675 6 859 6 640 6 612 15 2 449 2 858 3 043 3 087 2 382 5 833 9 808 10 412 9 872 10 274 45 1 606 1 882 1 852 2 017 1 890 4 151 7 577 9 134 8 932 9 361 37 888 1 010 1 072 1 032 1 184 2 549 5 022 6 464 6 415 6 612 15 422 505 601 552 634 1 295 2 637 3 641 3 584 3 698 11 385 375 348 430 289 602 1 499 1 907 1 911 1 941 7 10 11 71 77 80 90 59 89 35 59 16 22 10 12 9 9 10 0 2 247 915 1 109 1 582 1 847 70 68 93 75 73 109 57 50 81 32 45 51 25 51 37 20 39 60 84 1 221 5 095 6 726 7 400 7 835 105 1 017 5 187 6 181 7 785 9 246 90 541 3 082 3 454 4 451 3 881 62 276 1 495 1 985 2 746 2 771 39 142 610 1 027 1 473 1 218 51 51 397 475 822 771 UNKNOWN 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0–14 15–24 25–34 35–44 45–54 55–64 65+ 36 102 79 58 60 371 247 704 558 708 592 26 36 25 29 41 39 1 005 1 044 1 086 1 050 917 707 1 142 2 926 2 763 2 731 2 501 148 239 249 265 288 264 1 293 820 826 787 773 443 1 091 2 682 2 594 2 563 2 540 197 275 331 382 385 346 746 389 417 383 382 264 844 1 797 1 688 1 683 1 617 118 149 145 200 246 221 314 270 251 211 198 248 417 1 138 958 1 006 1 028 69 76 89 98 119 105 208 229 222 202 229 130 200 581 482 457 529 32 45 51 42 42 65 312 465 367 341 329 18 120 417 286 346 384 22 25 39 35 52 46 37 45 68 65 63 7 7 15 33 31 27 19 335 321 338 286 267 76 59 125 158 163 160 109 469 491 509 421 402 53 128 248 259 277 288 124 262 253 301 211 193 39 101 174 198 221 191 89 98 97 119 105 109 26 45 109 124 146 156 33 57 55 56 48 43 11 38 54 97 110 106 12 36 48 53 49 31 10 14 40 83 92 82 4 46 78 56 74 9 63 226 172 178 184 298 390 345 338 185 368 1 467 1 474 1 461 1 417 399 421 374 367 313 530 1 788 2 031 2 022 2 053 288 332 263 283 223 293 1 028 1 121 1 177 1 177 122 225 180 162 153 139 503 642 581 579 36 99 81 64 106 60 205 290 281 295 33 87 40 30 93 33 143 183 194 187 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 9 16 4 5 3 6 4 0 39 14 19 233 15 13 350 4 9 145 6 8 57 3 3 21 4 4 9 30 88 96 101 32 367 382 511 420 576 530 689 145 319 289 370 30 155 162 191 40 73 62 96 15 44 26 39 28 59 84 51 1 1 2 148 274 296 273 13 9 10 298 413 438 403 9 6 7 211 263 298 227 8 12 4 148 158 166 135 6 1 8 59 79 109 91 5 2 3 27 44 44 46 2 1 8 2 1 17 8 5 296 4 7 353 2 5 167 1 1 61 0 1 38 1 3 11 49 72 63 99 409 408 438 810 510 463 482 813 296 332 349 497 152 200 171 273 70 88 68 105 56 97 108 19 193 246 244 204 331 718 1 695 1 987 1 800 1 699 2 1 280 1 431 1 358 1 306 1 223 4 422 7 570 7 199 6 802 6 598 18 1 756 1 819 1 838 1 870 1 532 5 146 8 501 9 120 8 742 8 406 28 989 1 051 1 044 1 120 1 232 3 309 5 832 6 721 6 541 6 471 20 528 531 560 536 863 1 724 3 898 4 579 4 537 4 131 4 232 304 301 337 427 855 2 054 2 612 2 671 2 625 7 201 209 223 263 137 351 951 1 311 1 295 1 257 1 0 0 13 15 80 76 57 81 45 46 26 21 9 9 6 3 0 0 0 10 8 3 100 67 88 87 127 111 71 72 79 21 39 43 12 21 31 8 18 36 0 4 283 1 037 1 326 1 608 1 983 86 908 4 699 5 885 5 708 6 570 98 781 4 424 5 663 6 480 7 917 74 382 2 105 2 730 3 439 3 069 45 152 976 1 296 1 950 1 564 19 64 366 513 855 719 20 15 122 155 335 303 0 0 1 4 0 0 0 0 0 0 0 3 45 74 80 54 30 15 9 47 54 28 25 19 3 13 15 34 42 3 123 145 240 236 68 199 223 269 286 181 140 208 229 228 88 70 130 144 166 72 38 89 86 101 29 25 91 66 41 24 19 13 25 29 4 128 110 177 185 39 123 164 188 165 61 88 122 125 109 44 29 100 74 78 25 29 86 44 45 12 18 64 39 34 8 13 9 14 7 133 194 183 210 292 314 271 331 206 184 181 191 62 141 136 107 53 68 87 80 44 39 56 54 2 6 16 16 84 104 103 123 87 121 112 106 64 71 88 89 38 35 63 41 22 40 32 32 27 18 33 42 GLOBAL TUBERCULOSIS REPORT 2013 UNKNOWN 0 0 0 0 0 0 Data for all years can be downloaded from www.who.int/tb/data 0 0 8 6 0 0 0 0 0 0 0 0 0 0 0 0 0 MALE:FEMALE RATIO – 1.1 1.6 1.6 1.6 1.6 1.1 1.0 0.99 1.3 1.3 1.3 2.0 1.7 1.9 1.8 1.8 1.9 – 1.4 1.4 1.3 1.3 1.2 2.1 2.3 2.0 2.2 2.3 2.5 1.8 – 1.7 1.8 2.0 2.1 1.6 1.7 1.4 1.4 1.5 1.5 – – 2.0 – 2.6 2.4 1.1 – 2.0 1.2 1.2 1.3 – – 1.7 2.0 2.1 2.1 1.3 1.7 0.88 – 2.4 2.1 1.1 – – 1.2 1.2 1.4 2.2 – 1.4 1.5 1.6 1.6 1.4 1.1 1.1 1.2 1.2 1.3 1.7 – – 1.2 1.4 – – 0.93 0.95 1.1 – 1.3 1.4 1.2 1.2 1.3 1.2 – 1.6 – 1.4 1.4 1.6 1.7 2.4 – 2.5 2.4 2.1 2.2 7$%/($1HZVPHDUSRVLWLYHFDVHQRWLILFDWLRQE\DJHDQGVH[ ± Ghana Guinea Guinea-Bissau Kenya Lesotho Liberia Madagascar Malawi Mali Mauritania Mauritius Mozambique Namibia Niger Nigeria Rwanda Sao Tome and Principe Senegal Seychelles FEMALE 0–14 15–24 25–34 35–44 45–54 55–64 65+ 1995 2000 2005 2010 2011 2012 1995 2000 2005 2010 2011 2012 1995 2000 2005 2010 2011 2012 1995 2000 2005 2010 2011 2012 1995 2000 2005 2010 2011 2012 1995 2000 2005 2010 2011 2012 1995 2000 2005 2010 2011 2012 1995 2000 2005 2010 2011 2012 1995 2000 2005 2010 2011 2012 1995 2000 2005 2010 2011 2012 1995 2000 2005 2010 2011 2012 1995 2000 2005 2010 2011 2012 1995 2000 2005 2010 2011 2012 1995 2000 2005 2010 2011 2012 1995 2000 2005 2010 2011 2012 1995 2000 2005 2010 2011 2012 1995 2000 2005 2010 2011 2012 1995 2000 2005 2010 2011 2012 1995 2000 2005 2010 2011 2012 42 73 49 63 50 30 18 39 51 61 45 28 223 550 592 570 550 559 244 551 749 679 1 051 761 397 1 266 1 201 1 146 1 127 1 051 538 860 1 165 877 1 537 1 104 398 1 115 1 311 1 301 1 328 1 271 357 570 778 982 955 791 302 811 944 1 030 955 921 189 282 463 876 541 383 190 495 462 540 491 512 98 203 195 565 293 190 112 426 414 447 456 462 61 103 130 289 197 120 2 14 18 6 7 154 264 359 357 356 393 9 8 32 16 19 15 52 116 164 140 145 2 072 3 739 4 790 4 698 4 773 4 893 108 165 395 222 179 204 92 167 219 230 262 3 073 6 653 8 832 7 945 8 376 8 149 214 458 695 607 584 580 80 153 183 181 183 1 675 3 548 5 069 5 077 5 201 5 302 256 517 397 497 493 427 64 130 141 104 115 920 1 630 2 521 2 509 2 660 2 493 189 395 148 364 329 295 39 72 80 65 63 485 630 1 031 994 1 045 1 099 96 198 82 244 245 196 19 42 43 36 38 296 414 590 658 665 669 88 76 37 133 121 114 12 26 90 67 65 79 133 240 338 382 382 791 196 352 621 595 627 1 289 127 333 510 727 667 1 173 52 155 295 440 406 630 17 74 114 194 129 423 26 65 21 87 83 242 98 204 146 177 25 50 58 50 70 52 27 23 26 94 25 25 1 159 1 721 1 807 1 725 493 653 622 565 519 495 72 206 350 381 370 405 1 867 1 621 2 764 2 474 1 195 1 476 1 653 1 509 1 486 1 537 357 430 628 707 772 731 1 732 2 525 2 495 2 460 833 1 113 1 031 985 1 050 1 051 294 396 539 526 515 547 1 349 1 782 1 938 1 927 519 585 549 485 440 471 181 297 365 354 352 377 582 960 1 044 1 059 215 245 279 275 238 292 138 235 263 227 267 257 333 485 522 490 89 114 157 187 201 204 102 144 193 207 230 211 17 36 22 2 2 0 0 2 187 192 165 204 17 6 10 9 10 11 1 136 295 185 302 13 9 15 9 13 14 1 475 206 131 195 22 18 21 13 9 16 1 338 137 106 139 27 19 20 23 17 17 1 022 99 58 114 13 14 10 15 10 11 664 76 55 114 8 8 6 7 8 7 320 0 18 98 36 48 61 68 269 355 359 337 358 235 874 1 027 852 844 810 113 665 874 680 660 686 55 300 365 287 361 292 21 147 146 146 152 157 29 35 44 50 40 450 157 325 521 529 538 270 557 669 709 702 845 2 173 3 824 4 457 4 549 5 026 174 1 204 1 587 1 673 1 752 921 3 164 6 758 9 186 9 520 10 382 441 819 988 1 025 1 133 937 1 836 4 544 6 218 6 550 7 684 252 497 615 646 747 557 1 091 2 863 3 804 4 230 4 589 155 45 48 42 22 466 494 430 423 375 974 713 741 795 768 824 592 526 500 519 1 2 0 0 1 94 60 71 81 75 84 0 5 5 10 5 6 717 772 1 050 1 351 1 264 1 454 2 0 0 0 0 2 0 0 0 11 7 14 9 11 1 219 1 297 1 561 1 793 1 835 2 036 0 2 1 0 1 1 4 6 7 8 8 813 857 904 972 981 1 121 1 4 2 6 0 2 UNKNOWN 0–14 15–24 25–34 35–44 45–54 55–64 65+ 40 74 68 64 52 51 28 66 65 51 85 49 199 456 450 446 470 418 202 314 594 549 709 505 272 791 693 667 699 563 255 446 583 739 688 509 205 566 527 560 614 468 153 245 354 751 432 323 122 338 366 369 390 332 64 114 203 405 219 134 88 179 207 204 174 188 37 82 94 145 109 61 48 176 221 249 260 271 19 45 55 72 73 57 4 13 30 12 7 187 416 577 549 629 603 14 11 19 27 23 30 30 78 100 119 121 1 802 3 916 5 144 4 044 4 183 4 097 106 222 226 283 311 309 46 110 161 122 157 1 759 4 363 6 521 5 112 4 917 4 975 125 336 721 597 572 571 47 92 133 90 98 741 1 874 2 781 2 372 2 434 2 363 71 195 616 329 307 296 24 82 80 56 56 411 831 1 266 1 056 1 025 993 49 83 494 169 185 143 15 44 38 44 33 242 347 593 544 477 529 17 36 297 64 84 71 12 19 19 25 25 117 148 315 345 344 379 19 29 121 48 58 47 21 37 254 67 61 100 140 232 339 329 354 799 149 297 488 433 535 1 108 88 171 259 517 605 744 28 108 171 285 292 340 16 52 151 88 79 230 16 25 99 50 57 78 150 323 252 242 65 66 84 103 79 71 31 14 33 31 42 34 1 012 1 621 1 726 1 720 802 1 038 913 610 601 538 132 174 208 265 255 253 1 451 1 943 2 031 1 848 1 028 1 481 1 598 1 196 1 119 1 057 184 232 348 337 393 344 1 047 1 376 1 503 1 420 573 831 859 661 660 609 128 152 245 247 223 239 614 946 978 914 294 401 386 314 283 298 107 106 152 144 147 137 248 397 462 474 108 148 180 198 161 156 61 75 101 96 118 89 129 192 188 199 45 64 74 102 96 120 52 43 72 70 68 77 14 28 25 2 1 0 0 0 226 90 68 112 4 5 4 7 7 11 994 104 72 81 12 8 5 9 12 7 1 314 82 47 88 10 8 5 4 2 8 1 016 52 36 73 8 6 11 4 3 2 551 29 19 46 4 7 2 3 6 8 234 29 20 28 4 4 1 2 3 4 89 6 81 120 126 138 137 5 16 105 67 78 81 49 352 399 429 427 394 78 654 809 685 653 582 50 348 525 382 410 396 16 161 213 206 185 198 1 76 95 122 100 84 0 52 91 87 110 97 151 350 415 436 444 611 566 1 464 1 974 2 248 2 449 78 198 342 347 360 515 463 950 1 363 1 443 1 686 31 34 39 50 48 404 239 482 595 578 649 123 214 272 285 260 842 2 934 3 996 4 182 4 198 4 652 206 388 418 449 485 795 2 434 4 884 6 117 6 168 6 762 168 330 347 323 302 770 1 110 2 448 3 431 3 574 4 084 151 223 238 278 237 724 676 1 350 1 846 2 014 2 243 63 131 174 189 214 654 344 745 1 040 1 112 1 290 9 70 135 147 124 451 231 415 682 724 867 393 408 325 376 341 129 142 202 210 214 56 71 126 124 123 105 73 48 50 40 396 483 399 358 327 473 442 448 398 393 309 262 261 235 208 109 157 128 146 116 52 60 65 87 66 14 29 38 67 59 7 4 1 7 8 408 470 533 590 582 597 1 1 1 0 0 2 3 5 0 1 2 300 279 274 329 335 365 2 1 0 0 0 0 10 2 1 4 0 213 189 236 221 214 224 1 3 1 0 2 0 84 77 83 81 88 125 0 7 4 5 2 6 428 521 709 835 807 836 0 0 2 1 0 5 3 3 4 6 283 376 351 332 362 383 0 0 1 0 0 1 7 2 2 1 0 203 217 185 217 208 263 0 1 0 0 0 1 4 3 0 0 0 126 107 116 136 144 155 0 1 0 0 0 0 15 0 0 0 1 72 61 81 105 74 90 1 0 0 0 0 15 5 4 10 10 461 540 568 643 664 715 1 1 1 0 0 1 0 1 0 0 0 0 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 89 0 0 0 0 Data for all years can be downloaded from www.who.int/tb/data 0 0 0 1 UNKNOWN 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 43 0 0 0 0 MALE:FEMALE RATIO 1.7 1.8 2.0 2.0 1.9 2.1 2.0 2.0 1.8 1.6 2.0 2.1 – 2.0 1.6 1.5 1.6 1.6 1.6 1.4 1.3 1.6 1.6 1.6 2.4 2.0 0.72 1.4 1.3 1.2 – 1.2 1.4 1.1 1.4 1.2 1.4 – 1.5 1.4 1.5 1.5 1.2 1.1 1.1 1.3 1.3 1.4 1.7 2.2 2.0 2.1 2.0 2.2 – – – 2.6 2.5 2.4 2.3 1.9 2.9 2.6 2.0 2.0 1.4 – – – – – 2.5 1.4 1.3 1.3 1.3 1.4 – 1.9 2.6 2.9 2.8 3.1 1.0 1.2 1.4 1.5 1.6 1.6 – 2.1 1.6 1.7 1.8 2.0 – 0.73 1.7 2.4 1.8 1.6 2.3 2.1 2.2 2.3 2.2 2.3 3.5 2.7 3.0 3.5 1.0 1.2 GLOBAL TUBERCULOSIS REPORT 2013 AFRICAN REGION MALE YEAR 177 7$%/($1HZVPHDUSRVLWLYHFDVHQRWLILFDWLRQE\DJHDQGVH[ ± MALE Sierra Leone South Africa Swaziland Togo Uganda United Republic of Tanzania Zambia Zimbabwe FEMALE YEAR 0–14 15–24 25–34 35–44 45–54 55–64 65+ 1995 2000 2005 2010 2011 2012 1995 2000 2005 2010 2011 2012 1995 2000 2005 2010 2011 2012 1995 2000 2005 2010 2011 2012 1995 2000 2005 2010 2011 2012 1995 2000 2005 2010 2011 2012 1995 2000 2005 2010 2011 2012 1995 2000 2005 2010 2011 2012 10 18 45 64 75 70 184 287 490 718 825 858 305 486 792 1 176 1 224 1 324 201 361 651 1 076 1 099 1 213 99 190 397 663 781 841 47 113 226 320 334 416 22 47 124 254 287 274 116 2 035 1 496 1 472 1 132 4 11 9 30 16 18 7 4 11 21 15 9 370 283 257 268 295 272 183 200 190 232 190 208 91 349 135 723 10 422 9 925 9 772 9 074 59 130 162 207 161 163 95 101 177 150 169 171 1 193 1 511 1 598 2 055 2 075 2 174 2 108 2 357 2 062 1 975 1 975 2 086 659 2 175 1 240 1 999 20 576 20 855 20 487 19 894 117 352 406 537 459 479 151 168 320 350 340 338 2 491 3 497 4 075 4 735 5 044 5 029 4 091 4 836 4 939 4 493 4 405 4 707 1 668 2 610 3 166 2 135 19 465 19 842 19 360 18 510 130 249 285 369 318 332 123 144 283 358 350 341 1 797 2 479 3 209 4 133 4 613 4 493 2 916 3 430 4 025 4 141 4 073 4 397 1 124 3 045 2 160 1 146 11 143 12 386 12 111 11 331 98 138 139 192 158 168 82 109 125 217 234 237 1 115 1 279 1 576 2 214 2 466 2 479 1 754 2 022 2 310 2 427 2 402 2 435 487 435 917 435 4 124 5 155 5 220 5 054 40 37 57 109 69 84 64 48 79 116 123 121 602 607 725 905 994 1 015 1 007 1 202 1 279 1 309 1 211 1 293 231 261 358 212 1 705 2 211 2 164 2 085 16 17 27 50 46 38 49 39 69 80 85 87 323 395 539 613 604 633 640 834 1 054 1 161 1 127 1 114 130 174 321 105 141 1 033 1 003 2 897 3 088 2 194 2 412 810 846 280 319 207 220 210 150 152 120 837 710 784 783 2 264 2 208 2 467 2 421 1 855 1 682 2 071 2 086 762 761 780 796 295 350 377 360 656 252 278 271 GLOBAL TUBERCULOSIS REPORT 2013 UNKNOWN 0 0 0 0 0 0 0 16 423 21 0 0 0 0 0–14 15–24 25–34 35–44 45–54 55–64 65+ 18 27 54 77 115 80 165 249 393 648 678 703 193 298 518 742 796 861 110 225 312 556 543 667 65 92 207 293 343 391 24 49 114 180 219 201 11 30 47 131 116 132 122 2 561 1 933 1 932 1 545 5 10 14 51 35 39 9 13 23 39 11 17 402 400 371 401 400 364 201 257 271 248 221 282 129 150 168 1 283 13 632 13 023 12 751 11 547 52 198 318 354 281 284 80 107 157 163 167 165 1 376 1 649 1 811 1 964 2 092 2 194 1 904 2 106 1 852 1 689 1 660 1 651 1 125 932 1 507 1 716 19 343 20 205 19 250 17 452 57 298 453 662 495 535 96 124 236 285 277 287 1 845 2 782 3 099 2 923 2 853 2 912 2 532 3 426 3 521 2 988 2 896 2 906 1 779 1 118 2 463 933 11 338 12 910 12 807 11 430 39 62 207 276 220 242 45 50 146 148 146 154 1 104 1 510 1 800 1 691 1 809 1 733 1 324 1 738 1 892 2 013 2 140 2 108 717 1 305 1 433 423 5 416 6 873 6 955 5 939 29 62 73 104 86 88 38 36 67 78 89 109 635 671 818 924 973 864 735 868 968 1 044 944 1 022 257 186 569 167 2 352 3 165 3 266 2 846 8 24 21 54 40 51 23 24 41 62 50 48 312 316 389 365 409 419 380 494 547 578 490 507 117 112 235 80 1 348 2 128 2 223 2 059 6 5 8 16 24 27 15 15 32 29 38 28 113 163 257 248 313 281 179 269 354 471 381 422 63 75 185 151 180 940 1 024 1 683 1 646 1 063 1 077 422 376 162 189 99 124 269 173 174 173 1 136 974 1 084 939 2 242 2 185 2 161 2 053 1 255 1 283 1 386 1 286 578 490 448 483 193 265 274 231 603 171 160 161 UNKNOWN Data for all years can be downloaded from www.who.int/tb/data 0 0 0 0 0 0 0 1 252 33 0 0 0 0 MALE:FEMALE RATIO 1.5 1.5 1.7 1.6 1.6 1.6 – 1.4 1.2 1.2 1.2 1.3 2.4 1.4 0.99 0.98 1.0 1.0 1.9 1.7 1.5 1.6 1.7 1.6 1.4 1.3 1.4 1.8 1.8 1.8 1.8 1.6 1.7 1.7 1.8 1.8 1.0 2.3 1.3 – 1.7 1.7 – – 1.1 1.1 1.2 1.3 7$%/($ /DERUDWRULHV173VHUYLFHVGUXJPDQDJHPHQWDQGLQIHFWLRQFRQWURO LABORATORIES FREE THROUGH NTP SECONDNUMBER OF SMEAR LABS % OF SMEAR CULTURE DST b LABS LPAc LABS LABS USING LABS PER 5M LINE DST LABS USING PER 100K PER 5M PER 5M a POPULATION POPULATION POPULATION POPULATION XPERT MTB/RIF AVAILABLE LED Algeria Angola 0.6 0.6 0 – 3.8 0.5 0.3 0.5 0.1 1 Benin 0.8 9 0.5 0.5 0.5 1 Botswana 2.6 21 2.5 2.5 2.5 5 Burkina Faso 0.7 0 0.3 0.3 0.9 0 Burundi 1.7 9 0.5 0 0 0 Cameroon 1.1 4 0.9 0.5 0.5 1 Cape Verde 3.2 0 0 0 0 1 Central African Republic Chad Comoros 1.6 0.6 0 0 – 1.1 0 1.1 0 0 0 1 0 Congo 0.8 3 Côte d'Ivoire Democratic Republic of the Congo Equatorial Guinea 0.6 0 0.5 0.5 0 0 2.3 0 0.3 0.2 <0.1 26 NRLd In country Yes Yes In and out Yes of country Out of Yes country Out of Yes country Out of country In country Out of country No No TB NOTIF. RIFAMPICIN RATE PER USED 100 000 THROUGHOUT HEALTH-CARE TREATMENT WORKERS Yes (all suspects) Yes (all suspects) Yes (if TB is confirmed) Yes Yes Yes No Yes Yes Yes (all suspects) Yes Yes Yes (all suspects) Yes Yes Yes Yes (all suspects) Yes Yes Yes No Yes Yes Yes Yes (all suspects) Yes Yes Yes Yes Yes Yes (all suspects) Yes (all suspects) Yes (all suspects) Yes (if TB is confirmed) Yes (all suspects) Yes (if TB is confirmed) Yes Yes Yes Yes Yes Yes No Yes No Yes In and out Yes of country Yes Yes Yes Yes Yes Yes 1.3 0 0 0 0 0 No Yes 2.8 0.9 1.8 1.1 0 0 31 1 0.3 3.1 2.8 0.6 <0.1 3.1 2.8 0.6 0.3 0 0 0.6 7 0 0 0 No No No No Guinea 0.5 6 0.4 0.4 0 1 Guinea-Bissau 1.3 0 3.0 0 0 1 Kenya 4.2 8 0.2 0.2 0.2 15 Lesotho 0.9 17 2.4 2.4 2.4 5 Liberia 3.9 0 0 0 0 0 Madagascar Malawi Mali Mauritania 1.0 1.4 0.4 1.4 6 19 0 – 0.2 1.3 1.0 1.3 0.2 0.6 0.3 1.3 0.2 0.3 0.3 5 19 0 Mauritius – Yes Yes Yes Yes No Yes Out of country In and out of country Out of country Out of country No No No No Out of country Out of country Out of country Out of country Out of country Yes Yes Yes Yes Yes Yes Yes Yes Yes (if TB is confirmed) Yes (all suspects) Yes (all suspects) Yes (all suspects) Yes (all suspects) Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes (all suspects) Yes Yes Yes Yes (all suspects) Yes Yes Yes Yes (all suspects) Yes Yes Yes Yes (all suspects) Yes Yes Yes Yes (all suspects) Yes Yes Yes (all suspects) Yes (all suspects) Yes (if TB is confirmed) Yes Yes Yes Yes Yes Yes No 0.4 0 12 Namibia 1.4 100 2.2 2.2 2.2 1 Niger 1.1 1 0.3 0.3 0 0 Nigeria 0.8 2 0.1 <0.1 0.1 32 Rwanda Sao Tome and Principe 1.7 4.3 13 0 0.9 0 0.9 0 0.9 0 6 0 Yes No Yes Senegal 0.8 0 1.1 0.7 0.7 3 In country Yes 0 1.4 4.1 0 1.4 4.1 0 1.4 4.1 0 100 19 Out of Yes country No Yes In country Yes Yes Yes (all suspects) Yes Yes Yes Yes Yes Yes Yes Yes Togo 1.7 0 0.8 0.8 0 1 No Yes Uganda 3.2 8 0.6 0.6 0.6 25 Yes Yes (all suspects) Yes (all suspects) Yes (all suspects) Yes (if TB is confirmed) Yes (all suspects) United Republic of Tanzania 2.0 17 0.4 0.1 0.3 13 Yes Yes (all suspects) Yes Yes Zambia Zimbabwe 1.5 1.3 1 1 1.1 0.7 17 In country Yes No Yes Yes (all suspects) Yes (all suspects) Yes Yes Yes Yes c d 0 97 21 Yes Yes (all suspects) Yes (all suspects) 0.6 – Yes Yes Yes Yes Yes Yes (all suspects) 9 2.7 0.4 1.5 Yes Yes Yes Yes Yes Yes 1.2 Seychelles Yes (for smearpositive TB) Yes (all suspects) No Yes (all suspects) Yes (all suspects) Yes (if TB is confirmed) Yes Mozambique b 815 0.7 0 Yes Yes Yes Yes AFRICAN REGION Eritrea a 1 870 – Ethiopia Gabon Gambia Ghana Sierra Leone South Africa Swaziland TB DIAGNOSIS FIRSTLINE DRUGS 0 199 28 104 LED = Light emitting diode microscopes DST = Drug susceptibility testing LPA = Line probe assay NRL = National Reference Laboratory Data for all years can be downloaded from www.who.int/tb/data GLOBAL TUBERCULOSIS REPORT 2013 179 7$%/($0HDVXUHGSHUFHQWDJHRI7%FDVHVZLWK0'57%DPRVWUHFHQW\HDUDYDLODEOH New TB cases Algeria Angola Benin Botswana Burkina Faso Burundi Cameroon Cape Verde Central African Republic Chad Comoros Congo Côte d'Ivoire Democratic Republic of the Congo Equatorial Guinea Eritrea Ethiopia Gabon Gambia Ghana Guinea Guinea-Bissau Kenya Lesotho Liberia Madagascar Malawi Mali Mauritania Mauritius Mozambique Namibia Niger Nigeria Rwanda Sao Tome and Principe Senegal Seychelles Sierra Leone South Africa Swaziland Togo Uganda Previously treated TB cases Year Source Coverage Percentage Year Source 2002 Survey National Coverage Percentage 1.4 (0.60–2.7) 2002 Survey National 9.1 (1.1–29) 2010 2008 Survey Survey National National 0.5 (<0.1–2.0) 2.5 (1.5–3.5) 2011 2008 Surveillance Survey National National 13 (8.2–20) 6.6 (2.4–11) 2009 Survey Sub-national 0.44 (<0.1–2.5) 1998 Survey Sub-national 18 (7.0–35) 2006 Survey National 2005 Survey National 2000 Survey National 1.6 (0.86–2.8) 2005 Survey National 12 (5.6–21) 0.48 (<0.1–2.6) 2000 Survey National 0 (0–18) 1998 Survey Sub-national 0.56 (0.11–1.6) 1998 Survey Sub-national 2.5 (1.1–4.9) 28 (14–47) 1995 Survey National 0.91 (0.19–2.6) 1995 Survey National 5.7 (1.2–16) 2007 2011 Survey Survey National National 0.49 (0.13–1.3) 0.42 (0.14–0.97) 2007 2011 Survey Survey National National 3.9 (0.48–13) 4.8 (3.2–6.9) 2012 2007 2008 Surveillance Survey Survey National National National 0 (0–3.0) 3.5 (2.2–4.8) 3.8 (2.7–5.1) 2012 2007 2008 Surveillance Survey Survey National National National 0 (0–60) 12 (0–25) 16 (13–21) 2010 2005 Survey Survey National National 2.9 (2.1–4.0) 3.9 (2.5–5.8) 2006 2012 1997 2002 2009 Survey Surveillance Survey Survey Survey National National National National National (0.69–4.9) (0–23) (<0.1–4.7) (1.4–2.3) (4.8–11) 2010 2010 2012 2006 2012 1997 2002 2009 Survey Surveillance Surveillance Survey Surveillance Survey Survey Survey National National National National National National National National 14 19 88 17 0 23 6.7 34 12 (6.8–19) 2.1 0 0.85 1.8 7.7 (10–19) (15–23) (47–100) (7.0–31) (0–84) (5.0–54) (5.4–8.2) (28–39) 2011 Survey National 1.4 (0.60–2.2) 2011 Survey National United Republic of Tanzania 2007 Survey National 1.1 (0.30–2.8) 2007 Survey National 0 (0–5.9) Zambia Zimbabwe Survey Survey National National 0.33 (<0.1–1.2) 1.9 (1.0–3.3) 2008 1995 Survey Survey National National 8.1 (4.1–14) 8.3 (1.8–22) a 2008 1995 Empty rows indicate an absence of high-quality survey or surveillance data. In the absence of high-quality national data, high-quality sub-national data are used. GLOBAL TUBERCULOSIS REPORT 2013 Data for all years can be downloaded from www.who.int/tb/data 4')+101(6*'#/'4+%#5 6CDNG# 'UVKOCVGUQHVJGDWTFGPQHFKUGCUGECWUGFD[6$¿ 6CDNG# +PEKFGPEGPQVKßECVKQPCPFECUGFGVGEVKQPTCVGUCNNHQTOU¿ 6CDNG# %CUGPQVKßECVKQPU¿ Table A4.4 Treatment outcomes, new smear-positive cases, 1995–2011 192 Table A4.5 Treatment outcomes, retreatment cases, 1995–2011 195 6CDNG# *+8VGUVKPICPFRTQXKUKQPQH%26#46CPF+26¿ 6CDNG# 6GUVKPIHQT/&46$CPFPWODGTQHEQPßTOGFECUGUQH/&46$¿ 6CDNG# 0GYUOGCTRQUKVKXGECUGPQVKßECVKQPD[CIGCPFUGZ¿ Table A4.9 Laboratories, NTP services, drug management and infection control, 2012 205 6CDNG# /GCUWTGFRGTEGPVCIGQH6$ECUGUYKVJ/&46$OQUVTGEGPV[GCTCXCKNCDNG Estimates of mortality, prevalence and incidence Estimated values are shown as best estimates followed by lower and upper bounds. The lower and upper bounds are defined as the 2.5th and 97.5th centiles of outcome distributions produced in simulations. See ANNEX 1 for further details. Estimated numbers are shown rounded to two significant figures. Estimated rates are shown rounded to three significant figures unless the value is under 100, in which case rates are shown rounded to two significant figures. Estimates for all years are recalculated as new information becomes available and techniques are refined, so they may differ from those published in previous reports in this series. The main updates implemented in this report are explained in Box 2.1 of Chapter 2. Estimates published in previous global TB control reports should no longer be used. Data source Data shown in this annex are taken from the WHO global TB database on 1 October 2013. Data shown in the main part of the report were taken from the database in July 2013. As a result, data in this annex may differ slightly from those in the main part of the report. Data for all years can be downloaded from www.who.int/tb/data. Country notes Caribbean Islands Data collection from Caribbean Islands that are not Member States of WHO was resumed in 2011 after a break of a few years. This includes Aruba, Curaçao, Puerto Rico and Sint Maarten, which are Associate Members of the Pan American Health Organization, plus the territories of Anguilla, Bermuda, Bonaire, Saint Eustatius and Saba, British Virgin Islands, Cayman Islands, Montserrat and Turks and Caicos Islands. Data are not currently independently collected from the US Virgin Islands USA In addition to the 51 reporting areas, the USA includes territories that report separately to WHO. The data for these territories are not included in the data reported by the USA. Definitions of case types and outcomes do not exactly match those used by WHO. GLOBAL TUBERCULOSIS REPORT 2013 Data for all years can be downloaded from www.who.int/tb/data 7$%/($(VWLPDWHVRIWKHEXUGHQRIGLVHDVHFDXVHGE\7% ± Anguilla 1990 1995 2000 2005 2010 2011 2012 Antigua and 1990 Barbuda 1995 2000 2005 2010 2011 2012 Argentina 1990 1995 2000 2005 2010 2011 2012 Aruba 1990 1995 2000 2005 2010 2011 2012 Bahamas 1990 1995 2000 2005 2010 2011 2012 Barbados 1990 1995 2000 2005 2010 2011 2012 Belize 1990 1995 2000 2005 2010 2011 2012 Bermuda 1990 1995 2000 2005 2010 2011 2012 Bolivia 1990 (Plurinational 1995 State of) 2000 2005 2010 2011 2012 Bonaire, Saint 2010 Eustatius and Saba 2011 2012 Brazil 1990 1995 2000 2005 2010 2011 2012 British Virgin 1990 Islands 1995 2000 2005 2010 2011 2012 Canada 1990 1995 2000 2005 2010 2011 2012 Cayman Islands 1990 1995 2000 2005 2010 2011 2012 Chile 1990 1995 2000 2005 2010 2011 2012 Colombia 1990 1995 2000 2005 2010 2011 2012 a POPULATION (MILLIONS) <1 <1 <1 <1 <1 <1 <1 <1 <1 <1 <1 <1 <1 <1 33 35 37 39 40 41 41 <1 <1 <1 <1 <1 <1 <1 <1 <1 <1 <1 <1 <1 <1 <1 <1 <1 <1 <1 <1 <1 <1 <1 <1 <1 <1 <1 <1 <1 <1 <1 <1 <1 <1 <1 7 8 8 9 10 10 10 <1 <1 <1 150 162 175 186 195 197 199 <1 <1 <1 <1 <1 <1 <1 28 29 31 32 34 34 35 <1 <1 <1 <1 <1 <1 <1 13 14 15 16 17 17 17 33 37 40 43 46 47 48 NUMBER (THOUSANDS) 0 0 0 0 0 0 0 <0.01 0 <0.01 <0.01 <0.01 <0.01 <0.01 1.4 1.2 0.84 0.73 0.54 0.55 0.55 <0.01 <0.01 <0.01 <0.01 <0.01 <0.01 <0.01 0.043 0.012 <0.01 <0.01 <0.01 <0.01 <0.01 0 <0.01 <0.01 <0.01 <0.01 <0.01 <0.01 <0.01 0.014 <0.01 <0.01 0.013 0.014 0.014 0 0 0 0 <0.01 <0.01 <0.01 2.7 2.5 2.4 2.3 2.2 2.2 2.2 0 0 0 10 8.6 7.7 5.8 5.4 5.1 4.9 0 <0.01 <0.01 <0.01 <0.01 <0.01 <0.01 0.12 0.12 0.082 0.086 0.074 0.071 0.067 <0.01 0 0 0 0 0 0 0.76 0.5 0.3 0.24 0.23 0.22 0.21 1.7 2 1.3 1 0.9 0.84 0.77 (0–0) (0–0) (0–0) (0–0) (0–0) (0–14) (0–0) (<0.01–<0.01) (0–0) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (1.3–1.4) (1.1–1.2) (0.810–0.870) (0.700–0.760) (0.520–0.570) (0.520–0.570) (0.530–0.580) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (0.043–0.043) (0.012–0.012) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (0–0) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (0.013–0.016) (<0.01–<0.01) (<0.01–<0.01) (0.013–0.013) (0.014–0.014) (0.014–0.014) (0–0) (0–0) (0–0) (0–0) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (0.710–6.0) (1.2–4.4) (1.0–4.3) (0.950–4.1) (0.940–4.0) (0.930–4.0) (0.930–3.9) (0–0) (0–0) (0–0) (7.8–13) (6.8–11) (6.3–9.2) (5.2–6.5) (5.0–5.8) (4.8–5.4) (4.6–5.2) (0–0) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (0.110–0.120) (0.120–0.120) (0.081–0.082) (0.086–0.086) (0.074–0.074) (0.070–0.071) (0.067–0.068) (<0.01–<0.01) (0–0) (0–0) (0–0) (0–0) (0–0) (0–0) (0.710–0.820) (0.460–0.540) (0.290–0.310) (0.240–0.240) (0.220–0.230) (0.220–0.230) (0.210–0.220) (1.4–2.0) (1.8–2.2) (1.2–1.4) (1.0–1.0) (0.890–0.910) (0.830–0.850) (0.760–0.790) RATEa 0 0 0 0 0 0 0 3.9 0 1.8 1.4 1.4 1.4 1.4 4.2 3.3 2.3 1.9 1.3 1.3 1.3 0.78 0.78 0.78 0.78 0.78 0.78 0.78 17 4.3 2.2 1.1 0.51 0.43 0.37 0 0.63 0.71 0.62 0.69 0.69 0.69 2.5 7 3.3 2.2 4.3 4.3 4.3 0 0 0 0 0.18 0.18 0.18 40 33 28 24 22 21 21 0 0 0 7 5.3 4.4 3.1 2.7 2.6 2.5 0 5.5 5.3 4.6 4.1 4.1 4.1 0.42 0.4 0.27 0.27 0.22 0.21 0.19 4 0 0 0 0 0 0 5.8 3.5 1.9 1.5 1.3 1.3 1.2 5 5.3 3.2 2.4 1.9 1.8 1.6 (0–0) (0–0) (0–0) (0–0) (0–0) (0–100 000) (0–0) (3.5–4.3) (0–0) (1.5–2.2) (1.3–1.4) (1.2–1.5) (1.2–1.5) (1.2–1.5) (4.1–4.2) (3.3–3.4) (2.2–2.3) (1.8–2.0) (1.3–1.4) (1.3–1.4) (1.3–1.4) (<0.1–2.5) (<0.1–2.5) (<0.1–2.5) (<0.1–2.5) (<0.1–2.5) (<0.1–2.5) (<0.1–2.5) (17–17) (4.3–4.3) (2.1–2.3) (1.1–1.1) (0.49–0.53) (0.42–0.45) (0.36–0.38) (0–0) (0.62–0.64) (0.70–0.73) (0.61–0.63) (0.67–0.70) (0.67–0.70) (0.67–0.70) (1.9–3.1) (6.3–7.7) (3.2–3.3) (2.1–2.2) (4.3–4.3) (4.3–4.3) (4.3–4.3) (0–0) (0–0) (0–0) (0–0) (0.18–0.18) (0.18–0.18) (0.18–0.18) (10–89) (15–58) (12–51) (10–44) (9.3–39) (9.1–38) (8.8–37) (0–0) (0–0) (0–0) (5.2–9.0) (4.2–6.6) (3.6–5.3) (2.8–3.5) (2.5–3.0) (2.4–2.8) (2.3–2.6) (0–0) (5.5–5.5) (5.1–5.5) (4.4–4.7) (4.0–4.3) (4.0–4.3) (4.0–4.3) (0.41–0.44) (0.40–0.40) (0.26–0.27) (0.27–0.27) (0.22–0.22) (0.20–0.21) (0.19–0.19) (4.0–4.1) (0–0) (0–0) (0–0) (0–0) (0–0) (0–0) (5.3–6.2) (3.2–3.7) (1.8–2.0) (1.4–1.5) (1.3–1.4) (1.3–1.3) (1.2–1.2) (4.2–5.9) (4.8–5.9) (3.0–3.4) (2.3–2.4) (1.9–2.0) (1.8–1.8) (1.6–1.6) PREVALENCE (INCLUDING HIV) NUMBER (THOUSANDS) <0.01 <0.01 <0.01 <0.01 <0.01 <0.01 <0.01 <0.01 <0.01 <0.01 <0.01 <0.01 <0.01 <0.01 33 26 22 18 16 16 15 0.013 0.016 0.018 0.02 0.021 0.021 0.021 0.056 0.064 0.1 0.056 0.037 0.058 0.04 <0.01 <0.01 <0.01 0.016 <0.01 <0.01 <0.01 0.1 0.1 0.13 0.13 0.16 0.17 0.17 <0.01 <0.01 <0.01 <0.01 <0.01 <0.01 <0.01 28 27 25 24 23 23 23 (<0.01–<0.01) (<0.01–<0.01) (<0.01–0.011) (<0.01–0.012) (<0.01–0.012) (<0.01–0.012) (<0.01–0.012) (<0.01–<0.01) (<0.01–<0.01) (<0.01–0.012) (<0.01–0.018) (<0.01–0.016) (<0.01–0.015) (<0.01–<0.01) (12–64) (12–46) (9.5–39) (7.8–34) (7.1–29) (6.8–28) (6.5–27) (<0.01–0.024) (<0.01–0.031) (<0.01–0.035) (<0.01–0.038) (<0.01–0.039) (<0.01–0.039) (<0.01–0.039) (0.024–0.100) (0.027–0.120) (0.050–0.170) (0.025–0.100) (0.015–0.068) (0.028–0.098) (0.016–0.076) (<0.01–0.014) (<0.01–<0.01) (<0.01–0.011) (<0.01–0.027) (<0.01–0.013) (<0.01–<0.01) (<0.01–<0.01) (0.033–0.210) (0.037–0.200) (0.047–0.240) (0.055–0.230) (0.073–0.290) (0.073–0.290) (0.071–0.300) (<0.01–<0.01) (<0.01–0.013) (<0.01–<0.01) (<0.01–0.014) (<0.01–<0.01) (<0.01–<0.01) (<0.01–0.012) (11–55) (14–44) (12–43) (12–41) (11–39) (11–38) (11–38) <0.01 (<0.01–<0.01) 210 170 150 120 110 120 120 <0.01 <0.01 <0.01 <0.01 <0.01 <0.01 <0.01 3 3 2.6 2.4 2 2.2 2.1 <0.01 <0.01 0.012 <0.01 <0.01 <0.01 0.011 10 6.4 4.6 4 3.7 3.8 3.6 28 30 27 25 24 23 23 (73–420) (76–290) (65–260) (52–220) (47–210) (54–220) (51–210) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (1.3–5.6) (1.3–5.4) (1.1–4.8) (1.0–4.3) (0.770–3.7) (0.950–3.9) (0.900–3.8) (<0.01–<0.01) (<0.01–<0.01) (<0.01–0.020) (<0.01–<0.01) (<0.01–0.016) (<0.01–0.010) (<0.01–0.019) (4.4–18) (2.6–12) (1.9–8.6) (1.8–7.1) (1.5–6.7) (1.6–6.9) (1.4–6.7) (10–55) (15–51) (13–46) (12–43) (11–41) (11–40) (11–39) RATEa 60 47 56 54 50 50 49 2.8 4.8 9.3 9.4 5.3 6.8 4.8 102 74 59 48 40 38 36 20 20 20 20 20 20 20 22 23 34 17 10 16 11 2.6 1.5 2.1 5.7 2.8 0.79 1.8 55 49 52 48 53 52 51 3.9 13 1.2 13 3.8 3 11 419 352 299 258 227 221 215 (22–118) (23–81) (24–102) (23–99) (22–89) (22–89) (22–88) (0.83–6.0) (1.4–10) (4.6–16) (2.2–22) (0.24–18) (1.1–18) (1.6–9.9) (38–198) (33–131) (26–107) (20–87) (18–71) (17–68) (16–65) (7.9–38) (7.9–38) (7.9–38) (7.9–38) (7.9–38) (7.9–38) (7.9–38) (9.5–39) (9.7–41) (17–57) (7.6–30) (4.2–19) (7.6–27) (4.2–21) (0.93–5.2) (0.56–3.0) (0.79–4.2) (2.7–9.9) (1.4–4.7) (0.30–1.5) (0.77–3.1) (17–113) (18–95) (20–101) (20–86) (24–93) (23–93) (22–92) (1.2–8.3) (6.6–22) (0.35–2.5) (6.4–22) (0.97–8.6) (0.78–6.7) (5.3–19) (156–810) (180–580) (145–506) (126–436) (113–381) (110–370) (107–360) 8.1 (3.2–15) 140 103 84 66 58 62 59 23 23 8.4 2.7 9.2 0.97 1 11 10 8.5 7.3 5.7 6.3 6.1 12 10 28 2.2 15 8 18 76 44 30 25 21 22 21 85 83 68 58 51 49 48 (49–278) (47–180) (37–149) (28–119) (24–106) (27–112) (25–107) (9.3–43) (9.5–43) (2.5–18) (0.82–5.8) (4.3–16) (0.29–2.0) (0.30–2.1) (4.6–20) (4.3–18) (3.5–16) (3.1–13) (2.2–11) (2.7–11) (2.6–11) (3.5–25) (4.4–18) (14–48) (1.1–3.7) (5.5–28) (2.2–18) (8.2–33) (34–136) (18–82) (12–55) (11–44) (8.9–39) (9.5–40) (8.3–38) (31–165) (41–140) (33–116) (28–100) (24–87) (23–85) (22–83) INCIDENCE (INCLUDING HIV) NUMBER (THOUSANDS) <0.01 <0.01 <0.01 <0.01 <0.01 <0.01 <0.01 <0.01 0 <0.01 <0.01 <0.01 <0.01 <0.01 19 17 15 13 11 11 10 <0.01 0.013 0.014 0.016 0.016 0.016 0.016 0.053 0.066 0.094 0.055 0.036 0.047 0.037 <0.01 <0.01 <0.01 0.014 <0.01 0 <0.01 0.075 0.083 0.095 0.11 0.12 0.13 0.13 0 <0.01 0 <0.01 <0.01 <0.01 <0.01 17 16 16 15 14 14 13 0 <0.01 0 130 120 110 95 91 95 92 <0.01 <0.01 <0.01 0 <0.01 0 0 2.3 2.3 2 1.8 1.6 1.6 1.6 <0.01 <0.01 <0.01 <0.01 <0.01 <0.01 <0.01 7.1 4.8 3.5 2.9 2.7 2.8 2.8 18 18 17 17 16 16 16 (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (0–0) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (13–28) (14–21) (12–18) (11–15) (9.1–13) (8.9–13) (8.6–12) (<0.01–0.011) (0.011–0.014) (0.013–0.016) (0.014–0.018) (0.014–0.018) (0.014–0.018) (0.014–0.018) (0.046–0.060) (0.057–0.074) (0.083–0.110) (0.048–0.062) (0.031–0.040) (0.041–0.053) (0.032–0.042) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (0.012–0.016) (<0.01–<0.01) (0–0) (<0.01–<0.01) (0.052–0.100) (0.068–0.099) (0.078–0.110) (0.094–0.120) (0.100–0.150) (0.100–0.150) (0.110–0.160) (0–0) (<0.01–<0.01) (0–0) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (11–24) (14–19) (13–19) (12–18) (11–16) (11–16) (11–16) (0–0) (<0.01–<0.01) (0–0) (79–180) (94–140) (86–130) (80–110) (75–110) (78–110) (76–110) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (0–0) (<0.01–<0.01) (0–0) (0–0) (2.0–2.6) (2.0–2.6) (1.7–2.2) (1.6–2.0) (1.4–1.8) (1.4–1.9) (1.4–1.8) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (6.2–8.0) (4.2–5.4) (3.0–3.9) (2.5–3.3) (2.4–3.1) (2.5–3.2) (2.4–3.1) (12–25) (14–21) (14–21) (14–20) (13–19) (13–19) (13–19) RATEa 24 23 23 22 21 21 21 1.9 0 5.9 8.4 9.2 7.8 3.9 60 49 40 33 27 26 25 16 16 16 16 16 16 16 21 23 32 17 9.9 13 9.9 2.2 1.3 1.3 5.1 2.5 0 1.6 40 40 40 40 40 40 40 0 7.5 0 8.1 1.8 1.8 5.3 251 215 184 158 135 131 127 0 6.3 0 84 71 60 51 46 48 46 17 17 5.6 0 4.2 0 0 8.3 7.7 6.5 5.5 4.6 4.8 4.6 9.2 7.3 14 1.2 8.3 4.1 12 54 33 22 18 16 16 16 54 48 43 38 34 34 33 (15–35) (20–27) (18–27) (18–26) (18–25) (17–25) (17–25) (1.6–2.1) (0–0) (5.2–6.7) (7.3–9.5) (8.1–10) (6.9–8.9) (3.4–4.4) (39–85) (40–59) (33–49) (27–40) (23–32) (22–31) (21–30) (14–18) (14–18) (14–18) (14–18) (14–18) (14–18) (14–18) (18–23) (21–26) (28–36) (15–19) (8.7–11) (11–15) (8.7–11) (1.9–2.5) (1.1–1.5) (1.1–1.5) (4.4–5.7) (2.2–2.8) (0–0) (1.4–1.8) (28–54) (33–48) (33–48) (34–46) (33–48) (33–48) (33–48) (0–0) (6.6–8.5) (0–0) (7.1–9.1) (1.6–2.0) (1.5–2.0) (4.6–6.0) (166–354) (185–248) (151–221) (129–190) (111–161) (108–156) (105–151) (0–0) (5.5–7.2) (0–0) (53–121) (58–85) (49–72) (43–60) (38–55) (40–57) (38–55) (15–20) (15–20) (4.9–6.3) (0–0) (3.7–4.8) (0–0) (0–0) (7.3–9.4) (6.8–8.7) (5.7–7.3) (4.8–6.3) (4.0–5.2) (4.2–5.4) (4.0–5.2) (8.1–10) (6.4–8.2) (12–16) (1.1–1.4) (7.3–9.4) (3.6–4.6) (11–14) (47–61) (29–37) (20–25) (15–20) (14–18) (14–18) (14–18) (36–75) (39–58) (35–52) (31–46) (28–41) (28–40) (27–39) REGION OF THE AMERICAS MORTALITY (EXCLUDING HIV) YEAR Rates are per 100 000 population. Data for all years can be downloaded from www.who.int/tb/data GLOBAL TUBERCULOSIS REPORT 2013 7$%/($(VWLPDWHVRIWKHEXUGHQRIGLVHDVHFDXVHGE\7% ± MORTALITY (EXCLUDING HIV) YEAR Costa Rica Cuba Curaçao Dominica Dominican Republic Ecuador El Salvador Grenada Guatemala Guyana Haiti Honduras Jamaica Mexico Montserrat Netherlands Antilles Nicaragua a 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 1990 1995 2000 2005 2010 2011 2012 POPULATION (MILLIONS) 3 3 4 4 5 5 5 11 11 11 11 11 11 11 <1 <1 <1 <1 <1 <1 <1 <1 <1 <1 7 8 9 9 10 10 10 10 11 13 14 15 15 15 5 6 6 6 6 6 6 <1 <1 <1 <1 <1 <1 <1 9 10 11 13 14 15 15 <1 <1 <1 <1 <1 <1 <1 7 8 9 9 10 10 10 5 6 6 7 8 8 8 2 2 3 3 3 3 3 86 95 104 111 118 119 121 <1 <1 <1 <1 <1 <1 <1 <1 <1 <1 <1 4 5 5 5 6 6 6 NUMBER (THOUSANDS) 0.078 0.11 0.07 0.06 0.043 0.04 0.038 0.062 0.096 0.046 0.033 0.039 0.038 0.038 <0.01 <0.01 <0.01 <0.01 <0.01 <0.01 <0.01 <0.01 <0.01 <0.01 1 1 0.76 0.59 0.53 0.49 0.46 2 2 1.8 1.1 0.69 0.53 0.41 0.26 0.22 0.17 0.11 0.076 0.071 0.065 0 0 0 <0.01 <0.01 <0.01 <0.01 0.86 0.63 0.57 0.41 0.34 0.32 0.31 0.054 0.067 0.099 0.12 0.12 0.12 0.12 2.5 3 3.4 3.4 2.9 2.7 2.6 0.31 0.35 0.31 0.26 0.24 0.24 0.23 0.021 0.025 0.016 0.011 <0.01 <0.01 <0.01 6.7 5.3 3.5 2.7 2.6 2.2 2.2 0 <0.01 <0.01 <0.01 <0.01 <0.01 <0.01 <0.01 <0.01 <0.01 <0.01 0.45 0.41 0.33 0.3 0.26 0.19 0.19 (0.072–0.083) (0.100–0.110) (0.067–0.072) (0.058–0.061) (0.038–0.047) (0.036–0.045) (0.034–0.043) (0.059–0.065) (0.095–0.098) (0.045–0.047) (0.033–0.034) (0.039–0.040) (0.038–0.038) (0.038–0.038) (<0.01–<0.01) (0–<0.01) (0–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (0.550–1.6) (0.510–1.7) (0.400–1.2) (0.380–0.850) (0.390–0.680) (0.380–0.620) (0.380–0.550) (1.4–2.6) (1.4–2.7) (1.3–2.3) (0.910–1.2) (0.610–0.790) (0.460–0.610) (0.350–0.480) (0.150–0.390) (0.150–0.300) (0.120–0.210) (0.087–0.140) (0.056–0.100) (0.051–0.094) (0.046–0.088) (0–0) (0–0) (0–0) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (0.800–0.930) (0.570–0.700) (0.510–0.640) (0.370–0.460) (0.310–0.370) (0.290–0.350) (0.280–0.340) (0.036–0.075) (0.049–0.087) (0.061–0.150) (0.110–0.140) (0.098–0.130) (0.099–0.140) (0.099–0.140) (0.450–6.4) (1.1–6.0) (1.2–6.7) (1.2–6.6) (1.1–5.4) (1.1–5.1) (1.0–4.9) (0.096–0.650) (0.110–0.730) (0.060–0.760) (0.025–0.780) (<0.01–0.840) (<0.01–0.850) (<0.01–0.850) (0.016–0.026) (0.020–0.031) (0.013–0.020) (<0.01–0.013) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (6.4–7.0) (4.9–5.7) (3.3–3.6) (2.6–2.9) (2.5–2.7) (2.1–2.4) (2.1–2.3) (0–0) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (0.260–0.680) (0.260–0.600) (0.230–0.440) (0.220–0.380) (0.200–0.330) (0.150–0.240) (0.150–0.230) PREVALENCE (INCLUDING HIV) NUMBER (THOUSANDS) RATEa 2.5 3.1 1.8 1.4 0.92 0.85 0.8 0.58 0.88 0.41 0.3 0.35 0.33 0.33 0.19 <0.1 <0.1 7.6 2.4 3.4 1.3 3.2 2.1 2 14 13 8.7 6.3 5.3 4.9 4.4 19 17 14 7.7 4.6 3.5 2.7 4.8 3.8 2.8 1.8 1.2 1.1 1 0 0 0 1.6 0.76 0.99 0.99 9.7 6.3 5.1 3.3 2.3 2.2 2.1 7.5 9.1 13 16 15 15 15 36 39 40 37 29 27 25 6.4 6.2 5 3.8 3.1 3 2.9 0.87 1 0.63 0.4 0.26 0.24 0.22 7.8 5.5 3.3 2.5 2.2 1.9 1.8 0 11 21 22 21 24 24 0.59 0.57 0.59 0.59 11 8.9 6.4 5.4 4.5 3.3 3.1 (2.3–2.7) (3.0–3.2) (1.7–1.8) (1.3–1.4) (0.82–1.0) (0.76–0.95) (0.70–0.89) (0.55–0.62) (0.87–0.89) (0.40–0.42) (0.30–0.30) (0.35–0.35) (0.33–0.34) (0.33–0.34) (<0.1–0.63) (0–0.19) (0–0.18) (7.3–7.9) (2.2–2.5) (3.1–3.7) (1.3–1.3) (3.2–3.3) (2.1–2.1) (2.0–2.0) (7.6–22) (6.4–21) (4.6–14) (4.0–9.1) (3.9–6.8) (3.8–6.1) (3.7–5.3) (14–26) (12–24) (10–19) (6.6–9.0) (4.0–5.2) (3.0–4.0) (2.3–3.1) (2.8–7.4) (2.6–5.2) (2.1–3.6) (1.4–2.3) (0.90–1.6) (0.81–1.5) (0.73–1.4) (0–0) (0–0) (0–0) (1.6–1.6) (0.75–0.76) (0.95–1.0) (0.95–1.0) (9.0–10) (5.7–7.1) (4.6–5.7) (2.9–3.6) (2.1–2.6) (2.0–2.4) (1.9–2.2) (5.0–10) (6.7–12) (8.2–20) (14–19) (12–17) (12–17) (12–17) (6.3–90) (14–77) (14–78) (13–71) (11–55) (11–51) (10–48) (2.0–13) (1.9–13) (0.96–12) (0.36–11) (0.12–11) (<0.1–11) (<0.1–11) (0.68–1.1) (0.81–1.2) (0.51–0.77) (0.32–0.48) (0.21–0.31) (0.20–0.28) (0.18–0.26) (7.5–8.1) (5.2–5.9) (3.2–3.5) (2.4–2.6) (2.1–2.3) (1.8–2.0) (1.7–1.9) (0–0) (10–11) (21–22) (21–22) (21–22) (24–25) (24–25) (0.56–0.62) (0.54–0.60) (0.58–0.61) (0.57–0.61) (6.4–16) (5.6–13) (4.5–8.7) (4.1–6.9) (3.5–5.6) (2.6–4.1) (2.4–3.8) RATEa 3.6 3 2.5 1.7 0.93 0.78 0.6 6.4 3.5 2.2 1.6 1.6 1.6 1.6 <0.01 <0.01 <0.01 0.012 0.014 0.02 0.012 0.013 0.016 0.018 25 17 14 12 11 10 10 34 27 23 20 17 16 15 5.1 3.1 3.3 3.7 2.1 2.1 2.2 0.01 <0.01 <0.01 <0.01 <0.01 <0.01 <0.01 13 14 14 15 16 16 17 1.4 1.1 1 1.1 1 1 1 27 30 34 36 32 31 30 8.7 9.5 11 7.7 6.4 6.5 6.5 0.23 0.22 0.21 0.23 0.26 0.26 0.26 130 85 53 38 40 41 40 <0.01 <0.01 <0.01 <0.01 <0.01 <0.01 (1.7–6.3) (1.5–5.0) (1.3–4.0) (0.920–2.8) (0.460–1.6) (0.360–1.4) (0.220–1.2) (2.4–12) (1.7–5.9) (0.940–3.9) (0.730–2.8) (0.730–2.8) (0.700–2.8) (0.670–2.8) (<0.01–0.014) (<0.01–<0.01) (<0.01–<0.01) (<0.01–0.031) (<0.01–0.026) (<0.01–0.034) (<0.01–0.024) (<0.01–0.024) (<0.01–0.033) (<0.01–0.030) (9.4–47) (8.6–29) (6.8–23) (6.0–21) (5.3–18) (5.1–18) (4.9–17) (13–66) (14–46) (12–39) (10–34) (8.5–28) (8.1–27) (7.6–25) (1.7–10) (1.2–6.1) (1.6–5.7) (1.8–6.2) (0.740–4.0) (0.760–4.2) (0.770–4.3) (<0.01–0.020) (<0.01–0.014) (<0.01–0.015) (<0.01–0.014) (<0.01–0.013) (<0.01–0.015) (<0.01–0.015) (4.8–24) (6.8–23) (7.1–24) (7.4–25) (7.9–27) (8.0–28) (8.2–28) (0.520–2.7) (0.550–1.9) (0.490–1.8) (0.470–1.9) (0.430–1.9) (0.430–1.9) (0.430–1.9) (8.2–56) (14–51) (17–58) (17–61) (15–55) (15–53) (14–52) (3.0–18) (3.0–19) (3.4–22) (2.5–16) (2.2–13) (2.2–13) (2.1–13) (0.081–0.440) (0.100–0.380) (0.095–0.370) (0.110–0.400) (0.130–0.430) (0.130–0.440) (0.130–0.440) (61–210) (43–140) (27–87) (19–63) (19–67) (20–69) (19–69) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) 118 87 63 40 20 16 12 60 32 19 14 14 14 14 5 0.97 0.95 17 19 28 17 19 23 25 339 215 159 131 107 103 98 340 242 187 148 113 106 98 95 55 56 60 33 34 34 11 8.2 8.6 8.1 5.5 7.1 6.8 142 139 129 119 112 111 110 193 153 139 139 132 131 131 376 378 400 388 326 309 296 178 169 169 112 84 84 82 9.5 8.9 8.1 8.7 9.4 9.4 9.5 145 89 51 34 34 34 33 20 8.2 11 42 9.9 4.7 (54–205) (44–143) (33–101) (21–65) (9.8–33) (7.6–29) (4.7–24) (23–115) (15–54) (8.4–35) (6.4–25) (6.4–25) (6.2–25) (5.9–25) (2.0–9.4) (0.38–1.8) (0.37–1.8) (2.7–43) (7.3–36) (13–49) (6.3–34) (7.9–34) (7.2–46) (12–42) (130–646) (108–360) (78–268) (65–220) (53–181) (50–173) (48–165) (127–655) (121–403) (93–313) (74–248) (57–187) (53–176) (49–163) (32–191) (21–105) (27–96) (29–103) (12–65) (12–67) (12–68) (3.9–21) (4.1–14) (4.1–15) (3.9–14) (1.3–13) (2.2–15) (2.1–14) (53–274) (69–233) (63–217) (59–200) (55–189) (55–188) (54–187) (72–372) (75–258) (66–239) (62–248) (55–241) (54–241) (54–242) (115–787) (180–648) (193–681) (187–659) (156–556) (148–528) (140–509) (60–358) (54–348) (54–347) (36–228) (29–170) (28–169) (27–168) (3.4–19) (4.1–15) (3.7–14) (4.1–15) (4.6–16) (4.6–16) (4.7–16) (71–246) (46–146) (26–84) (17–57) (16–57) (16–58) (16–57) (10–33) (2.5–17) (3.3–23) (21–69) (2.9–21) (1.4–10) 0.013 0.014 <0.01 0.01 7.6 6.4 5.5 4.6 2.9 3.1 3.3 (<0.01–0.024) (<0.01–0.025) (<0.01–0.019) (<0.01–0.021) (2.8–15) (3.0–11) (2.6–9.5) (2.2–8.0) (1.0–5.9) (1.1–6.3) (1.1–6.7) 6.7 7.2 5 5.6 183 137 108 85 50 53 55 (2.5–13) (3.1–13) (1.5–11) (1.7–12) (68–354) (65–236) (51–186) (39–146) (17–101) (18–106) (19–112) INCIDENCE (INCLUDING HIV) NUMBER (THOUSANDS) 1.5 1.5 1.4 1 0.65 0.59 0.51 2.6 2 1.4 1 1 1 1 <0.01 <0.01 <0.01 0.01 0.01 <0.01 <0.01 <0.01 <0.01 <0.01 11 9.7 8.6 7.7 6.7 6.6 6.4 18 15 13 11 9.7 9.4 9.1 3.4 2.6 2.2 2.4 1.8 1.7 1.6 <0.01 <0.01 <0.01 <0.01 <0.01 <0.01 <0.01 6.6 7.1 7.6 8.2 8.8 9 9.1 0.65 0.65 0.78 0.88 0.87 0.87 0.87 18 19 23 25 23 22 22 5.6 6.4 7.1 5 4.1 4.2 4.3 0.15 0.16 0.17 0.18 0.18 0.18 0.18 57 44 32 25 26 27 27 <0.01 <0.01 0 <0.01 0 0 0 <0.01 0.01 <0.01 <0.01 4.5 4 3.4 2.9 2.5 2.4 2.3 (1.3–1.7) (1.3–1.7) (1.2–1.5) (0.880–1.1) (0.570–0.740) (0.510–0.660) (0.440–0.580) (1.6–3.9) (1.7–2.5) (1.1–1.8) (0.850–1.3) (0.840–1.3) (0.830–1.3) (0.840–1.3) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–0.015) (<0.01–0.012) (<0.01–0.012) (<0.01–0.011) (<0.01–0.011) (<0.01–0.011) (<0.01–0.011) (6.6–16) (7.9–12) (7.1–10) (6.3–9.2) (5.6–8.0) (5.4–7.8) (5.3–7.6) (11–26) (13–19) (11–16) (9.4–14) (8.0–12) (7.8–11) (7.5–11) (2.3–4.7) (2.3–2.9) (1.8–2.6) (1.9–2.9) (1.5–2.0) (1.4–1.9) (1.4–1.8) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (4.1–9.7) (5.8–8.5) (6.2–9.1) (6.7–9.9) (7.3–11) (7.4–11) (7.5–11) (0.400–0.960) (0.530–0.780) (0.630–0.930) (0.720–1.1) (0.720–1.0) (0.720–1.0) (0.710–1.0) (11–26) (16–23) (19–28) (21–30) (19–27) (18–27) (18–26) (3.6–7.9) (4.1–9.2) (4.6–10) (3.2–7.2) (2.7–5.9) (2.7–6.0) (2.8–6.1) (0.110–0.210) (0.130–0.190) (0.140–0.200) (0.140–0.210) (0.150–0.210) (0.150–0.220) (0.150–0.220) (49–66) (38–51) (27–37) (21–28) (23–30) (23–31) (23–32) (<0.01–<0.01) (<0.01–<0.01) (0–0) (<0.01–<0.01) (0–0) (0–0) (0–0) (<0.01–0.011) (<0.01–0.012) (<0.01–<0.01) (<0.01–<0.01) (2.9–6.3) (3.2–4.8) (2.8–4.1) (2.4–3.5) (2.1–2.8) (2.0–2.7) (2.0–2.7) RATEa 48 43 35 23 14 12 11 25 19 13 9.2 9.3 9.3 9.3 3.9 0.76 0.74 15 14 14 13 13 13 13 148 121 100 82 67 65 62 174 136 107 83 65 62 59 63 45 37 39 28 27 25 4.6 4.5 4.4 4.2 4.1 4.1 4.1 74 71 68 65 62 61 60 89 89 104 115 111 110 109 247 247 271 272 230 222 213 113 115 114 73 54 54 54 6.5 6.5 6.5 6.5 6.6 6.6 6.6 67 46 31 22 22 23 23 11 4.1 0 24 0 0 0 5.3 5.3 3.2 4.7 108 85 68 53 42 40 38 Rates are per 100 000 population. GLOBAL TUBERCULOSIS REPORT 2013 Data for all years can be downloaded from www.who.int/tb/data (42–54) (37–48) (31–39) (20–26) (12–16) (11–14) (9.3–12) (15–37) (15–23) (10–16) (7.5–11) (7.4–11) (7.4–11) (7.4–11) (3.4–4.4) (0.67–0.86) (0.65–0.84) (9.3–21) (12–17) (11–17) (11–16) (11–16) (11–16) (11–15) (91–218) (99–146) (82–120) (67–98) (55–80) (53–77) (51–74) (108–257) (111–164) (87–128) (68–100) (54–77) (51–74) (48–70) (43–88) (39–50) (30–44) (32–47) (24–33) (23–31) (22–29) (2.9–6.8) (3.8–5.2) (3.6–5.2) (3.5–5.1) (3.4–4.9) (3.4–4.9) (3.4–4.9) (47–109) (58–85) (55–81) (53–78) (51–73) (50–73) (50–72) (55–132) (73–107) (85–125) (94–138) (91–132) (91–131) (90–130) (153–365) (202–297) (221–325) (222–326) (190–275) (183–265) (176–254) (73–162) (74–164) (74–163) (47–104) (35–77) (35–77) (35–77) (4.7–8.8) (5.4–7.9) (5.4–7.9) (5.4–7.9) (5.4–7.8) (5.4–7.8) (5.4–7.8) (57–77) (40–53) (26–36) (19–26) (19–26) (19–26) (19–26) (9.4–12) (3.6–4.7) (0–0) (21–27) (0–0) (0–0) (0–0) (4.6–6.0) (4.6–6.0) (2.8–3.7) (4.1–5.3) (71–152) (70–102) (55–81) (44–64) (36–49) (35–46) (33–44) 7$%/($(VWLPDWHVRIWKHEXUGHQRIGLVHDVHFDXVHGE\7% ± Panama Paraguay Peru Puerto Rico Saint Kitts and Nevis Saint Lucia Saint Vincent and the Grenadines Sint Maarten (Dutch part) Suriname Trinidad and Tobago Turks and Caicos Islands United States of America Uruguay US Virgin Islands Venezuela (Bolivarian Republic of) a 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 POPULATION (MILLIONS) 2 3 3 3 4 4 4 4 5 5 6 6 7 7 22 24 26 28 29 30 30 4 4 4 4 4 4 4 <1 <1 <1 <1 <1 <1 <1 <1 <1 <1 <1 <1 <1 <1 <1 <1 <1 <1 <1 <1 <1 <1 <1 <1 <1 <1 <1 <1 <1 <1 <1 1 1 1 1 1 1 1 <1 <1 <1 <1 <1 <1 <1 255 268 285 298 312 315 318 3 3 3 3 3 3 3 <1 <1 <1 <1 <1 <1 <1 20 22 24 27 29 30 30 NUMBER (THOUSANDS) 0.2 0.2 0.2 0.22 0.19 0.19 0.19 0.2 0.23 0.23 0.28 0.19 0.2 0.2 7.5 6.2 3.7 2.7 1.8 1.7 1.5 0.069 0.081 0.017 0.017 0.01 <0.01 <0.01 0 <0.01 <0.01 <0.01 <0.01 <0.01 <0.01 <0.01 0.012 <0.01 <0.01 <0.01 <0.01 <0.01 <0.01 <0.01 <0.01 <0.01 <0.01 <0.01 <0.01 <0.01 <0.01 <0.01 0.027 0.016 <0.01 <0.01 0.014 0.014 0.014 0.032 0.034 0.025 0.018 0.028 0.028 0.028 0 0 <0.01 <0.01 <0.01 <0.01 <0.01 2.6 1.4 0.81 0.64 0.61 0.47 0.44 0.085 0.076 0.069 0.067 0.054 0.053 0.051 <0.01 <0.01 <0.01 <0.01 <0.01 <0.01 <0.01 0.85 0.81 0.67 0.63 0.71 0.72 0.73 (0.130–0.290) (0.160–0.250) (0.180–0.230) (0.210–0.230) (0.190–0.200) (0.190–0.190) (0.180–0.190) (0.150–0.250) (0.170–0.290) (0.160–0.310) (0.220–0.350) (0.160–0.230) (0.160–0.230) (0.160–0.240) (2.5–15) (3.3–9.9) (2.3–5.4) (2.1–3.4) (1.3–2.3) (1.2–2.1) (1.1–2.0) (0.069–0.070) (0.080–0.081) (0.017–0.017) (0.017–0.017) (0.010–0.010) (<0.01–<0.01) (<0.01–<0.01) (0–0) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–0.016) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (0–<0.01) (0–<0.01) (0–<0.01) (0.019–0.037) (<0.01–0.027) (<0.01–<0.01) (<0.01–<0.01) (0.012–0.015) (0.012–0.015) (0.012–0.016) (0.031–0.033) (0.033–0.034) (0.024–0.025) (0.018–0.018) (0.028–0.028) (0.028–0.028) (0.028–0.028) (0–0) (0–0) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (2.5–2.6) (1.4–1.4) (0.790–0.820) (0.640–0.650) (0.590–0.630) (0.440–0.500) (0.390–0.480) (0.078–0.092) (0.073–0.078) (0.066–0.072) (0.064–0.070) (0.051–0.057) (0.050–0.056) (0.048–0.054) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (0.830–0.870) (0.790–0.830) (0.650–0.690) (0.630–0.630) (0.410–1.1) (0.410–1.1) (0.420–1.1) RATEa 8.1 7.4 6.6 6.6 5.2 5.1 4.9 4.6 4.8 4.3 4.7 3 3 3 34 26 14 9.7 6.1 5.6 5.1 2 2.2 0.45 0.45 0.28 0.25 0.23 0 2.1 2.4 2.2 2.5 2.5 2.5 4 8.3 0.81 3.5 1.4 1.3 1.2 1 3.7 3.3 0.86 4.8 2.6 2.6 0.4 0.26 0.13 6.7 3.6 1.2 1.7 2.6 2.6 2.6 2.6 2.7 1.9 1.4 2.1 2.1 2.1 0 0 6.1 3.9 3.5 3.5 3.5 1 0.51 0.28 0.22 0.2 0.15 0.14 2.7 2.3 2.1 2 1.6 1.6 1.5 3 2.4 2.8 0.94 0.96 0.96 0.96 4.3 3.7 2.7 2.4 2.4 2.4 2.4 (5.2–12) (5.8–9.2) (5.9–7.4) (6.3–6.9) (5.1–5.4) (5.0–5.2) (4.8–5.0) (3.5–5.9) (3.6–6.1) (3.1–5.8) (3.7–5.9) (2.5–3.6) (2.5–3.6) (2.5–3.6) (11–70) (14–41) (8.9–21) (7.4–12) (4.6–7.8) (4.1–7.2) (3.8–6.7) (2.0–2.0) (2.2–2.2) (0.45–0.45) (0.45–0.46) (0.27–0.28) (0.25–0.25) (0.23–0.23) (0–0) (2.1–2.2) (2.3–2.5) (2.1–2.3) (2.3–2.6) (2.3–2.6) (2.3–2.6) (3.8–4.2) (6.3–11) (0.71–0.92) (3.3–3.6) (1.3–1.5) (1.2–1.4) (1.1–1.4) (0.95–1.1) (3.6–3.8) (3.0–3.6) (0.86–0.87) (4.7–4.8) (2.5–2.6) (2.5–2.6) (0–2.0) (0–1.4) (<0.1–0.43) (4.6–9.2) (1.7–6.2) (0.98–1.5) (1.5–1.9) (2.3–2.9) (2.3–2.9) (2.3–2.9) (2.5–2.7) (2.7–2.7) (1.9–2.0) (1.4–1.4) (2.1–2.1) (2.1–2.1) (2.1–2.1) (0–0) (0–0) (5.7–6.6) (3.9–4.0) (3.4–3.7) (3.4–3.7) (3.4–3.7) (0.99–1.0) (0.50–0.52) (0.28–0.29) (0.21–0.22) (0.19–0.20) (0.14–0.16) (0.12–0.15) (2.5–3.0) (2.3–2.4) (2.0–2.2) (1.9–2.1) (1.5–1.7) (1.5–1.6) (1.4–1.6) (3.0–3.1) (2.4–2.4) (2.8–2.8) (0.94–0.95) (0.94–0.97) (0.94–0.97) (0.94–0.97) (4.2–4.4) (3.6–3.8) (2.7–2.8) (2.3–2.4) (1.4–3.8) (1.4–3.8) (1.4–3.8) PREVALENCE (INCLUDING HIV) NUMBER (THOUSANDS) RATEa 1.9 1.6 1.6 1.8 2.2 2.3 2.4 4.2 3.7 3.8 4.1 4.2 4.2 4.2 120 85 70 54 37 37 36 0.22 0.4 0.27 0.15 0.12 0.07 0.11 <0.01 <0.01 <0.01 <0.01 <0.01 <0.01 <0.01 0.027 0.035 0.024 0.023 0.015 0.011 <0.01 0.071 0.061 0.055 0.049 0.035 0.031 0.027 <0.01 <0.01 <0.01 0.53 0.69 0.6 0.47 0.35 0.33 0.31 0.21 0.23 0.29 0.2 0.26 0.26 0.37 (0.740–3.6) (0.600–3.0) (0.600–3.0) (0.670–3.4) (0.920–3.9) (1.0–4.0) (1.2–4.2) (2.0–7.0) (1.9–6.2) (1.9–6.4) (2.1–7.0) (2.0–7.1) (2.1–7.1) (2.1–7.1) (42–240) (37–150) (30–130) (23–99) (12–77) (12–74) (12–73) (0.064–0.460) (0.170–0.740) (0.110–0.490) (0.066–0.270) (0.055–0.210) (0.026–0.140) (0.053–0.200) (<0.01–<0.01) (<0.01–0.014) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–0.051) (0.014–0.065) (<0.01–0.044) (<0.01–0.044) (<0.01–0.033) (<0.01–0.022) (<0.01–0.018) (0.025–0.140) (0.028–0.110) (0.026–0.094) (0.020–0.092) (0.011–0.071) (0.010–0.064) (<0.01–0.061) (<0.01–0.011) (<0.01–<0.01) (<0.01–<0.01) (0.200–1.0) (0.230–1.4) (0.180–1.3) (0.150–0.980) (0.120–0.700) (0.130–0.620) (0.120–0.590) (0.099–0.350) (0.090–0.440) (0.140–0.490) (0.073–0.390) (0.096–0.500) (0.096–0.520) (0.170–0.650) 77 57 52 53 59 61 64 98 78 72 70 65 64 63 554 355 268 195 127 124 121 6.1 11 7 4 3.2 1.9 3 0.56 17 7.3 3.7 5.6 5.1 5.1 19 24 15 14 8.6 6.1 4.8 66 57 51 45 32 29 24 11 7.4 3.3 129 157 128 94 66 62 58 17 19 23 15 20 20 28 <0.01 0.016 0.013 <0.01 0.015 0.01 38 35 24 21 17 16 15 1.5 0.91 0.96 0.89 0.96 1.2 1.1 <0.01 <0.01 0.011 0.011 0.011 0.011 0.011 11 12 12 13 15 15 15 (<0.01–0.015) (<0.01–0.029) (<0.01–0.021) (<0.01–0.015) (<0.01–0.026) (<0.01–0.022) (15–71) (15–62) (10–45) (9.3–38) (7.1–30) (6.7–28) (6.5–27) (0.690–2.6) (0.340–1.8) (0.410–1.7) (0.390–1.6) (0.400–1.8) (0.560–2.1) (0.490–2.1) (<0.01–0.011) (<0.01–0.016) (<0.01–0.020) (<0.01–0.020) (<0.01–0.020) (<0.01–0.020) (<0.01–0.020) (3.9–20) (5.4–20) (5.5–21) (6.2–23) (7.3–25) (7.3–25) (7.6–26) 47 86 47 24 47 32 15 13 8.6 7.2 5.3 5 4.7 48 28 29 27 29 36 34 5.6 7.3 9.9 9.9 9.9 9.9 9.9 53 53 50 50 52 50 52 (30–146) (22–110) (20–99) (20–101) (25–107) (28–108) (30–110) (48–165) (39–129) (36–120) (35–118) (32–110) (32–108) (31–106) (191–1 100) (156–634) (116–481) (82–357) (40–263) (42–248) (41–243) (1.8–13) (4.5–20) (2.9–13) (1.7–7.1) (1.5–5.6) (0.69–3.7) (1.4–5.3) (0.17–1.2) (6.2–32) (2.2–15) (1.1–7.9) (1.6–12) (1.3–12) (1.7–10) (7.2–37) (9.6–44) (5.9–28) (5.4–26) (2.5–18) (2.0–13) (1.5–9.9) (24–129) (26–99) (24–87) (18–84) (10–65) (9.1–59) (5.6–56) (3.0–25) (1.6–17) (1.3–6.3) (50–245) (52–320) (38–273) (30–195) (22–133) (24–117) (22–110) (8.1–29) (7.2–35) (11–39) (5.7–30) (7.2–38) (7.2–39) (13–48) (14–100) (37–156) (24–79) (7.5–50) (21–82) (9.1–68) (5.9–28) (5.7–23) (3.6–16) (3.1–13) (2.3–9.6) (2.1–9.0) (2.0–8.4) (22–83) (11–54) (12–53) (12–48) (12–53) (17–62) (14–61) (2.1–11) (2.2–15) (3.8–19) (3.9–19) (3.9–19) (3.8–19) (3.9–19) (20–103) (25–92) (22–88) (23–87) (25–87) (25–85) (25–87) INCIDENCE (INCLUDING HIV) NUMBER (THOUSANDS) 1.2 1.3 1.4 1.6 1.8 1.8 1.8 2.8 2.5 2.6 2.9 3 3 3 69 58 48 39 31 30 29 0.18 0.3 0.2 0.13 0.092 0.058 0.082 0 <0.01 0 0 <0.01 <0.01 <0.01 0.021 0.027 0.018 0.018 0.012 <0.01 <0.01 0.029 0.029 0.028 0.027 0.027 0.026 0.026 <0.01 <0.01 <0.01 0.26 0.4 0.4 0.31 0.24 0.23 0.22 0.14 0.19 0.23 0.19 0.25 0.26 0.32 0 <0.01 0.012 <0.01 <0.01 0.01 <0.01 30 26 19 16 13 12 11 1 0.72 0.74 0.72 0.8 0.94 0.93 <0.01 <0.01 <0.01 <0.01 <0.01 <0.01 <0.01 7 7.7 8.4 9 9.7 9.8 9.9 (0.810–1.6) (1.1–1.6) (1.2–1.7) (1.3–1.9) (1.5–2.0) (1.6–2.0) (1.6–2.0) (2.6–3.0) (2.3–2.7) (2.4–2.8) (2.7–3.1) (2.7–3.2) (2.8–3.2) (2.8–3.2) (43–100) (47–70) (39–57) (33–46) (27–35) (26–34) (25–32) (0.160–0.210) (0.260–0.340) (0.180–0.230) (0.110–0.150) (0.081–0.100) (0.050–0.065) (0.072–0.092) (0–0) (<0.01–<0.01) (0–0) (0–0) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (0.019–0.024) (0.023–0.030) (0.016–0.021) (0.016–0.020) (0.011–0.014) (<0.01–0.010) (<0.01–<0.01) (0.018–0.043) (0.023–0.035) (0.023–0.033) (0.022–0.033) (0.022–0.032) (0.022–0.032) (0.022–0.031) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (0.170–0.360) (0.260–0.570) (0.260–0.580) (0.200–0.450) (0.160–0.340) (0.170–0.310) (0.160–0.290) (0.120–0.160) (0.170–0.220) (0.200–0.260) (0.170–0.220) (0.220–0.290) (0.230–0.290) (0.280–0.360) (0–0) (<0.01–<0.01) (0.010–0.014) (<0.01–<0.01) (<0.01–<0.01) (<0.01–0.012) (<0.01–0.010) (26–33) (23–30) (16–21) (14–18) (11–15) (11–14) (10–13) (0.890–1.2) (0.630–0.810) (0.650–0.840) (0.630–0.810) (0.700–0.910) (0.820–1.1) (0.810–1.1) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (4.9–9.4) (6.3–9.2) (6.8–10) (7.4–11) (8.0–12) (8.1–12) (8.2–12) RATEa 47 47 47 47 48 48 48 66 52 49 49 46 45 45 317 242 184 140 106 101 95 5.2 8.2 5.3 3.5 2.5 1.6 2.2 0 13 0 0 4.4 2.2 4.3 15 18 12 11 6.9 5.1 3.3 27 27 26 25 24 24 24 8.1 5.3 2.6 63 92 86 63 46 44 41 11 15 18 15 19 19 24 0 36 63 29 22 33 28 12 9.8 6.6 5.4 4.1 3.8 3.6 33 22 22 22 24 28 27 4.5 4.3 7.7 7.7 7.7 7.7 7.7 35 35 34 34 33 33 33 (33–65) (39–57) (39–56) (39–57) (42–54) (42–54) (42–54) (61–72) (48–56) (45–53) (45–53) (42–50) (42–49) (41–48) (196–468) (198–290) (151–221) (118–164) (93–120) (88–114) (83–108) (4.6–5.9) (7.2–9.2) (4.6–6.0) (3.0–3.9) (2.2–2.8) (1.4–1.8) (1.9–2.5) (0–0) (12–15) (0–0) (0–0) (3.8–5.0) (1.9–2.5) (3.8–4.9) (13–17) (16–21) (10–13) (9.5–12) (6.1–7.8) (4.5–5.8) (2.9–3.7) (17–40) (22–32) (21–31) (20–30) (20–29) (20–29) (20–29) (7.1–9.2) (4.6–6.0) (2.3–2.9) (41–90) (59–131) (56–124) (41–90) (31–65) (32–58) (30–55) (9.9–13) (13–17) (16–20) (13–17) (17–21) (17–22) (21–27) (0–0) (32–41) (55–72) (26–33) (20–25) (29–37) (25–32) (10–13) (8.5–11) (5.8–7.5) (4.8–6.1) (3.6–4.7) (3.4–4.3) (3.2–4.1) (29–37) (20–25) (20–25) (19–24) (21–27) (24–31) (24–31) (3.9–5.0) (3.8–4.9) (6.8–8.7) (6.8–8.7) (6.8–8.7) (6.8–8.7) (6.8–8.7) (25–47) (28–42) (28–41) (28–41) (27–40) (27–40) (27–39) REGION OF THE AMERICAS MORTALITY (EXCLUDING HIV) YEAR Rates are per 100 000 population. Data for all years can be downloaded from www.who.int/tb/data GLOBAL TUBERCULOSIS REPORT 2013 7$%/($,QFLGHQFHQRWLILFDWLRQDQGFDVHGHWHFWLRQUDWHVDOOIRUPV ± INCIDENCE (INCLUDING HIV) YEAR Anguilla 1990 1995 2000 2005 2010 2011 2012 Antigua and 1990 Barbuda 1995 2000 2005 2010 2011 2012 Argentina 1990 1995 2000 2005 2010 2011 2012 Aruba 1990 1995 2000 2005 2010 2011 2012 Bahamas 1990 1995 2000 2005 2010 2011 2012 Barbados 1990 1995 2000 2005 2010 2011 2012 Belize 1990 1995 2000 2005 2010 2011 2012 Bermuda 1990 1995 2000 2005 2010 2011 2012 Bolivia 1990 (Plurinational 1995 State of) 2000 2005 2010 2011 2012 Bonaire, Saint 2010 Eustatius and Saba 2011 2012 Brazil 1990 1995 2000 2005 2010 2011 2012 British Virgin 1990 Islands 1995 2000 2005 2010 2011 2012 Canada 1990 1995 2000 2005 2010 2011 2012 Cayman Islands 1990 1995 2000 2005 2010 2011 2012 Chile 1990 1995 2000 2005 2010 2011 2012 Colombia 1990 1995 2000 2005 2010 2011 2012 a b POPULATION (MILLIONS) <1 <1 <1 <1 <1 <1 <1 <1 <1 <1 <1 <1 <1 <1 33 35 37 39 40 41 41 <1 <1 <1 <1 <1 <1 <1 <1 <1 <1 <1 <1 <1 <1 <1 <1 <1 <1 <1 <1 <1 <1 <1 <1 <1 <1 <1 <1 <1 <1 <1 <1 <1 <1 <1 7 8 8 9 10 10 10 <1 <1 <1 150 162 175 186 195 197 199 <1 <1 <1 <1 <1 <1 <1 28 29 31 32 34 34 35 <1 <1 <1 <1 <1 <1 <1 13 14 15 16 17 17 17 33 37 40 43 46 47 48 NUMBER (THOUSANDS) <0.01 <0.01 <0.01 <0.01 <0.01 <0.01 <0.01 <0.01 0 <0.01 <0.01 <0.01 <0.01 <0.01 19 17 15 13 11 11 10 <0.01 0.013 0.014 0.016 0.016 0.016 0.016 0.053 0.066 0.094 0.055 0.036 0.047 0.037 <0.01 <0.01 <0.01 0.014 <0.01 0 <0.01 0.075 0.083 0.095 0.11 0.12 0.13 0.13 0 <0.01 0 <0.01 <0.01 <0.01 <0.01 17 16 16 15 14 14 13 0 <0.01 0 130 120 110 95 91 95 92 <0.01 <0.01 <0.01 0 <0.01 0 0 2.3 2.3 2 1.8 1.6 1.6 1.6 <0.01 <0.01 <0.01 <0.01 <0.01 <0.01 <0.01 7.1 4.8 3.5 2.9 2.7 2.8 2.8 18 18 17 17 16 16 16 (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (0–0) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (13–28) (14–21) (12–18) (11–15) (9.1–13) (8.9–13) (8.6–12) (<0.01–0.011) (0.011–0.014) (0.013–0.016) (0.014–0.018) (0.014–0.018) (0.014–0.018) (0.014–0.018) (0.046–0.060) (0.057–0.074) (0.083–0.110) (0.048–0.062) (0.031–0.040) (0.041–0.053) (0.032–0.042) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (0.012–0.016) (<0.01–<0.01) (0–0) (<0.01–<0.01) (0.052–0.100) (0.068–0.099) (0.078–0.110) (0.094–0.120) (0.100–0.150) (0.100–0.150) (0.110–0.160) (0–0) (<0.01–<0.01) (0–0) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (11–24) (14–19) (13–19) (12–18) (11–16) (11–16) (11–16) (0–0) (<0.01–<0.01) (0–0) (79–180) (94–140) (86–130) (80–110) (75–110) (78–110) (76–110) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (0–0) (<0.01–<0.01) (0–0) (0–0) (2.0–2.6) (2.0–2.6) (1.7–2.2) (1.6–2.0) (1.4–1.8) (1.4–1.9) (1.4–1.8) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (6.2–8.0) (4.2–5.4) (3.0–3.9) (2.5–3.3) (2.4–3.1) (2.5–3.2) (2.4–3.1) (12–25) (14–21) (14–21) (14–20) (13–19) (13–19) (13–19) NUMBER (THOUSANDS) RATEa 24 23 23 22 21 21 21 1.9 0 5.9 8.4 9.2 7.8 3.9 60 49 40 33 27 26 25 16 16 16 16 16 16 16 21 23 32 17 9.9 13 9.9 2.2 1.3 1.3 5.1 2.5 0 1.6 40 40 40 40 40 40 40 0 7.5 0 8.1 1.8 1.8 5.3 251 215 184 158 135 131 127 0 6.3 0 84 71 60 51 46 48 46 17 17 5.6 0 4.2 0 0 8.3 7.7 6.5 5.5 4.6 4.8 4.6 9.2 7.3 14 1.2 8.3 4.1 12 54 33 22 18 16 16 16 54 48 43 38 34 34 33 INCIDENCE HIV-POSITIVE (15–35) (20–27) (18–27) (18–26) (18–25) (17–25) (17–25) (1.6–2.1) (0–0) (5.2–6.7) (7.3–9.5) (8.1–10) (6.9–8.9) (3.4–4.4) (39–85) (40–59) (33–49) (27–40) (23–32) (22–31) (21–30) (14–18) (14–18) (14–18) (14–18) (14–18) (14–18) (14–18) (18–23) (21–26) (28–36) (15–19) (8.7–11) (11–15) (8.7–11) (1.9–2.5) (1.1–1.5) (1.1–1.5) (4.4–5.7) (2.2–2.8) (0–0) (1.4–1.8) (28–54) (33–48) (33–48) (34–46) (33–48) (33–48) (33–48) (0–0) (6.6–8.5) (0–0) (7.1–9.1) (1.6–2.0) (1.5–2.0) (4.6–6.0) (166–354) (185–248) (151–221) (129–190) (111–161) (108–156) (105–151) (0–0) (5.5–7.2) (0–0) (53–121) (58–85) (49–72) (43–60) (38–55) (40–57) (38–55) (15–20) (15–20) (4.9–6.3) (0–0) (3.7–4.8) (0–0) (0–0) (7.3–9.4) (6.8–8.7) (5.7–7.3) (4.8–6.3) (4.0–5.2) (4.2–5.4) (4.0–5.2) (8.1–10) (6.4–8.2) (12–16) (1.1–1.4) (7.3–9.4) (3.6–4.6) (11–14) (47–61) (29–37) (20–25) (15–20) (14–18) (14–18) (14–18) (36–75) (39–58) (35–52) (31–46) (28–41) (28–40) (27–39) <0.01 <0.01 <0.01 <0.01 0.16 0.27 0.29 0.28 0.27 0.27 0.27 (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (0.11–0.23) (0.22–0.32) (0.24–0.35) (0.23–0.34) (0.23–0.32) (0.23–0.32) (0.22–0.32) RATEa 4.2 7.7 4.9 1.5 0.5 0.8 0.8 0.7 0.7 0.7 0.7 (1.6–7.9) (4.9–11) (2.6–7.9) (0.50–3.0) (0.33–0.71) (0.62–0.91) (0.64–0.95) (0.59–0.87) (0.56–0.80) (0.55–0.80) (0.55–0.78) 0.019 0.029 0.041 0.022 0.013 0.012 <0.01 <0.01 <0.01 <0.01 <0.01 <0.01 (0.017–0.021) (0.026–0.033) (0.036–0.047) (0.020–0.025) (0.012–0.015) (0.011–0.014) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) 7.4 10 14 6.8 3.7 3.3 2.3 0.1 0.2 0.3 1.6 1 (6.5–8.3) (9.1–12) (12–16) (5.9–7.7) (3.2–4.2) (2.9–3.7) (2.0–2.6) (0.12–0.15) (0.14–0.18) (0.24–0.31) (1.4–1.8) (0.83–1.1) <0.01 <0.01 0.011 0.018 0.022 0.025 0.026 0.026 (<0.01–<0.01) (<0.01–<0.01) (<0.01–0.013) (0.015–0.022) (0.019–0.026) (0.021–0.030) (0.021–0.031) (0.021–0.032) 0.5 2.8 5.3 7.5 8.2 8.2 8.1 8.1 (0.47–0.60) (1.9–3.8) (4.3–6.4) (6.2–9.1) (7.1–9.4) (6.7–9.8) (6.6–9.7) (6.6–9.7) 0.86 0.94 0.86 0.77 0.52 0.48 0.43 5.5 12 12 15 17 17 16 0.11 0.17 0.098 0.11 0.11 0.11 0.11 0.021 0.043 0.072 0.084 0.086 0.088 0.084 0.36 1.2 1.7 1.8 1.8 1.7 1.6 (0.57–1.2) (0.80–1.1) (0.71–1.0) (0.63–0.92) (0.43–0.62) (0.40–0.57) (0.36–0.52) 13 12 10 8.2 5.1 4.7 4.1 (8.4–18) (11–14) (8.3–12) (6.7–9.8) (4.2–6.1) (3.8–5.5) (3.4–4.9) (3.5–8.0) (9.9–15) (9.8–14) (12–18) (14–20) (14–20) (13–19) 3.7 7.5 6.9 8 8.5 8.6 8 (2.3–5.3) (6.1–9.0) (5.6–8.3) (6.7–9.4) (7.1–10) (7.1–10) (6.6–9.5) (0.095–0.12) (0.15–0.20) (0.086–0.11) (0.094–0.12) (0.095–0.12) (0.098–0.13) (0.096–0.12) (0.019–0.024) (0.038–0.049) (0.063–0.081) (0.074–0.095) (0.076–0.098) (0.077–0.099) (0.074–0.095) (0.24–0.50) (0.95–1.4) (1.4–2.0) (1.4–2.1) (1.5–2.1) (1.4–2.0) (1.3–1.9) 0.4 0.6 0.3 0.3 0.3 0.3 0.3 0.2 0.3 0.5 0.5 0.5 0.5 0.5 1.1 3.2 4.3 4.1 3.8 3.5 3.3 (0.34–0.44) (0.52–0.67) (0.28–0.36) (0.29–0.38) (0.28–0.36) (0.28–0.37) (0.28–0.36) (0.14–0.18) (0.26–0.34) (0.41–0.53) (0.45–0.58) (0.44–0.57) (0.44–0.57) (0.42–0.54) (0.73–1.5) (2.6–3.8) (3.5–5.1) (3.3–4.9) (3.1–4.6) (2.9–4.2) (2.7–4.0) NOTIFIED NEW AND RELAPSE NUMBER b RATEa GLOBAL TUBERCULOSIS REPORT 2013 PERCENT 0 2 0 20 0 88 (75–100) 1 0 0 1 0 4 6 7 6 3 12 309 13 450 11 767 10 576 7 336 9 733 8 758 7.3 0 0 1.6 0 5.2 7.3 8 6.8 3.4 38 39 32 27 18 24 21 34 (29–41) 0 0 87 (77–99) 87 87 87 87 87 63 79 79 82 67 91 84 (77–99) (77–99) (77–99) (77–99) (77–99) (44–97) (65–96) (66–96) (68–100) (56–80) (76–110) (71–100) 6 8 28 46 57 82 48 31 41 32 5 3 3 5.9 7.8 27 18 20 28 15 8.6 11 8.6 1.9 1.1 1.1 37 50 170 87 87 87 87 87 87 87 87 87 87 (33–43) (44–57) (150–200) (77–99) (77–99) (77–99) (77–99) (77–99) (77–99) (77–99) (77–99) (77–99) (77–99) 6 0 4 57 95 106 102 145 74 84 0 4 0 2.1 0 1.4 30 46 44 38 47 23 26 0 6.5 0 1 1 3 11 166 14 422 10 127 9 748 8 363 8 521 8 257 0 1 0 74 570 91 013 77 899 80 675 74 395 77 647 75 122 1.5 1.5 4.6 164 189 119 104 82 83 79 0 5.5 0 50 56 45 43 38 39 38 87 87 87 65 88 65 66 61 63 62 1 0 1 0 0 1 997 1 965 1 723 1 552 1 361 1 430 1 653 2 2 5 4.8 0 3.7 0 0 7.2 6.7 5.6 4.8 4 4.1 4.7 8 6.3 12 87 (77–99) 87 87 87 87 87 87 100 87 87 87 (77–99) (77–99) (77–99) (77–99) (77–99) (77–99) (91–120) (77–99) (77–99) (77–99) 4 2 6 6 151 4 150 3 021 2 505 2 376 2 450 2 394 12 447 9 912 11 630 10 360 11 420 11 884 11 424 7.2 3.5 10 47 29 20 15 14 14 14 37 27 29 24 25 25 24 87 87 87 87 87 87 87 87 87 87 70 56 68 62 71 75 73 (77–99) (77–99) (77–99) (77–99) (77–99) (77–99) (77–99) (77–99) (77–99) (77–99) (50–100) (47–69) (56–83) (52–76) (60–86) (63–91) (61–88) Rates are per 100 000 population. NOTIFIED NEW AND RELAPSE includes cases for which the treatment history is unknown. CASE DETECTION Data for all years can be downloaded from www.who.int/tb/data 87 (77–99) 87 76 110 110 94 120 59 65 (77–99) (56–110) (96–140) (93–140) (82–110) (98–140) (49–72) (54–79) 87 (77–99) (77–99) (77–99) (77–99) (46–99) (76–100) (54–79) (55–81) (51–74) (53–76) (52–75) 87 (77–99) 60 79 74 85 82 82 82 (41–94) (66–97) (62–91) (72–100) (69–99) (69–99) (69–99) 87 (77–99) 7$%/($,QFLGHQFHQRWLILFDWLRQDQGFDVHGHWHFWLRQUDWHVDOOIRUPV ± YEAR Costa Rica Cuba Curaçao Dominica Dominican Republic Ecuador El Salvador Grenada Guatemala Guyana Haiti Honduras Jamaica Mexico Montserrat Netherlands Antilles Nicaragua a b 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 1990 1995 2000 2005 2010 2011 2012 3 3 4 4 5 5 5 11 11 11 11 11 11 11 <1 <1 <1 <1 <1 <1 <1 <1 <1 <1 7 8 9 9 10 10 10 10 11 13 14 15 15 15 5 6 6 6 6 6 6 <1 <1 <1 <1 <1 <1 <1 9 10 11 13 14 15 15 <1 <1 <1 <1 <1 <1 <1 7 8 9 9 10 10 10 5 6 6 7 8 8 8 2 2 3 3 3 3 3 86 95 104 111 118 119 121 <1 <1 <1 <1 <1 <1 <1 <1 <1 <1 <1 4 5 5 5 6 6 6 NUMBER (THOUSANDS) 1.5 1.5 1.4 1 0.65 0.59 0.51 2.6 2 1.4 1 1 1 1 <0.01 <0.01 <0.01 0.01 0.01 <0.01 <0.01 <0.01 <0.01 <0.01 11 9.7 8.6 7.7 6.7 6.6 6.4 18 15 13 11 9.7 9.4 9.1 3.4 2.6 2.2 2.4 1.8 1.7 1.6 <0.01 <0.01 <0.01 <0.01 <0.01 <0.01 <0.01 6.6 7.1 7.6 8.2 8.8 9 9.1 0.65 0.65 0.78 0.88 0.87 0.87 0.87 18 19 23 25 23 22 22 5.6 6.4 7.1 5 4.1 4.2 4.3 0.15 0.16 0.17 0.18 0.18 0.18 0.18 57 44 32 25 26 27 27 <0.01 <0.01 0 <0.01 0 0 0 <0.01 0.01 <0.01 <0.01 4.5 4 3.4 2.9 2.5 2.4 2.3 (1.3–1.7) (1.3–1.7) (1.2–1.5) (0.880–1.1) (0.570–0.740) (0.510–0.660) (0.440–0.580) (1.6–3.9) (1.7–2.5) (1.1–1.8) (0.850–1.3) (0.840–1.3) (0.830–1.3) (0.840–1.3) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–0.015) (<0.01–0.012) (<0.01–0.012) (<0.01–0.011) (<0.01–0.011) (<0.01–0.011) (<0.01–0.011) (6.6–16) (7.9–12) (7.1–10) (6.3–9.2) (5.6–8.0) (5.4–7.8) (5.3–7.6) (11–26) (13–19) (11–16) (9.4–14) (8.0–12) (7.8–11) (7.5–11) (2.3–4.7) (2.3–2.9) (1.8–2.6) (1.9–2.9) (1.5–2.0) (1.4–1.9) (1.4–1.8) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (4.1–9.7) (5.8–8.5) (6.2–9.1) (6.7–9.9) (7.3–11) (7.4–11) (7.5–11) (0.400–0.960) (0.530–0.780) (0.630–0.930) (0.720–1.1) (0.720–1.0) (0.720–1.0) (0.710–1.0) (11–26) (16–23) (19–28) (21–30) (19–27) (18–27) (18–26) (3.6–7.9) (4.1–9.2) (4.6–10) (3.2–7.2) (2.7–5.9) (2.7–6.0) (2.8–6.1) (0.110–0.210) (0.130–0.190) (0.140–0.200) (0.140–0.210) (0.150–0.210) (0.150–0.220) (0.150–0.220) (49–66) (38–51) (27–37) (21–28) (23–30) (23–31) (23–32) (<0.01–<0.01) (<0.01–<0.01) (0–0) (<0.01–<0.01) (0–0) (0–0) (0–0) (<0.01–0.011) (<0.01–0.012) (<0.01–<0.01) (<0.01–<0.01) (2.9–6.3) (3.2–4.8) (2.8–4.1) (2.4–3.5) (2.1–2.8) (2.0–2.7) (2.0–2.7) a RATE 48 43 35 23 14 12 11 25 19 13 9.2 9.3 9.3 9.3 3.9 0.76 0.74 15 14 14 13 13 13 13 148 121 100 82 67 65 62 174 136 107 83 65 62 59 63 45 37 39 28 27 25 4.6 4.5 4.4 4.2 4.1 4.1 4.1 74 71 68 65 62 61 60 89 89 104 115 111 110 109 247 247 271 272 230 222 213 113 115 114 73 54 54 54 6.5 6.5 6.5 6.5 6.6 6.6 6.6 67 46 31 22 22 23 23 11 4.1 0 24 0 0 0 5.3 5.3 3.2 4.7 108 85 68 53 42 40 38 (42–54) (37–48) (31–39) (20–26) (12–16) (11–14) (9.3–12) (15–37) (15–23) (10–16) (7.5–11) (7.4–11) (7.4–11) (7.4–11) (3.4–4.4) (0.67–0.86) (0.65–0.84) (9.3–21) (12–17) (11–17) (11–16) (11–16) (11–16) (11–15) (91–218) (99–146) (82–120) (67–98) (55–80) (53–77) (51–74) (108–257) (111–164) (87–128) (68–100) (54–77) (51–74) (48–70) (43–88) (39–50) (30–44) (32–47) (24–33) (23–31) (22–29) (2.9–6.8) (3.8–5.2) (3.6–5.2) (3.5–5.1) (3.4–4.9) (3.4–4.9) (3.4–4.9) (47–109) (58–85) (55–81) (53–78) (51–73) (50–73) (50–72) (55–132) (73–107) (85–125) (94–138) (91–132) (91–131) (90–130) (153–365) (202–297) (221–325) (222–326) (190–275) (183–265) (176–254) (73–162) (74–164) (74–163) (47–104) (35–77) (35–77) (35–77) (4.7–8.8) (5.4–7.9) (5.4–7.9) (5.4–7.9) (5.4–7.8) (5.4–7.8) (5.4–7.8) (57–77) (40–53) (26–36) (19–26) (19–26) (19–26) (19–26) (9.4–12) (3.6–4.7) (0–0) (21–27) (0–0) (0–0) (0–0) (4.6–6.0) (4.6–6.0) (2.8–3.7) (4.1–5.3) (71–152) (70–102) (55–81) (44–64) (36–49) (35–46) (33–44) INCIDENCE HIV-POSITIVE NUMBER (THOUSANDS) 0.031 0.066 0.092 0.074 0.074 0.071 0.064 0.023 0.028 0.033 0.023 0.035 0.037 0.037 0.25 0.81 1.1 0.98 0.64 0.59 0.54 0.71 0.96 1.2 1.2 0.97 0.92 0.84 0.082 0.16 0.23 0.27 0.19 0.18 0.2 (0.027–0.035) (0.058–0.075) (0.080–0.10) (0.065–0.084) (0.065–0.084) (0.062–0.080) (0.056–0.072) (0.014–0.034) (0.023–0.034) (0.026–0.040) (0.019–0.028) (0.028–0.043) (0.030–0.045) (0.030–0.046) (0.15–0.37) (0.66–0.98) (0.90–1.3) (0.80–1.2) (0.53–0.76) (0.49–0.71) (0.44–0.64) (0.44–1.0) (0.78–1.2) (0.96–1.4) (0.99–1.5) (0.80–1.2) (0.76–1.1) (0.70–1.0) (0.055–0.11) (0.14–0.18) (0.19–0.28) (0.22–0.32) (0.16–0.21) (0.15–0.20) (0.17–0.23) <0.01 (<0.01–<0.01) <0.01 0.14 0.38 0.78 0.99 1.3 1.4 1.5 0.05 0.12 0.24 0.27 0.22 0.22 0.2 3.2 5.6 6.8 6.5 4.6 4.5 4.3 0.24 0.77 0.84 0.37 0.19 0.18 0.17 0.01 0.033 0.052 0.053 0.042 0.041 0.04 2.6 2.6 2 1.5 1.5 1.6 1.6 0.015 0.02 0.027 0.034 0.042 0.044 0.047 (0–<0.01) (0.086–0.20) (0.31–0.46) (0.63–0.93) (0.81–1.2) (1.1–1.5) (1.1–1.7) (1.2–1.8) (0.031–0.074) (0.098–0.14) (0.20–0.29) (0.22–0.33) (0.18–0.27) (0.18–0.26) (0.16–0.23) (2.0–4.8) (4.6–6.8) (5.6–8.2) (5.3–7.9) (3.8–5.5) (3.7–5.4) (3.5–5.1) (0.16–0.35) (0.49–1.1) (0.52–1.2) (0.23–0.54) (0.12–0.28) (0.11–0.26) (0.10–0.25) (<0.01–0.013) (0.027–0.040) (0.042–0.062) (0.043–0.064) (0.034–0.050) (0.034–0.049) (0.033–0.048) (2.2–3.0) (2.2–3.0) (1.7–2.3) (1.3–1.7) (1.3–1.7) (1.3–1.8) (1.4–1.8) (<0.01–0.025) (0.011–0.031) (0.015–0.041) (0.020–0.053) (0.025–0.062) (0.027–0.066) (0.028–0.070) NOTIFIED NEW AND RELAPSE a RATE 1 1.9 2.3 1.7 1.6 1.5 1.3 0.2 0.3 0.3 0.2 0.3 0.3 0.3 3.5 10 13 11 6.4 5.8 5.2 7 8.5 9.4 8.8 6.5 6 5.4 1.5 2.7 3.9 4.4 3 2.8 3.2 (0.87–1.1) (1.7–2.2) (2.0–2.7) (1.5–1.9) (1.4–1.8) (1.3–1.7) (1.2–1.5) (0.13–0.32) (0.21–0.31) (0.23–0.36) (0.16–0.24) (0.25–0.38) (0.26–0.40) (0.26–0.41) (2.1–5.1) (8.3–12) (10–15) (8.6–13) (5.2–7.6) (4.8–7.0) (4.3–6.3) (4.3–10) (6.9–10) (7.7–11) (7.2–11) (5.3–7.7) (5.0–7.2) (4.5–6.5) (1.0–2.1) (2.4–3.1) (3.2–4.7) (3.6–5.2) (2.5–3.4) (2.4–3.2) (2.7–3.7) 1 (<0.1–3.2) 0.5 1.5 3.8 6.9 7.8 9 9.5 10 6.9 16 33 36 28 27 25 45 72 79 71 47 45 42 4.9 14 14 5.4 2.5 2.3 2.1 0.4 1.4 2 2 1.5 1.5 1.5 3 2.7 1.9 1.3 1.3 1.3 1.3 0.4 0.4 0.5 0.6 0.7 0.8 0.8 (0–3.0) (0.97–2.3) (3.1–4.6) (5.7–8.3) (6.4–9.4) (7.4–11) (7.8–11) (8.2–12) (4.3–10) (13–20) (27–39) (29–43) (23–34) (22–33) (20–29) (28–67) (59–87) (65–95) (58–85) (39–56) (37–54) (35–50) (3.2–7.1) (8.7–20) (8.4–20) (3.3–7.9) (1.5–3.7) (1.4–3.4) (1.3–3.2) (0.30–0.57) (1.1–1.6) (1.6–2.4) (1.6–2.4) (1.3–1.8) (1.2–1.8) (1.2–1.7) (2.6–3.5) (2.3–3.1) (1.6–2.2) (1.1–1.5) (1.1–1.5) (1.1–1.5) (1.1–1.5) (0.18–0.61) (0.24–0.66) (0.30–0.81) (0.36–0.97) (0.43–1.1) (0.45–1.1) (0.47–1.2) a b CASE DETECTION NUMBER RATE PERCENT 230 586 585 534 492 514 475 546 1 553 1 183 772 827 805 734 5 1 1 6 8 7.5 17 15 12 11 11 9.9 5.2 14 11 6.8 7.3 7.1 6.5 3.4 0.66 0.64 8.5 11 16 40 43 53 75 88 93 21 76 82 74 79 77 70 87 87 87 57 78 (14–18) (35–45) (38–49) (47–61) (67–86) (78–100) (82–110) (14–34) (63–94) (67–100) (61–91) (65–99) (63–97) (57–88) (77–99) (77–99) (77–99) (40–91) (66–95) 8 2 7 2 597 4 053 5 291 5 003 3 964 4 309 4 262 8 243 7 893 6 908 4 416 4 832 5 106 5 456 2 367 2 422 1 485 1 794 1 700 1 896 2 053 0 4 0 11 2.8 9.8 36 51 61 54 40 42 41 81 70 55 32 32 33 35 44 42 25 30 27 30 33 0 4 0 86 22 75 24 42 61 65 59 66 67 47 51 52 38 50 54 60 70 95 68 75 96 110 130 0 89 0 (72–100) (18–26) (63–92) (16–39) (35–51) (51–75) (54–80) (49–71) (55–80) (56–81) (32–76) (43–63) (43–63) (32–47) (42–60) (45–66) (50–73) (50–100) (84–110) (56–83) (63–92) (83–110) (98–130) (110–150) 4 2 1 3 813 3 119 2 913 3 803 3 322 3 040 3 442 168 296 422 639 712 710 748 3.8 1.9 0.95 43 31 26 30 23 21 23 23 41 57 84 91 90 94 93 46 23 58 44 38 46 38 34 38 26 45 54 73 82 82 86 (78–110) (39–56) (19–28) (39–92) (37–54) (32–47) (39–57) (32–46) (28–41) (32–46) (18–42) (38–56) (45–67) (61–89) (68–99) (68–99) (72–100) 6 212 10 420 14 311 14 222 14 315 16 568 3 647 4 984 6 406 3 333 2 876 3 233 3 014 123 109 127 90 130 105 91 14 437 11 329 18 434 18 524 20 155 19 857 20 470 1 79 121 155 144 143 163 74 89 103 48 38 42 38 5.2 4.4 4.9 3.4 4.7 3.8 3.3 17 12 18 17 17 17 17 9.3 32 45 57 62 64 76 66 78 90 66 70 77 70 79 68 75 51 72 58 50 25 26 58 75 77 73 75 87 (27–39) (37–55) (47–70) (52–76) (54–78) (64–93) (46–100) (54–120) (63–140) (46–100) (49–110) (54–120) (49–110) (59–110) (56–83) (63–92) (43–63) (61–88) (49–70) (42–61) (22–29) (22–30) (50–67) (66–87) (66–89) (63–86) (64–87) (77–99) 0 1 0 0 0 0 21 0 0 0 5 2.8 2 944 2 842 2 402 1 907 2 448 2 693 2 790 71 61 47 35 42 46 47 REGION OF THE AMERICAS INCIDENCE (INCLUDING HIV) POPULATION (MILLIONS) (77–100) 87 (77–99) 87 (77–99) 66 72 70 65 100 110 120 (47–100) (60–88) (58–85) (54–80) (86–120) (98–130) (110–140) Rates are per 100 000 population. NOTIFIED NEW AND RELAPSE includes cases for which the treatment history is unknown. Data for all years can be downloaded from www.who.int/tb/data GLOBAL TUBERCULOSIS REPORT 2013 7$%/($,QFLGHQFHQRWLILFDWLRQDQGFDVHGHWHFWLRQUDWHVDOOIRUPV ± INCIDENCE (INCLUDING HIV) YEAR Panama Paraguay Peru Puerto Rico Saint Kitts and Nevis Saint Lucia Saint Vincent and the Grenadines Sint Maarten (Dutch part) Suriname Trinidad and Tobago Turks and Caicos Islands United States of America Uruguay US Virgin Islands Venezuela (Bolivarian Republic of) a b POPULATION (MILLIONS) NUMBER (THOUSANDS) INCIDENCE HIV-POSITIVE NUMBER (THOUSANDS) RATEa 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2 3 3 3 4 4 4 4 5 5 6 6 7 7 22 24 26 28 29 30 30 4 4 4 4 4 4 4 <1 <1 <1 <1 <1 <1 <1 <1 <1 <1 <1 <1 <1 <1 <1 <1 <1 <1 1.2 1.3 1.4 1.6 1.8 1.8 1.8 2.8 2.5 2.6 2.9 3 3 3 69 58 48 39 31 30 29 0.18 0.3 0.2 0.13 0.092 0.058 0.082 0 <0.01 0 0 <0.01 <0.01 <0.01 0.021 0.027 0.018 0.018 0.012 <0.01 <0.01 0.029 0.029 0.028 0.027 (0.810–1.6) (1.1–1.6) (1.2–1.7) (1.3–1.9) (1.5–2.0) (1.6–2.0) (1.6–2.0) (2.6–3.0) (2.3–2.7) (2.4–2.8) (2.7–3.1) (2.7–3.2) (2.8–3.2) (2.8–3.2) (43–100) (47–70) (39–57) (33–46) (27–35) (26–34) (25–32) (0.160–0.210) (0.260–0.340) (0.180–0.230) (0.110–0.150) (0.081–0.100) (0.050–0.065) (0.072–0.092) (0–0) (<0.01–<0.01) (0–0) (0–0) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (0.019–0.024) (0.023–0.030) (0.016–0.021) (0.016–0.020) (0.011–0.014) (<0.01–0.010) (<0.01–<0.01) (0.018–0.043) (0.023–0.035) (0.023–0.033) (0.022–0.033) 47 47 47 47 48 48 48 66 52 49 49 46 45 45 317 242 184 140 106 101 95 5.2 8.2 5.3 3.5 2.5 1.6 2.2 0 13 0 0 4.4 2.2 4.3 15 18 12 11 6.9 5.1 3.3 27 27 26 25 (33–65) (39–57) (39–56) (39–57) (42–54) (42–54) (42–54) (61–72) (48–56) (45–53) (45–53) (42–50) (42–49) (41–48) (196–468) (198–290) (151–221) (118–164) (93–120) (88–114) (83–108) (4.6–5.9) (7.2–9.2) (4.6–6.0) (3.0–3.9) (2.2–2.8) (1.4–1.8) (1.9–2.5) (0–0) (12–15) (0–0) (0–0) (3.8–5.0) (1.9–2.5) (3.8–4.9) (13–17) (16–21) (10–13) (9.5–12) (6.1–7.8) (4.5–5.8) (2.9–3.7) (17–40) (22–32) (21–31) (20–30) 2010 2011 2012 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 <1 <1 <1 <1 <1 <1 <1 <1 <1 <1 <1 <1 <1 1 1 1 1 1 1 1 <1 <1 <1 <1 <1 <1 <1 255 268 285 298 312 315 318 3 3 3 3 3 3 3 <1 <1 <1 <1 <1 <1 <1 20 22 24 27 29 30 30 0.027 0.026 0.026 <0.01 <0.01 <0.01 0.26 0.4 0.4 0.31 0.24 0.23 0.22 0.14 0.19 0.23 0.19 0.25 0.26 0.32 0 <0.01 0.012 <0.01 <0.01 0.01 <0.01 30 26 19 16 13 12 11 1 0.72 0.74 0.72 0.8 0.94 0.93 <0.01 <0.01 <0.01 <0.01 <0.01 <0.01 <0.01 7 7.7 8.4 9 9.7 9.8 9.9 (0.022–0.032) (0.022–0.032) (0.022–0.031) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (0.170–0.360) (0.260–0.570) (0.260–0.580) (0.200–0.450) (0.160–0.340) (0.170–0.310) (0.160–0.290) (0.120–0.160) (0.170–0.220) (0.200–0.260) (0.170–0.220) (0.220–0.290) (0.230–0.290) (0.280–0.360) (0–0) (<0.01–<0.01) (0.010–0.014) (<0.01–<0.01) (<0.01–<0.01) (<0.01–0.012) (<0.01–0.010) (26–33) (23–30) (16–21) (14–18) (11–15) (11–14) (10–13) (0.890–1.2) (0.630–0.810) (0.650–0.840) (0.630–0.810) (0.700–0.910) (0.820–1.1) (0.810–1.1) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (4.9–9.4) (6.3–9.2) (6.8–10) (7.4–11) (8.0–12) (8.1–12) (8.2–12) 24 24 24 8.1 5.3 2.6 63 92 86 63 46 44 41 11 15 18 15 19 19 24 0 36 63 29 22 33 28 12 9.8 6.6 5.4 4.1 3.8 3.6 33 22 22 22 24 28 27 4.5 4.3 7.7 7.7 7.7 7.7 7.7 35 35 34 34 33 33 33 (20–29) (20–29) (20–29) (7.1–9.2) (4.6–6.0) (2.3–2.9) (41–90) (59–131) (56–124) (41–90) (31–65) (32–58) (30–55) (9.9–13) (13–17) (16–20) (13–17) (17–21) (17–22) (21–27) (0–0) (32–41) (55–72) (26–33) (20–25) (29–37) (25–32) (10–13) (8.5–11) (5.8–7.5) (4.8–6.1) (3.6–4.7) (3.4–4.3) (3.2–4.1) (29–37) (20–25) (20–25) (19–24) (21–27) (24–31) (24–31) (3.9–5.0) (3.8–4.9) (6.8–8.7) (6.8–8.7) (6.8–8.7) (6.8–8.7) (6.8–8.7) (25–47) (28–42) (28–41) (28–41) (27–40) (27–40) (27–39) RATEa 0.072 0.21 0.29 0.3 0.25 0.24 0.23 0.05 0.1 0.15 0.2 0.2 0.22 0.24 0.58 1.2 1.3 0.89 0.53 0.5 0.49 (0.050–0.099) (0.17–0.25) (0.24–0.34) (0.24–0.36) (0.22–0.28) (0.21–0.27) (0.20–0.26) (0.046–0.055) (0.093–0.11) (0.13–0.16) (0.18–0.21) (0.19–0.22) (0.20–0.24) (0.22–0.26) (0.36–0.86) (0.98–1.4) (1.0–1.5) (0.75–1.0) (0.46–0.60) (0.44–0.57) (0.43–0.55) 2.9 7.5 9.5 8.8 6.7 6.5 6.1 1.2 2.1 2.7 3.3 3.2 3.4 3.5 2.7 5 4.9 3.2 1.8 1.7 1.6 (2.0–4.0) (6.1–9.0) (7.9–11) (7.2–11) (5.9–7.6) (5.7–7.3) (5.3–6.8) (1.1–1.3) (1.9–2.3) (2.5–2.9) (3.1–3.6) (2.9–3.4) (3.1–3.6) (3.3–3.8) (1.6–3.9) (4.1–6.0) (4.0–5.8) (2.7–3.8) (1.6–2.0) (1.5–1.9) (1.4–1.8) 0.039 0.017 0.012 0.013 (0.027–0.054) (<0.01–0.027) (<0.01–0.020) (<0.01–0.024) 1 0.5 0.3 0.4 (0.72–1.4) (0.25–0.72) (0.15–0.53) (0.14–0.65) <0.01 (<0.01–<0.01) <0.01 (<0.01–<0.01) 0.7 (<0.1–2.7) 0.4 (0–1.7) <0.01 (<0.01–0.015) 3.6 (<0.1–13) <0.01 (<0.01–0.017) <0.01 (<0.01–0.016) <0.01 (<0.01–0.017) 7.3 (2.0–16) 7.6 (2.9–14) 8.7 (3.9–15) 0.023 0.12 0.16 0.1 0.06 0.053 0.047 <0.01 0.018 0.049 0.048 0.07 0.069 0.083 5.7 28 34 21 12 10 8.7 0.2 1.5 3.9 3.7 5.2 5.1 6.2 (0.015–0.033) (0.077–0.17) (0.10–0.22) (0.066–0.15) (0.040–0.085) (0.038–0.071) (0.033–0.062) (<0.01–<0.01) (0.016–0.021) (0.043–0.055) (0.042–0.054) (0.061–0.079) (0.060–0.078) (0.073–0.094) (3.7–8.2) (18–39) (22–48) (13–29) (7.7–16) (7.2–13) (6.2–12) (0.16–0.21) (1.3–1.7) (3.4–4.4) (3.2–4.2) (4.6–5.9) (4.5–5.8) (5.5–7.0) <0.01 (<0.01–<0.01) 4.5 (0.21–15) 1.6 2.2 1.2 1.3 1.2 1.1 1.1 0.013 0.022 0.067 0.11 0.13 0.15 0.14 (1.4–1.8) (1.9–2.5) (1.1–1.4) (1.2–1.5) (1.0–1.4) (1.0–1.3) (0.96–1.2) (0.011–0.014) (0.019–0.025) (0.059–0.076) (0.093–0.12) (0.11–0.14) (0.13–0.17) (0.12–0.16) 0.6 0.8 0.4 0.5 0.4 0.4 0.4 0.4 0.7 2 3.2 3.8 4.4 4.2 (0.54–0.69) (0.71–0.91) (0.38–0.49) (0.39–0.50) (0.34–0.43) (0.32–0.41) (0.30–0.39) (0.35–0.46) (0.60–0.78) (1.8–2.3) (2.8–3.6) (3.3–4.3) (3.9–5.0) (3.7–4.8) (0.17–0.33) (0.30–0.56) (0.44–0.78) (0.56–0.98) (0.72–1.1) (1.0–1.5) (0.94–1.4) 1.2 1.9 2.4 2.8 3.1 4.3 3.9 (0.88–1.7) (1.4–2.5) (1.8–3.2) (2.1–3.7) (2.5–3.7) (3.5–5.2) (3.1–4.7) 0.24 0.42 0.59 0.76 0.89 1.3 1.2 NOTIFIED NEW AND RELAPSE b CASE DETECTION NUMBER RATEa 846 1 300 1 169 1 637 1 496 1 571 1 520 2 167 1 745 1 950 2 075 2 352 2 372 2 416 37 905 45 310 38 661 33 747 31 073 31 241 29 760 159 262 174 113 80 50 71 0 5 0 0 2 1 2 13 11 9 14 9 7 11 2 13 16 7 34 47 38 49 41 42 40 51 36 36 35 36 36 36 174 189 149 122 106 105 99 4.5 7.1 4.6 3 2.2 1.4 1.9 0 12 0 0 3.8 1.9 3.7 9.4 7.5 5.7 8.5 5.1 3.9 6.1 1.9 12 15 6.4 72 99 81 100 85 88 84 77 70 74 71 79 79 81 55 78 81 87 100 100 100 87 87 87 87 87 87 87 87 87 87 61 41 49 78 73 76 180 6.8 45 57 26 (77–99) (77–99) (77–99) (54–70) (36–47) (43–56) (69–89) (65–84) (67–87) (160–210) (4.6–11) (38–55) (48–70) (21–31) 15 17 30 3 2 1 82 14 16 27 7.1 4.6 2.3 20 56 64 110 87 87 87 32 (47–68) (54–78) (96–140) (77–99) (77–99) (77–99) (22–50) 89 117 194 125 128 120 166 198 166 219 224 274 0 19 23 37 24 24 9.8 13 16 13 16 17 20 0 22 37 79 54 58 87 87 87 87 87 87 87 (15–34) (26–58) (57–120) (41–74) (44–80) (77–99) (77–99) (77–99) (77–99) (77–99) (77–99) (77–99) 6 9 8 25 701 22 728 16 310 14 080 11 181 10 521 9 945 886 625 645 622 699 817 808 4 4 19 28 25 10 8.5 5.7 4.7 3.6 3.3 3.1 28 19 19 19 21 24 24 3.9 3.7 87 87 87 87 87 87 87 87 87 87 87 87 87 87 87 87 87 87 87 (77–99) (77–99) (77–99) (77–99) (77–99) (77–99) (77–99) (77–99) (77–99) (77–99) (77–99) (77–99) (77–99) (77–99) (77–99) (77–99) (77–99) (77–99) (77–99) 5 457 5 578 6 466 6 847 6 451 6 282 6 495 28 25 26 26 22 21 22 78 73 77 76 67 64 65 (58–110) (60–89) (64–95) (63–93) (56–81) (54–78) (55–79) Rates are per 100 000 population. NOTIFIED NEW AND RELAPSE includes cases for which the treatment history is unknown. GLOBAL TUBERCULOSIS REPORT 2013 Data for all years can be downloaded from www.who.int/tb/data PERCENT (52–100) (83–120) (68–97) (85–130) (76–97) (78–100) (75–95) (71–84) (65–75) (69–81) (66–77) (73–86) (73–86) (75–88) (37–89) (65–96) (67–98) (74–100) (88–110) (93–120) (92–120) (77–99) (77–99) (77–99) (77–99) (77–99) (77–99) (77–99) 87 (77–99) 7$%/($&DVHQRWLILFDWLRQV ± a YEAR Anguilla •0 0• Antigua and Barbuda •2 3• Argentina • 38 21 • •0 27 • Aruba Bahamas • 18 9• Barbados •2 1• Belize • 30 26 • Bermuda •0 5• Bolivia (Plurinational State of) • 164 79 • Bonaire, Saint Eustatius and Saba Brazil • 50 38 • British Virgin Islands •0 0• Canada •7 5• Cayman Islands •8 10 • Chile • 47 14 • Colombia • 37 24 • 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 NEW AND b RELAPSE 0 2 1 0 0 1 0 4 6 7 6 3 12 309 13 450 11 767 10 576 7 336 9 733 8 758 NEW CASES % SMEARRE-TREAT EXCL. TOTAL SMEAR- SMEAR-NEGATIVE/ EXTRAHISTORY POS AMONG OTHER RELAPSE NEW PULM POSITIVE UNKNOWN PULMONARY RELAPSE RETREAT UNKNOWN 0 2 0 0 0 0 1 0 0 0 0 0 3 6 6 6 1 1 0 0 0 1 5 698 4 749 4 709 3 973 5 150 4 661 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 1 0 0 0 2 1 3 067 1 773 1 561 854 1 426 1 291 0 159 138 143 104 143 290 314 322 1 724 666 426 758 848 1 828 809 716 1 072 1 170 2 0 20 1 1 0 1 1 2 0 38 56 30 19 23 21 11 23 8 3 12 11 8 4 7 7 5 0 1 1 0 0 1 0 2 1 1 0 0 2 1 1 0 1 0 4 2 2 0 0 0 0 0 3 3 0 0 0 0 0 6 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 36 44 59 97 64 36 34 55 29 47 0 36 1 1 3 0 0 5 0 0 0 0 4 6 11 1 10 7 0 4 0 2 0 4 6 15 1 12 7 0 0 0 0 2 0 2 0 0 0 0 0 1 0 1 0 1 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 7 010 6 458 6 278 5 613 5 746 5 568 0 0 0 1 408 1 565 1 250 630 643 571 0 0 0 1 133 1 288 1 673 1 694 1 721 1 672 0 0 0 63 451 547 408 411 446 1 630 225 257 226 227 63 2 081 772 665 637 673 1 0 0 0 1 0 45 650 41 186 42 093 37 932 40 294 40 152 29 291 23 622 23 990 23 030 20 961 20 770 13 814 10 457 11 037 10 017 10 067 10 297 18 15 11 2 634 3 089 3 398 3 555 3 867 8 700 6 548 7 551 6 490 7 633 11 334 9 637 10 949 10 045 11 500 466 0 2 755 25 1 0 1 0 0 1 997 1 965 1 723 1 552 1 361 1 430 1 653 2 2 5 1 0 1 0 0 549 436 492 433 358 407 478 0 0 0 0 516 656 528 446 472 456 574 0 0 0 0 723 634 482 562 444 469 519 0 0 0 0 0 0 20 4 0 0 0 0 0 0 0 180 195 145 39 48 59 58 0 0 0 0 64 24 22 33 0 0 0 0 180 195 145 103 72 81 91 0 0 0 0 29 44 56 68 39 39 24 0 5 2 0 1 0 0 0 0 0 0 4 2 6 6 151 4 150 3 021 2 505 2 376 2 450 2 394 12 447 9 912 11 630 10 360 11 420 11 884 11 424 2 1 5 2 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 561 1 290 1 186 1 154 1 196 1 173 1 284 879 502 502 473 538 1 017 694 631 553 594 518 0 0 0 225 158 186 167 187 165 128 96 85 66 225 158 314 263 272 231 0 0 0 7 530 8 358 6 870 7 028 6 807 6 523 1 380 1 446 1 429 1 696 2 355 2 279 1 002 1 487 1 618 1 985 2 275 2 264 311 0 0 339 443 400 447 358 469 554 405 339 443 869 1 001 763 0 0 0 6 8 28 46 57 82 48 31 41 32 5 3 3 6 0 4 57 95 106 102 145 74 84 0 4 0 1 1 3 11 166 14 422 10 127 9 748 8 363 8 521 8 257 0 1 0 74 570 91 013 77 899 80 675 74 395 77 647 75 122 0 0 0 0 0 0 0 0 0 0 1 4 668 4 110 3 357 2 011 2 705 2 341 4 7 6 0 a Rates are per 100 000 population. b NEW AND RELAPSE includes cases for which the treatment history is unknown. 0 0 0 0 0 Data for all years can be downloaded from www.who.int/tb/data 0 0 0 0 1 0 806 49 0 0 0 18 0 – 0 – – 0 – – 75 100 100 100 50 – 55 54 58 66 66 67 – – – – 67 100 23 – 78 71 79 86 66 66 – 100 100 – 100 REGION OF THE AMERICAS NEW AND RELAPSE NOTIFICATION RATE 1990–2012 100 – 51 44 67 67 100 50 – 50 – 100 0 50 – 83 80 83 90 90 91 0 0 – 61 64 64 62 66 66 – – 100 100 52 40 48 49 43 47 45 – 0 100 – 50 50 83 – 55 59 70 70 72 69 – 85 85 83 81 74 74 GLOBAL TUBERCULOSIS REPORT 2013 7$%/($&DVHQRWLILFDWLRQV ± NEW AND RELAPSE NOTIFICATION RATEa 1990–2012 YEAR Costa Rica •7 10 • Cuba •5 7• Curaçao Dominica •8 10 • Dominican Republic • 36 41 • Ecuador • 81 35 • El Salvador • 44 33 • Grenada •0 1• Guatemala • 43 23 • Guyana • 23 94 • Haiti •0 163 • Honduras • 74 38 • Jamaica •5 3• Mexico • 17 17 • Montserrat •9 0• Netherlands Antilles •0 190 0• 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 NEW AND b RELAPSE NEW CASES % SMEARRE-TREAT EXCL. TOTAL SMEAR- SMEAR-NEGATIVE/ EXTRAHISTORY POS AMONG OTHER RELAPSE NEW PULM POSITIVE UNKNOWN PULMONARY RELAPSE RETREAT UNKNOWN 230 586 585 534 492 514 475 546 1 553 1 183 772 827 805 734 5 1 1 6 8 245 349 330 267 285 257 71 184 81 89 128 99 31 98 104 108 85 102 834 675 467 462 437 374 5 0 1 520 257 160 212 219 200 0 1 0 199 201 103 98 86 112 0 0 0 1 0 0 10 6 2 0 0 0 5 8 2 7 2 597 4 053 5 291 5 003 3 964 4 309 4 262 8 243 7 893 6 908 4 416 4 832 5 106 5 456 2 367 2 422 1 485 1 794 1 700 1 896 2 053 0 4 0 0 35 19 25 16 17 26 7 10 5 0 35 45 32 26 22 2 0 0 54 50 40 45 57 46 122 9 11 16 14 54 172 49 56 73 60 2 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 1 0 1 1 0 1 2 0 0 0 244 540 602 578 655 544 100 49 44 204 610 420 324 342 374 309 196 163 178 204 610 729 520 505 552 0 0 0 2 237 1 338 635 404 380 285 420 400 330 655 808 856 0 0 111 106 403 400 397 348 280 392 263 244 315 386 795 663 641 663 1 008 1 059 972 1 079 1 237 2 241 278 402 338 371 313 181 108 255 328 384 415 0 0 0 91 78 62 62 88 180 36 30 21 10 271 114 92 83 98 2 0 0 0 0 0 0 4 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 368 2 052 2 420 2 121 1 961 2 212 546 518 588 265 309 382 205 202 256 348 243 311 436 415 393 249 141 101 152 112 144 58 29 48 57 249 141 159 181 160 201 85 119 240 325 323 309 187 231 352 274 282 339 22 34 33 75 78 77 6 0 0 0 2 38 8 38 27 23 46 17 124 206 221 2 84 25 162 233 244 5 887 7 340 8 242 8 011 9 254 2 930 5 292 4 335 4 553 4 956 1 367 1 484 1 307 1 374 1 914 0 0 0 236 195 338 377 444 110 33 43 46 155 346 228 381 423 599 2 306 3 404 2 069 1 842 2 060 1 945 2 214 2 396 721 482 616 509 232 370 362 382 377 362 0 0 0 100 236 181 170 180 198 25 10 32 100 236 181 195 190 230 93 90 53 76 35 46 14 20 31 46 39 33 2 4 6 6 6 9 0 0 24 0 2 13 0 2 1 3 5 17 3 3 2 13 5 19 4 6 0 0 0 0 9 220 11 676 11 997 12 572 12 960 13 038 1 807 1 675 421 2 812 2 497 2 681 302 2 081 2 657 3 464 3 529 3 839 2 831 0 0 139 421 618 722 871 773 914 1 408 544 671 878 1 335 2 026 1 266 1 542 1 651 585 0 0 0 1 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 2 3 0 0 0 0 0 0 4 2 1 3 813 3 119 2 913 3 803 3 322 3 040 3 442 168 296 422 639 712 710 748 6 212 10 420 14 311 14 222 14 315 16 568 3 647 4 984 6 406 3 333 2 876 3 233 3 014 123 109 127 90 130 105 91 14 437 11 329 18 434 18 524 20 155 19 857 20 470 1 8 2 5 0 0 1 0 0 0 2 787 2 907 2 949 2 159 2 454 2 483 1 418 1 234 1 032 803 809 817 5 890 5 064 3 048 3 373 3 521 3 856 3 a Rates are per 100 000 population. b NEW AND RELAPSE includes cases for which the treatment history is unknown. GLOBAL TUBERCULOSIS REPORT 2013 0 0 0 0 0 0 0 0 0 438 0 0 0 0 0 0 0 0 0 0 Data for all years can be downloaded from www.who.int/tb/data 0 – 78 65 80 75 69 72 – 62 72 74 69 67 65 100 0 100 – 100 – – 100 100 83 – 66 70 74 73 75 75 – 72 79 83 89 90 93 – – 78 72 74 74 80 – 100 – 100 50 100 – 81 80 80 89 86 85 – 31 34 41 54 53 48 – – 67 58 66 64 65 – 51 59 74 79 77 79 – 87 82 63 62 47 58 – 84 87 97 82 84 83 – – 100 – – 40 – 7$%/($&DVHQRWLILFDWLRQV ± YEAR Nicaragua • 71 47 • Panama • 34 40 • Paraguay • 51 36 • Peru • 174 99 • Puerto Rico •5 2• Saint Kitts and Nevis •0 4• Saint Lucia •9 6• Saint Vincent and the Grenadines •2 27 • Sint Maarten (Dutch part) Suriname • 20 24 • Trinidad and Tobago • 10 20 • •0 25 • Turks and Caicos Islands United States of America • 10 3• Uruguay • 28 24 • US Virgin Islands •4 0• Venezuela (Bolivarian Republic of) • 28 22 • 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 NEW AND b RELAPSE 2 944 2 842 2 402 1 907 2 448 2 693 2 790 846 1 300 1 169 1 637 1 496 1 571 1 520 2 167 1 745 1 950 2 075 2 352 2 372 2 416 37 905 45 310 38 661 33 747 31 073 31 241 29 760 159 262 174 113 80 50 71 0 5 0 0 2 1 2 13 11 9 14 9 7 11 2 13 16 7 15 17 30 3 2 1 82 NEW CASES % SMEARRE-TREAT EXCL. TOTAL SMEAR- SMEAR-NEGATIVE/ EXTRAHISTORY POS AMONG OTHER RELAPSE NEW PULM POSITIVE UNKNOWN PULMONARY RELAPSE RETREAT UNKNOWN 169 127 129 144 167 159 268 286 282 294 0 0 0 0 93 191 134 124 155 108 134 247 211 179 215 0 18 0 105 127 123 516 273 109 177 207 28 530 273 214 304 330 75 0 0 809 647 712 583 4 381 3 195 2 776 2 047 1 735 1 794 1 404 1 603 1 945 4 381 4 989 4 180 3 650 3 680 23 24 16 4 8 10 0 0 0 0 0 4 0 3 0 0 0 0 0 4 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 2 0 0 0 0 0 0 11 7 11 9 7 11 1 1 0 0 0 0 0 0 0 0 0 0 0 0 1 2 0 0 0 2 0 0 0 0 3 2 0 0 0 0 0 0 5 9 6 8 8 27 3 2 0 7 4 1 7 9 3 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 3 0 0 0 0 0 0 0 89 117 194 125 128 120 166 198 166 219 224 274 0 37 49 130 64 83 40 54 42 34 28 12 6 14 20 13 2 2 1 2 7 115 95 136 121 167 68 61 50 58 77 81 12 17 12 20 19 19 6 9 8 25 701 22 728 16 310 14 080 11 181 10 521 9 945 886 625 645 622 699 817 808 4 4 3 8 5 1 1 2 8 093 5 883 5 111 3 695 3 742 3 563 5 457 5 578 6 466 6 847 6 451 6 282 6 495 1 568 1 471 1 253 1 440 1 552 1 484 854 541 395 575 653 817 253 231 160 274 335 339 1 066 460 860 707 830 778 993 748 900 1 260 1 318 1 371 1 391 114 589 505 425 433 434 28 74 216 287 235 248 870 791 665 499 515 494 127 170 150 269 251 221 86 108 187 32 096 22 580 18 490 17 264 17 754 17 653 7 803 6 018 5 592 5 201 5 164 4 556 5 411 5 682 5 335 5 185 5 564 5 233 128 81 60 37 29 41 111 69 37 35 13 17 4 0 0 2 1 2 0 0 0 5 0 0 0 167 159 99 159 153 150 108 41 56 77 55 60 28 14 326 0 0 0 4 3 0 2 0 4 0 0 0 0 6 6 5 2 1 2 10 6 5 1 8 16 11 7 0 0 1 0 0 0 0 0 22 5 9 5 7 7 26 13 39 42 47 22 31 22 44 49 54 0 0 0 1 0 1 0 0 0 1 0 0 1 1 0 2 1 0 0 0 0 10 795 7 204 6 030 4 990 4 556 4 261 3 835 3 211 2 939 2 134 2 189 2 100 5 12 0 362 34 21 349 348 355 368 467 432 178 165 147 218 249 269 78 77 73 72 48 59 32 0 0 0 20 39 15 41 53 48 4 0 0 7 20 39 19 41 53 55 0 0 0 2 2 0 3 056 3 525 3 653 3 252 3 224 3 446 1 517 1 616 1 853 1 758 1 649 1 617 709 948 1 094 1 077 1 196 1 143 0 0 0 272 377 247 248 213 289 103 194 195 282 272 377 350 442 408 571 116 0 0 a Rates are per 100 000 population. b NEW AND RELAPSE includes cases for which the treatment history is unknown. Data for all years can be downloaded from www.who.int/tb/data 0 0 2 0 4 0 0 0 0 0 0 – 65 73 76 71 70 64 – 90 44 63 62 66 64 100 46 53 65 73 73 74 – 80 79 77 77 77 79 – 54 54 62 51 69 71 – 100 REGION OF THE AMERICAS NEW AND RELAPSE NOTIFICATION RATEa 1990–2012 100 100 100 – 100 88 92 100 100 100 – 42 69 86 53 47 90 100 100 0 – – 48 48 76 65 75 – 9 65 66 70 61 67 – – – – 75 89 71 – 43 45 46 43 45 46 – 66 68 71 63 65 62 – 50 – – – – – – 67 69 66 65 66 68 GLOBAL TUBERCULOSIS REPORT 2013 191 7$%/($7UHDWPHQWRXWFRPHVQHZVPHDUSRVLWLYHFDVHV ± % OF COHORT TREATMENT SUCCESS (%)a 1995–2011 Anguilla •0 0• Antigua and Barbuda •0 17 • Argentina • 12 52 • •0 92 • Aruba Bahamas •0 70 • Barbados •0 0• Belize • 52 0• •0 0• • 62 86 • Bermuda Bolivia (Plurinational State of) Bonaire, Saint Eustatius and Saba Brazil • 17 76 • British Virgin Islands •0 0• Canada •0 62 • Cayman Islands •0 100 • Chile • 79 71 • Colombia •0 77 • Costa Rica •0 88 • • 90 88 • Cuba a 192 YEAR 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 NUMBER NOTIFIED SIZE OF COHORT 0 0 0 0 0 0 3 6 1 6 6 5 698 4 749 4 709 4 044 3 973 5 150 4 6 3 6 6 5 707 5 177 4 709 5 062 5 088 5 600 6 4 7 38 56 30 26 19 23 3 3 2 6 0 36 44 59 82 97 64 2 0 1 0 7 010 6 458 6 278 5 937 5 613 5 746 0 0 45 650 41 186 42 093 39 267 37 932 40 294 1 0 1 0 436 492 433 462 358 407 0 5 1 2 1 1 561 1 290 1 186 1 152 1 154 1 196 7 530 8 358 6 870 7 319 7 028 6 807 245 349 330 271 267 285 834 675 467 418 462 437 13 30 26 19 23 11 2 6 0 29 45 59 142 1 1 1 7 010 6 212 6 278 5 897 5 571 5 770 0 0 0 45 650 34 007 42 093 40 818 41 840 42 764 1 1 0 0 492 459 850 854 858 5 1 2 2 1 1 111 1 360 1 147 1 365 1 437 1 462 1 634 7 778 6 899 7 364 6 805 349 306 166 297 282 834 673 466 415 458 443 COHORT AS % NOTIFIED – – – – – – – 133 100 300 100 100 100 109 100 125 128 109 – – – – – 186 – – 100 100 100 100 – – – 100 100 – 81 102 100 – 146 – – – – – 100 – 100 96 100 99 99 100 – – – 100 83 100 104 110 106 – 100 – – 0 – – 100 106 184 239 211 – 100 – 200 100 100 71 105 97 118 125 122 – 20 113 94 105 100 – 100 93 61 111 99 100 100 100 99 99 101 CURED 100 50 67 0 5 26 19 19 20 18 COMPLETED 0 0 33 17 7 20 34 26 27 33 DIED 0 33 33 33 33 1 5 5 4 4 5 92 FAILED DEFAULTED 0 0 0 0 0 33 50 3 6 5 7 8 8 0 0 0 0 0 0 8 0 17 0 0 0 84 43 37 43 40 36 0 17 12 16 4 40 69 53 65 17 8 16 26 7 0 5 0 20 12 11 4 0 0 0 0 45 100 100 45 0 0 9 0 0 0 0 0 0 0 0 0 52 78 56 0 0 19 10 9 12 3 0 2 28 2 12 7 11 0 0 0 0 53 73 76 84 86 84 0 0 0 9 6 2 1 2 2 0 0 0 4 4 3 4 4 3 0 0 0 1 1 1 1 1 1 0 0 0 9 9 5 5 5 5 100 100 100 24 7 12 4 3 5 17 49 31 31 37 37 0 22 44 41 37 38 1 4 5 5 5 5 1 0 1 1 0 0 3 9 9 10 11 10 79 16 9 11 10 9 0 100 0 0 0 0 22 8 10 12 8 13 59 65 65 54 5 9 7 8 9 0 0 0 0 1 1 0 0 0 59 22 17 15 29 0 0 50 50 100 79 82 83 61 51 50 40 0 0 0 0 0 11 20 22 0 0 0 0 0 7 9 9 9 9 7 0 0 0 0 0 0 0 0 0 0 0 0 100 0 0 0 8 6 6 7 6 6 60 0 50 50 0 5 2 2 12 14 15 70 63 68 69 66 10 9 9 10 11 5 6 6 7 7 1 1 2 1 1 8 7 9 9 10 6 14 6 4 5 43 85 49 75 85 90 91 90 87 89 83 14 4 4 12 3 0 2 2 3 1 5 10 5 5 7 7 4 4 6 7 7 8 1 2 1 2 1 3 1 1 2 1 2 12 3 1 2 2 2 1 1 1 2 3 19 1 39 2 2 2 1 1 0 0 0 100 0 TREATMENT SUCCESS = percent cured + percent completed then rounded to the nearest digit. GLOBAL TUBERCULOSIS REPORT 2013 NOT EVALUATED Data for all years can be downloaded from www.who.int/tb/data 7$%/($7UHDWPHQWRXWFRPHVQHZVPHDUSRVLWLYHFDVHV ± Curaçao Dominica •0 100 • • 64 83 • Dominican Republic Ecuador • 39 78 • El Salvador •0 93 • Grenada •0 100 • Guatemala • 61 86 • • 44 72 • Guyana Haiti • 70 84 • • 64 88 • • 67 47 • • 75 86 • Honduras Jamaica Mexico Montserrat •0 0• Netherlands Antilles •0 Nicaragua • 80 86 • • 69 84 • • 51 78 • • 83 74 • Panama Paraguay Peru Puerto Rico • 68 a 73 • YEAR 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 NUMBER NOTIFIED SIZE OF COHORT 5 5 0 5 4 8 2 2 787 2 907 2 949 2 441 2 159 2 454 5 890 5 064 3 048 3 317 3 373 3 521 1 008 1 059 930 972 1 079 2 0 4 4 1 2 368 2 052 2 420 1 609 2 121 1 961 85 119 240 328 325 323 5 887 7 340 8 242 8 011 2 306 3 404 2 069 1 881 1 842 2 060 93 90 53 77 76 35 9 220 11 676 11 997 11 862 12 572 12 960 1 4 3 2 2 007 2 760 2 697 2 441 2 194 2 454 5 236 2 150 3 330 3 373 3 441 1 008 1 059 930 972 1 079 6 4 4 1 2 368 1 908 2 121 2 121 2 056 296 119 257 328 325 323 3 081 5 887 7 340 8 435 8 242 8 390 2 226 2 362 1 905 1 881 1 918 2 004 93 99 53 76 76 59 9 220 11 538 12 172 11 821 12 304 12 622 0 1 0 0 0 0 2 5 1 568 1 471 1 253 1 329 1 440 1 552 1 066 460 860 755 707 830 748 900 1 260 1 498 1 318 1 371 32 096 22 580 18 490 17 391 17 264 17 754 128 81 60 30 37 29 1 536 1 437 1 496 1 552 1 704 1 565 1 388 460 873 768 717 861 748 900 1 452 1 467 1 317 1 367 28 185 22 230 14 793 14 212 17 264 16 694 128 81 60 37 37 40 COHORT AS % NOTIFIED – – – – – – 100 38 100 72 95 91 100 102 100 89 – 71 100 100 98 – 100 100 100 100 100 – – – 100 100 100 100 93 – 132 100 105 348 100 107 100 100 100 – 100 100 – 100 105 97 69 92 100 104 97 100 110 100 99 100 169 100 99 101 100 98 97 – – – – – – – 250 – 98 98 119 117 118 101 130 100 102 102 101 104 100 100 115 98 100 100 88 98 80 82 100 94 100 100 100 123 100 138 DEFAULTED NOT EVALUATED 0 0 0 2 2 2 2 1 2 8 0 0 0 13 19 7 7 7 8 14 0 0 0 16 4 3 2 6 3 37 3 4 3 3 3 3 3 3 6 8 7 7 5 11 8 10 1 0 1 1 0 7 4 5 4 4 1 1 4 2 1 5 2 2 2 2 8 1 0 0 0 0 33 50 25 0 0 5 11 3 5 1 1 4 7 0 0 0 0 31 1 6 6 5 34 13 57 57 41 50 70 14 8 12 10 10 25 5 7 6 6 6 65 40 53 14 34 22 6 12 6 4 4 15 6 6 5 11 12 7 8 6 7 4 5 6 5 5 4 7 6 5 6 6 5 10 23 13 14 9 7 4 6 5 6 6 5 1 1 1 1 5 9 9 8 38 24 26 19 18 16 21 13 7 8 7 6 4 5 4 6 6 5 17 11 26 11 5 5 12 9 6 5 5 4 1 1 0 6 3 9 2 4 4 3 10 6 7 5 5 25 3 3 2 2 2 5 20 4 5 38 41 6 8 11 2 1 2 CURED COMPLETED 100 67 100 43 37 80 79 73 76 0 33 0 21 34 5 6 7 7 39 0 0 0 5 5 4 4 5 4 2 81 71 75 73 3 4 4 4 78 91 88 91 93 67 50 75 100 56 75 77 77 81 10 43 2 13 30 22 57 72 67 72 74 39 81 81 79 79 82 2 5 4 55 13 25 69 64 71 82 82 72 DIED FAILED 1 1 1 1 1 1 1 1 1 0 1 0 1 1 0 1 0 0 0 0 0 3 1 1 1 1 1 20 66 70 73 69 66 68 10 27 68 65 64 68 8 21 46 75 69 70 75 90 91 70 57 68 75 81 78 0 14 13 12 16 18 18 60 33 12 16 16 16 43 45 33 5 9 8 9 0 11 12 6 68 64 0 0 0 72 4 5 5 4 5 3 14 7 8 7 7 5 3 5 5 7 8 7 3 2 2 3 2 3 23 31 22 16 14 25 REGION OF THE AMERICAS % OF COHORT a TREATMENT SUCCESS (%) 1995–2011 80 2 1 2 1 2 2 1 2 0 1 1 1 0 0 0 0 1 2 2 2 1 5 7 0 0 3 2 10 9 6 7 6 7 13 22 10 12 12 10 17 22 8 5 5 5 6 3 4 6 5 5 8 5 3 0 5 0 4 2 3 3 3 3 3 10 1 0 0 0 29 7 7 7 8 9 6 4 1 9 20 11 2 0 0 3 0 0 TREATMENT SUCCESS = percent cured + percent completed then rounded to the nearest digit. Data for all years can be downloaded from www.who.int/tb/data GLOBAL TUBERCULOSIS REPORT 2013 193 7$%/($7UHDWPHQWRXWFRPHVQHZVPHDUSRVLWLYHFDVHV ± % OF COHORT TREATMENT SUCCESS (%)a 1995–2011 Saint Kitts and Nevis • 60 100 • Saint Lucia •0 57 • Saint Vincent and the Grenadines •0 56 • Sint Maarten (Dutch part) Suriname • 14 76 • • 69 72 • Trinidad and Tobago Turks and Caicos Islands •0 22 • United States of America • 76 78 • Uruguay • 68 85 • • 50 0• US Virgin Islands Venezuela (Bolivarian Republic of) • 74 a 80 • YEAR 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 NUMBER NOTIFIED 4 0 0 4 2 1 11 7 11 7 9 7 5 9 6 3 8 8 3 2 37 49 149 130 64 7 115 95 154 136 121 SIZE OF COHORT 5 5 2 1 8 13 7 9 7 13 1 8 9 3 2 51 37 143 73 75 78 194 106 154 136 123 2 3 3 8 8 093 5 883 5 111 4 014 3 695 3 742 349 348 355 409 368 467 2 4 9 8 116 5 901 5 136 7 460 7 034 5 955 370 344 345 406 368 467 2 3 056 3 525 3 653 3 436 3 252 3 224 3 056 3 390 3 581 3 433 3 157 3 224 COHORT AS % NOTIFIED 125 – – 125 100 100 – 114 118 100 100 100 – 144 – 33 100 112 – 100 100 – 100 – 96 56 117 1 114 169 112 100 100 102 – – – – 133 112 100 100 100 186 190 159 106 99 97 99 100 100 100 – – – – – 100 96 98 100 97 100 FAILED COMPLETED DIED 20 40 20 0 20 0 80 100 100 0 0 0 0 0 0 0 0 0 0 0 0 20 0 0 88 15 22 43 12 54 57 67 14 0 31 29 0 14 0 0 0 0 29 0 0 14 0 0 0 0 0 11 0 100 0 0 0 0 0 0 0 44 0 0 11 0 0 11 0 0 0 0 0 33 100 100 0 100 10 49 100 0 4 19 0 0 12 16 0 0 0 0 8 14 0 0 67 3 64 60 71 49 22 68 61 72 69 3 0 5 21 46 4 8 4 3 11 12 13 19 11 12 14 9 11 1 0 0 1 2 1 3 1 16 4 4 10 6 16 14 11 15 5 23 7 0 13 0 1 1 1 0 33 0 33 0 0 0 0 100 0 0 33 0 DEFAULTED 75 41 85 80 73 80 81 50 68 76 83 84 83 80 22 76 83 84 60 64 78 27 0 4 7 5 4 6 0 0 0 0 15 11 8 6 6 6 10 13 11 12 10 8 0 4 4 5 4 5 5 1 1 0 0 0 0 0 1 1 1 4 1 4 6 5 7 0 25 11 6 3 6 32 29 15 17 0 1 2 0 0 50 1 0 0 0 0 0 8 13 10 11 11 12 13 6 2 1 0 3 67 4 3 2 TREATMENT SUCCESS = percent cured + percent completed then rounded to the nearest digit. 194 GLOBAL TUBERCULOSIS REPORT 2013 NOT EVALUATED CURED Data for all years can be downloaded from www.who.int/tb/data 7$%/($7UHDWPHQWRXWFRPHVUHWUHDWPHQWFDVHV ± % OF COHORT Anguilla •0 0• Antigua and Barbuda •0 50 • Argentina •0 41 • •0 0• Aruba Bahamas •0 100 • Barbados •0 0• Belize • 23 0• Bermuda •0 0• Bolivia (Plurinational State of) • 66 73 • Bonaire, Saint Eustatius and Saba Brazil •0 49 • British Virgin Islands •0 0• Canada •0 56 • Cayman Islands •0 0• Chile •0 43 • Colombia •0 45 • Costa Rica •0 81 • • 82 68 • Cuba a YEAR 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 NUMBER NOTIFIED SIZE OF COHORT 0 0 0 0 0 0 0 0 2 0 2 1 0 2 1 828 809 827 716 1 072 1 615 893 1 114 1 492 1 0 4 5 2 2 4 5 2 2 0 0 0 0 4 6 15 12 1 12 0 0 0 13 14 1 0 1 0 0 0 462 804 772 598 589 560 0 0 1 11 334 9 637 9 818 10 949 10 045 7 859 9 479 10 664 10 721 12 083 0 0 63 2 081 772 732 665 637 0 0 0 195 145 103 94 72 81 0 0 0 0 0 225 158 314 306 263 272 339 443 616 869 1 001 0 35 45 31 32 26 54 172 49 51 56 73 0 0 0 145 106 95 94 101 0 0 0 0 150 140 219 336 281 0 920 1 001 69 49 2 35 26 55 58 48 61 55 72 COHORT AS % NOTIFIED – – – – – – – – – 50 – 100 – – 200 108 156 139 – – – – – – – – 100 100 100 100 – – – – – – 325 – 93 – 100 – – – – – – – 733 39 100 82 89 88 – – 100 – 69 98 109 98 120 – – – – – – – 100 103 101 131 125 – – – – – – – 95 45 72 128 103 – – 0 – 106 100 – 197 109 6 109 100 102 34 98 120 98 99 CURED COMPLETED DIED FAILED DEFAULTED NOT EVALUATED 100 0 0 0 0 0 50 0 50 0 0 0 7 10 9 9 26 20 23 33 5 4 4 5 0 1 1 0 9 13 15 16 53 52 49 38 25 20 0 0 50 60 100 100 0 20 0 0 0 0 0 0 25 0 0 0 0 0 0 0 23 0 23 8 38 8 57 29 14 0 0 0 57 49 63 73 72 71 9 11 3 5 5 2 7 12 5 7 5 6 5 2 3 2 3 3 15 8 7 7 10 10 7 16 19 7 5 7 30 26 15 18 19 10 22 28 28 30 4 7 8 8 9 0 2 2 2 2 14 19 23 25 23 41 25 24 19 17 16 8 4 15 8 16 59 60 56 49 6 7 7 9 9 1 0 0 0 0 2 3 1 0 0 60 23 27 20 35 32 69 15 14 24 26 3 9 12 19 8 14 7 6 7 1 1 2 2 1 18 9 7 9 15 15 3 60 58 33 11 32 5 13 3 7 1 4 7 23 73 22 23 55 0 37 54 82 78 67 69 67 53 9 12 0 43 27 0 7 10 4 50 11 12 7 10 6 15 4 19 3 2 0 0 4 5 3 4 5 4 3 25 24 0 9 4 5 2 2 7 11 10 30 2 50 0 0 0 0 21 0 0 0 5 15 15 REGION OF THE AMERICAS TREATMENT SUCCESS (%)a 1995–2011 TREATMENT SUCCESS = percent cured + percent completed then rounded to the nearest digit. Data for all years can be downloaded from www.who.int/tb/data GLOBAL TUBERCULOSIS REPORT 2013 195 7$%/($7UHDWPHQWRXWFRPHVUHWUHDWPHQWFDVHV ± % OF COHORT a TREATMENT SUCCESS (%) 1995–2011 Curaçao Dominica •0 0• Dominican Republic •0 61 • Ecuador •0 35 • El Salvador •0 90 • Grenada •0 0• Guatemala • 73 64 • Guyana •0 49 • Haiti •0 72 • Honduras •0 68 • Jamaica • 67 25 • Mexico •0 61 • Montserrat •0 0• Netherlands Antilles •0 Nicaragua • 78 69 • Panama •0 59 • Paraguay •0 67 • Peru •0 0• Puerto Rico •0 a 196 0• YEAR 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 NUMBER NOTIFIED SIZE OF COHORT 0 3 0 1 0 1 204 610 729 452 520 505 0 1 1 498 530 434 384 415 386 795 756 663 641 641 271 114 113 92 83 181 114 113 92 83 554 756 0 0 0 0 249 141 159 128 181 160 2 84 25 205 162 233 346 228 381 423 100 236 181 225 195 190 2 13 5 20 19 4 1 335 2 026 1 535 1 266 1 542 0 0 0 254 164 181 181 182 38 23 205 162 233 55 228 381 381 453 180 169 192 164 165 6 5 19 19 4 138 1 456 1 229 1 272 1 352 0 0 0 0 0 0 0 167 159 268 282 286 282 108 134 247 235 211 179 28 530 273 177 214 304 289 230 181 178 204 134 42 237 203 208 203 144 164 188 216 228 4 381 4 989 4 324 4 180 3 650 4 521 2 299 2 163 0 0 4 0 113 0 4 0 COHORT AS % NOTIFIED – – – – – – 0 – 100 – 82 73 96 74 82 – – 70 100 – 100 – 67 100 100 100 100 – – – – – – 102 116 – 141 100 114 – 45 92 100 100 100 – 16 100 – 100 107 – 76 93 85 84 87 300 – 100 95 100 100 – 10 72 80 100 88 – – – – – – – – – 173 145 68 63 71 48 – 31 96 86 99 113 – 27 60 106 101 75 – 103 46 50 – – – – – – 100 – CURED COMPLETED DIED FAILED DEFAULTED 0 0 100 0 0 0 0 100 0 0 0 0 29 56 47 51 46 26 5 6 13 15 3 7 13 9 7 4 8 5 5 5 27 19 29 18 20 11 6 0 4 6 56 46 8 9 5 6 10 8 12 16 9 16 29 6 3 5 10 46 63 68 85 88 90 3 0 3 2 0 9 6 3 2 2 3 4 1 3 0 18 13 8 1 5 3 8 1 3 2 59 63 15 16 4 4 2 4 4 10 17 2 55 55 51 8 8 14 5 5 11 7 7 4 20 20 20 4 4 1 24 22 0 0 6 29 35 51 52 43 13 9 14 14 9 5 9 0 1 1 26 13 18 28 33 3 13 17 5 8 42 63 49 60 61 15 7 20 14 11 5 3 7 5 4 7 0 3 2 6 22 13 10 10 10 9 14 11 8 9 44 59 50 66 64 0 10 9 7 9 5 67 8 6 10 7 9 17 2 2 1 2 2 0 6 17 10 15 16 17 29 7 22 1 4 0 16 5 0 20 58 26 25 5 26 0 0 0 0 80 21 21 25 0 0 21 50 33 48 56 55 47 4 7 5 7 14 8 7 9 9 10 7 4 6 6 5 12 14 10 11 10 36 20 14 10 14 69 65 71 70 60 58 10 10 12 6 16 10 4 6 7 3 8 10 3 2 2 6 4 2 11 15 7 11 9 14 3 2 2 3 2 4 19 23 18 23 24 24 35 30 34 34 2 9 10 11 11 0 4 0 3 2 48 22 37 30 28 7 7 4 0 0 19 44 47 54 60 40 26 9 6 7 6 4 9 8 4 1 4 2 4 25 10 11 9 9 9 16 20 20 16 78 78 49 0 21 4 5 4 7 5 2 6 11 12 4 1 12 73 23 0 4 1 0 25 25 0 0 50 TREATMENT SUCCESS = percent cured + percent completed then rounded to the nearest digit. GLOBAL TUBERCULOSIS REPORT 2013 NOT EVALUATED Data for all years can be downloaded from www.who.int/tb/data 7$%/($7UHDWPHQWRXWFRPHVUHWUHDWPHQWFDVHV ± % OF COHORT Saint Kitts and Nevis •0 0• Saint Lucia •0 0• Saint Vincent and the Grenadines •0 0• Sint Maarten (Dutch part) Suriname •0 64 • Trinidad and Tobago •0 35 • Turks and Caicos Islands •0 0• •0 0• United States of America Uruguay • 76 79 • •0 0• US Virgin Islands Venezuela (Bolivarian Republic of) •0 a 80 • YEAR 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 NUMBER NOTIFIED 0 2 0 0 0 SIZE OF COHORT 2 0 0 0 3 2 3 0 0 4 3 0 2 2 0 1 0 0 0 0 0 1 8 15 16 11 22 31 22 60 44 49 1 3 0 0 3 12 11 11 22 21 60 44 49 3 2 1 0 0 20 39 19 37 41 53 25 272 377 350 428 442 408 30 41 41 53 247 261 248 400 COHORT AS % NOTIFIED – – 100 – – – – 33 – 100 – – – 100 – 50 0 – – – – – – – 80 69 100 – 71 95 100 100 100 – – – – 0 0 – – – – – – 125 – 158 111 100 100 – – – – – – – – 71 61 56 98 CURED COMPLETED DIED FAILED DEFAULTED 50 100 NOT EVALUATED 50 0 0 0 0 0 33 67 0 0 0 100 0 0 0 0 0 0 0 0 0 100 0 50 45 45 0 9 18 8 27 36 0 0 0 42 0 0 0 18 0 23 19 48 43 22 45 38 20 20 12 14 29 15 14 12 9 0 0 0 9 14 17 23 51 0 0 0 0 2 33 33 33 0 0 0 56 20 16 0 8 0 57 46 56 74 17 10 20 6 13 34 15 11 3 0 0 0 7 7 5 9 3 2 5 0 80 80 83 80 0 0 0 4 4 6 9 2 2 1 0 12 13 10 10 2 2 0 0 REGION OF THE AMERICAS TREATMENT SUCCESS (%)a 1995–2011 TREATMENT SUCCESS = percent cured + percent completed then rounded to the nearest digit. Data for all years can be downloaded from www.who.int/tb/data GLOBAL TUBERCULOSIS REPORT 2013 197 7$%/($+,9WHVWLQJDQGSURYLVLRQRI&37$57DQG,37– % OF TB PATIENTS WITH KNOWN HIV STATUS YEAR 2005–2012 Anguilla – – Antigua and Barbuda • 100 100 • Argentina – 15 • – 3• Aruba Bahamas – 100 • – 100 • Barbados Belize • 100 81 • Bermuda – 100 • Bolivia (Plurinational State of) •0 60 • Bonaire, Saint Eustatius and Saba Brazil • 59 55 • British Virgin Islands – – Canada • 26 42 • Cayman Islands – 100 • – 16 • • 53 66 • Chile Colombia Costa Rica • 67 94 • Cuba • 93 83 • Curaçao Dominica – 75 • Dominican Republic •1 61 • •0 86 • Ecuador El Salvador • 84 99 • Grenada – 100 • Guatemala • 16 85 • • 70 94 • •0 81 • Guyana Haiti 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 NUMBER OF TB % OF TB PATIENTS WITH PATIENTS WITH KNOWN HIV KNOWN HIV STATUS STATUS 0 100 86 75 100 0 0 0 6 6 6 4 14 13 15 1 121 1 313 1 434 3.4 1 100 100 100 75 100 100 33 42 32 8 6 0 4 106 142 64 68 1 1 1 3 0 1 897 3 928 5 049 0 0 0 51 552 51 764 53 455 45 733 0 0 0 0 414 658 513 716 1 3 2 6 11 16 53 43 53 66 67 99 96 94 93 100 95 83 0 0 100 286 392 5 537 5 079 6 579 7 791 374 494 505 453 729 862 780 618 0 0 1 38 67 75 1.5 60 57 61 0.21 100 68 86 84 96 98 99 3 2 6 78 2 489 2 540 2 721 10 5 183 3 640 4 974 1 544 1 667 1 878 2 036 0 4 2 1 600 2 121 2 223 2 982 456 734 852 914 0 9 518 11 213 13 518 100 100 100 98 84 81 100 100 100 0 22 45 60 0 59 63 64 55 0 26 48 35 42 100 100 100 16 63 72 85 70 88 93 94 0 67 78 81 GLOBAL TUBERCULOSIS REPORT 2013 PATIENTS NOTIFIED (NEW AND RETREAT) 1 0 0 6 7 8 4 11 242 7 762 10 491 9 606 6 8 29 50 32 42 32 6 0 4 106 145 76 84 1 1 3 9 973 8 620 8 747 8 484 0 1 0 87 223 81 946 84 137 82 755 0 1 0 0 1 616 1 385 1 452 1 686 4 2 6 2 633 2 472 2 535 2 460 10 360 11 889 12 438 11 829 560 499 524 480 781 838 821 748 5 1 1 8 3 8 5 312 4 160 4 472 4 440 4 808 5 095 5 350 5 771 1 830 1 730 1 917 2 063 4 2 1 3 861 3 351 3 088 3 499 656 836 916 969 14 344 14 265 14 361 16 723 NUMBER OF HIV-POSITIVE TB PATIENTS % OF TESTED TB PATIENTS HIV-POSITIVE % OF HIV% OF HIVNUMBER OF POSITIVE TB POSITIVE TB HIV-POSITIVE PATIENTS ON PATIENTS ON PEOPLE CPT ART PROVIDED IPT 0 0 0 3 5 4 2 50 83 67 50 672 735 685 60 56 48 1 100 16 12 8 2 2 0 1 25 29 24 19 0 0 0 0 0 130 333 164 0 0 0 8 249 9 338 9 088 9 049 0 0 0 0 63 53 61 57 0 0 0 0 48 29 25 25 33 31 42 38 0 0 25 24 20 38 28 0 0 0 0 0 68 100 100 68 100 100 100 6.9 8.5 3.2 0 87 36 100 16 18 17 20 0 85 92 100 100 148 140 353 1 231 1 292 1 400 50 54 36 49 0 56 62 54 0 0 1 0 1 0 0 3 547 460 557 3 427 576 669 188 180 194 214 0 1 0 0 478 255 285 293 80 209 199 284 1 797 1 892 2 320 2 705 100 40 50 50 100 100 100 100 0 0 5 1 100 75 67 62 100 409 50 0 0 674 27 15 8.1 12 8 0 0 0 0 52 36 6.4 24 20 18 13 11 7.1 11 0 6.5 7.9 8.7 0 0 35 36 34 84 0 0 0 34 81 62 89 94 33 0 0 3.8 22 18 20 30 8.2 16 13 12 11 10 11 100 100 0 7.9 58 69 0 0 3.8 93 48 20 82 85 66 38 63 77 83 25 0 0 80 12 13 9.8 18 28 23 31 0 0 100 16 0 240 100 30 95 77 94 71 59 83 59 144 119 154 20 21 20 13 11 59 9.8 6.9 46 15 283 0 1 366 1 429 1 339 100 953 5 041 100 455 0 0 Data for all years can be downloaded from www.who.int/tb/data 4 112 7$%/($+,9WHVWLQJDQGSURYLVLRQRI&37$57DQG,37– Honduras • 44 76 • • 83 69 • •7 70 • Jamaica Mexico Montserrat • 100 – Netherlands Antilles Nicaragua •0 72 • • 86 96 • – 73 • Panama Paraguay Peru •2 18 • • 82 86 • Puerto Rico Saint Kitts and Nevis – 100 • •7 100 • Saint Lucia Saint Vincent and the Grenadines • 100 91 • Sint Maarten (Dutch part) Suriname • 73 91 • Trinidad and Tobago • 69 97 • Turks and Caicos Islands – 0• United States of America • 59 84 • Uruguay • 92 95 • US Virgin Islands – – Venezuela (Bolivarian Republic of) • 39 73 • 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 NUMBER OF TB % OF TB PATIENTS WITH PATIENTS WITH KNOWN HIV KNOWN HIV STATUS STATUS 44 54 75 76 83 87 85 69 6.9 43 56 70 100 1 455 1 557 2 443 2 312 79 128 92 65 1 382 8 915 11 416 15 005 1 0 0 PATIENTS NOTIFIED (NEW AND RETREAT) 3 333 2 901 3 243 3 046 95 147 108 94 19 932 20 699 20 528 21 348 1 0 0 0 NUMBER OF HIV-POSITIVE TB PATIENTS 200 201 261 259 28 30 17 13 217 1 645 1 520 1 233 0 0 0 14 13 11 11 35 23 18 20 16 18 13 8.2 0 2 30 60 60 105 200 240 241 224 100 144 174 154 668 853 960 979 28 14 10 11 18 11 8.1 100 8.9 14 17 30 18 22 18 0 0 0 0 0 14 9.1 14 30 38 29 0 0 0 23 34 32 30 34 23 33 26 20 20 0 13 8.5 7.6 7.5 13 16 14 17 15 9.2 13 12 0 56 55 72 86 96 95 96 2 0 1 440 1 552 2 117 1 569 1 558 1 608 1 600 33 60 73 1.9 29 21 18 82 95 92 86 817 1 533 1 906 668 9 539 7 052 5 836 93 76 46 61 100 100 100 7.1 100 100 100 100 59 76 91 100 100 100 73 85 89 91 69 98 95 97 71 10 0 59 66 83 84 92 92 94 95 2 1 2 1 9 7 11 7 10 13 31 3 2 1 87 173 117 121 124 254 252 311 5 5 1 0 8 273 7 404 8 752 8 376 574 646 769 775 7 10 8 14 080 11 181 10 521 9 945 626 699 817 815 0 0 0 0 0 1 1 1 3 5 9 0 0 0 20 58 38 36 42 58 84 82 1 1 0 0 1 035 627 668 625 74 104 110 134 39 78 64 73 2 678 5 213 4 133 4 956 6 950 6 645 6 477 6 777 392 479 519 581 2 076 2 575 2 822 2 934 1 828 1 630 1 695 1 675 2 348 2 461 2 549 2 623 35 541 32 477 32 844 31 705 113 80 50 71 2 2 1 2 14 9 7 11 7 17 17 34 3 2 1 119 204 131 133 179 258 266 321 % OF TESTED TB PATIENTS HIV-POSITIVE 4.2 3.9 5 13 15 15 14 Data for all years can be downloaded from www.who.int/tb/data NUMBER OF % OF HIV% OF HIVPOSITIVE TB POSITIVE TB HIV-POSITIVE PATIENTS ON PATIENTS ON PEOPLE PROVIDED IPT ART CPT 0 90 50 52 43 0 90 72 74 54 100 82 100 70 70 26 25 24 0 67 67 78 63 94 89 67 67 74 10 84 93 65 0 25 60 67 56 79 1.2 68 87 43 50 82 50 50 36 100 100 0 100 100 0 100 80 67 80 67 29 19 24 28 0 100 10 38 55 69 36 34 19 29 0 100 0 0 0 0 34 31 24 10 18 0 39 33 32 89 0 27 286 465 152 230 400 REGION OF THE AMERICAS % OF TB PATIENTS WITH KNOWN HIV STATUS YEAR 2005–2012 1 214 1 183 1 416 1 0 11 102 GLOBAL TUBERCULOSIS REPORT 2013 199 7$%/($7HVWLQJIRU0'57%DQGQXPEHURIFRQILUPHGFDVHVRI0'57%± YEAR TOTAL CONFIRMED CASES OF a MDR-TB 2005 2010 2011 2012 Antigua and 2005 Barbuda 2010 2011 2012 Argentina 2005 2010 2011 2012 Aruba 2005 2010 2011 2012 Bahamas 2005 2010 2011 2012 Barbados 2005 2010 2011 2012 Belize 2005 2010 2011 2012 Bermuda 2005 2010 2011 2012 Bolivia 2005 (Plurinational 2010 State of) 2011 2012 Bonaire, Saint 2010 Eustatius and Saba 2011 2012 Brazil 2005 2010 2011 2012 British Virgin 2005 Islands 2010 2011 2012 Canada 2005 2010 2011 2012 Cayman Islands 2005 2010 2011 2012 Chile 2005 2010 2011 2012 Colombia 2005 2010 2011 2012 Costa Rica 2005 2010 2011 2012 Cuba 2005 2010 2011 2012 Curaçao 2010 2011 2012 Dominica 2005 2010 2011 2012 Dominican 2005 Republic 2010 2011 2012 Ecuador 2005 2010 2011 2012 El Salvador 2005 2010 2011 2012 Grenada 2005 2010 2011 2012 Guatemala 2005 2010 2011 2012 Guyana 2005 2010 2011 2012 NEW PULMONARY CASES ESTIMATED CASES OF MDR-TB AMONG NOTIFIED ESTIMATED CASES OF MDR-TB AMONG NOTIFIED NUMBER OF b BACT+VE TESTED FOR MDR-TB Anguilla 200 0 0 0 0 0 0 276 109 103 63 0 (0–0) 0.18 (<0.1–0.27) 0 0 0 0 (0–0) <0.1 (<0.1–<0.1) 340 (230–440) 160 (88–260) 0.85 (0.57–1.1) 0.57 (0.36–0.81) 0 0 1 1 0 0 0 0 0 0 0 0 0 0 63 106 83 117 0 1 0 373 573 566 684 0 0 0 22 15 19 9 0 0 0 6 10 9 18 131 108 105 3 3 0 1 1 7 10 8 0 0 0 0 0 0 108 117 92 253 176 354 223 14 2 4 8 0 0 0 40 18 27 69 5 3 0 0 0 0 2369 5 1.2 (<0.1–6.1) 1.2 (<0.1–6.1) 21 31 27 0 0 0 0 <0.1 (<0.1–0.10) <0.1 (<0.1–0.10) 2.5 (1.7–3.4) 1.6 (1.0–2.2) 0 0 (0–1.7) 1 1 2 0 (0–1.7) 150 (88–210) 0 (0–0) 1 700 (1 400–2 000) 74 (27–160) 0 (0–0) 0 98 1376 0 0 850 (620–1 100) 22 21 700 0 (0–0) 0 (0–0) 0 0 0 1130 987 7.4 (2.2–13) 6.0 (2.4–12) 1244 0 (0–3.1) 0 (0–3.1) 19 (7.5–30) 12 (4.4–26) 310 (220–400) 210 (140–320) 6.4 (0.81–12) 5.4 (1.5–14) 11 (3.4–19) 4.3 (0.52–15) 0 (0–0.98) 0 (0–0.98) 0 (0–0) 0 (0–5.9) 330 (230–430) 220 (140–330) 380 (320–450) 210 (150–280) 16 (5.9–26) 5.1 (0.61–18) <0.1 (<0.1–<0.1) 1 1 5 49 65 71 125 1240 2620 2378 2 203 32 273 169 174 313 269 5 1 1 1 1 2 32 12 79 117 363 239 529 12 0 238 252 <0.1 (<0.1–<0.1) 20 140 (100–180) 48 (25–70) 89 (55–140) 0 37 14 (9.1–20) 0 2 3 PREVIOUSLY TREATED CASES % OF b BACT+VE TESTED FOR MDR-TB – – – – – 0 0 0 46 – – – – – 71 – – 95 97 84 – 0 – 0 0 – – 0 – 100 100 200 – 0 1.7 22 – – – – <0.1 <0.1 1.6 – 0 – – 150 130 – 140 – 50 100 100 3.2 4.4 4.8 8.4 – 17 36 33 0.49 64 9.6 95 32 36 60 61 100 100 100 – 12 50 40 – 1.4 0.42 3.1 3.2 10 6.3 13 1.1 0 22 20 – – – – 0.83 – 0 1.4 – 0 0.62 0.97 ESTIMATED CASES OF MDR-TB AMONG NOTIFIED 0 (0–0) 0.14 (<0.1–0.23) 180 (110–260) 0.27 (<0.1–0.46) 0 (0–0) 0 (0–0) 0.96 (0.32–1.6) 0 (0–0) 75 (60–94) 0 (0–0) 860 (660–1 100) 0 (0–0) 1.4 (<0.1–7.8) 0 (0–0) 6.7 (2.2–15) 98 (74–130) 1.0 (<0.1–5.0) 7.1 (2.7–14) 0 (0–0) 0 (0–2.0) 110 (71–150) 170 (150–190) 11 (4.8–20) 0 (0–0) 53 (40–69) 33 (11–56) NUMBER OF % OF NOTIFIED NOTIFIED TESTED FOR TESTED FOR MDR-TB MDR-TB – 0 – 0 – 0 – – 0 – 0 0 0 0 1290 160 – – – – – – – – 2 100 1 50 0 – – 0 – 0 – 0 – 3 20 – – 0 0 – 0 – 0 – 0 – – 664 100 597 94 634 94 0 – 1 100 0 – 5917 61 643 5.9 604 6.0 198 1.7 – 0 – 0 – 0 – – 51 71 – 63 69 – 0 – 0 – 0 – 226 72 276 100 277 100 172 74 – 495 57 568 57 391 51 1 2.2 – 16 62 22 100 19 39 31 55 76 100 51 85 – 0 – 0 – – 1 – 1 100 1 50 – 106 20 77 15 193 35 502 63 584 88 284 44 827 120 14 12 2 2.2 69 83 73 74 – – – – 40 25 18 9.9 27 17 74 37 – 0 0 55 24 1 0.41 a TOTAL CONFIRMED CASES OF MDR-TB includes cases with unknown previous treatment history (i.e. not included under NEW CASES or PREVIOUSLY TREATED CASES). b BACT+VE = bacteriologically positive cases. GLOBAL TUBERCULOSIS REPORT 2013 Data for all years can be downloaded from www.who.int/tb/data 7$%/($7HVWLQJIRU0'57%DQGQXPEHURIFRQILUPHGFDVHVRI0'57%± a MDR-TB 2005 2010 2011 2012 Honduras 2005 2010 2011 2012 Jamaica 2005 2010 2011 2012 Mexico 2005 2010 2011 2012 Montserrat 2005 2010 2011 2012 Netherlands Antilles 2005 Nicaragua 2005 2010 2011 2012 Panama 2005 2010 2011 2012 Paraguay 2005 2010 2011 2012 Peru 2005 2010 2011 2012 Puerto Rico 2005 2010 2011 2012 Saint Kitts and 2005 Nevis 2010 2011 2012 Saint Lucia 2005 2010 2011 2012 Saint Vincent and 2005 the Grenadines 2010 2011 2012 Sint Maarten 2010 (Dutch part) 2011 2012 Suriname 2005 2010 2011 2012 Trinidad and 2005 Tobago 2010 2011 2012 Turks and Caicos 2005 Islands 2010 2011 2012 United States 2005 of America 2010 2011 2012 Uruguay 2005 2010 2011 2012 US Virgin Islands 2005 2010 2011 2012 Venezuela 2005 (Bolivarian 2010 Republic of) 2011 2012 NEW PULMONARY CASES ESTIMATED CASES OF MDR-TB AMONG NOTIFIED ESTIMATED CASES OF MDR-TB AMONG NOTIFIED Haiti a b 41 86 81 3 9 5 6 0 1 1 0 394 140 140 114 1 0 0 0 50 18 13 21 5 10 7 11 13 1 6 7 2748 1048 1663 1225 0 0 3 1 0 0 0 0 0 0 6 0 0 0 0 0 0 1 0 0 0 3 0 0 390 (270–520) b BACT+VE TESTED FOR MDR-TB 53 2 310 (200–440) 71 (37–110) 43 (19–84) 2.6 (1.7–3.4) 1.7 (1.1–2.4) 480 (350–620) 380 (330–440) 0 (0–0) NUMBER OF 3 57 30 41 11 40 28 16 314 21 6 13 0 0 0 0 (0–0) 8 50 200 46 (21–70) 56 (35–78) 55 (19–90) 2 200 (2 100–2 300) 1.0 (0–2.6) <0.1 (<0.1–<0.1) 14 (1.7–52) 27 (17–38) 29 58 25 2 6.5 (0.16–36) 115 227 235 890 (820–960) 1199 14484 0 (0–3.8) <0.1 (<0.1–<0.1) 0.24 (0.15–0.34) 0.24 (0.15–0.34) 1.2 (0.78–1.6) 0.66 (0.42–0.93) 69 44 52 0 0 0 0 2 0 6 2 1 2 0 <0.1 (<0.1–<0.1) <0.1 (<0.1–<0.1) 49 1 0 3.4 (2.4–4.5) 2.5 (1.6–3.5) 0 11 (8.4–13) 4.5 (2.2–6.4) 0.13 (<0.1–0.18) 0.13 (<0.1–0.18) 6 1 124 107 119 81 1 1 1 81 (63–100) 1.3 (0–3.8) – 28 21 25 21 100 (58–150) 81 (63–100) 0 (0–5.5) 10064 7593 6899 6790 160 422 466 – 26 (7.2–67) 163 26 565 460 PREVIOUSLY TREATED CASES % OF b BACT+VE TESTED FOR MDR-TB 0.72 <0.1 – – 0.13 3.1 1.5 2.1 19 31 64 28 2.1 0.16 <0.1 <0.1 0 – – – – 0.64 3.5 13 – 3.3 8.2 2.3 0.26 – 8.2 15 15 – – 6.5 79 – 100 110 98 – 0 0 0 – 0 29 0 86 22 12 7.4 – 0 – 44 0.70 0 – 0 – – 2.4 – – – – 110 110 99 100 – 36 75 88 – – – – 4.3 0.78 17 13 ESTIMATED CASES OF MDR-TB AMONG NOTIFIED 82 (28–140) 28 (13–51) 0.82 (0.28–1.4) 100 (84–130) 0 (0–0) 31 (18–49) 29 (9.9–49) 48 (20–92) 1 300 (1 200–1 400) 1.0 (<0.1–2.7) 0 (0–0) 0 (0–0) 0.55 (0.18–0.92) 0 (0–0) 0.96 (0.32–1.6) 6.4 (5.0–7.9) 0 (0–0) – 1.3 (<0.1–6.9) – 77 (43–120) NUMBER OF % OF NOTIFIED NOTIFIED TESTED FOR TESTED FOR MDR-TB MDR-TB – 39 10 – 81 14 0 0 62 32 65 34 96 42 2 40 5 26 1 25 0 0 74 3.7 505 40 180 12 148 9.0 0 – 0 – 0 – – – 8 3.0 150 52 67 24 – 48 19 17 8.1 40 22 7 3.3 – 52 24 93 31 89 27 2336 47 – 598 16 1902 52 – 4 100 0 – 3 100 – 0 – 0 – 0 – – 0 – 0 – 0 – 0 – – 0 – 0 0 – – – 0 0 – 0 0 – 3 14 – – 10 19 – – – – 505 – 345 – 304 – 339 – – 22 54 38 72 42 76 – – – – 15 4.3 160 36 195 48 148 26 REGION OF THE AMERICAS YEAR TOTAL CONFIRMED CASES OF TOTAL CONFIRMED CASES OF MDR-TB includes cases with unknown previous treatment history (i.e. not included under NEW CASES or PREVIOUSLY TREATED CASES). BACT+VE = bacteriologically positive cases. Data for all years can be downloaded from www.who.int/tb/data GLOBAL TUBERCULOSIS REPORT 2013 201 7$%/($1HZVPHDUSRVLWLYHFDVHQRWLILFDWLRQE\DJHDQGVH[ ± MALE YEAR Anguilla Antigua and Barbuda Argentina Aruba Bahamas Barbados Belize Bermuda Bolivia (Plurinational State of) Bonaire, Saint Eustatius and Saba Brazil British Virgin Islands Canada Cayman Islands Chile Colombia Costa Rica Cuba Curaçao Dominica 202 1995 2000 2005 2010 2011 2012 1995 2000 2005 2010 2011 2012 1995 2000 2005 2010 2011 2012 1995 2000 2005 2010 2011 2012 1995 2000 2005 2010 2011 2012 1995 2000 2005 2010 2011 2012 1995 2000 2005 2010 2011 2012 1995 2000 2005 2010 2011 2012 1995 2000 2005 2010 2011 2012 2010 2011 2012 1995 2000 2005 2010 2011 2012 1995 2000 2005 2010 2011 2012 1995 2000 2005 2010 2011 2012 1995 2000 2005 2010 2011 2012 1995 2000 2005 2010 2011 2012 1995 2000 2005 2010 2011 2012 1995 2000 2005 2010 2011 2012 1995 2000 2005 2010 2011 2012 2010 2011 2012 1995 2000 2005 2010 2011 2012 0–14 15–24 25–34 35–44 FEMALE 45–54 55–64 65+ 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 2 1 0 0 1 2 3 1 1 0 0 0 0 1 0 1 0 0 0 0 0 1 1 0 97 64 56 143 59 278 621 536 664 533 594 530 491 657 484 402 358 309 434 299 419 384 302 397 180 368 340 340 358 182 3 1 3 2 5 7 2 7 9 4 3 4 4 2 3 2 2 0 0 0 2 2 1 3 3 1 5 6 6 0 2 2 2 2 0 0 1 2 0 0 0 2 0 0 0 0 0 0 1 2 0 2 0 1 0 0 0 1 5 8 9 8 2 0 0 0 2 7 8 16 14 7 1 0 0 4 2 6 22 9 5 2 0 0 0 6 8 24 16 4 0 0 0 1 3 5 11 2 3 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 166 157 95 100 99 0 0 0 1 182 1 320 1 150 1 231 1 096 0 0 0 797 725 622 685 672 0 0 0 518 439 415 372 368 0 0 0 1 894 317 298 336 277 7 268 5 074 4 405 4 877 5 027 11 568 6 119 6 381 6 755 6 811 0 0 0 1 5 3 3 2 1 0 0 0 28 34 37 30 34 33 0 0 0 0 24 6 3 2 4 4 UNKNOWN 0–14 15–24 25–34 35–44 45–54 0 0 0 65+ UNKNOWN 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 1 2 1 0 0 0 0 0 0 1 2 0 1 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 330 348 282 289 181 2 9 15 121 90 59 142 67 544 530 421 587 652 479 474 426 470 614 262 290 233 279 375 230 198 184 192 364 179 169 153 169 321 216 240 176 213 322 1 4 13 1 0 2 4 1 5 7 7 2 2 8 1 0 2 0 3 1 1 1 1 0 0 0 0 0 0 5 1 2 1 3 5 1 3 1 0 0 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 1 5 3 18 0 2 0 0 0 1 0 0 6 2 4 5 2 4 0 0 0 2 1 4 7 0 3 0 0 0 0 2 4 7 8 4 2 0 0 1 4 3 9 4 4 0 0 0 1 1 2 4 1 1 0 0 0 2 4 4 5 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 466 391 395 371 358 0 0 0 340 346 338 302 353 0 0 0 366 415 409 457 380 0 0 0 0 0 191 160 119 146 101 0 0 0 831 846 744 778 792 0 0 0 588 533 471 459 480 0 0 0 334 276 238 235 223 0 0 0 254 226 191 183 204 0 0 0 192 182 162 155 193 0 0 0 233 262 264 272 249 0 0 0 0 0 11 906 6 128 5 293 5 462 5 387 8 623 5 259 4 762 5 054 5 128 5 085 2 803 2 875 3 083 3 103 4 494 2 140 1 947 2 142 2 160 43 41 38 1 859 355 280 356 303 6 719 3 496 2 677 2 815 2 798 7 215 3 663 3 008 3 131 3 013 5 395 2 626 2 211 2 230 2 173 3 582 1 897 1 720 1 779 1 785 2 384 1 112 1 038 1 164 1 113 2 496 1 104 979 1 069 1 030 15 0 6 0 0 0 31 45 45 28 36 32 0 0 0 60 46 44 36 31 53 0 0 0 34 41 40 32 40 51 1 0 0 41 32 20 25 33 35 0 0 0 70 79 68 62 70 97 0 0 0 7 4 6 1 3 6 0 0 0 33 33 28 28 23 32 0 0 0 28 40 40 24 29 34 0 0 0 22 30 27 16 28 29 0 0 0 12 25 24 10 14 19 0 0 0 18 12 13 19 9 11 0 0 0 51 66 37 44 55 45 0 3 1 0 1 0 0 0 0 148 81 74 90 88 91 0 0 2 182 160 128 115 139 122 1 0 2 204 198 179 144 143 135 0 0 1 155 150 162 159 164 170 0 1 0 141 132 115 122 127 117 0 0 0 163 126 133 157 134 149 0 0 0 24 10 4 6 6 4 0 0 0 100 66 55 56 62 59 0 0 0 120 96 78 76 75 69 0 0 0 108 70 60 59 66 53 1 0 0 75 54 56 56 69 56 0 0 0 73 58 36 40 48 60 0 0 0 107 83 93 72 71 76 246 178 148 105 92 1 14 1 2 0 2 2 0 2 3 2 1 0 0 0 763 623 602 663 613 17 31 43 18 23 18 59 71 20 17 14 15 0 0 0 1 030 685 765 714 744 38 53 38 48 24 33 118 167 73 61 51 45 0 0 0 963 666 540 558 497 24 62 53 33 29 28 83 90 90 89 83 83 2 0 0 743 687 710 702 653 19 39 34 27 33 34 75 74 50 78 86 70 1 0 0 610 510 610 594 616 23 28 20 22 22 41 75 55 58 53 50 45 0 0 0 746 695 814 753 740 22 49 34 28 36 23 156 75 51 57 48 36 0 0 0 0 194 179 146 98 79 2 13 1 0 2 2 1 2 2 1 1 0 0 0 0 587 581 560 461 519 17 21 21 18 18 11 17 9 14 15 6 13 1 0 1 758 533 576 535 555 15 33 31 20 27 24 52 22 17 15 18 12 1 0 0 523 457 428 324 376 11 24 18 12 23 11 29 26 26 14 18 16 0 0 0 381 389 374 337 355 7 20 16 14 19 12 39 22 13 16 17 12 0 0 0 304 292 284 278 252 9 23 6 15 12 8 48 23 22 17 17 13 0 0 0 510 395 471 390 432 14 24 14 8 17 5 80 39 29 26 26 13 0 0 0 0 0 0 0 0 2 0 0 2 0 0 0 1 3 0 2 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 2 0 0 1 0 0 0 0 0 1 0 0 0 55–64 1 0 0 0 0 0 0 0 0 0 1 0 GLOBAL TUBERCULOSIS REPORT 2013 0 0 0 0 0 0 0 0 0 0 0 5 0 0 0 1 0 2 0 0 0 0 Data for all years can be downloaded from www.who.int/tb/data 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 1 0 3 0 0 0 0 0 0 0 0 MALE:FEMALE RATIO – – – – – – – 0.33 0.50 5.0 7.0 – – 1.2 1.3 1.4 1.4 0.71 – – – – 2.5 0.56 2.4 1.0 – 1.7 2.3 1.3 – 2.0 – 1.0 – – 0.83 2.1 1.8 2.5 3.3 1.5 – – – – – – – 1.5 1.5 1.6 1.6 1.5 – – – – 1.7 2.0 2.2 2.2 2.3 – – – – – – 1.5 1.3 1.5 1.5 1.5 1.7 – – – 1.0 – – 1.7 2.0 2.1 2.2 2.0 2.1 – 1.6 1.4 1.5 1.7 1.5 1.9 1.7 2.1 2.0 1.4 2.4 2.1 3.7 2.8 3.4 3.2 3.7 1.5 – – – – – 1.0 – – 7$%/($1HZVPHDUSRVLWLYHFDVHQRWLILFDWLRQE\DJHDQGVH[ ± Dominican Republic Ecuador El Salvador Grenada Guatemala Guyana Haiti Honduras Jamaica Mexico Montserrat Netherlands Antilles Nicaragua Panama Paraguay Peru Puerto Rico Saint Kitts and Nevis Saint Lucia 1995 2000 2005 2010 2011 2012 1995 2000 2005 2010 2011 2012 1995 2000 2005 2010 2011 2012 1995 2000 2005 2010 2011 2012 1995 2000 2005 2010 2011 2012 1995 2000 2005 2010 2011 2012 1995 2000 2005 2010 2011 2012 1995 2000 2005 2010 2011 2012 1995 2000 2005 2010 2011 2012 1995 2000 2005 2010 2011 2012 1995 2000 2005 2010 2011 2012 1995 2000 2005 1995 2000 2005 2010 2011 2012 1995 2000 2005 2010 2011 2012 1995 2000 2005 2010 2011 2012 1995 2000 2005 2010 2011 2012 1995 2000 2005 2010 2011 2012 1995 2000 2005 2010 2011 2012 1995 2000 2005 2010 2011 2012 FEMALE 0–14 15–24 25–34 35–44 45–54 55–64 65+ 73 43 29 20 15 410 399 276 333 317 481 483 346 406 489 344 386 292 318 315 173 228 170 200 197 125 123 112 133 126 113 105 85 112 111 48 32 45 37 446 499 481 506 468 529 547 567 308 314 364 387 237 309 323 359 150 227 272 291 159 246 232 333 13 5 5 3 5 99 97 101 114 131 124 140 170 183 194 114 128 96 106 122 92 104 77 96 100 62 74 62 77 87 107 117 101 115 115 0 0 0 1 0 1 1 1 0 51 36 39 60 18 235 220 251 187 197 280 236 258 245 205 236 216 185 207 172 165 177 187 172 162 142 112 127 143 136 0 1 139 140 115 165 152 7 4 12 2 8 5 8 20 48 32 26 30 5 19 130 38 54 39 6 14 116 65 61 68 9 7 81 49 54 64 6 6 41 22 19 23 7 9 20 13 13 8 67 69 98 102 126 42 30 13 15 17 18 2 0 0 1 0 1 836 1 045 1 225 1 155 1 359 280 123 238 177 194 247 9 6 4 7 2 10 898 1 035 1 357 1 342 1 563 540 371 280 246 291 285 14 13 6 15 6 8 613 701 718 670 758 204 246 215 207 227 192 9 13 6 15 3 3 350 451 469 442 473 130 277 152 165 184 184 11 15 10 8 4 5 147 222 259 206 271 236 214 134 113 120 129 8 6 6 6 4 5 118 156 160 132 164 58 43 152 157 184 146 9 5 7 7 3 1 214 100 125 128 133 1 079 1 095 1 081 1 124 1 153 1 387 1 376 1 375 1 440 1 480 1 162 1 314 1 380 1 503 1 522 1 235 1 238 1 392 1 532 1 484 972 1 042 1 119 1 112 1 153 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 UNKNOWN UNKNOWN 0–14 15–24 25–34 35–44 45–54 55–64 65+ 65 57 43 30 26 317 339 239 242 230 325 332 207 274 260 212 209 142 159 148 115 119 102 103 119 79 72 54 66 62 75 54 62 58 68 48 52 49 59 329 298 340 333 305 308 311 337 199 178 177 184 139 158 141 164 85 113 118 146 127 110 121 153 0 0 0 28 6 6 6 5 81 85 63 61 81 76 82 65 61 73 63 59 49 44 80 63 50 58 52 90 39 42 51 69 64 47 70 68 92 90 0 0 0 0 0 0 1 0 0 0 0 0 0 51 41 38 29 25 224 199 339 194 186 255 167 245 190 192 221 175 277 179 154 146 135 176 139 154 129 87 88 108 102 94 111 95 103 106 3 1 14 2 2 4 5 11 41 22 17 17 7 8 62 25 19 10 6 7 41 19 17 17 5 5 30 20 17 12 2 5 11 10 7 7 4 3 9 6 9 5 0 0 0 96 116 158 148 160 54 25 27 28 19 15 2 1 0 0 1 1 914 1 097 1 268 1 282 1 476 208 21 219 186 181 180 7 8 1 5 3 1 857 1 099 1 223 1 250 1 415 292 269 222 163 194 157 6 8 5 4 4 5 513 633 608 595 698 134 258 125 106 138 115 5 7 4 5 0 4 275 414 358 363 416 76 270 107 103 99 88 5 2 0 1 3 2 132 170 207 196 219 136 160 81 69 98 75 2 5 1 0 1 0 71 132 134 128 156 48 38 104 107 126 114 2 1 3 2 1 0 1 126 1 288 1 303 1 299 1 284 0 0 0 176 125 112 136 134 663 771 791 776 778 828 733 763 765 743 698 710 730 698 686 832 784 852 889 840 595 637 713 734 824 709 784 836 824 824 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 2 0 0 0 0 0 1 0 0 1 0 23 18 17 22 10 0 86 3 5 6 10 19 18 16 23 18 9 4 147 552 371 178 194 163 157 273 0 155 44 76 69 96 88 64 112 168 163 182 180 1 311 5 290 3 802 172 174 159 189 235 0 193 78 129 127 104 103 71 103 185 244 238 230 849 2 875 2 670 175 147 116 141 156 0 112 61 129 80 91 104 96 105 136 129 135 158 454 1 546 1 513 126 108 106 115 108 0 126 37 84 62 99 67 74 86 117 143 151 143 322 1 041 1 075 96 64 61 82 61 0 42 27 57 61 63 51 57 80 87 103 124 116 200 801 641 92 90 79 108 94 0 83 26 49 49 47 61 61 71 99 99 103 129 216 796 708 24 34 23 27 4 0 72 6 11 7 11 9 13 12 31 18 14 16 149 633 375 176 188 135 154 61 0 120 43 73 51 55 62 65 69 89 106 110 95 1 005 3 686 2 674 215 173 122 149 145 0 111 34 81 52 64 57 49 86 98 99 103 98 660 2 472 2 111 98 98 103 92 161 0 75 35 62 46 58 45 46 41 69 39 55 60 373 1 156 1 046 83 76 61 75 108 0 57 19 33 45 44 46 35 41 52 50 39 55 259 609 699 64 46 54 50 64 0 16 12 30 23 40 22 34 30 29 46 36 38 162 499 333 46 61 47 79 72 0 40 16 41 29 48 44 53 46 71 45 62 60 152 624 472 4 0 0 0 0 0 3 1 4 0 1 1 12 4 4 3 4 5 20 19 7 2 3 1 15 9 9 4 6 6 9 10 7 5 6 8 19 14 7 8 2 10 0 0 0 1 1 0 0 0 0 2 4 3 1 1 0 6 5 2 0 1 3 5 3 5 2 1 1 7 7 4 6 0 2 4 1 1 2 3 3 9 3 7 4 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 1 1 0 1 0 2 1 1 0 2 0 0 4 1 1 1 3 0 2 2 2 2 2 0 0 0 0 1 0 0 0 1 1 0 0 1 0 0 0 0 0 1 1 1 0 0 0 1 0 0 0 1 0 1 0 1 0 2 1 0 0 0 0 0 0 0 0 0 0 0 11 6 7 Data for all years can be downloaded from www.who.int/tb/data 0 0 0 0 0 0 5 4 2 MALE:FEMALE RATIO – 1.4 1.5 1.5 1.6 1.7 – – 1.5 1.8 1.8 1.8 – 1.5 1.7 1.7 1.8 1.6 – – – 3.0 – – 1.1 1.2 0.92 1.3 1.1 – 1.5 2.0 2.2 2.1 2.7 3.3 – 1.1 1.0 1.1 1.0 1.0 1.6 1.3 1.3 1.4 1.4 1.6 2.1 1.8 2.8 3.5 1.7 2.5 – 1.6 1.6 1.6 1.7 1.7 – – – – – – – 1.5 – 1.2 1.2 1.3 1.3 1.5 – 1.6 1.7 1.6 1.8 1.6 1.7 1.5 1.8 1.9 2.2 2.2 2.3 1.3 1.3 1.4 – – – 2.4 2.4 1.7 1.5 3.1 3.1 – – – 1.0 – 1.0 – 1.3 0.83 2.0 – 4.5 GLOBAL TUBERCULOSIS REPORT 2013 REGION OF THE AMERICAS MALE YEAR 203 7$%/($1HZVPHDUSRVLWLYHFDVHQRWLILFDWLRQE\DJHDQGVH[ ± MALE YEAR Saint Vincent and the Grenadines Sint Maarten (Dutch part) Suriname Trinidad and Tobago Turks and Caicos Islands United States of America Uruguay US Virgin Islands Venezuela (Bolivarian Republic of) 204 1995 2000 2005 2010 2011 2012 2010 2011 2012 1995 2000 2005 2010 2011 2012 1995 2000 2005 2010 2011 2012 1995 2000 2005 2010 2011 2012 1995 2000 2005 2010 2011 2012 1995 2000 2005 2010 2011 2012 1995 2000 2005 2010 2011 2012 1995 2000 2005 2010 2011 2012 FEMALE 0–14 15–24 25–34 35–44 45–54 55–64 65+ 0 0 0 0 0 1 0 0 0 1 0 0 1 2 5 1 4 2 0 2 1 2 1 3 2 3 0 0 0 0 5 1 2 2 0 4 0 1 0 0 0 0 0 0 1 0 0 0 0 2 0 0 0 1 0 6 7 5 4 6 6 7 10 11 14 7 6 8 21 7 7 15 18 11 21 27 31 3 12 35 15 15 10 27 13 17 13 22 2 6 19 18 14 12 17 21 32 15 28 0 3 5 3 9 7 7 10 20 16 12 4 4 10 5 7 4 7 3 8 7 11 0 0 0 19 6 14 5 12 10 4 0 1 1 0 3 0 0 2 0 355 365 383 246 235 239 28 36 42 46 58 38 0 0 3 876 602 535 360 403 322 40 48 48 70 93 98 0 1 2 2 1 417 906 666 371 374 333 35 45 39 35 55 56 1 0 0 0 1 121 904 767 505 557 502 49 41 45 46 45 52 1 0 1 0 742 577 499 403 434 455 38 30 34 33 36 39 0 0 0 0 1 099 738 624 466 486 529 50 34 36 31 37 29 0 35 22 28 23 312 320 340 379 395 376 353 405 413 333 303 353 402 391 363 375 265 253 307 319 332 288 241 273 GLOBAL TUBERCULOSIS REPORT 2013 UNKNOWN UNKNOWN 0–14 15–24 25–34 35–44 45–54 55–64 65+ 0 0 0 1 0 0 0 0 0 0 0 0 1 0 1 1 1 3 0 0 0 0 1 0 1 0 1 3 2 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 2 0 1 0 2 0 0 0 0 1 2 3 3 4 1 1 6 5 4 4 6 9 6 2 6 1 7 4 7 9 7 7 11 3 1 10 5 5 2 9 3 7 3 10 0 2 6 2 7 5 5 5 5 4 8 1 1 2 2 1 3 2 4 2 2 4 1 2 8 1 0 0 4 3 2 5 12 0 0 0 0 0 0 26 14 11 9 15 14 2 2 1 3 1 2 0 0 0 280 246 241 195 160 161 21 28 33 24 29 25 0 0 2 579 376 348 265 254 262 26 22 30 36 55 26 1 0 0 499 349 276 183 199 169 18 21 17 12 19 21 1 0 1 285 253 242 165 150 175 12 13 9 10 12 15 0 0 0 202 152 161 130 138 148 9 12 8 5 11 13 0 0 0 591 396 322 223 269 243 17 16 12 16 16 15 0 0 0 0 0 37 26 25 32 351 269 252 276 299 306 316 281 267 188 178 203 183 145 178 167 146 147 150 161 216 188 190 199 0 0 0 0 0 0 0 0 0 0 0 2 0 0 Data for all years can be downloaded from www.who.int/tb/data 0 0 2 0 0 0 0 0 0 0 1 1 MALE:FEMALE RATIO – 8.0 2.5 3.0 3.0 2.4 0.50 1.0 – – 1.4 3.6 2.6 4.3 2.3 2.8 2.6 2.4 4.0 3.3 2.0 – – – 0.50 – 0.67 2.3 2.3 2.2 2.0 2.1 2.0 2.3 2.1 2.2 2.5 2.3 2.7 – – – – – – – – 1.4 1.6 1.5 1.6 7$%/($ /DERUDWRULHV173VHUYLFHVGUXJPDQDJHPHQWDQGLQIHFWLRQFRQWURO FREE THROUGH NTP Anguilla – Antigua and Barbuda – Argentina 1.7 0 Aruba – Bahamas – Barbados – Belize 0.9 Bermuda Bolivia (Plurinational State of) Bonaire, Saint Eustatius and Saba Brazil 0 0 1.9 0 0 0 0 0 – 5.1 0 24.8 0.5 0 0 – 2.0 – British Virgin Islands – Canada – Cayman Islands Chile Colombia Costa Rica Cuba 12.5 5.5 0.9 0.2 13 – 1.0 5.6 2.2 0 0 0 – Curaçao – Dominica – 11.2 124.6 14.6 0.3 0.4 1 0.3 0.5 0 1 4 4 Dominican Republic Ecuador 2.0 2.3 2 0 5.8 5.8 1 0.3 0 0 5 El Salvador 3.3 0 8.7 0.8 0 1 Grenada 1.9 18 3.3 1 0 0 Guyana 2.5 100 6.3 6.3 6.3 0 Haiti 2.5 6 1.0 1 1 7 Honduras 2.1 0 3.2 0.6 0 0 Jamaica 0.1 100 0 0 0 0 Mexico 1.0 0 2.7 0.6 <0.1 6 Montserrat – Nicaragua 3.2 100 1.7 0.8 Panama 1.4 0 14.5 1.3 1.3 3 Paraguay Peru 1.8 4.8 23 0 8.2 11.0 0.7 1.8 0 0.2 0 0 Puerto Rico – Saint Kitts and Nevis – Saint Lucia – Saint Vincent and the Grenadines – Sint Maarten (Dutch part) – 0.6 0 Trinidad and Tobago – Turks and Caicos Islands United States of America – – Uruguay US Virgin Islands Venezuela (Bolivarian Republic of) a b c d <0.1 100 9.4 0 0 No No No No Yes (all suspects) Yes Yes Yes Yes (all suspects) Yes Yes Yes No No Yes Yes Yes (other criteria) Yes Yes Yes Yes (all suspects) Yes Yes No Yes (all suspects) Yes Yes Yes Yes (all suspects) Yes Yes Yes Yes (all suspects) Yes Yes Yes Yes (all suspects) Yes Yes (all suspects) Don't know Yes Yes 0 2 1.5 1.5 1.5 0 3.5 0.2 0.2 0 Yes Yes Yes (all suspects) No Yes Yes Yes (all suspects) Yes Yes Yes Yes (all suspects) Yes Yes Yes Yes Yes Yes Yes (all suspects) Yes (all suspects) Yes (all suspects) Yes (all suspects) Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes (all suspects) Yes Yes Yes Yes (all suspects) Yes Yes Yes Yes Yes (all suspects) Yes (all suspects) Yes Yes Yes Yes Yes Out of Yes country In and out Yes of country Yes Out of Yes country Out of Yes country In and out Yes of country Out of No country Out of Yes country Yes (all suspects) Yes Yes Yes (all suspects) Yes Yes Yes (all suspects) Yes Yes Yes (all suspects) Yes Yes 83 14 Yes (all suspects) Yes Yes Yes (all suspects) Yes Yes 109 Yes (all suspects) Yes Yes 21 Yes (all suspects) Yes Yes 33 Yes (all suspects) No Yes Yes (all suspects) Yes Yes Yes Yes Yes Yes Yes (if TB is confirmed) Yes (all suspects) Yes (all suspects) Yes Yes Yes Yes Yes Yes (all suspects) Yes Yes No Yes (all suspects) Yes Yes Yes Yes (all suspects) Yes Yes No Yes In country In country Out of country No Out of country Out of country Out of country Out of country In and out of country TB DIAGNOSIS TB NOTIF. RIFAMPICIN RATE PER USED 100 000 THROUGHOUT HEALTH-CARE TREATMENT WORKERS Yes – Guatemala Suriname No Out of country In country Out of country Out of country Out of country Out of country Out of country Out of country Out of country In country Out of country In country Out of country In country In country No No Out of country Out of country In country In country Out of country NRLd FIRSTLINE DRUGS Yes Yes (all suspects) Yes Yes No Yes (other criteria) Yes Yes Yes Yes (all suspects) Yes Yes REGION OF THE AMERICAS LABORATORIES SECONDNUMBER OF SMEAR LABS % OF SMEAR CULTURE DST b LABS LPAc LABS LABS USING LABS PER 5M LINE DST LABS USING PER 100K PER 5M PER 5M a POPULATION POPULATION POPULATION POPULATION XPERT MTB/RIF AVAILABLE LED 7 Yes Yes (all suspects) Yes Yes In country Yes Out of Yes country Yes (all suspects) Yes Yes Yes (all suspects) Yes Yes 31 In country Yes Yes (all suspects) Yes Yes 2 242 – 0.8 0 LED = Light emitting diode microscopes DST = Drug susceptibility testing LPA = Line probe assay NRL = National Reference Laboratory Data for all years can be downloaded from www.who.int/tb/data GLOBAL TUBERCULOSIS REPORT 2013 205 7$%/($0HDVXUHGSHUFHQWDJHRI7%FDVHVZLWK0'57%DPRVWUHFHQW\HDUDYDLODEOH New TB cases Year Anguilla Antigua and Barbuda Argentina Aruba Bahamas Barbados Belize Bermuda Bolivia (Plurinational State of) Bonaire, Saint Eustatius and Saba Brazil British Virgin Islands Canada Cayman Islands Chile Colombia Costa Rica Cuba Curaçao Dominica Dominican Republic Ecuador El Salvador Grenada Guatemala Guyana Haiti Honduras Jamaica Mexico Montserrat Nicaragua Panama Paraguay Peru Puerto Rico Saint Kitts and Nevis Saint Lucia Saint Vincent and the Grenadines Sint Maarten (Dutch part) Suriname Trinidad and Tobago Turks and Caicos Islands United States of America Uruguay Venezuela (Bolivarian Republic of) a Source Previously treated TB cases Coverage Percentage Year Source Coverage Percentage 2005 Survey National 2.2 (1.2–3.6) 2005 Survey National 15 (9.8–23) 2012 Surveillance National 3.7 (<0.1–19) 2012 Surveillance National 0 (0–98) 2012 Surveillance National 0 (0–98) 2012 Surveillance National 11 (8.9–14) 2012 Surveillance National 1996 Survey National 2011 Surveillance National 2008 Survey Sub-national 2012 2012 2001 2005 2006 2012 2012 2011 1995 2002 2001 Surveillance Surveillance Survey Survey Survey Surveillance Surveillance Surveillance Survey Survey Survey National National National National National National National National National National National 2002 Survey National 2004 Survey 2009 Survey 0 (0–84) 1.2 (0.44–2.6) 50 (1.3–99) 2011 Surveillance National 100 (2.5–100) 1.4 (1.0–1.8) 2008 Survey Sub-national 7.5 (5.7–9.9) 2012 2012 2012 2012 2012 2012 2012 2012 1995 2012 2012 Surveillance Surveillance Surveillance Surveillance Surveillance Surveillance Surveillance Surveillance Survey Surveillance Surveillance National National National National National National National National National National National 1.6 0 2.9 13 4.5 12 0 0 20 26 11 3 (1.8–4.6) 2002 Survey National 26 (20–34) National 1.8 (0.76–3.4) 2004 Survey National 12 (5.8–22) National 2.4 (2.1–2.8) 2009 Survey National 6.3 (5.1–7.8) 0.57 0 0.69 2.4 1.5 0.74 0 0 6.6 4.9 0.33 (0.23–1.2) (0–52) (0.25–1.5) (1.6–3.6) (0.42–3.9) (<0.1–2.7) (0–98) (0–98) (4.1–10) (3.5–6.7) (<0.1–1.2) (<0.1–8.5) (0–98) (0.95–6.7) (9.6–17) (0.12–23) (4.4–24) (0–98) (0–98) (13–28) (23–29) (4.9–20) 2006 Survey National 0.63 (<0.1–2.2) 2010 Surveillance National 11 (6.2–17) 2008 2012 2012 Survey Surveillance Surveillance National National National 0.31 (<0.1–1.7) 3.9 (3.6–4.2) 0 (0–6.5) 2008 2012 2012 Survey Surveillance Surveillance National National National 15 (6.1–28) 35 (33–37) 33 (0.84–91) 2012 2012 Surveillance Surveillance National National 1 (0.80–1.3) 0 (0–0.79) 2012 2012 Surveillance Surveillance National National 2.9 (1.4–5.4) 2.4 (<0.1–13) 1999 Survey National 0.52 (0.14–1.3) 1999 Survey National 13 (7.6–22) Empty rows indicate an absence of high-quality survey or surveillance data. In the absence of high-quality national data, high-quality sub-national data are used. 206 GLOBAL TUBERCULOSIS REPORT 2013 Data for all years can be downloaded from www.who.int/tb/data '#56'40/'&+6'44#0'#04')+10 Table A4.1 Estimates of the burden of disease caused by TB, 1990–2012 209 6CDNG# +PEKFGPEGPQVKßECVKQPCPFECUGFGVGEVKQPTCVGUCNNHQTOU¿ 6CDNG# %CUGPQVKßECVKQPU¿ Table A4.4 Treatment outcomes, new smear-positive cases, 1995–2011 215 Table A4.5 Treatment outcomes, retreatment cases, 1995–2011 217 6CDNG# *+8VGUVKPICPFRTQXKUKQPQH%26#46CPF+26¿ 6CDNG# 6GUVKPIHQT/&46$CPFPWODGTQHEQPßTOGFECUGUQH/&46$¿ 6CDNG# 0GYUOGCTRQUKVKXGECUGPQVKßECVKQPD[CIGCPFUGZ¿ Table A4.9 Laboratories, NTP services, drug management and infection control, 2012 223 6CDNG# /GCUWTGFRGTEGPVCIGQH6$ECUGUYKVJ/&46$OQUVTGEGPV[GCTCXCKNCDNG Estimates of mortality, prevalence and incidence Estimated values are shown as best estimates followed by lower and upper bounds. The lower and upper bounds are defined as the 2.5th and 97.5th centiles of outcome distributions produced in simulations. See ANNEX 1 for further details. Estimated numbers are shown rounded to two significant figures. Estimated rates are shown rounded to three significant figures unless the value is under 100, in which case rates are shown rounded to two significant figures. Estimates for all years are recalculated as new information becomes available and techniques are refined, so they may differ from those published in previous reports in this series. The main updates implemented in this report are explained in Box 2.1 of Chapter 2. Estimates published in previous global TB control reports should no longer be used. Data source Data shown in this annex are taken from the WHO global TB database on 1 October 2013. Data shown in the main part of the report were taken from the database in July 2013. As a result, data in this annex may differ slightly from those in the main part of the report. Data for all years can be downloaded from www.who.int/tb/data. GLOBAL TUBERCULOSIS REPORT 2013 Data for all years can be downloaded from www.who.int/tb/data 7$%/($(VWLPDWHVRIWKHEXUGHQRIGLVHDVHFDXVHGE\7% ± YEAR Afghanistan Bahrain Djibouti Egypt Iran (Islamic Republic of) Iraq Jordan Kuwait Lebanon Libyan Arab Jamahiriya Morocco Oman Pakistan Qatar Saudi Arabia Somalia a 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 12 18 21 25 28 29 30 <1 <1 <1 <1 1 1 1 <1 <1 <1 <1 <1 <1 <1 56 61 66 72 78 79 81 56 60 66 70 74 75 76 18 20 24 27 31 32 33 3 4 5 5 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(0.840–1.4) (0.700–0.830) (0.420–0.490) (0.530–0.600) (0.350–0.400) (0.870–5.3) (1.1–6.5) (0.830–5.1) (0.680–4.2) (0.730–4.5) (0.780–4.7) (0.700–4.7) (0.410–2.4) (0.310–2.6) (0.180–2.9) (0.100–3.1) (0.039–3.4) (0.030–3.5) (0.025–3.5) (0–0.330) (0–0.390) (0–0.410) (0–0.410) (0–0.420) (0–0.420) (0–0.420) (0.017–0.022) (0.021–0.024) (0.014–0.015) (0.022–0.023) (0.033–0.033) (0.018–0.018) (0.030–0.031) (0.046–0.130) (0.034–0.110) (0.020–0.069) (0.025–0.074) (0.035–0.110) (0.039–0.120) (0.038–0.120) (0.170–0.840) (0.120–0.500) (0.120–0.490) (0.120–0.390) (0.140–0.570) (0.140–0.610) (0.180–0.760) (4.8–7.7) (3.7–6.8) (2.8–6.1) (2.0–5.5) (1.5–5.2) (1.5–5.2) (1.4–5.1) (<0.01–0.200) (<0.01–0.230) (<0.01–0.230) (0–0.250) (0–0.260) (0–0.280) (0–0.300) (24–170) (32–180) (36–190) (33–160) (28–110) (27–110) (27–110) (0.030–0.032) (0.016–0.017) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (0.061–1.9) (0.068–2.1) (0.075–2.3) (0.091–2.8) (0.100–3.1) (0.100–3.2) (0.110–3.2) (1.7–12) (1.8–9.7) (1.9–9.7) (1.9–8.9) (2.3–11) (2.4–11) (2.5–12) a RATE 31 49 53 39 35 36 37 7 3.5 2.5 0.85 0.44 0.39 0.34 99 60 57 83 82 79 76 3.2 2.5 1.7 1.1 0.58 0.71 0.46 4.6 5.4 3.8 3 3 3.1 2.9 6.9 5.7 4.7 3.9 3.2 3 2.9 1.2 0.93 0.81 0.7 0.57 0.55 0.53 0.94 1.4 0.76 0.99 1.1 0.58 0.94 3.1 2.2 1.2 1.2 1.5 1.6 1.5 10 5.9 5.3 4.2 5.4 5.5 6.8 25 19 15 12 9.8 9.5 9.2 3.2 2.3 1.8 1.4 1 0.97 0.92 72 71 69 53 37 35 34 6.5 3.3 0.7 0.15 0.22 0.19 0.17 3.9 3.8 3.9 3.9 3.9 3.9 3.9 90 79 68 56 59 61 64 (7.3–72) (17–100) (19–102) (16–73) (15–65) (15–66) (15–68) (6.5–7.4) (3.2–3.8) (2.2–3.0) (0.78–0.93) (0.38–0.51) (0.32–0.46) (0.28–0.41) (24–226) (23–114) (25–102) (33–156) (34–149) (34–144) (33–139) (2.5–3.9) (1.9–3.2) (1.3–2.2) (0.97–1.2) (0.54–0.62) (0.66–0.76) (0.43–0.50) (1.5–9.4) (1.8–11) (1.3–7.7) (0.97–6.0) (0.98–6.0) (1.0–6.3) (0.92–6.1) (2.3–14) (1.5–13) (0.77–12) (0.38–11) (0.13–11) (0.10–11) (<0.1–11) (0–9.9) (0–9.0) (0–8.6) (0–7.8) (0–6.5) (0–6.3) (0–6.0) (0.81–1.1) (1.3–1.5) (0.75–0.78) (0.97–1.0) (1.1–1.1) (0.57–0.58) (0.93–0.95) (1.7–5.0) (1.1–3.7) (0.61–2.1) (0.62–1.8) (0.80–2.4) (0.86–2.6) (0.81–2.5) (3.9–20) (2.6–11) (2.3–9.4) (2.1–6.9) (2.4–9.5) (2.3–10) (2.9–12) (19–31) (14–25) (9.7–21) (6.8–18) (4.9–16) (4.6–16) (4.4–16) (0.14–11) (<0.1–10) (0–10) (0–10) (0–9.4) (0–9.2) (0–9.0) (22–152) (25–139) (25–135) (21–101) (16–66) (15–63) (15–61) (6.3–6.6) (3.1–3.4) (0.62–0.78) (0.12–0.17) (0.15–0.30) (0.12–0.27) (0.10–0.25) (0.37–11) (0.37–11) (0.37–11) (0.37–11) (0.37–11) (0.37–11) (0.39–11) (27–190) (29–153) (26–131) (23–105) (24–111) (24–115) (25–120) PREVALENCE (INCLUDING HIV) NUMBER (THOUSANDS) 38 79 92 92 99 100 110 0.16 0.081 0.37 0.42 0.34 0.32 0.38 6.2 5.4 5.6 7.1 7.7 7.7 7.7 48 37 28 24 23 23 23 29 35 27 23 24 25 25 17 16 14 19 24 23 24 0.61 0.65 0.48 0.47 0.57 0.57 0.6 0.48 0.46 0.77 0.71 1.7 0.98 1.1 1.2 1.1 0.66 0.61 0.83 0.91 0.95 3.6 2.9 3 2.8 3.5 3.7 4.1 57 64 46 41 44 46 46 0.8 0.4 0.57 0.36 0.45 0.51 0.6 650 740 820 760 670 670 670 0.28 0.54 0.43 0.53 0.82 0.78 1.2 4 3.9 5.3 5.1 7.7 6.1 4.9 46 42 45 45 53 56 59 (13–77) (37–140) (43–160) (46–150) (50–160) (52–170) (54–180) (0.049–0.350) (0.024–0.170) (0.180–0.630) (0.170–0.790) (0.110–0.690) (0.120–0.630) (0.180–0.650) (2.2–12) (2.2–10) (2.4–10) (3.4–12) (3.7–13) (3.6–13) (3.6–13) (22–84) (19–61) (14–46) (12–41) (12–39) (12–39) (12–39) (12–53) (15–64) (11–51) (9.4–42) (9.9–44) (11–47) (10–47) (4.9–35) (4.9–34) (5.0–29) (8.8–33) (13–40) (12–39) (12–40) (0.230–1.2) (0.250–1.2) (0.180–0.930) (0.170–0.910) (0.240–1.0) (0.250–1.0) (0.280–1.0) (0.230–0.830) (0.160–0.930) (0.300–1.5) (0.240–1.4) (0.860–2.9) (0.330–2.0) (0.360–2.1) (0.460–2.3) (0.340–2.2) (0.220–1.3) (0.260–1.1) (0.370–1.5) (0.410–1.6) (0.390–1.7) (1.7–6.4) (1.3–5.1) (1.3–5.4) (1.1–5.5) (1.5–6.3) (1.8–6.4) (1.9–7.0) (24–110) (30–110) (20–84) (17–75) (19–79) (20–82) (19–83) (0.360–1.4) (0.140–0.790) (0.280–0.960) (0.120–0.730) (0.170–0.870) (0.200–0.950) (0.260–1.1) (250–1 300) (330–1 300) (370–1 400) (380–1 300) (330–1 100) (330–1 100) (320–1 100) (0.110–0.520) (0.260–0.910) (0.180–0.780) (0.230–0.950) (0.290–1.6) (0.260–1.6) (0.560–2.1) (1.8–7.0) (1.4–7.6) (2.2–9.7) (1.9–9.8) (3.7–13) (2.5–11) (1.6–10) (17–89) (19–73) (21–76) (23–76) (27–89) (28–94) (29–99) INCIDENCE (INCLUDING HIV) a RATE 327 447 449 369 350 352 358 33 14 56 48 27 25 29 1 050 809 775 920 922 911 897 85 60 42 34 30 29 29 51 58 41 32 32 34 33 94 79 61 70 78 73 73 18 15 10 9 8.8 8.5 8.5 23 29 41 31 58 31 33 45 35 20 15 19 20 20 86 61 57 51 58 61 66 232 240 161 137 138 143 140 44 18 26 14 16 17 18 589 584 573 483 389 381 376 59 107 72 64 47 41 60 25 21 26 21 28 22 17 732 663 604 537 555 566 581 (112–655) (208–775) (210–775) (185–617) (177–580) (177–585) (181–595) (9.9–70) (4.3–30) (27–94) (19–89) (9.0–55) (9.0–49) (14–49) (368–2 070) (326–1 510) (333–1 400) (444–1 570) (440–1 580) (430–1 570) (418–1 560) (39–149) (31–99) (20–70) (17–57) (15–50) (15–49) (15–48) (21–93) (24–106) (17–77) (13–60) (13–59) (14–62) (13–61) (28–200) (24–167) (21–121) (32–122) (41–128) (37–123) (36–122) (6.8–35) (5.8–29) (3.8–20) (3.3–17) (3.8–16) (3.7–15) (3.9–15) (11–40) (9.9–59) (16–77) (11–62) (29–98) (11–63) (11–65) (17–87) (11–72) (6.9–41) (6.5–28) (8.6–34) (9.1–36) (8.5–37) (39–150) (27–108) (24–104) (19–98) (25–104) (29–105) (31–113) (97–426) (112–415) (68–292) (57–251) (59–251) (62–257) (58–257) (20–78) (6.5–37) (13–44) (4.9–29) (6.1–31) (6.7–31) (7.8–33) (222–1 130) (262–1 030) (260–1 010) (239–810) (191–657) (185–647) (181–641) (24–108) (52–182) (30–132) (28–115) (17–92) (14–82) (27–105) (11–43) (7.7–41) (11–48) (7.8–40) (13–48) (9.1–40) (5.5–36) (272–1 410) (305–1 160) (291–1 030) (267–900) (279–925) (283–947) (287–975) NUMBER (THOUSANDS) 22 33 39 47 54 55 56 0.13 0.049 0.24 0.32 0.28 0.26 0.26 3.7 4.1 4.5 4.8 5.2 5.2 5.3 19 19 17 15 14 14 14 18 21 17 14 15 16 16 9.5 11 12 13 14 14 15 0.48 0.51 0.38 0.38 0.41 0.4 0.4 0.32 0.39 0.59 0.59 1.1 0.77 0.85 0.94 0.88 0.56 0.45 0.6 0.67 0.73 1.7 1.9 2.1 2.2 2.4 2.4 2.5 36 41 33 30 32 33 33 0.55 0.32 0.37 0.3 0.35 0.39 0.44 260 290 330 370 400 410 410 0.21 0.35 0.32 0.37 0.67 0.64 0.84 2.8 3.1 4 4.1 5.1 4.5 4.2 18 18 21 24 28 28 29 (14–33) (27–40) (32–47) (38–56) (44–64) (45–66) (47–67) (0.120–0.150) (0.043–0.056) (0.210–0.270) (0.280–0.360) (0.250–0.320) (0.230–0.290) (0.230–0.290) (2.3–5.3) (3.4–4.9) (3.8–5.2) (3.9–5.8) (4.3–6.2) (4.3–6.2) (4.4–6.3) (16–23) (16–23) (14–20) (13–18) (12–16) (12–16) (12–16) (13–23) (16–28) (12–22) (10–19) (11–19) (11–21) (11–21) (8.3–11) (9.4–12) (10–14) (11–15) (12–16) (13–16) (13–17) (0.420–0.550) (0.450–0.580) (0.340–0.440) (0.330–0.430) (0.360–0.460) (0.350–0.460) (0.360–0.460) (0.280–0.360) (0.340–0.440) (0.520–0.670) (0.520–0.670) (0.960–1.2) (0.680–0.870) (0.740–0.960) (0.820–1.1) (0.770–1.0) (0.490–0.630) (0.400–0.510) (0.530–0.680) (0.590–0.760) (0.640–0.830) (1.4–2.0) (1.5–2.3) (1.7–2.5) (1.9–2.6) (2.0–2.9) (2.0–2.9) (2.0–2.9) (27–47) (33–49) (29–38) (26–34) (28–36) (29–37) (29–38) (0.490–0.630) (0.280–0.360) (0.320–0.420) (0.260–0.340) (0.310–0.400) (0.340–0.440) (0.380–0.500) (160–380) (240–350) (270–400) (300–440) (330–480) (340–490) (340–490) (0.190–0.240) (0.310–0.400) (0.280–0.360) (0.330–0.420) (0.580–0.750) (0.560–0.720) (0.730–0.950) (2.4–3.1) (2.7–3.5) (3.5–4.5) (3.6–4.6) (4.5–5.8) (4.0–5.1) (3.7–4.8) (11–27) (15–22) (17–25) (20–29) (23–33) (23–34) (24–35) RATEa 189 189 189 189 189 189 189 27 8.8 36 37 23 20 20 619 619 619 619 620 620 620 34 32 26 21 18 17 17 31 35 26 20 20 21 21 54 53 50 48 45 45 45 14 12 8.1 7.2 6.3 6 5.8 15 24 31 26 37 25 26 35 29 17 11 14 15 16 40 40 40 40 40 40 40 147 152 117 100 100 103 103 31 15 17 12 13 13 13 231 231 231 231 231 231 231 44 70 54 46 38 33 41 17 17 20 16 19 16 15 285 285 285 285 286 286 286 (117–279) (155–227) (155–227) (155–227) (156–225) (156–225) (156–226) (24–31) (7.7–9.9) (31–40) (32–41) (20–26) (18–23) (17–22) (395–893) (506–744) (528–718) (506–744) (512–738) (512–738) (512–738) (29–40) (27–37) (22–30) (18–25) (15–21) (15–20) (14–19) (23–41) (26–46) (19–34) (15–27) (14–26) (15–27) (15–28) (47–62) (46–60) (44–57) (42–54) (40–52) (39–51) (39–51) (13–16) (10–13) (7.1–9.1) (6.3–8.1) (5.5–7.1) (5.2–6.8) (5.1–6.5) (14–18) (21–28) (27–35) (23–29) (32–42) (22–28) (23–30) (31–39) (26–33) (15–20) (10–13) (12–16) (13–17) (14–18) (33–48) (33–48) (33–48) (34–46) (33–48) (33–48) (33–48) (110–189) (124–182) (102–132) (88–113) (88–114) (90–117) (90–117) (27–35) (13–17) (15–19) (10–13) (11–14) (11–15) (12–15) (143–341) (189–278) (189–278) (189–278) (190–276) (190–276) (190–276) (39–50) (61–79) (47–61) (40–52) (33–43) (29–38) (36–46) (15–19) (15–19) (17–22) (14–19) (17–21) (14–18) (13–17) (176–421) (233–343) (233–343) (233–343) (236–340) (236–340) (236–340) EASTERN MEDITERRANEAN REGION MORTALITY (EXCLUDING HIV) POPULATION (MILLIONS) Rates are per 100 000 population. Data for all years can be downloaded from www.who.int/tb/data GLOBAL TUBERCULOSIS REPORT 2013 209 7$%/($(VWLPDWHVRIWKHEXUGHQRIGLVHDVHFDXVHGE\7% ± MORTALITY (EXCLUDING HIV) South Sudan Sudan Syrian Arab Republic Tunisia United Arab Emirates West Bank and Gaza Strip Yemen a YEAR POPULATION (MILLIONS) 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 10 11 26 30 34 40 46 36 37 12 14 16 18 22 22 22 8 9 10 10 11 11 11 2 2 3 4 8 9 9 2 3 3 4 4 4 4 12 15 18 20 23 23 24 NUMBER (THOUSANDS) 3.1 3.2 11 9 9.3 9.3 10 8 8 0.97 0.85 0.56 0.47 0.47 0.47 0.46 0.24 0.3 0.26 0.25 0.31 0.33 0.32 0.017 0.022 0.029 0.02 0.022 0.015 <0.01 <0.01 0.035 0.018 0.012 <0.01 <0.01 <0.01 3.8 3.5 3.3 2.8 1.4 1.4 1.3 (1.3–5.6) (1.4–5.8) (4.4–22) (3.8–16) (4.0–17) (4.0–17) (4.3–18) (3.4–15) (3.3–15) (0.270–2.1) (0.370–1.5) (0.280–0.930) (0.220–0.810) (0.210–0.830) (0.210–0.830) (0.210–0.820) (0.130–0.370) (0.160–0.470) (0.140–0.410) (0.140–0.400) (0.170–0.500) (0.180–0.520) (0.170–0.500) (0–0.110) (0–0.140) (0–0.190) (0–0.150) (0–0.150) (0–0.097) (<0.01–0.045) (<0.01–<0.01) (0.034–0.036) (0.018–0.019) (0.012–0.012) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (1.1–8.2) (1.5–6.3) (1.4–6.0) (1.2–5.2) (0.640–2.5) (0.630–2.5) (0.600–2.4) PREVALENCE (INCLUDING HIV) NUMBER (THOUSANDS) RATEa 30 30 44 30 27 24 22 22 22 7.8 5.9 3.4 2.6 2.2 2.2 2.1 2.9 3.3 2.7 2.5 2.9 3.1 2.9 0.95 0.95 0.95 0.49 0.26 0.17 0.1 0.45 1.3 0.57 0.34 0.23 0.23 0.23 32 23 19 14 6.2 6 5.6 (13–54) (13–54) (17–84) (13–55) (12–49) (10–42) (9.4–40) (9.3–40) (9.0–40) (2.2–17) (2.6–11) (1.7–5.7) (1.2–4.4) (0.99–3.9) (0.98–3.8) (0.96–3.7) (1.6–4.6) (1.8–5.3) (1.5–4.3) (1.4–4.0) (1.6–4.7) (1.7–4.8) (1.6–4.6) (0–6.1) (0–6.1) (0–6.1) (0–3.6) (0–1.8) (0–1.1) (0–0.49) (0.43–0.46) (1.3–1.4) (0.56–0.58) (0.33–0.35) (0.23–0.24) (0.22–0.23) (0.22–0.23) (9.3–70) (9.8–42) (8.1–34) (5.9–26) (2.8–11) (2.7–11) (2.5–9.9) 28 28 99 89 90 90 96 76 77 11 9.3 7 5.9 5.6 5.5 5.3 3.2 3.9 3.3 3.3 4.1 4.4 4.5 0.39 0.51 0.65 0.44 0.52 0.37 0.22 0.18 0.27 0.45 0.29 0.25 0.34 0.47 35 36 35 29 17 17 17 (13–47) (13–47) (48–170) (45–150) (45–150) (45–150) (48–160) (38–130) (39–130) (3.6–22) (3.9–17) (2.5–14) (2.1–12) (2.1–11) (2.1–10) (2.1–9.9) (1.3–5.8) (1.7–6.9) (1.4–6.0) (1.4–5.9) (1.7–7.6) (1.8–8.1) (1.7–8.5) (0.170–0.710) (0.220–0.910) (0.280–1.2) (0.190–0.800) (0.230–0.930) (0.160–0.660) (0.077–0.440) (0.091–0.320) (0.230–0.800) (0.340–1.3) (0.240–0.910) (0.240–0.870) (0.290–1.1) (0.370–1.4) (13–66) (18–60) (17–59) (14–48) (7.5–29) (7.4–30) (7.1–30) RATEa 268 257 386 296 262 226 210 209 207 86 65 43 33 26 25 24 39 43 35 33 39 41 41 22 22 22 11 6.2 4.2 2.4 8.6 10 14 8.1 6.1 8.3 11 293 239 198 142 73 72 70 (129–456) (124–437) (185–659) (149–491) (132–436) (113–378) (105–350) (105–347) (104–345) (29–174) (27–119) (15–85) (11–65) (9.8–50) (9.8–47) (9.7–45) (16–72) (18–77) (15–63) (14–59) (16–71) (17–75) (16–78) (9.2–39) (9.2–39) (9.3–39) (4.5–19) (2.7–11) (1.8–7.4) (0.84–4.8) (4.4–15) (8.7–31) (11–41) (6.8–26) (6.0–22) (7.1–26) (8.7–32) (112–558) (118–401) (97–335) (71–239) (33–129) (32–129) (30–127) INCIDENCE (INCLUDING HIV) NUMBER (THOUSANDS) 15 16 44 47 50 53 54 42 42 7.5 6.6 5.7 4.8 4.3 4.1 3.9 2.3 2.7 2.4 2.4 3 3.2 3.4 0.22 0.28 0.36 0.21 0.26 0.21 0.16 0.12 0.22 0.33 0.23 0.21 0.26 0.32 16 21 20 16 11 11 12 (13–18) (13–19) (36–52) (39–56) (41–59) (43–63) (45–65) (35–51) (35–51) (5.3–10) (5.4–7.9) (4.9–6.6) (4.0–5.6) (3.5–5.1) (3.4–4.9) (3.2–4.6) (2.0–2.6) (2.4–3.1) (2.1–2.7) (2.1–2.7) (2.6–3.4) (2.8–3.6) (3.0–3.8) (0.160–0.280) (0.200–0.370) (0.260–0.480) (0.150–0.270) (0.190–0.340) (0.150–0.270) (0.120–0.210) (0.110–0.140) (0.200–0.250) (0.290–0.370) (0.200–0.260) (0.190–0.240) (0.230–0.290) (0.280–0.360) (10–24) (17–25) (17–24) (13–19) (9.2–13) (9.4–14) (9.6–14) Rates are per 100 000 population. 210 GLOBAL TUBERCULOSIS REPORT 2013 Data for all years can be downloaded from www.who.int/tb/data RATEa 146 146 170 158 144 133 119 117 114 61 46 35 26 20 19 18 29 31 25 23 28 30 31 12 12 12 5 3.1 2.3 1.7 6 8.6 10 6.5 5.3 6.3 7.6 137 137 116 81 49 49 49 (121–174) (121–174) (140–203) (130–188) (119–172) (110–158) (98–142) (96–139) (94–136) (43–82) (38–55) (30–40) (22–31) (16–24) (16–22) (15–21) (25–32) (27–35) (22–28) (21–27) (25–32) (26–34) (27–35) (8.7–16) (8.7–16) (8.7–16) (3.6–6.5) (2.3–4.1) (1.7–3.0) (1.2–2.3) (5.2–6.8) (7.5–9.7) (9.0–12) (5.7–7.3) (4.6–6.0) (5.5–7.1) (6.7–8.6) (85–202) (112–165) (94–139) (66–97) (40–58) (40–58) (40–58) 7$%/($,QFLGHQFHQRWLILFDWLRQDQGFDVHGHWHFWLRQUDWHVDOOIRUPV ± Afghanistan Bahrain Djibouti Egypt Iran (Islamic Republic of) Iraq Jordan Kuwait Lebanon Libyan Arab Jamahiriya Morocco Oman Pakistan Qatar Saudi Arabia Somalia a b 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 POPULATION (MILLIONS) 12 18 21 25 28 29 30 <1 <1 <1 <1 1 1 1 <1 <1 <1 <1 <1 <1 <1 56 61 66 72 78 79 81 56 60 66 70 74 75 76 18 20 24 27 31 32 33 3 4 5 5 6 7 7 2 2 2 2 3 3 3 3 3 3 4 4 4 5 4 5 5 6 6 6 6 25 27 29 30 32 32 33 2 2 2 3 3 3 3 111 127 144 158 173 176 179 <1 <1 <1 <1 2 2 2 16 19 20 25 27 28 28 6 6 7 8 10 10 10 NUMBER (THOUSANDS) 22 33 39 47 54 55 56 0.13 0.049 0.24 0.32 0.28 0.26 0.26 3.7 4.1 4.5 4.8 5.2 5.2 5.3 19 19 17 15 14 14 14 18 21 17 14 15 16 16 9.5 11 12 13 14 14 15 0.48 0.51 0.38 0.38 0.41 0.4 0.4 0.32 0.39 0.59 0.59 1.1 0.77 0.85 0.94 0.88 0.56 0.45 0.6 0.67 0.73 1.7 1.9 2.1 2.2 2.4 2.4 2.5 36 41 33 30 32 33 33 0.55 0.32 0.37 0.3 0.35 0.39 0.44 260 290 330 370 400 410 410 0.21 0.35 0.32 0.37 0.67 0.64 0.84 2.8 3.1 4 4.1 5.1 4.5 4.2 18 18 21 24 28 28 29 (14–33) (27–40) (32–47) (38–56) (44–64) (45–66) (47–67) (0.120–0.150) (0.043–0.056) (0.210–0.270) (0.280–0.360) (0.250–0.320) (0.230–0.290) (0.230–0.290) (2.3–5.3) (3.4–4.9) (3.8–5.2) (3.9–5.8) (4.3–6.2) (4.3–6.2) (4.4–6.3) (16–23) (16–23) (14–20) (13–18) (12–16) (12–16) (12–16) (13–23) (16–28) (12–22) (10–19) (11–19) (11–21) (11–21) (8.3–11) (9.4–12) (10–14) (11–15) (12–16) (13–16) (13–17) (0.420–0.550) (0.450–0.580) (0.340–0.440) (0.330–0.430) (0.360–0.460) (0.350–0.460) (0.360–0.460) (0.280–0.360) (0.340–0.440) (0.520–0.670) (0.520–0.670) (0.960–1.2) (0.680–0.870) (0.740–0.960) (0.820–1.1) (0.770–1.0) (0.490–0.630) (0.400–0.510) (0.530–0.680) (0.590–0.760) (0.640–0.830) (1.4–2.0) (1.5–2.3) (1.7–2.5) (1.9–2.6) (2.0–2.9) (2.0–2.9) (2.0–2.9) (27–47) (33–49) (29–38) (26–34) (28–36) (29–37) (29–38) (0.490–0.630) (0.280–0.360) (0.320–0.420) (0.260–0.340) (0.310–0.400) (0.340–0.440) (0.380–0.500) (160–380) (240–350) (270–400) (300–440) (330–480) (340–490) (340–490) (0.190–0.240) (0.310–0.400) (0.280–0.360) (0.330–0.420) (0.580–0.750) (0.560–0.720) (0.730–0.950) (2.4–3.1) (2.7–3.5) (3.5–4.5) (3.6–4.6) (4.5–5.8) (4.0–5.1) (3.7–4.8) (11–27) (15–22) (17–25) (20–29) (23–33) (23–34) (24–35) RATEa 189 189 189 189 189 189 189 27 8.8 36 37 23 20 20 619 619 619 619 620 620 620 34 32 26 21 18 17 17 31 35 26 20 20 21 21 54 53 50 48 45 45 45 14 12 8.1 7.2 6.3 6 5.8 15 24 31 26 37 25 26 35 29 17 11 14 15 16 40 40 40 40 40 40 40 147 152 117 100 100 103 103 31 15 17 12 13 13 13 231 231 231 231 231 231 231 44 70 54 46 38 33 41 17 17 20 16 19 16 15 285 285 285 285 286 286 286 (117–279) (155–227) (155–227) (155–227) (156–225) (156–225) (156–226) (24–31) (7.7–9.9) (31–40) (32–41) (20–26) (18–23) (17–22) (395–893) (506–744) (528–718) (506–744) (512–738) (512–738) (512–738) (29–40) (27–37) (22–30) (18–25) (15–21) (15–20) (14–19) (23–41) (26–46) (19–34) (15–27) (14–26) (15–27) (15–28) (47–62) (46–60) (44–57) (42–54) (40–52) (39–51) (39–51) (13–16) (10–13) (7.1–9.1) (6.3–8.1) (5.5–7.1) (5.2–6.8) (5.1–6.5) (14–18) (21–28) (27–35) (23–29) (32–42) (22–28) (23–30) (31–39) (26–33) (15–20) (10–13) (12–16) (13–17) (14–18) (33–48) (33–48) (33–48) (34–46) (33–48) (33–48) (33–48) (110–189) (124–182) (102–132) (88–113) (88–114) (90–117) (90–117) (27–35) (13–17) (15–19) (10–13) (11–14) (11–15) (12–15) (143–341) (189–278) (189–278) (189–278) (190–276) (190–276) (190–276) (39–50) (61–79) (47–61) (40–52) (33–43) (29–38) (36–46) (15–19) (15–19) (17–22) (14–19) (17–21) (14–18) (13–17) (176–421) (233–343) (233–343) (233–343) (236–340) (236–340) (236–340) INCIDENCE HIV-POSITIVE NUMBER (THOUSANDS) RATEa 0.041 0.072 0.1 0.16 0.25 0.28 0.31 (0.025–0.060) (0.040–0.11) (0.058–0.16) (0.090–0.24) (0.15–0.38) (0.17–0.41) (0.19–0.46) 0.4 0.4 0.5 0.6 0.9 1 1 (0.22–0.52) (0.23–0.65) (0.28–0.77) (0.36–0.96) (0.54–1.3) (0.58–1.4) (0.63–1.5) 0.011 0.012 0.012 0.082 0.43 0.74 0.74 0.6 0.57 0.54 <0.01 0.029 0.1 0.18 0.14 0.14 0.13 0.011 0.051 0.15 0.21 0.26 0.28 0.29 0 0 0 0 <0.01 0 0 (<0.01–0.022) (<0.01–0.023) (<0.01–0.025) (0.052–0.12) (0.35–0.52) (0.63–0.86) (0.61–0.89) (0.49–0.71) (0.47–0.68) (0.45–0.64) (<0.01–0.012) (0.024–0.034) (0.085–0.12) (0.15–0.21) (0.12–0.17) (0.12–0.16) (0.11–0.16) (<0.01–0.014) (0.037–0.067) (0.11–0.20) (0.15–0.27) (0.19–0.34) (0.20–0.37) (0.21–0.39) (0–0) (0–0) (0–0) (0–0) (0–0.010) (0–0) (0–0) 0.8 0.9 0.9 14 65 102 96 72 68 63 <0.1 <0.1 0.2 0.3 0.2 0.2 0.2 <0.1 <0.1 0.2 0.3 0.4 0.4 0.4 0 0 0 0 <0.1 0 0 (0.28–1.7) (0.33–1.8) (0.25–1.9) (8.9–20) (53–78) (87–118) (78–115) (59–85) (56–80) (52–75) (<0.1–<0.1) (<0.1–<0.1) (0.13–0.18) (0.21–0.29) (0.16–0.21) (0.15–0.20) (0.14–0.19) (<0.1–<0.1) (<0.1–0.11) (0.16–0.30) (0.21–0.39) (0.25–0.46) (0.27–0.49) (0.28–0.51) (0–0) (0–0) (0–0) (0–0) (0–<0.1) (0–0) (0–0) <0.01 (0–<0.01) <0.01 (<0.01–<0.01) <0.01 (<0.01–<0.01) <0.01 (<0.01–<0.01) <0.01 <0.01 0.012 0.014 0.017 0.031 0.036 0.041 0.2 (<0.1–0.49) 0.2 (<0.1–0.41) 0.1 (<0.1–0.31) (<0.01–<0.01) <0.1 (0–<0.1) (<0.01–<0.01) 0.3 (0.23–0.30) (0.011–0.014) 0.4 (0.35–0.45) (0.012–0.015) 0.4 (0.37–0.48) (0.015–0.019) 0.4 (0.37–0.47) (0.027–0.035) 0.7 (0.62–0.80) (0.032–0.041) 0.8 (0.71–0.92) (0.036–0.047) 0.9 (0.77–1.0) 0.21 (0.16–0.26) 0.025 0.094 0.19 0.29 0.5 0.55 0.59 <0.01 <0.01 <0.01 <0.01 <0.01 0.011 0.014 0.026 0.059 0.23 0.8 2.4 3.1 3.8 0 (0–0) 3.4 (2.6–4.3) (0.019–0.033) 0.1 (<0.1–0.13) (0.076–0.11) 0.4 (0.28–0.42) (0.16–0.21) 0.7 (0.57–0.74) (0.26–0.33) 1 (0.85–1.1) (0.43–0.56) 1.6 (1.4–1.8) (0.48–0.62) 1.7 (1.5–1.9) (0.51–0.67) 1.8 (1.6–2.0) (<0.01–<0.01) 0.1 (0.10–0.14) (<0.01–<0.01) 0.1 (<0.1–0.12) (<0.01–<0.01) 0.1 (<0.1–0.11) (<0.01–<0.01) 0.1 (<0.1–0.12) (<0.01–<0.01) 0.3 (0.26–0.34) (<0.01–0.012) 0.4 (0.31–0.41) (0.013–0.016) 0.4 (0.38–0.49) (0.016–0.038) <0.1 (<0.1–<0.1) (0.048–0.070) <0.1 (<0.1–<0.1) (0.19–0.28) 0.2 (0.13–0.19) (0.65–0.98) 0.5 (0.41–0.62) (2.0–2.9) 1.4 (1.1–1.7) (2.5–3.7) 1.7 (1.4–2.1) (3.1–4.6) 2.1 (1.7–2.6) <0.01 (<0.01–<0.01) <0.1 (<0.1–0.12) <0.01 (<0.01–<0.01) <0.1 (0–0.12) 0.12 (0.092–0.15) 0.1 (0.077–0.13) 0.4 (0.34–0.56) 0.4 (0.28–0.46) 0.3 0.56 0.77 0.85 0.85 0.85 0.85 4.8 8.9 10 10 8.9 8.6 8.3 (0.19–0.44) (0.46–0.68) (0.63–0.93) (0.70–1.0) (0.70–1.0) (0.70–1.0) (0.70–1.0) (2.9–7.0) (7.3–11) (8.6–13) (8.2–12) (7.3–11) (7.1–10) (6.9–9.9) NOTIFIED NEW AND RELAPSEb CASE DETECTION NUMBER RATEa PERCENT 4 332 37 20 (13–32) 7 107 21 844 28 029 27 983 29 381 117 43 207 280 246 225 225 2 100 35 88 99 96 99 24 7.6 31 32 20 17 17 356 18 46 52 51 52 87 87 87 87 87 87 87 57 3 971 3 109 4 172 3 686 3 474 2 142 11 145 10 762 11 446 9 260 8 974 8 453 9 255 15 936 11 850 9 212 10 362 10 980 11 042 14 735 9 697 9 697 9 454 9 707 8 837 8 664 439 498 306 367 338 328 331 277 336 513 517 957 672 737 549 400 500 435 404 3.8 18 16 16 12 11 10 16 26 18 13 14 15 14 84 48 41 35 31 28 26 13 12 6.4 7 5.2 4.9 4.7 13 21 27 23 32 22 23 89 65 81 70 65 11 58 63 75 66 65 62 53 75 70 65 70 70 70 160 90 81 72 69 62 59 91 97 80 98 83 81 82 87 87 87 87 87 87 87 (76–100) (54–79) (68–98) (59–85) (55–79) (9.4–13) (49–68) (54–75) (64–89) (57–78) (56–76) (54–73) (40–72) (57–100) (53–96) (49–89) (53–96) (53–96) (52–97) (140–180) (80–100) (71–93) (64–82) (61–79) (54–71) (52–68) (80–100) (86–110) (70–91) (86–110) (74–95) (72–93) (72–93) (77–99) (77–99) (77–99) (77–99) (77–99) (77–99) (77–99) 983 571 391 513 496 630 442 1 440 1 341 2 098 32 18 9.8 12 11 14 10 30 26 38 110 100 86 85 74 86 26 76 65 94 (98–130) (90–120) (76–98) (75–97) (65–84) (76–99) (22–32) (63–93) (54–79) (81–110) 1 518 1 549 27 658 29 829 28 852 26 269 28 359 28 640 28 635 482 276 321 261 308 337 382 156 759 13 142 11 050 142 017 264 235 264 934 267 475 184 304 279 325 580 553 728 2 415 25 25 112 111 100 87 90 89 88 27 13 15 10 11 11 12 141 10 7.7 90 153 150 149 39 61 47 40 33 29 36 15 62 63 76 73 86 87 89 87 86 87 87 87 87 87 87 87 61 4.5 3.3 39 66 65 65 87 87 87 87 87 87 87 87 (52–76) (53–77) (59–100) (61–90) (76–98) (77–99) (79–100) (77–99) (75–98) (77–99) (77–99) (77–99) (77–99) (77–99) (77–99) (77–99) (41–99) (3.7–5.5) (2.8–4.1) (32–48) (55–80) (54–79) (54–78) (77–99) (77–99) (77–99) (77–99) (77–99) (77–99) (77–99) (77–99) 3 452 3 539 4 465 3 932 3 690 17 14 16 14 13 87 87 87 87 87 (77–99) (77–99) (77–99) (77–99) (77–99) 2 504 5 686 12 904 10 139 11 653 11 975 39 77 152 105 118 117 14 27 53 37 41 41 (12–17) (22–33) (44–65) (31–45) (35–50) (34–50) (15–22) (39–57) (44–63) (43–62) (44–63) (77–99) (77–99) (77–99) (77–99) (77–99) (77–99) (77–99) (40–90) EASTERN MEDITERRANEAN REGION INCIDENCE (INCLUDING HIV) YEAR Rates are per 100 000 population. NOTIFIED NEW AND RELAPSE includes cases for which the treatment history is unknown. Data for all years can be downloaded from www.who.int/tb/data GLOBAL TUBERCULOSIS REPORT 2013 211 7$%/($,QFLGHQFHQRWLILFDWLRQDQGFDVHGHWHFWLRQUDWHVDOOIRUPV ± INCIDENCE (INCLUDING HIV) YEAR South Sudan Sudan Syrian Arab Republic Tunisia United Arab Emirates West Bank and Gaza Strip Yemen a b 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 POPULATION (MILLIONS) 10 11 26 30 34 40 46 36 37 12 14 16 18 22 22 22 8 9 10 10 11 11 11 2 2 3 4 8 9 9 2 3 3 4 4 4 4 12 15 18 20 23 23 24 NUMBER (THOUSANDS) 15 16 44 47 50 53 54 42 42 7.5 6.6 5.7 4.8 4.3 4.1 3.9 2.3 2.7 2.4 2.4 3 3.2 3.4 0.22 0.28 0.36 0.21 0.26 0.21 0.16 0.12 0.22 0.33 0.23 0.21 0.26 0.32 16 21 20 16 11 11 12 (13–18) (13–19) (36–52) (39–56) (41–59) (43–63) (45–65) (35–51) (35–51) (5.3–10) (5.4–7.9) (4.9–6.6) (4.0–5.6) (3.5–5.1) (3.4–4.9) (3.2–4.6) (2.0–2.6) (2.4–3.1) (2.1–2.7) (2.1–2.7) (2.6–3.4) (2.8–3.6) (3.0–3.8) (0.160–0.280) (0.200–0.370) (0.260–0.480) (0.150–0.270) (0.190–0.340) (0.150–0.270) (0.120–0.210) (0.110–0.140) (0.200–0.250) (0.290–0.370) (0.200–0.260) (0.190–0.240) (0.230–0.290) (0.280–0.360) (10–24) (17–25) (17–24) (13–19) (9.2–13) (9.4–14) (9.6–14) INCIDENCE HIV-POSITIVE NUMBER (THOUSANDS) RATEa 146 146 170 158 144 133 119 117 114 61 46 35 26 20 19 18 29 31 25 23 28 30 31 12 12 12 5 3.1 2.3 1.7 6 8.6 10 6.5 5.3 6.3 7.6 137 137 116 81 49 49 49 (121–174) (121–174) (140–203) (130–188) (119–172) (110–158) (98–142) (96–139) (94–136) (43–82) (38–55) (30–40) (22–31) (16–24) (16–22) (15–21) (25–32) (27–35) (22–28) (21–27) (25–32) (26–34) (27–35) (8.7–16) (8.7–16) (8.7–16) (3.6–6.5) (2.3–4.1) (1.7–3.0) (1.2–2.3) (5.2–6.8) (7.5–9.7) (9.0–12) (5.7–7.3) (4.6–6.0) (5.5–7.1) (6.7–8.6) (85–202) (112–165) (94–139) (66–97) (40–58) (40–58) (40–58) 0.4 1.5 3.5 5.2 5.6 4.4 4.3 <0.01 <0.01 <0.01 <0.01 <0.01 <0.01 <0.01 (0.33–0.48) (1.2–1.8) (2.9–4.2) (4.3–6.2) (4.6–6.7) (3.6–5.3) (3.5–5.1) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) RATEa 1.6 5 10 13 12 12 12 0 <0.1 <0.1 <0.1 <0.1 <0.1 <0.1 (1.3–1.9) (4.1–6.0) (8.5–12) (11–16) (10–15) (10–14) (9.5–14) (0–0) (<0.1–<0.1) (<0.1–<0.1) (<0.1–<0.1) (<0.1–<0.1) (<0.1–<0.1) (<0.1–<0.1) 0.012 (<0.01–0.030) 0.2 (<0.1–0.35) <0.01 (<0.01–0.021) <0.1 (<0.1–0.23) <0.01 0.031 0.11 0.18 0.15 0.15 0.16 (<0.01–<0.01) <0.1 (<0.1–<0.1) (0.022–0.042) 0.2 (0.14–0.28) (0.074–0.14) 0.6 (0.42–0.81) (0.12–0.25) 0.9 (0.58–1.3) (0.093–0.21) 0.7 (0.41–0.93) (0.096–0.22) 0.7 (0.41–0.94) (0.098–0.23) 0.7 (0.41–0.95) NOTIFIED NEW AND RELAPSE b RATEa 7 217 8 403 212 14 320 24 807 27 562 26 131 19 348 18 775 6 018 4 404 5 090 4 310 3 666 3 620 3 003 2 054 2 383 2 038 2 079 2 368 3 015 3 239 285 70 78 0.82 48 72 70 57 53 50 48 31 31 24 17 17 14 25 27 21 21 22 28 30 16 48 53 0.48 30 50 52 48 46 44 80 67 89 90 86 88 77 89 87 86 88 79 94 96 130 115 103 131 103 79 64 77 82 28 31 32 32 4 650 14 428 13 651 9 063 8 916 8 636 9 867 3.8 2.5 1.6 1.2 0.86 3.1 3 2.6 0.79 0.77 0.78 0.76 39 96 78 45 39 37 41 32 50 50 50 50 51 35 25 12 15 12 10 29 70 67 56 80 76 85 Rates are per 100 000 population. NOTIFIED NEW AND RELAPSE includes cases for which the treatment history is unknown. 212 GLOBAL TUBERCULOSIS REPORT 2013 CASE DETECTION NUMBER Data for all years can be downloaded from www.who.int/tb/data PERCENT (40–58) (45–64) (0.41–0.59) (25–37) (42–61) (44–64) (40–58) (38–55) (37–54) (59–110) (56–82) (77–100) (77–110) (72–100) (74–110) (65–93) (78–100) (77–99) (76–98) (78–100) (70–90) (83–110) (84–110) (100–180) (24–44) (38–69) (38–69) (38–69) (38–69) (45–59) (30–39) (22–28) (11–14) (13–17) (11–14) (8.8–11) (20–47) (58–86) (56–83) (46–68) (67–97) (64–92) (71–100) 7$%/($&DVHQRWLILFDWLRQV ± YEAR Afghanistan • 37 99 • Bahrain • 24 17 • Djibouti • 356 404 • Egypt •4 10 • Iran (Islamic Republic of) • 16 14 • Iraq • 84 26 • Jordan • 13 5• Kuwait • 13 23 • Lebanon •0 14 • Libyan Arab Jamahiriya • 10 25 • Morocco • 112 88 • Oman • 27 12 • Pakistan • 141 149 • Qatar • 39 36 • Saudi Arabia • 15 a b 13 • 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 NEW AND b RELAPSE 4 332 NEW CASES % SMEARRE-TREAT EXCL. TOTAL SMEAR- SMEAR-NEGATIVE/ EXTRAHISTORY POS AMONG OTHER RELAPSE NEW PULM POSITIVE UNKNOWN PULMONARY RELAPSE RETREAT UNKNOWN 7 107 21 844 28 029 27 983 29 381 117 43 207 280 246 225 225 2 100 2 892 9 949 12 947 13 789 13 319 2 358 6 085 7 085 6 155 7 405 1 620 4 954 6 248 6 286 6 906 633 623 702 237 856 1 116 1 130 1 049 17 23 101 90 89 101 14 16 72 58 47 47 85 8 107 98 89 77 0 0 0 0 3 971 3 109 4 172 3 686 3 474 2 142 11 145 10 762 11 446 9 260 8 974 8 453 9 255 15 936 11 850 9 212 10 362 10 980 11 042 14 735 9 697 9 697 9 454 9 707 8 837 8 664 439 498 306 367 338 328 331 277 336 513 517 957 672 737 1 391 1 120 1 181 1 336 1 170 518 739 538 569 547 1 875 1 058 2 253 1 587 1 567 0 0 0 4 229 4 606 5 217 4 679 4 508 4 295 9 204 2 693 2 617 1 158 1 055 937 4 684 2 843 3 163 3 048 3 074 2 915 5 347 5 361 4 581 5 188 5 539 5 409 1 587 3 194 3 194 3 096 3 618 3 059 2 760 6 432 2 642 1 807 1 985 1 980 2 191 12 394 13 962 3 188 2 887 2 693 2 463 2 315 3 779 3 442 2 530 2 869 3 076 3 105 754 1 367 2 753 2 703 3 009 2 957 3 261 187 89 86 117 103 85 210 69 76 69 81 73 175 180 187 385 222 328 983 571 391 513 496 630 442 1 440 1 341 2 098 1 518 1 549 27 658 29 829 28 852 26 269 28 359 28 640 28 635 482 276 321 261 308 337 382 156 759 13 142 11 050 142 017 264 235 264 934 267 475 184 304 279 325 580 553 728 2 415 3 452 3 539 4 465 3 932 3 690 209 184 197 237 856 1 325 1 314 1 246 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 184 192 200 194 190 61 19 37 72 184 253 219 231 262 0 0 0 0 0 0 0 753 620 449 375 337 306 289 328 333 300 753 620 738 703 670 606 0 0 0 0 0 0 0 477 405 274 320 385 337 154 440 515 441 477 405 428 760 900 778 20 0 0 0 0 0 0 68 562 768 387 358 328 390 411 435 68 562 768 777 769 763 0 0 0 101 145 187 150 128 172 12 0 0 0 6 3 6 2 2 1 4 16 16 18 6 3 10 18 18 19 0 0 14 0 42 89 95 163 141 140 115 244 234 407 309 269 0 0 0 0 0 0 4 0 1 2 0 0 0 0 0 0 0 0 4 0 1 2 0 0 0 0 0 0 0 0 197 202 131 194 188 240 528 149 75 99 101 131 255 214 181 210 206 250 0 0 3 6 4 10 1 9 0 2 0 0 0 3 6 4 12 1 9 607 860 626 82 474 814 652 762 731 644 305 372 462 533 0 0 14 171 12 872 12 757 12 239 11 822 11 572 4 095 2 934 2 142 2 174 2 272 2 343 11 563 13 046 11 370 12 730 13 331 13 522 135 164 131 152 180 205 60 37 37 28 32 39 81 112 89 124 122 131 2 578 3 285 48 220 104 263 105 733 110 545 3 806 5 578 68 337 105 623 103 824 109 425 3 037 1 846 22 789 45 443 45 537 41 410 60 53 96 223 197 180 135 98 73 101 120 331 109 128 156 256 236 217 1 595 1 722 2 302 2 055 2 028 722 545 687 586 549 1 023 1 067 1 311 1 227 1 022 0 0 0 0 2 269 271 20 27 47 0 0 0 0 1 216 1 215 1 198 429 1 130 764 1 645 2 345 1 962 0 0 0 0 0 0 0 8 4 4 3 7 5 0 1 0 8 4 9 3 8 0 0 0 0 0 0 184 341 2 671 5 870 5 947 6 095 2 754 5 055 5 460 5 622 184 341 5 425 10 925 11 407 11 717 3 036 3 893 0 1 0 0 0 0 0 1 0 0 0 0 0 0 0 0 112 205 122 64 91 84 83 143 112 205 206 147 234 43 0 0 0 0 0 – – 55 62 65 69 64 – 55 59 58 61 65 68 – – 73 60 69 70 68 – 31 63 67 80 81 82 – 45 67 72 72 74 71 11 19 50 52 57 55 54 – 47 56 53 63 56 54 – 81 67 66 70 61 70 – 27 58 64 66 65 65 – – 88 64 – 71 63 – 78 81 86 85 84 83 – 69 82 78 84 85 84 – 40 37 41 50 50 50 – 31 35 57 69 62 35 – – 69 76 77 78 79 EASTERN MEDITERRANEAN REGION NEW AND RELAPSE NOTIFICATION RATEa 1990–2012 Rates are per 100 000 population. NEW AND RELAPSE includes cases for which the treatment history is unknown. Data for all years can be downloaded from www.who.int/tb/data GLOBAL TUBERCULOSIS REPORT 2013 213 7$%/($&DVHQRWLILFDWLRQV ± NEW AND RELAPSE NOTIFICATION RATEa 1990–2012 YEAR Somalia •0 117 • South Sudan Sudan •1 50 • Syrian Arab Republic • 48 14 • Tunisia • 25 30 • United Arab Emirates • 16 1• West Bank and Gaza Strip •3 1• Yemen • 39 a b 41 • 1990 1995 2000 2005 2010 2011 2012 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 NEW AND b RELAPSE NEW CASES % SMEARRE-TREAT EXCL. TOTAL SMEAR- SMEAR-NEGATIVE/ EXTRAHISTORY POS AMONG OTHER RELAPSE POSITIVE UNKNOWN PULMONARY RELAPSE RETREAT UNKNOWN NEW PULM 2 504 5 686 12 904 10 139 11 653 11 975 7 217 8 403 212 14 320 24 807 27 562 26 131 19 348 18 775 6 018 4 404 5 090 4 310 3 666 3 620 3 003 2 054 2 383 2 038 2 079 2 368 3 015 3 239 285 115 103 131 103 79 64 77 82 28 31 32 32 4 650 14 428 13 651 9 063 8 916 8 636 9 867 1 572 3 776 7 068 5 225 5 884 6 127 2 797 3 120 692 837 3 168 2 654 3 159 3 188 2 610 3 413 318 722 2 258 1 885 2 261 2 271 1 639 1 685 102 330 368 310 366 521 134 351 512 705 717 699 537 706 8 761 12 311 12 730 9 958 7 266 6 587 2 655 6 512 9 212 9 144 6 746 6 948 1 675 3 843 5 434 6 217 4 624 4 561 0 0 474 2 141 186 812 712 679 1 616 1 110 1 037 1 056 474 2 141 1 802 1 922 1 749 1 735 0 0 1 295 1 584 1 350 1 122 1 027 809 1 507 1 409 796 544 393 364 1 574 2 000 2 103 1 948 1 915 1 702 0 0 0 0 28 97 61 52 60 44 83 161 55 32 28 97 144 213 115 76 0 225 84 1 243 1 099 915 1 091 1 031 1 059 407 179 239 151 317 282 733 727 874 1 090 1 616 1 853 0 61 51 36 51 45 19 61 51 36 51 64 0 73 62 56 46 42 3 12 28 27 15 41 25 47 30 20 0 0 0 0 0 4 0 0 2 2 1 3 6 0 6 1 3 8 0 0 0 0 9 37 7 13 11 17 58 10 6 6 5 6 15 12 13 8 0 0 0 0 3 1 0 0 0 0 3 1 0 0 0 3 681 5 565 3 379 3 584 3 135 3 321 7 390 4 176 2 780 2 313 2 400 2 808 3 082 3 470 2 553 2 715 2 880 3 486 0 0 0 275 440 351 304 221 252 134 77 83 275 440 351 438 298 335 0 0 0 0 0 134 351 410 375 349 389 171 185 Rates are per 100 000 population. NEW AND RELAPSE includes cases for which the treatment history is unknown. 214 GLOBAL TUBERCULOSIS REPORT 2013 Data for all years can be downloaded from www.who.int/tb/data 0 0 0 0 0 0 0 – 69 82 69 66 65 66 52 48 – 77 65 58 52 52 49 – 46 53 63 67 72 69 – 75 86 79 88 76 79 – – 96 84 67 63 74 – 13 100 54 68 69 74 – 33 57 55 61 57 54 7$%/($7UHDWPHQWRXWFRPHVQHZVPHDUSRVLWLYHFDVHV ± % OF COHORT Afghanistan •0 91 • Bahrain •0 34 • Djibouti • 75 82 • • 62 88 • Egypt Iran (Islamic Republic of) •0 85 • • 80 89 • • 92 92 • • 71 93 • • 91 80 • Iraq Jordan Kuwait Lebanon Libyan Arab Jamahiriya • 65 59 • • 90 80 • • 84 97 • • 70 92 • • 81 49 • Morocco Oman Pakistan Qatar Saudi Arabia •0 61 • • 86 86 • Somalia South Sudan Sudan • 79 a 70 • YEAR 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 2010 2011 1995 2000 2005 2009 2010 2011 NUMBER NOTIFIED 2 892 9 949 12 497 12 947 13 789 17 23 101 131 90 89 1 391 1 120 1 377 1 181 1 336 4 229 4 606 5 217 5 201 4 679 4 508 5 347 5 361 4 581 5 152 5 188 5 539 3 194 3 194 3 096 3 347 3 618 3 059 187 89 86 109 117 103 175 180 187 386 385 222 197 202 131 179 194 188 607 860 936 731 14 171 12 872 12 757 11 907 12 239 11 822 135 164 131 164 152 180 2 578 3 285 48 220 101 887 104 263 105 733 60 53 96 220 223 197 1 595 1 722 2 201 2 302 2 055 1 572 3 776 7 068 6 047 5 225 5 884 2 797 8 761 12 311 12 730 10 541 9 958 7 266 SIZE OF COHORT 3 136 10 013 12 497 12 947 13 789 22 15 192 162 124 1 751 1 391 1 120 1 277 1 177 1 334 2 118 4 611 5 154 5 201 4 682 4 508 5 866 4 581 5 201 5 269 5 532 11 553 3 194 3 096 3 347 3 618 3 059 193 89 86 109 117 103 175 180 187 386 385 222 200 190 131 179 192 188 626 860 792 731 14 171 12 872 12 683 11 935 12 492 11 822 93 112 104 334 152 212 802 4 074 48 205 101 809 104 434 105 733 43 53 96 5 219 294 1 285 1 722 2 201 2 302 2 055 1 278 3 776 7 059 6 047 5 225 5 884 2 114 2 767 8 326 14 599 12 730 10 883 7 729 7 266 COHORT AS % NOTIFIED – 108 101 100 100 100 – 96 15 147 180 139 – 100 100 93 100 100 50 100 99 100 100 100 – 109 100 101 102 100 362 100 100 100 100 100 103 100 100 100 100 100 100 100 100 100 100 100 102 94 100 100 99 100 – – 100 – – 100 100 100 99 100 102 100 69 68 79 204 100 118 31 124 100 100 100 100 72 100 100 2 98 149 – 81 100 100 100 100 81 100 100 100 100 100 – 99 95 119 100 103 78 100 CURED COMPLETED DIED FAILED DEFAULTED NOT EVALUATED 76 83 83 86 88 9 7 4 3 4 3 2 2 2 2 3 1 1 1 1 6 2 2 2 2 2 5 9 5 5 73 93 98 96 34 60 48 71 72 68 65 38 75 66 72 59 66 0 0 0 0 0 16 14 9 7 12 17 24 12 13 16 27 21 27 7 2 4 1 3 2 1 1 1 1 2 3 3 3 3 3 0 0 0 0 0 1 1 1 1 1 1 3 2 2 2 3 2 0 0 0 0 0 20 21 16 17 16 13 19 5 3 4 4 3 0 0 0 0 65 1 14 2 3 2 3 14 3 13 3 4 5 81 78 77 77 79 60 86 76 80 80 83 91 89 71 54 57 46 40 54 53 41 63 84 35 89 81 65 68 65 65 4 5 6 6 6 20 5 10 10 9 6 1 1 12 21 30 47 31 15 10 44 24 9 56 3 11 17 12 15 0 6 7 7 7 8 0 3 3 2 3 3 3 2 5 6 1 3 3 1 1 0 0 0 0 4 2 6 2 2 1 2 3 3 4 4 5 2 2 1 1 2 1 1 7 7 3 0 0 0 0 0 0 0 0 1 1 1 1 1 3 3 2 3 3 10 3 7 6 6 5 2 4 6 11 6 5 1 9 7 4 3 3 10 3 6 2 18 2 33 3 4 5 3 1 5 1 3 1 1 1 3 2 0 0 3 0 25 21 29 11 9 4 0 1 0 10 0 16 0 40 29 2 0 27 2 43 42 75 82 76 77 77 73 84 93 90 49 97 95 51 58 71 74 75 75 81 66 74 80 63 46 21 17 14 7 5 8 8 7 0 0 0 0 1 1 1 2 1 1 1 3 31 37 7 7 9 9 9 8 1 0 49 0 2 20 16 13 17 16 16 0 0 9 0 3 2 2 1 2 3 2 2 2 2 9 4 10 2 3 3 4 4 3 2 2 2 5 8 1 0 0 0 0 0 0 1 1 1 1 1 1 0 0 0 0 0 0 0 0 0 20 17 9 4 4 4 0 0 0 20 0 32 3 3 1 1 7 2 2 9 5 0 0 0 0 0 4 4 4 2 2 2 14 26 16 0 33 19 62 60 54 52 53 82 81 85 83 87 84 67 62 44 50 64 62 56 47 11 5 11 10 9 4 2 4 2 2 2 8 11 35 25 18 19 24 23 7 7 6 5 6 4 4 4 4 3 4 5 4 2 4 3 3 2 2 0 1 1 1 1 5 2 1 2 2 2 1 1 7 2 1 1 1 1 13 10 10 14 16 5 3 4 3 3 3 15 18 11 9 9 10 12 13 6 17 18 18 17 0 9 2 7 4 6 3 4 1 11 5 6 5 14 EASTERN MEDITERRANEAN REGION TREATMENT SUCCESS (%)a 1995–2011 TREATMENT SUCCESS = percent cured + percent completed then rounded to the nearest digit. Data for all years can be downloaded from www.who.int/tb/data GLOBAL TUBERCULOSIS REPORT 2013 215 7$%/($7UHDWPHQWRXWFRPHVQHZVPHDUSRVLWLYHFDVHV ± % OF COHORT a TREATMENT SUCCESS (%) 1995–2011 Syrian Arab Republic • 61 84 • Tunisia •0 87 • United Arab Emirates •0 73 • West Bank and Gaza Strip • 100 100 • • 52 88 • Yemen a YEAR 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 NUMBER NOTIFIED SIZE OF COHORT COHORT AS % NOTIFIED 1 295 1 584 1 350 1 143 1 122 1 027 1 243 1 099 915 931 1 091 1 031 1 295 1 562 1 350 1 144 1 122 1 009 100 99 100 100 100 98 – 100 99 100 100 100 – 100 100 100 98 130 144 – 171 110 92 100 100 100 106 99 100 101 73 62 71 56 46 9 37 7 10 13 11 3 681 5 565 3 379 3 576 3 584 3 135 1 099 910 931 1 091 1 026 73 62 71 55 60 13 12 11 12 11 3 681 5 565 3 566 3 557 3 584 3 174 DIED FAILED DEFAULTED COMPLETED 45 69 76 76 75 65 16 10 13 12 14 19 2 4 3 4 3 3 9 3 2 1 2 2 24 11 6 4 4 10 5 4 1 3 2 1 87 83 72 62 63 4 7 11 24 24 3 2 3 3 3 2 1 2 1 1 2 2 3 4 5 2 4 9 6 5 56 42 21 24 2 100 18 31 52 45 72 7 6 11 7 3 4 0 1 0 0 5 15 14 24 23 10 6 0 0 0 0 58 18 8 18 43 59 69 79 77 79 42 64 75 82 9 13 11 9 9 9 0 9 0 0 1 3 3 3 3 2 0 0 17 0 1 1 1 1 1 1 0 9 0 0 35 14 6 4 4 5 0 0 0 0 11 10 10 4 7 3 TREATMENT SUCCESS = percent cured + percent completed then rounded to the nearest digit. 216 GLOBAL TUBERCULOSIS REPORT 2013 NOT EVALUATED CURED Data for all years can be downloaded from www.who.int/tb/data 7$%/($7UHDWPHQWRXWFRPHVUHWUHDWPHQWFDVHV ± % OF COHORT Afghanistan •0 77 • Bahrain •0 0• Djibouti •0 63 • Egypt •0 72 • Iran (Islamic Republic of) •0 72 • Iraq •0 75 • Jordan •0 80 • Kuwait •0 0• Lebanon •0 100 • Libyan Arab Jamahiriya •0 0• Morocco • 76 66 • Oman •0 67 • • 70 80 • Pakistan Qatar • 67 0• Saudi Arabia •0 63 • Somalia •0 72 • South Sudan Sudan •0 a 55 • YEAR 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 2010 2011 1995 2000 2005 2009 2010 2011 NUMBER NOTIFIED 237 856 1 290 1 325 1 314 0 0 0 0 0 184 253 210 219 231 753 620 738 748 703 670 477 405 428 773 760 900 68 562 768 751 777 769 6 3 10 20 18 18 4 0 1 1 2 0 3 6 4 10 12 1 SIZE OF COHORT 304 856 1 325 1 937 0 0 0 268 253 194 213 227 956 738 748 703 599 606 448 708 781 892 953 751 777 769 6 24 5 15 1 1 2 0 5 4 10 12 1 271 23 85 47 1 469 1 605 1 645 2 345 0 8 4 7 9 3 184 341 5 425 9 200 10 925 11 407 1 0 0 0 0 112 205 144 206 147 134 351 512 655 705 717 537 474 2 141 1 802 1 993 1 922 1 749 1 650 1 668 2 899 2 623 7 7 9 3 374 907 5 009 8 801 8 394 11 407 3 0 0 0 139 96 151 249 147 351 524 655 705 717 434 527 1 828 2 147 1 517 1 749 COHORT AS % NOTIFIED – 128 100 – 100 147 – – – – – – – 146 100 92 97 98 – 154 100 100 100 89 – 150 105 92 103 99 – – 124 100 100 100 – 200 – 120 28 83 – – 100 100 100 – – 83 100 100 100 100 – – – – – – – – – 104 176 112 – 88 – 100 100 100 203 266 92 96 77 100 300 – – – – – – 124 47 105 121 100 – 100 102 100 100 100 – 98 – – 101 108 79 100 CURED COMPLETED DIED FAILED DEFAULTED NOT EVALUATED 73 87 5 2 4 3 4 1 11 2 3 5 73 58 6 19 3 2 3 2 1 2 14 17 27 58 67 53 47 9 10 8 17 16 0 3 3 6 4 3 2 2 2 5 22 24 18 19 22 37 2 3 3 6 52 41 39 38 35 11 17 39 34 36 7 10 6 6 6 12 12 5 8 6 13 8 7 8 10 5 12 4 6 7 63 68 48 49 49 13 8 25 20 22 6 9 8 8 9 5 3 3 5 4 6 4 5 4 4 7 8 11 15 12 60 57 36 39 12 27 40 36 4 3 4 5 8 3 5 7 12 9 13 12 4 1 3 1 83 17 0 0 0 0 17 0 13 62 60 67 4 0 0 0 20 0 17 0 20 0 20 0 0 0 0 100 100 100 0 0 0 0 0 0 0 0 0 0 0 0 25 20 17 100 0 0 8 0 0 0 0 0 17 20 0 20 0 0 20 80 75 60 58 11 22 2 0 45 65 12 4 4 10 7 55 60 40 38 17 9 24 28 4 4 4 3 5 3 3 3 14 16 21 21 5 8 9 8 86 0 0 14 0 0 57 44 67 48 37 61 63 68 63 67 43 56 0 22 17 15 18 16 17 0 0 0 33 2 6 5 4 3 4 0 0 0 0 5 3 3 3 3 3 0 0 0 0 24 29 11 8 6 8 0 0 0 0 0 8 5 3 3 4 33 43 40 45 31 41 15 9 15 19 22 7 9 8 8 9 3 5 1 2 3 13 18 17 22 10 19 19 14 17 15 53 76 50 48 43 23 20 1 5 10 14 29 34 38 5 6 6 6 7 5 7 5 2 4 5 6 9 2 3 5 3 4 4 23 28 34 6 27 23 11 5 5 53 33 28 22 29 38 40 33 3 3 2 3 1 1 1 1 9 15 14 13 6 10 16 27 EASTERN MEDITERRANEAN REGION TREATMENT SUCCESS (%)a 1995–2011 TREATMENT SUCCESS = percent cured + percent completed then rounded to the nearest digit. Data for all years can be downloaded from www.who.int/tb/data GLOBAL TUBERCULOSIS REPORT 2013 217 7$%/($7UHDWPHQWRXWFRPHVUHWUHDWPHQWFDVHV ± % OF COHORT TREATMENT SUCCESS (%)a 1995–2011 Syrian Arab Republic •0 70 • Tunisia •0 79 • United Arab Emirates •0 33 • West Bank and Gaza Strip •0 0• Yemen • 43 a 67 • YEAR 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 NUMBER NOTIFIED 28 97 144 176 213 115 SIZE OF COHORT 189 144 176 213 225 61 51 42 36 51 52 0 6 0 1 3 5 0 3 3 2 0 3 275 440 351 314 438 298 42 0 0 14 437 351 291 298 COHORT AS % NOTIFIED – 195 100 100 100 196 – 69 – – – 102 – – 83 – 300 100 – – – 0 – – 5 99 100 93 – 100 CURED COMPLETED 44 53 48 23 20 10 14 22 58 49 74 54 DIED DEFAULTED 4 5 9 4 5 20 9 4 3 5 15 19 15 11 20 7 0 3 1 1 0 5 2 10 10 25 2 8 10 2 80 0 0 0 20 0 0 0 67 33 33 0 0 0 0 67 0 0 29 64 48 70 14 8 9 7 21 7 2 3 14 6 3 4 14 11 7 7 7 4 30 9 62 5 5 3 6 19 TREATMENT SUCCESS = percent cured + percent completed then rounded to the nearest digit. GLOBAL TUBERCULOSIS REPORT 2013 NOT EVALUATED FAILED Data for all years can be downloaded from www.who.int/tb/data 7$%/($+,9WHVWLQJDQGSURYLVLRQRI&37$57DQG,37– Afghanistan – 25 • • 46 82 • Bahrain Djibouti •7 36 • Egypt – 17 • – 14 • – 86 • • 23 51 • Iran (Islamic Republic of) Iraq Jordan Kuwait • 100 100 • Lebanon •1 67 • Libyan Arab Jamahiriya – 100 • – 20 • Morocco Oman • 98 100 • Pakistan •0 4• • 100 0• Qatar Saudi Arabia – 89 • Somalia •0 44 • •1 15 • •8 53 • •6 18 • – 62 • South Sudan Sudan Syrian Arab Republic Tunisia United Arab Emirates West Bank and Gaza Strip •0 100 • •0 6• Yemen 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 NUMBER OF TB % OF TB PATIENTS WITH PATIENTS WITH KNOWN HIV KNOWN HIV STATUS STATUS 18 23 25 46 65 66 82 7.1 52 19 36 5 170 6 445 7 275 128 161 148 184 224 2 163 718 1 289 47 37 17 4 483 3 441 1 514 8.4 12 14 904 1 343 1 574 66 84 86 23 99 78 51 100 100 100 100 0.77 52 48 67 6 711 7 754 7 821 86 352 267 177 517 957 672 737 3 269 236 424 97 100 2 128 1 498 1 549 0.75 6.2 20 98 100 100 100 0 2.3 3.1 3.8 100 0 0 0.14 215 1 856 5 827 257 313 337 383 0 6 283 8 264 10 419 325 0 0 1 72 86 89 0 26 34 44 47 51 0.62 28 15 15 7.9 2.2 16 53 6.2 6.6 12 18 3 278 3 469 3 420 0 2 741 4 140 5 359 3 542 4 584 180 7 532 3 082 3 070 345 85 586 1 601 129 156 360 593 64 76 62 0 100 100 100 0 0 0 6.2 84 81 53 0 31 32 32 0 0 0 612 PATIENTS NOTIFIED (NEW AND RETREAT) 21 844 28 238 28 167 29 578 280 246 225 225 3 170 4 191 3 723 3 546 11 735 9 588 9 307 8 753 9 366 10 802 11 495 11 483 9 454 10 097 9 248 9 099 371 354 344 349 517 957 672 737 391 515 496 630 2 367 1 545 1 549 26 269 28 788 29 770 29 399 261 313 337 383 144 771 269 290 270 394 273 097 325 580 553 728 3 539 4 549 4 015 3 833 13 006 10 469 12 021 12 285 7 583 8 924 29 178 27 241 20 385 19 831 4 393 3 827 3 675 3 035 2 079 2 368 3 015 3 258 105 132 106 85 28 31 32 32 9 063 9 050 8 713 9 950 NUMBER OF HIV-POSITIVE TB PATIENTS % OF TESTED TB PATIENTS HIV-POSITIVE % OF HIV% OF HIVNUMBER OF POSITIVE TB POSITIVE TB HIV-POSITIVE PATIENTS ON PATIENTS ON PEOPLE CPT ART PROVIDED IPT 2 5 5 6 6 7 1 135 248 177 130 <0.1 <0.1 <0.1 4.7 3.7 4.7 0.54 60 11 25 10 100 80 100 0 0 0 0 15 0 100 80 100 0 0 43 100 15 11 22 64 7 12 17 0.16 0.35 1.1 100 100 100 100 100 100 254 291 283 28 22 18 16 20 27 28 37 41 1 2 2 0 0 1 0 3 3 0 3 3 7 9 3 <0.1 <0.1 <0.1 0 0 0.37 0 0.58 0.31 0 0.41 100 2.6 3.8 0.71 100 100 50 0 50 50 100 100 100 100 100 100 100 0 100 100 100 100 100 100 212 128 105 10 8.5 6.8 1.4 0 17 41 357 10 4 8 14 0 28 34 30 0 0 0 1 7.9 2.2 6.1 3.9 1.3 2.4 3.7 100 100 100 100 100 88 100 100 68 100 100 100 88 100 0.45 0.41 0.29 0 39 100 100 43 56 73 100 100 100 38 68 85 79 82 62 10 160 0 0 0 26 20 27 27 28 10 100 25 17 100 100 100 100 100 100 100 0 100 100 100 100 100 100 100 100 100 100 77 77 79 21 231 206 192 428 534 150 247 292 231 0 5 7 5 2 7 10 14 4 3 4 0 0 0 0 0 0 0 26 4.8 3.7 7.5 0 0 0 161 155 0 0 100 2.3 2.2 2.3 8.4 5 3.6 12 12 83 3.3 9.5 7.5 0 5.9 1.2 0.31 1.6 4.5 2.8 2.4 25 EASTERN MEDITERRANEAN REGION % OF TB PATIENTS WITH YEAR KNOWN HIV STATUS 2005–2012 68 9 0 14 0 0 24 38 54 0 0 0 4.2 Data for all years can be downloaded from www.who.int/tb/data 62 0 0 0 GLOBAL TUBERCULOSIS REPORT 2013 219 7$%/($7HVWLQJIRU0'57%DQGQXPEHURIFRQILUPHGFDVHVRI0'57%± YEAR TOTAL CONFIRMED CASES OF a MDR-TB Afghanistan Bahrain Djibouti Egypt Iran (Islamic Republic of) Iraq Jordan Kuwait Lebanon Libyan Arab Jamahiriya Morocco Oman Pakistan Qatar Saudi Arabia Somalia South Sudan Sudan Syrian Arab Republic Tunisia United Arab Emirates West Bank and Gaza Strip Yemen a b 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 19 19 31 4 0 9 4 39 0 96 134 116 27 58 43 50 110 84 62 19 10 4 13 6 5 0 4 3 7 3 6 8 NEW PULMONARY CASES ESTIMATED CASES OF MDR-TB AMONG NOTIFIED ESTIMATED CASES OF MDR-TB AMONG NOTIFIED % OF BACT+VEb TESTED FOR MDR-TB BACT+VE TESTED FOR MDR-TB – 1.8 – – 2.0 70 99 110 0 – – – – – 0.70 0.59 4.5 4.7 13 6.8 – 0 – 2.5 97 63 30 91 280 100 100 – 37 2.1 9.6 4.2 0.47 – – – 1.4 0.38 0.50 0.85 95 59 100 100 – <0.1 – 0.42 190 100 1.6 2.0 – – – – – 9.3 4.4 0 – – – – 0.29 0.65 0 1.7 12 13 – 0.55 0.19 0.28 – – 5.0 52 – 0 0 0 – 1.5 – 5.5 238 1 100 (0–2 900) 750 (21–2 600) 2.8 (0.57–8.0) 2.8 (0.57–8.0) 81 (40–120) 31 (1.7–58) 330 (270–390) 180 (99–260) 750 (590–910) 380 (260–530) 2 162 154 160 0 39 31 205 271 717 411 0 420 (0–870) 180 (5.1–610) 15 (5.4–25) 10 (3.7–21) 0 (0–6.1) 0 (0–6.1) 9.9 (3.5–16) 3.9 (0.47–14) 69 98 74 55 77 516 437 282 48 4 18 10 4 1 36 (1.0–120) 180 54 45 80 5 1 4 6 444 344 1602 2 4 4 2 14 22 20 57 20 0 6 3 45 49 62 116 7 25 24 13 12 12 15 4 0 1 2 36 (1.0–120) 300 (190–410) 66 (22–150) 5.9 (1.2–11) 5.9 (2.2–13) 180 47 61 103 125 185 219 248 9 11 000 (0–29 000) 7 700 (220–27 000) 6.3 (1.7–16) 6.3 (1.7–16) 84 (64–100) 46 (36–62) 770 (600–930) 480 (250–720) 250 (120–390) 120 (6.5–220) 580 (280–870) 240 (14–460) 97 (65–130) 73 (46–110) 461 264 324 9 10 488 261 0 36 43 0 63 408 155 6 2 3 19 (7.0–30) 11 (0–23) 2.0 (1.5–2.5) 1.0 (0.51–1.5) 3 26 0.81 (<0.1–2.8) 0 0 0 0 0 0 1 4 1.1 (0–3.0) 8 150 (100–210) 89 110 (31–180) PREVIOUSLY TREATED CASES NUMBER OF 183 b ESTIMATED CASES OF MDR-TB AMONG NOTIFIED 400 (93–700) 0 (0–0) 50 (19–81) 150 (130–180) 380 (270–480) 240 (57–430) 5.4 (0.70–13) 0 (0–0) 6.0 (2.0–8.6) – 240 (150–350) 0 (0–3.0) 3 700 (880–6 600) 0 (0–0) 37 (28–48) 280 (160–410) 140 (52–220) 330 (130–540) 24 (16–33) 7.6 (2.9–12) 0.95 (0.74–1.2) 0.32 (<0.1–0.56) 49 (27–73) NUMBER OF % OF NOTIFIED NOTIFIED TESTED FOR TESTED FOR MDR-TB MDR-TB – 34 2.6 – 38 3.0 0 – 0 – 0 – 1 – 0 0 – – – – – 497 74 438 72 41 9.6 169 22 322 36 207 27 – 185 24 224 29 159 21 33 330 7 39 6 33 6 32 1 100 0 0 0 – – 4 100 14 120 1 100 6 67 – – – – – 403 24 229 9.8 416 21 11 280 8 89 3 100 8 100 – 306 2.8 – 154 1.3 0 – 0 – 0 – – – – – – – 79 11 14 2.0 0 0 8 1.5 – 4 0.22 – 82 4.7 129 7.4 0 0 12 5.6 70 61 23 30 – 6 17 10 20 12 19 – – 0 0 3 38 – 0 – 0 0 0 0 – 34 7.8 – 17 5.1 TOTAL CONFIRMED CASES OF MDR-TB includes cases with unknown previous treatment history (i.e. not included under NEW CASES or PREVIOUSLY TREATED CASES). BACT+VE = bacteriologically positive cases. 220 GLOBAL TUBERCULOSIS REPORT 2013 Data for all years can be downloaded from www.who.int/tb/data 7$%/($1HZVPHDUSRVLWLYHFDVHQRWLILFDWLRQE\DJHDQGVH[ ± Afghanistan Bahrain Djibouti Egypt Iran (Islamic Republic of) Iraq Jordan Kuwait Lebanon Libyan Arab Jamahiriya Morocco Oman Pakistan Qatar Saudi Arabia Somalia South Sudan Sudan 1995 2000 2005 2010 2011 2012 1995 2000 2005 2010 2011 2012 1995 2000 2005 2010 2011 2012 1995 2000 2005 2010 2011 2012 1995 2000 2005 2010 2011 2012 1995 2000 2005 2010 2011 2012 1995 2000 2005 2010 2011 2012 1995 2000 2005 2010 2011 2012 1995 2000 2005 2010 2011 2012 1995 2000 2005 2010 2011 2012 1995 2000 2005 2010 2011 2012 1995 2000 2005 2010 2011 2012 1995 2000 2005 2010 2011 2012 1995 2000 2005 2010 2011 2012 1995 2000 2005 2010 2011 2012 1995 2000 2005 2010 2011 2012 2011 2012 1995 2000 2005 2010 2011 2012 FEMALE 0–14 15–24 25–34 35–44 45–54 55–64 65+ 52 151 197 204 188 0 0 0 0 1 0 228 606 986 1 010 1 116 0 0 0 10 5 9 183 560 819 895 801 1 3 0 16 19 28 149 472 491 613 586 2 2 2 11 13 16 129 453 490 570 521 3 5 3 12 14 11 94 470 641 700 585 1 3 0 4 8 8 80 419 622 692 651 3 4 4 4 2 2 17 18 28 35 22 223 21 25 9 23 23 118 29 16 18 13 16 1 125 21 13 42 35 27 0 0 0 2 0 0 0 0 0 1 0 0 3 5 0 1 1 2 2 5 2 302 220 211 212 208 542 641 524 358 382 373 751 438 352 292 289 288 862 627 424 370 304 283 19 8 8 5 9 8 15 10 12 16 13 14 26 16 12 8 14 18 112 101 114 347 252 243 265 240 665 827 606 617 611 597 754 467 531 487 543 601 1 409 317 644 482 395 317 37 16 17 14 10 12 51 44 45 67 41 59 32 28 19 21 18 21 212 239 293 139 119 151 149 147 460 667 421 783 596 582 636 387 338 354 398 442 1 085 297 261 384 313 263 17 13 9 10 13 8 32 32 29 50 36 49 30 20 15 15 13 13 78 86 168 67 62 67 97 81 408 476 414 725 715 698 494 295 281 296 315 303 863 205 245 276 237 203 20 9 4 12 8 5 17 21 26 48 35 35 16 15 10 12 15 14 46 36 52 60 47 49 45 47 463 307 243 407 387 379 737 344 260 310 351 317 900 135 189 286 223 203 26 14 6 12 13 7 9 11 8 10 11 15 16 17 12 12 6 12 22 29 19 42 29 20 33 26 160 158 123 217 168 164 921 642 630 760 877 850 271 101 148 228 183 180 11 2 5 6 5 7 0 5 3 11 5 3 10 14 8 10 8 6 21 32 35 5 2 142 99 79 51 79 54 1 1 1 2 1 0 29 55 621 1 548 1 216 1 317 0 0 0 0 0 85 86 2 508 2 061 2 222 1 982 1 929 1 840 7 8 21 12 17 18 274 498 5 278 11 860 12 143 12 605 8 7 19 59 36 34 173 136 2 872 2 423 2 515 2 553 2 450 2 426 12 9 11 27 25 33 230 387 4 759 10 462 10 515 10 838 12 19 15 72 64 52 148 136 1 737 1 705 1 583 1 611 1 479 1 423 7 11 24 15 12 23 178 256 4 263 8 320 8 435 8 848 11 9 17 38 36 45 54 63 819 855 1 057 1 273 1 175 1 183 7 12 15 16 23 12 140 232 3 834 7 969 8 608 9 026 13 7 19 22 14 21 18 31 573 485 580 712 682 672 10 9 19 8 10 8 124 153 3 332 6 934 7 320 7 753 4 2 5 5 10 8 21 22 553 595 591 515 518 561 11 11 5 10 11 19 95 130 2 453 6 066 6 323 6 492 4 1 1 0 3 0 0 8 14 4 13 46 113 125 109 113 129 39 42 250 785 425 209 107 117 131 182 335 227 228 334 740 1 343 1 036 1 147 1 147 251 356 604 1 028 1 358 1 185 899 869 268 276 458 406 394 730 724 1 114 886 1 047 1 014 599 753 796 1 511 1 990 1 781 1 359 1 274 213 201 242 225 214 201 408 725 496 587 560 402 462 634 1 351 1 541 1 335 981 802 158 175 210 225 210 127 254 458 355 398 449 259 267 486 1 119 1 151 863 689 466 86 70 116 113 133 278 195 330 266 330 296 135 135 362 638 724 497 386 404 107 107 102 106 96 109 142 319 277 277 307 57 87 337 677 493 391 372 331 UNKNOWN 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 160 0 0 0 0 0 0 0 0 0 0–14 15–24 25–34 35–44 45–54 55–64 65+ 93 320 445 465 400 0 0 1 0 0 1 414 1 651 2 107 2 167 2 280 1 1 1 8 9 2 565 1 959 2 263 2 325 2 204 1 2 0 15 5 11 339 1 302 1 455 1 564 1 482 2 0 3 7 6 8 205 869 1 112 1 146 1 150 0 1 1 1 6 4 99 471 831 903 850 1 1 0 1 0 1 36 246 488 535 505 1 1 0 1 1 0 12 23 20 31 20 134 55 48 8 7 8 234 77 45 54 37 43 725 37 44 73 66 36 1 0 1 3 0 1 0 1 0 4 0 3 1 4 1 0 0 2 5 6 8 147 123 104 139 132 288 457 431 199 192 187 1 039 593 394 433 473 434 304 338 305 394 368 340 15 8 6 14 8 9 8 11 13 41 23 40 16 31 25 36 37 48 34 43 36 156 117 120 118 94 367 343 298 352 355 346 890 410 205 288 313 318 1 208 241 260 294 258 225 4 9 6 24 11 12 24 24 31 78 30 73 18 26 14 48 51 72 31 35 36 47 66 89 104 73 274 257 205 423 387 379 664 322 186 208 184 206 915 136 151 198 164 154 10 1 6 4 8 7 9 12 11 30 15 15 13 9 8 17 12 16 19 24 35 31 23 36 57 36 256 211 218 292 280 274 613 320 260 276 296 252 800 134 197 205 159 186 14 2 5 3 4 1 4 5 3 10 9 12 8 7 3 7 9 9 20 24 21 17 13 24 30 26 160 112 132 192 198 193 685 407 382 398 441 374 886 103 135 220 201 174 12 2 8 5 8 3 4 3 1 11 2 6 5 4 3 4 1 4 13 16 21 10 8 19 21 18 75 48 42 97 94 92 788 647 701 1 014 1 009 965 200 87 80 166 153 169 7 5 5 3 6 5 2 1 5 8 2 4 3 6 1 3 3 3 11 22 20 8 10 191 170 167 117 100 77 2 2 2 3 5 0 85 130 1 447 3 212 2 679 2 630 1 0 0 0 2 59 47 1 708 1 530 1 330 1 098 1 153 1 162 18 17 13 18 20 20 375 591 6 463 14 481 14 652 15 445 2 0 5 7 9 6 47 37 1 288 1 121 943 841 794 832 13 5 5 22 21 37 381 416 5 611 10 513 10 684 10 902 3 4 10 16 15 9 37 19 703 672 546 426 433 408 5 7 3 6 9 10 267 274 3 987 7 749 7 880 8 263 1 3 2 2 6 1 22 24 461 398 403 386 371 306 5 5 4 4 13 10 178 163 2 866 6 410 6 590 6 876 0 1 1 1 1 1 25 18 317 406 343 310 324 286 6 11 5 4 7 9 143 103 2 060 4 879 4 977 5 494 0 0 2 1 2 0 29 13 299 352 398 364 335 342 3 6 3 5 6 6 79 56 1 338 4 338 3 711 4 056 1 0 0 0 1 1 28 31 33 35 28 38 85 169 91 114 121 60 58 359 817 381 195 113 115 172 205 239 200 207 158 354 752 467 495 553 181 212 490 925 1 102 761 512 536 182 184 271 245 236 139 319 636 444 465 554 318 302 613 1 134 1 203 979 620 562 79 98 105 110 107 97 219 436 341 348 396 239 221 299 905 978 772 513 470 51 73 70 64 50 40 110 292 188 260 267 172 139 403 771 729 520 352 299 50 51 49 49 49 25 72 212 137 168 165 59 62 342 327 411 279 188 170 70 61 58 46 63 16 41 157 132 135 169 26 24 305 323 244 191 175 172 Data for all years can be downloaded from www.who.int/tb/data UNKNOWN 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 MALE:FEMALE RATIO – 0.52 0.46 0.49 0.51 0.50 1.7 2.8 1.5 1.7 2.3 2.7 – 2.3 2.0 1.9 1.7 1.9 1.9 2.1 1.7 2.0 1.9 1.9 0.90 0.94 1.1 0.94 1.0 1.1 1.3 1.6 1.6 1.3 1.2 1.1 2.1 2.3 1.3 1.1 1.3 1.2 2.4 2.2 1.9 1.1 1.7 1.1 2.1 1.3 1.4 0.69 0.66 0.56 3.7 3.1 3.9 – 2.2 2.8 1.9 1.8 2.1 2.5 2.4 2.4 1.1 1.2 2.7 1.5 1.2 1.2 0.71 0.99 1.0 1.0 1.1 1.1 6.5 5.6 3.8 7.3 4.8 8.0 – 1.5 1.4 1.8 1.7 1.7 3.6 2.1 1.7 1.9 2.0 1.8 1.7 2.1 1.2 1.4 1.5 1.7 1.9 1.8 GLOBAL TUBERCULOSIS REPORT 2013 EASTERN MEDITERRANEAN REGION MALE YEAR 221 7$%/($1HZVPHDUSRVLWLYHFDVHQRWLILFDWLRQE\DJHDQGVH[ ± MALE Syrian Arab Republic Tunisia United Arab Emirates West Bank and Gaza Strip Yemen 222 FEMALE YEAR 0–14 15–24 25–34 35–44 45–54 55–64 65+ 1995 2000 2005 2010 2011 2012 1995 2000 2005 2010 2011 2012 1995 2000 2005 2010 2011 2012 1995 2000 2005 2010 2011 2012 1995 2000 2005 2010 2011 2012 13 8 9 7 8 7 332 359 266 170 139 91 255 289 237 212 195 146 111 125 111 101 116 90 70 86 112 80 81 85 59 76 62 65 49 46 50 55 63 49 45 41 16 5 9 6 10 139 103 115 110 88 208 172 194 194 191 156 133 170 118 149 109 115 125 126 114 65 53 93 108 93 101 81 88 63 88 2 4 4 6 5 12 10 1 0 0 1 7 3 2 2 13 7 4 0 7 3 4 0 3 5 5 1 4 1 5 0 4 3 2 3 0 1 0 57 110 48 68 33 30 1 2 0 2 400 789 493 507 406 436 0 1 2 605 689 553 569 471 472 2 1 1 256 493 366 322 297 315 1 1 1 2 201 314 242 231 193 232 3 1 0 4 148 255 149 164 143 172 3 3 2 45 127 78 138 96 122 GLOBAL TUBERCULOSIS REPORT 2013 UNKNOWN UNKNOWN 0–14 15–24 25–34 35–44 45–54 55–64 65+ 22 23 27 16 20 5 158 195 182 164 113 104 97 101 108 105 97 75 53 53 59 47 56 35 44 46 59 41 35 33 37 38 32 38 36 32 20 28 23 27 37 19 7 7 4 10 7 68 66 64 60 51 59 61 64 60 56 43 39 39 50 46 21 36 34 44 48 21 16 40 35 46 58 28 52 47 72 3 16 1 3 0 0 4 0 0 0 1 4 0 0 2 6 5 1 4 6 2 0 1 3 2 0 5 2 3 1 1 1 4 0 3 2 4 0 0 0 0 0 0 0 0 0 0 83 161 44 98 85 75 0 0 1 420 799 426 471 446 437 1 1 1 1 720 627 410 409 375 381 0 1 0 348 517 265 264 251 246 1 1 0 0 200 345 181 174 168 207 2 2 1 106 247 85 106 113 115 0 0 1 92 92 39 63 58 81 0 0 0 0 0 0 0 0 0 Data for all years can be downloaded from www.who.int/tb/data 0 0 0 0 0 0 MALE:FEMALE RATIO 2.1 2.1 1.8 1.6 1.6 1.7 – 2.9 2.6 2.7 2.4 2.2 – 1.6 – 2.3 0.92 1.1 3.5 – 2.5 2.2 1.8 3.2 0.87 1.0 1.3 1.3 1.1 1.2 7$%/($ /DERUDWRULHV173VHUYLFHVGUXJPDQDJHPHQWDQGLQIHFWLRQFRQWURO FREE THROUGH NTP Afghanistan 2.0 2 0.3 0 0 1 Bahrain 1.4 11 7.6 3.8 7.6 1 Djibouti Egypt Iran (Islamic Republic of) 2.1 0.2 0.5 0 0 0 5.8 1.1 3.6 5.8 <0.1 0.5 5.8 0 0 1 0 0 Iraq 0.8 0 1.5 0.2 0 5 Jordan Kuwait 0.2 0.4 0 0 0.7 1.5 0.7 1.5 0 0 1 0 Lebanon 2.2 3 Out of country Out of country In country In country In country Out of country No No Out of country No No In country NRLd TB DIAGNOSIS Yes Yes (all suspects) Yes No No Yes (all suspects) Yes Yes Yes Yes Yes Yes (all suspects) Yes (all suspects) Yes (all suspects) Yes Yes Yes Yes Yes Yes Yes Yes (all suspects) Yes Yes 1 Yes (all suspects) Yes (all suspects) Yes Yes Yes Yes 0 0 0 6.0 0 3.2 1.1 0.4 0.5 7.5 0.8 <0.1 0.3 0.6 – 13 0 0 0 1 0 6.5 2.2 13.6 0.2 2.4 2.1 0 1.6 0.3 1.5 0.1 2.4 2.1 0 0 1.5 <0.1 2.4 0.4 0 0 0 15 1 8 3 South Sudan 0.6 – Sudan 0.8 0 0.1 0.1 0 0 No Yes Syrian Arab Republic Tunisia United Arab Emirates West Bank and Gaza Strip 1.4 0.7 – 0 – 0.2 5.1 0.2 2.3 0.2 0.5 0 2 0 0 a b c d 1.5 0 1.2 0 1.0 – 0.8 0.4 0 Yes Yes Libya Morocco Oman Pakistan Qatar Saudi Arabia Somalia Yemen TB NOTIF. RIFAMPICIN RATE PER USED 100 000 THROUGHOUT HEALTH-CARE TREATMENT WORKERS FIRSTLINE DRUGS Yes Yes (all suspects) Yes Yes Yes Yes Yes Yes Yes No Yes No No Out of No country Yes (all suspects) Yes (all suspects) Yes (all suspects) Yes (all suspects) Yes (all suspects) Yes (all suspects) Yes (all suspects) Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes (all suspects) Yes Yes 8 0 Yes Yes No Yes In country Yes No Yes (if TB is confirmed) Yes (all suspects) Yes (all suspects) Yes (all suspects) Yes Yes Yes Yes Yes Yes 30 508 No Yes Yes (all suspects) Yes Yes 204 No Yes Yes (if TB is confirmed) Yes Yes 36 EASTERN MEDITERRANEAN REGION LABORATORIES SECONDNUMBER OF SMEAR LABS % OF SMEAR CULTURE DST b LABS LPAc LABS LABS USING LABS PER 5M LINE DST LABS USING PER 100K PER 5M PER 5M a POPULATION POPULATION POPULATION POPULATION XPERT MTB/RIF AVAILABLE LED LED = Light emitting diode microscopes DST = Drug susceptibility testing LPA = Line probe assay NRL = National Reference Laboratory Data for all years can be downloaded from www.who.int/tb/data GLOBAL TUBERCULOSIS REPORT 2013 223 7$%/($0HDVXUHGSHUFHQWDJHRI7%FDVHVZLWK0'57%DPRVWUHFHQW\HDUDYDLODEOH New TB cases Afghanistan Bahrain Djibouti Egypt Iran (Islamic Republic of) Iraq Jordan Kuwait Lebanon Libya Morocco Oman Pakistan Qatar Saudi Arabia Somalia South Sudan Sudan Syrian Arab Republic Tunisia United Arab Emirates West Bank and Gaza Strip Yemen a Year Source Coverage 2012 Surveillance National 2011 1998 Survey Survey 2009 2011 2003 Previously treated TB cases Percentage Year Source Coverage Percentage 1.9 (0.39–5.4) 2012 Surveillance National 100 (2.5–100) National National 3.4 (1.9–4.9) 5 (3.4–7.0) 2012 1998 Surveillance Survey National National 25 (21–29) 48 (35–62) Surveillance Surveillance Survey National National National 6.3 (2.4–13) 0 (0–1.3) 1.1 (0.13–3.8) 2009 2011 2012 Surveillance Surveillance Surveillance National National National 29 (3.7–71) 0 (0–98) 67 (22–96) 2006 2012 Survey Surveillance National National 0.48 (0.15–1.1) 2.4 (0.89–5.2) 2006 2012 Survey Surveillance National National 12 (7.8–18) 0 (0–37) 2010 2010 2011 Surveillance Survey Survey National National National 1.2 (0.34–3.1) 1.8 (1.4–2.4) 5.2 (2.7–7.7) 2010 2010 2011 Surveillance Survey Survey National National National 0 (0–98) 16 (12–21) 41 (23–58) 2003 2012 Survey Survey National National 2011 2012 Surveillance Survey National National 31 (21–44) 12 (4.5–19) 2011 Survey National 2011 Survey National 15 (8.1–22) 6.2 (3.9–9.3) 0.82 (0–1.7) 1.7 (0.50–3.0) Empty rows indicate an absence of high-quality survey or surveillance data. In the absence of high-quality national data, high-quality sub-national data are used. 224 GLOBAL TUBERCULOSIS REPORT 2013 Data for all years can be downloaded from www.who.int/tb/data '7412'#04')+10 Table A4.1 Estimates of the burden of disease caused by TB, 1990–2012 227 6CDNG# +PEKFGPEGPQVKßECVKQPCPFECUGFGVGEVKQPTCVGUCNNHQTOU¿ 6CDNG# %CUGPQVKßECVKQPU¿ Table A4.4 Treatment outcomes, new smear-positive cases, 1995–2011 239 Table A4.5 Treatment outcomes, retreatment cases, 1995–2011 242 6CDNG# *+8VGUVKPICPFRTQXKUKQPQH%26#46CPF+26¿ 6CDNG# 6GUVKPIHQT/&46$CPFPWODGTQHEQPßTOGFECUGUQH/&46$¿ 6CDNG# 0GYUOGCTRQUKVKXGECUGPQVKßECVKQPD[CIGCPFUGZ¿ Table A4.9 Laboratories, NTP services, drug management and infection control, 2012 252 6CDNG# /GCUWTGFRGTEGPVCIGQH6$ECUGUYKVJ/&46$OQUVTGEGPV[GCTCXCKNCDNG Estimates of mortality, prevalence and incidence Estimated values are shown as best estimates followed by lower and upper bounds. The lower and upper bounds are defined as the 2.5th and 97.5th centiles of outcome distributions produced in simulations. See ANNEX 1 for further details. Estimated numbers are shown rounded to two significant figures. Estimated rates are shown rounded to three significant figures unless the value is under 100, in which case rates are shown rounded to two significant figures. Estimates for all years are recalculated as new information becomes available and techniques are refined, so they may differ from those published in previous reports in this series. The main updates implemented in this report are explained in Box 2.1 of Chapter 2. Estimates published in previous global TB control reports should no longer be used. Data source Data shown in this annex are taken from the WHO global TB database on 1 October 2013. Data shown in the main part of the report were taken from the database in July 2013. As a result, data in this annex may differ slightly from those in the main part of the report. Data for all years can be downloaded from www.who.int/tb/data. Country notes EU/EEA countries Notification and treatment outcome data for European Union and European Economic Area countries are provisional. Denmark Data for Denmark exclude Greenland. France Data from France include data from 5 overseas departments (French Guiana, Guadeloupe, Martinique, Mayotte and Réunion). Russian Federation The reported number of TB patients with known HIV status in 2010–2012 (Table A4.6) is for new TB patients in the civilian sector only. It was not possible to calculate the percentage of all TB patients with known HIV status. 226 GLOBAL TUBERCULOSIS REPORT 2013 Data for all years can be downloaded from www.who.int/tb/data 7$%/($(VWLPDWHVRIWKHEXUGHQRIGLVHDVHFDXVHGE\7% ± Albania Andorra Armenia Austria Azerbaijan Belarus Belgium Bosnia and Herzegovina Bulgaria Croatia Cyprus Czech Republic Denmark Estonia Finland France a 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 POPULATION (MILLIONS) 3 3 3 3 3 3 3 <1 <1 <1 <1 <1 <1 <1 4 3 3 3 3 3 3 8 8 8 8 8 8 8 7 8 8 9 9 9 9 10 10 10 10 9 9 9 10 10 10 11 11 11 11 5 4 4 4 4 4 4 9 8 8 8 7 7 7 5 5 4 4 4 4 4 <1 <1 <1 1 1 1 1 10 10 10 10 11 11 11 5 5 5 5 6 6 6 2 1 1 1 1 1 1 5 5 5 5 5 5 5 57 58 59 61 63 64 64 NUMBER (THOUSANDS) 0.11 0.023 0.027 0.018 0.012 0.011 <0.01 <0.01 <0.01 <0.01 <0.01 <0.01 <0.01 <0.01 0.16 0.19 0.19 0.26 0.23 0.17 0.19 0.14 0.074 0.069 0.05 0.032 0.04 0.035 0.82 1.8 1.8 0.82 0.39 0.39 0.39 0.5 0.76 0.8 1.1 0.76 0.66 0.57 0.1 0.13 0.081 0.062 0.043 0.041 0.04 0.46 0.22 0.23 0.21 0.2 0.2 0.2 0.22 0.34 0.59 0.26 0.19 0.16 0.15 0.39 0.25 0.19 0.11 0.082 0.066 0.061 <0.01 <0.01 0 <0.01 <0.01 <0.01 <0.01 0.19 0.092 0.12 0.065 0.035 0.051 0.037 0.054 0.024 0.021 0.019 0.035 0.017 0.022 0.071 0.15 0.11 0.049 0.036 0.036 0.036 0.13 0.092 0.083 0.037 0.016 0.021 0.015 1 0.79 0.65 0.43 0.33 0.31 0.3 (0.081–0.130) (0.018–0.028) (0.019–0.037) (0.013–0.025) (<0.01–0.018) (<0.01–0.017) (<0.01–0.016) (<0.01–<0.01) (<0.01–<0.01) (0–<0.01) (0–<0.01) (<0.01–<0.01) (<0.01–<0.01) (0–<0.01) (0.110–0.200) (0.160–0.230) (0.170–0.220) (0.190–0.320) (0.180–0.280) (0.130–0.210) (0.150–0.230) (0.140–0.140) (0.074–0.074) (0.069–0.069) (0.050–0.051) (0.032–0.033) (0.040–0.041) (0.035–0.036) (0.610–1.1) (1.3–2.3) (1.4–2.2) (0.660–1.0) (0.330–0.440) (0.340–0.450) (0.340–0.450) (0.470–0.540) (0.700–0.830) (0.760–0.850) (0.990–1.1) (0.700–0.820) (0.600–0.720) (0.510–0.630) (0.097–0.100) (0.130–0.130) (0.080–0.083) (0.062–0.063) (0.043–0.044) (0.041–0.042) (0.039–0.040) (0.440–0.480) (0.210–0.230) (0.210–0.240) (0.200–0.230) (0.180–0.220) (0.170–0.220) (0.180–0.220) (0.210–0.220) (0.340–0.350) (0.570–0.600) (0.260–0.270) (0.190–0.190) (0.160–0.160) (0.150–0.150) (0.380–0.410) (0.240–0.270) (0.180–0.200) (0.110–0.110) (0.082–0.083) (0.066–0.067) (0.060–0.062) (<0.01–<0.01) (<0.01–<0.01) (0–0) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (0.190–0.190) (0.091–0.092) (0.120–0.120) (0.064–0.065) (0.035–0.035) (0.050–0.051) (0.037–0.037) (0.053–0.056) (0.023–0.025) (0.020–0.021) (0.019–0.020) (0.034–0.036) (0.016–0.018) (0.021–0.023) (0.070–0.072) (0.140–0.150) (0.110–0.110) (0.048–0.050) (0.035–0.036) (0.036–0.037) (0.036–0.036) (0.130–0.130) (0.092–0.092) (0.083–0.084) (0.037–0.037) (0.016–0.016) (0.021–0.021) (0.015–0.015) (0.980–1.0) (0.760–0.810) (0.630–0.670) (0.410–0.440) (0.320–0.350) (0.300–0.330) (0.280–0.310) a RATE 3.1 0.68 0.82 0.57 0.38 0.34 0.31 2.4 2.1 1.3 0.86 0.58 0.32 0.91 4.4 6 6.3 8.5 7.7 5.6 6.3 1.8 0.93 0.86 0.61 0.38 0.48 0.42 11 23 22 9.6 4.2 4.2 4.2 4.9 7.5 8.1 11 8 7 6 1 1.3 0.79 0.59 0.4 0.38 0.36 10 6.3 5.9 5.5 5.2 5.1 5.2 2.4 4.1 7.3 3.4 2.6 2.2 2 8.2 5.4 4.2 2.5 1.9 1.5 1.4 0.2 0.2 0 0.37 0.11 0.21 0.2 1.8 0.89 1.2 0.63 0.33 0.48 0.35 1.1 0.47 0.38 0.36 0.63 0.3 0.4 4.5 10 8 3.7 2.7 2.8 2.8 2.5 1.8 1.6 0.71 0.3 0.39 0.29 1.8 1.4 1.1 0.7 0.53 0.5 0.46 (2.3–3.9) (0.55–0.83) (0.57–1.1) (0.39–0.79) (0.23–0.58) (0.20–0.53) (0.16–0.49) (0.16–7.6) (<0.1–8.5) (0–6.2) (0–3.9) (<0.1–2.3) (0.16–0.54) (0–4.9) (3.2–5.8) (4.9–7.2) (5.6–7.0) (6.5–11) (6.1–9.5) (4.5–6.9) (5.1–7.6) (1.8–1.9) (0.92–0.93) (0.86–0.86) (0.61–0.61) (0.38–0.39) (0.47–0.49) (0.41–0.42) (8.5–15) (17–29) (17–27) (7.7–12) (3.7–4.9) (3.7–4.9) (3.7–4.9) (4.6–5.2) (6.9–8.1) (7.6–8.5) (10–12) (7.3–8.6) (6.3–7.7) (5.4–6.7) (0.97–1.0) (1.3–1.3) (0.78–0.81) (0.59–0.60) (0.39–0.40) (0.37–0.38) (0.35–0.36) (9.7–11) (5.9–6.6) (5.5–6.3) (5.0–6.0) (4.6–5.7) (4.6–5.7) (4.6–5.8) (2.4–2.5) (4.0–4.2) (7.2–7.5) (3.4–3.5) (2.5–2.6) (2.2–2.2) (2.0–2.1) (8.0–8.5) (5.0–5.7) (4.0–4.4) (2.5–2.5) (1.9–1.9) (1.5–1.5) (1.4–1.4) (0.16–0.25) (0.16–0.25) (0–0) (0.32–0.41) (0.10–0.13) (0.19–0.23) (0.16–0.25) (1.8–1.8) (0.88–0.89) (1.2–1.2) (0.63–0.63) (0.33–0.34) (0.47–0.48) (0.35–0.35) (1.0–1.1) (0.45–0.48) (0.38–0.39) (0.35–0.36) (0.61–0.66) (0.28–0.32) (0.38–0.42) (4.5–4.6) (9.9–10) (7.9–8.2) (3.6–3.8) (2.7–2.8) (2.8–2.8) (2.8–2.8) (2.5–2.5) (1.8–1.8) (1.6–1.6) (0.71–0.71) (0.30–0.30) (0.39–0.39) (0.28–0.29) (1.7–1.8) (1.3–1.4) (1.1–1.1) (0.68–0.72) (0.51–0.55) (0.47–0.52) (0.44–0.49) PREVALENCE (INCLUDING HIV) NUMBER (THOUSANDS) 1.2 1.1 0.98 0.87 0.74 0.72 0.68 0.034 0.033 0.021 0.017 0.011 <0.01 0.017 1 1.9 2.9 3.5 2.7 2.3 2.4 2.5 2.5 2 1.5 1 1.1 0.91 54 120 140 66 20 16 12 5.2 11 13 11 10 10 10 2.6 2.2 2.1 1.7 1.7 1.5 1.4 6.5 4.6 2.8 2.3 2.6 2.7 2.8 4.2 8.4 7 6.2 3.9 3.5 3.1 4.4 3.3 2.5 1.6 1.1 0.96 0.84 0.038 0.05 0.045 0.051 0.1 0.069 0.069 3.1 2.8 2.2 1.6 0.99 0.9 0.77 0.61 0.64 1 0.67 0.46 0.58 0.56 0.81 0.93 1.3 0.7 0.37 0.44 0.38 1.3 1.1 0.85 0.55 0.48 0.48 0.39 16 16 11 8.5 8.9 8.7 7.4 (0.440–2.4) (0.420–2.1) (0.380–1.8) (0.370–1.6) (0.320–1.3) (0.310–1.3) (0.280–1.3) (0.013–0.064) (0.015–0.058) (<0.01–0.035) (<0.01–0.029) (<0.01–0.020) (<0.01–0.015) (<0.01–0.028) (0.420–1.8) (0.890–3.3) (1.4–4.8) (1.7–6.0) (1.2–4.8) (1.0–4.2) (1.1–4.1) (1.1–4.5) (1.2–4.4) (0.890–3.5) (0.690–2.7) (0.420–1.9) (0.510–2.0) (0.370–1.7) (25–94) (56–220) (62–240) (31–110) (9.9–34) (7.3–28) (4.1–23) (2.2–9.5) (5.1–19) (6.0–23) (4.4–19) (4.6–18) (4.6–18) (4.7–18) (1.1–4.6) (0.930–3.9) (0.920–3.7) (0.690–3.0) (0.740–2.9) (0.660–2.8) (0.560–2.6) (1.9–14) (2.1–8.1) (0.830–5.9) (0.640–5.0) (1.1–4.7) (1.2–4.8) (1.3–4.8) (1.9–7.5) (4.2–14) (3.3–12) (3.0–11) (1.6–7.1) (1.4–6.4) (1.3–5.8) (2.1–7.7) (1.3–6.1) (1.0–4.7) (0.620–3.0) (0.420–2.0) (0.390–1.8) (0.340–1.6) (0.011–0.080) (0.017–0.100) (0.015–0.091) (0.020–0.095) (0.049–0.180) (0.023–0.140) (0.021–0.150) (1.3–5.6) (1.1–5.3) (0.880–4.1) (0.690–2.8) (0.420–1.8) (0.380–1.6) (0.310–1.4) (0.300–1.0) (0.220–1.3) (0.490–1.7) (0.310–1.2) (0.170–0.880) (0.260–1.0) (0.240–1.0) (0.410–1.3) (0.350–1.8) (0.610–2.3) (0.280–1.3) (0.130–0.740) (0.200–0.780) (0.160–0.680) (0.550–2.3) (0.500–1.9) (0.370–1.5) (0.240–0.980) (0.190–0.900) (0.190–0.900) (0.130–0.790) (7.7–26) (8.5–27) (5.6–19) (4.0–15) (4.6–15) (4.5–14) (3.7–12) INCIDENCE (INCLUDING HIV) a RATE 36 32 30 27 24 23 22 62 51 31 21 14 9 21 28 59 93 118 92 79 79 33 32 25 19 12 13 11 744 1 600 1 690 776 221 172 124 51 106 130 109 107 107 108 26 21 20 16 15 14 13 145 131 73 59 67 70 73 48 101 88 81 53 48 43 92 70 57 36 24 22 20 5 5.8 4.8 4.9 9.4 6.2 6.1 30 27 21 15 9.4 8.5 7.2 12 12 19 12 8.3 10 10 52 65 97 53 29 34 29 25 22 16 10 9 8.9 7.2 28 28 19 14 14 14 12 (13–70) (12–61) (12–56) (11–49) (10–43) (9.7–42) (8.9–40) (24–118) (23–91) (15–54) (9.8–36) (6.3–26) (2.7–19) (11–36) (12–52) (28–101) (46–158) (58–198) (42–161) (34–142) (37–137) (15–58) (15–55) (11–43) (8.4–33) (5.0–23) (6.0–23) (4.4–20) (343–1 300) (717–2 820) (768–2 970) (366–1 340) (109–371) (79–302) (44–245) (22–93) (51–182) (60–225) (46–199) (48–189) (49–188) (50–188) (11–46) (9.1–39) (9.0–36) (6.6–29) (6.8–27) (6.0–25) (5.1–24) (43–307) (59–229) (22–154) (17–129) (28–123) (31–124) (35–126) (21–85) (51–169) (42–151) (39–139) (22–97) (20–88) (17–80) (43–160) (28–130) (23–105) (14–69) (9.7–46) (9.1–41) (7.9–36) (1.5–10) (2.0–12) (1.6–9.6) (2.0–9.2) (4.4–16) (2.1–13) (1.8–13) (12–54) (11–51) (8.6–40) (6.7–28) (4.0–17) (3.6–16) (2.9–13) (5.8–20) (4.3–24) (9.1–33) (5.7–21) (3.1–16) (4.6–19) (4.2–18) (26–85) (24–125) (45–168) (21–98) (10–57) (15–60) (13–52) (11–45) (9.8–38) (7.2–30) (4.5–19) (3.6–17) (3.6–17) (2.4–15) (14–47) (15–46) (9.4–31) (6.4–24) (7.3–23) (7.1–22) (5.7–20) NUMBER (THOUSANDS) 0.84 0.82 0.75 0.63 0.53 0.52 0.51 0.026 0.023 0.014 0.012 <0.01 <0.01 0.01 0.63 1.2 1.9 2.3 1.8 1.6 1.5 1.7 1.7 1.4 1.1 0.76 0.77 0.67 22 49 55 29 12 10 8.9 3.5 6.9 8.4 6.9 6.7 6.6 6.6 1.8 1.6 1.5 1.2 1.2 1.1 1.1 4.2 3 2.4 2 1.9 1.9 1.9 2.9 5.2 4.6 4.1 2.8 2.6 2.3 3 2.4 1.9 1.2 0.79 0.71 0.62 0.033 0.041 0.038 0.039 0.07 0.059 0.061 2.2 2.1 1.6 1.1 0.72 0.65 0.57 0.4 0.52 0.68 0.45 0.36 0.41 0.41 0.49 0.72 0.91 0.55 0.33 0.34 0.3 0.89 0.76 0.61 0.39 0.36 0.36 0.3 11 11 7.7 6.3 6 5.9 5.3 (0.600–1.1) (0.680–0.970) (0.630–0.870) (0.530–0.730) (0.450–0.620) (0.440–0.610) (0.430–0.590) (0.023–0.030) (0.020–0.026) (0.012–0.016) (0.010–0.013) (<0.01–<0.01) (<0.01–<0.01) (<0.01–0.012) (0.470–0.810) (1.0–1.4) (1.6–2.1) (2.1–2.6) (1.6–2.2) (1.3–1.9) (1.3–1.8) (1.5–2.0) (1.5–1.9) (1.2–1.5) (0.940–1.2) (0.660–0.860) (0.680–0.870) (0.590–0.760) (18–26) (41–59) (46–66) (24–34) (9.8–14) (8.6–12) (7.3–11) (2.8–4.3) (5.9–8.1) (6.9–9.9) (5.3–8.8) (5.3–8.1) (5.4–8.0) (5.4–8.0) (1.6–2.1) (1.4–1.8) (1.3–1.7) (1.1–1.4) (1.0–1.3) (0.990–1.3) (0.940–1.2) (2.6–6.2) (2.4–3.6) (2.0–2.9) (1.7–2.4) (1.6–2.2) (1.6–2.2) (1.6–2.1) (2.5–3.3) (4.5–5.9) (4.0–5.3) (3.6–4.6) (2.5–3.2) (2.2–2.9) (2.0–2.6) (2.6–3.4) (2.1–2.8) (1.6–2.1) (1.1–1.4) (0.690–0.900) (0.620–0.810) (0.540–0.700) (0.029–0.038) (0.036–0.047) (0.033–0.043) (0.034–0.044) (0.061–0.079) (0.051–0.066) (0.053–0.069) (2.0–2.5) (1.8–2.4) (1.4–1.8) (0.980–1.3) (0.630–0.820) (0.570–0.740) (0.500–0.640) (0.350–0.460) (0.450–0.580) (0.590–0.760) (0.400–0.510) (0.320–0.410) (0.360–0.470) (0.360–0.470) (0.430–0.550) (0.630–0.810) (0.800–1.0) (0.480–0.620) (0.290–0.370) (0.300–0.390) (0.260–0.340) (0.780–1.0) (0.670–0.860) (0.530–0.690) (0.340–0.440) (0.310–0.410) (0.310–0.410) (0.260–0.340) (11–12) (10–12) (7.2–8.1) (5.9–6.7) (5.6–6.4) (5.5–6.2) (4.9–5.6) RATEa 24 24 23 20 17 17 16 49 37 21 14 10 4.4 13 18 38 61 77 62 55 52 23 21 17 13 9 9.2 7.9 305 637 682 335 131 113 95 34 68 84 72 70 70 70 18 16 14 12 11 10 9.7 94 84 63 52 50 49 49 33 62 58 53 38 35 32 62 52 42 28 18 16 14 4.4 4.8 4 3.8 6.4 5.3 5.4 22 20 16 11 6.8 6.2 5.3 7.8 9.8 13 8.4 6.5 7.4 7.4 31 50 67 42 25 26 23 18 15 12 7.4 6.7 6.7 5.5 20 19 13 10 9.5 9.2 8.2 (18–32) (20–29) (19–26) (17–23) (14–20) (14–19) (14–19) (43–55) (32–41) (18–24) (12–16) (9.1–12) (3.9–5.0) (12–15) (13–23) (32–44) (53–68) (68–87) (53–73) (45–65) (43–61) (20–26) (19–24) (15–19) (11–15) (7.9–10) (8.0–10) (6.9–8.9) (252–363) (526–759) (563–813) (276–398) (108–156) (93–135) (78–114) (27–42) (58–80) (69–100) (55–91) (56–86) (57–85) (57–85) (16–21) (14–18) (13–16) (10–13) (9.5–12) (9.0–12) (8.5–11) (58–138) (69–101) (51–75) (43–63) (43–57) (42–56) (42–56) (29–37) (54–71) (50–66) (46–61) (33–43) (30–40) (28–36) (54–70) (45–59) (37–47) (24–31) (16–21) (14–19) (13–16) (3.8–4.9) (4.2–5.5) (3.5–4.6) (3.3–4.3) (5.6–7.2) (4.6–5.9) (4.7–6.1) (19–24) (18–23) (14–18) (9.6–12) (6.0–7.7) (5.4–7.0) (4.7–6.0) (6.9–8.9) (8.6–11) (11–14) (7.3–9.5) (5.7–7.3) (6.5–8.4) (6.5–8.4) (27–35) (44–57) (58–75) (36–47) (22–28) (23–30) (20–26) (16–20) (13–17) (10–13) (6.5–8.4) (5.9–7.6) (5.8–7.5) (4.9–6.3) (19–21) (18–20) (12–14) (9.5–11) (8.9–10) (8.6–9.8) (7.7–8.7) EUROPEAN REGION MORTALITY (EXCLUDING HIV) YEAR Rates are per 100 000 population. Data for all years can be downloaded from www.who.int/tb/data GLOBAL TUBERCULOSIS REPORT 2013 227 7$%/($(VWLPDWHVRIWKHEXUGHQRIGLVHDVHFDXVHGE\7% ± MORTALITY (EXCLUDING HIV) YEAR Georgia Germany Greece Greenland Hungary Iceland Ireland Israel Italy Kazakhstan Kyrgyzstan Latvia Lithuania Luxembourg Malta Monaco a 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 POPULATION (MILLIONS) 5 5 5 4 4 4 4 80 83 84 84 83 83 83 10 11 11 11 11 11 11 <1 <1 <1 <1 <1 <1 <1 10 10 10 10 10 10 10 <1 <1 <1 <1 <1 <1 <1 4 4 4 4 4 5 5 4 5 6 7 7 8 8 57 57 57 59 61 61 61 16 16 15 15 16 16 16 4 5 5 5 5 5 5 3 2 2 2 2 2 2 4 4 3 3 3 3 3 <1 <1 <1 <1 <1 <1 <1 <1 <1 <1 <1 <1 <1 <1 <1 <1 <1 <1 <1 <1 <1 NUMBER (THOUSANDS) 0.48 0.42 0.37 0.17 0.67 0.2 0.2 1.1 1.2 0.49 0.32 0.3 0.29 0.29 0.16 0.16 0.089 0.094 0.074 0.078 0.076 <0.01 <0.01 <0.01 <0.01 <0.01 <0.01 <0.01 0.55 0.57 0.36 0.18 0.1 0.075 0.073 <0.01 <0.01 <0.01 <0.01 <0.01 <0.01 <0.01 0.051 0.036 0.059 0.015 0.027 0.02 0.018 0.02 0.072 0.034 0.022 0.017 0.017 0.017 0.61 0.68 0.5 0.37 0.3 0.28 0.26 2.1 5.2 4.8 4.2 2.1 1.7 1.3 0.4 0.72 1.3 0.82 0.61 0.57 0.52 0.19 0.34 0.3 0.18 0.083 0.068 0.053 0.26 0.49 0.37 0.36 0.21 0.15 0.09 <0.01 0 <0.01 <0.01 <0.01 <0.01 <0.01 <0.01 <0.01 <0.01 <0.01 <0.01 <0.01 <0.01 <0.01 <0.01 <0.01 <0.01 <0.01 <0.01 <0.01 (0.430–0.550) (0.360–0.470) (0.320–0.420) (0.150–0.200) (0.370–1.1) (0.160–0.240) (0.160–0.240) (1.0–1.1) (1.2–1.2) (0.490–0.500) (0.320–0.330) (0.290–0.300) (0.280–0.290) (0.280–0.290) (0.160–0.170) (0.150–0.170) (0.085–0.092) (0.090–0.098) (0.070–0.078) (0.075–0.082) (0.073–0.080) (<0.01–0.017) (<0.01–0.017) (<0.01–0.017) (<0.01–0.018) (<0.01–0.038) (<0.01–0.038) (<0.01–<0.01) (0.550–0.550) (0.570–0.580) (0.350–0.360) (0.180–0.180) (0.100–0.100) (0.075–0.075) (0.073–0.073) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (0.051–0.052) (0.036–0.036) (0.058–0.059) (0.015–0.015) (0.027–0.027) (0.019–0.020) (0.018–0.018) (0.020–0.021) (0.069–0.074) (0.034–0.035) (0.022–0.023) (0.017–0.018) (0.017–0.018) (0.017–0.018) (0.590–0.630) (0.660–0.690) (0.480–0.520) (0.370–0.370) (0.300–0.300) (0.280–0.280) (0.260–0.270) (1.9–2.3) (4.8–5.6) (4.3–5.3) (3.8–4.5) (1.9–2.4) (1.5–1.9) (1.0–1.5) (0.340–0.470) (0.620–0.830) (1.1–1.4) (0.810–0.830) (0.610–0.610) (0.560–0.570) (0.510–0.530) (0.190–0.190) (0.340–0.350) (0.290–0.310) (0.180–0.190) (0.080–0.086) (0.066–0.070) (0.052–0.054) (0.260–0.260) (0.490–0.500) (0.360–0.370) (0.360–0.360) (0.210–0.210) (0.150–0.150) (0.088–0.091) (<0.01–<0.01) (0–0) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (0–<0.01) (0–<0.01) (0–<0.01) (0–<0.01) (0–<0.01) (0–<0.01) (<0.01–<0.01) PREVALENCE (INCLUDING HIV) NUMBER (THOUSANDS) RATEa 8.9 8.2 7.7 3.8 15 4.5 4.5 1.3 1.4 0.59 0.39 0.36 0.35 0.35 1.6 1.5 0.81 0.85 0.66 0.7 0.69 9.5 9.5 9.5 9.6 14 14 6.7 5.3 5.5 3.5 1.8 1 0.75 0.73 0.4 0.71 0.36 0.33 0.29 0.28 0.27 1.5 1 1.5 0.37 0.61 0.43 0.39 0.45 1.3 0.57 0.34 0.23 0.23 0.23 1.1 1.2 0.87 0.63 0.49 0.46 0.43 13 33 33 28 13 11 7.8 9.1 16 25 16 11 10 9.5 7.2 14 13 8.1 4 3.3 2.6 7 14 11 11 6.9 5 3 0.55 0 0.24 0.22 0.19 0.19 0.42 0.28 0.27 0.25 0.23 0.25 0.69 0.37 0.27 0.26 <0.1 <0.1 0.21 <0.1 0.1 (7.8–10) (7.2–9.3) (6.7–8.8) (3.3–4.5) (8.4–24) (3.7–5.5) (3.7–5.5) (1.3–1.3) (1.4–1.5) (0.58–0.60) (0.38–0.39) (0.35–0.36) (0.34–0.35) (0.34–0.35) (1.5–1.7) (1.4–1.6) (0.77–0.84) (0.81–0.89) (0.63–0.70) (0.67–0.74) (0.65–0.72) (0.61–30) (0.61–30) (0.61–30) (0.54–31) (<0.1–66) (<0.1–66) (1.8–15) (5.3–5.3) (5.5–5.6) (3.5–3.5) (1.8–1.8) (1.0–1.0) (0.75–0.75) (0.73–0.73) (0.40–0.40) (0.71–0.71) (0.36–0.37) (0.33–0.33) (0.29–0.29) (0.28–0.28) (0.27–0.27) (1.4–1.5) (1.0–1.0) (1.5–1.5) (0.37–0.37) (0.61–0.61) (0.43–0.43) (0.38–0.39) (0.43–0.46) (1.3–1.4) (0.56–0.58) (0.33–0.35) (0.23–0.24) (0.22–0.23) (0.22–0.23) (1.0–1.1) (1.2–1.2) (0.84–0.91) (0.63–0.64) (0.49–0.50) (0.46–0.47) (0.43–0.44) (11–14) (31–36) (29–37) (25–30) (12–15) (9.1–12) (6.3–9.3) (7.6–11) (13–18) (23–28) (16–16) (11–12) (10–11) (9.3–9.8) (7.1–7.3) (14–14) (12–13) (7.9–8.3) (3.8–4.1) (3.2–3.4) (2.5–2.6) (7.0–7.0) (13–14) (10–11) (11–11) (6.8–6.9) (4.9–5.0) (2.9–3.0) (0.54–0.56) (0–0) (0.23–0.24) (0.21–0.22) (0.19–0.20) (0.19–0.19) (0.41–0.43) (0.27–0.29) (0.26–0.28) (0.25–0.25) (0.23–0.23) (0.24–0.25) (0.69–0.69) (0.36–0.37) (0–1.5) (0–1.4) (<0.1–0.17) (0–0.54) (0–1.1) (<0.1–0.24) (<0.1–0.24) 38 29 24 14 8.2 7.9 6.9 23 19 15 9.3 6.4 6.6 6.4 1.5 1.5 1 1.2 0.62 0.7 0.71 0.14 0.14 0.14 0.14 0.2 0.2 0.11 5.5 6.9 5.2 3 2.6 2.9 2.9 0.03 0.017 0.023 0.016 0.046 0.013 0.014 0.94 0.68 0.59 0.68 0.61 0.64 0.5 0.39 0.56 0.85 0.54 0.46 0.63 0.85 7 9.7 5.1 6.1 4.5 5.3 5.7 19 110 97 51 42 50 31 7.5 15 22 17 11 11 12 3 5.9 4.6 2.3 1.3 1.2 1.6 2.5 4.9 5.5 4.2 3.1 3 2.8 0.083 0.045 0.076 0.06 0.045 0.036 0.053 0.025 0.024 0.025 0.031 0.043 0.044 0.069 <0.01 <0.01 <0.01 <0.01 <0.01 <0.01 <0.01 (18–67) (15–48) (13–40) (7.5–23) (3.8–14) (3.7–14) (2.9–13) (10–42) (7.8–35) (6.6–26) (4.1–17) (2.7–12) (2.9–12) (2.8–12) (0.690–2.6) (0.620–2.7) (0.390–2.0) (0.590–2.1) (0.200–1.3) (0.280–1.3) (0.310–1.3) (0.053–0.260) (0.054–0.260) (0.053–0.260) (0.056–0.260) (0.092–0.340) (0.092–0.340) (0.032–0.230) (2.3–10) (3.0–12) (2.2–9.6) (1.2–5.5) (1.3–4.5) (1.4–4.8) (1.4–4.8) (0.014–0.053) (<0.01–0.034) (0.011–0.038) (<0.01–0.028) (0.024–0.075) (<0.01–0.027) (<0.01–0.028) (0.360–1.8) (0.260–1.3) (0.240–1.1) (0.290–1.2) (0.250–1.1) (0.280–1.1) (0.180–0.970) (0.130–0.780) (0.190–1.1) (0.370–1.5) (0.200–1.0) (0.150–0.940) (0.260–1.2) (0.400–1.5) (3.2–12) (4.6–17) (1.7–10) (2.6–11) (1.6–9.0) (2.2–9.8) (2.5–10) (8.3–33) (54–180) (50–160) (23–92) (19–75) (25–85) (12–57) (3.8–12) (7.5–25) (11–37) (8.0–29) (4.7–20) (5.2–20) (5.5–21) (1.6–4.9) (3.1–9.6) (2.3–7.6) (0.990–4.1) (0.540–2.4) (0.520–2.3) (0.780–2.6) (1.2–4.4) (2.4–8.5) (2.7–9.3) (2.0–7.2) (1.4–5.6) (1.3–5.2) (1.3–5.0) (0.039–0.140) (0.015–0.091) (0.036–0.130) (0.026–0.110) (0.019–0.083) (0.013–0.071) (0.026–0.089) (<0.01–0.052) (<0.01–0.049) (0.011–0.046) (0.011–0.061) (0.014–0.087) (0.015–0.089) (0.032–0.120) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) RATEa 704 571 516 315 186 182 158 29 23 18 11 7.7 7.9 7.8 15 14 9.5 11 5.6 6.3 6.3 245 245 245 247 345 346 190 53 67 51 29 26 29 29 12 6.3 8.1 5.3 14 4.1 4.3 27 19 16 16 14 14 11 8.6 10 14 8.1 6.1 8.3 11 12 17 9 10 7.5 8.8 9.4 116 706 668 340 266 312 189 170 326 449 334 204 211 217 114 237 194 102 63 60 76 69 136 157 127 103 97 93 22 11 17 13 8.9 7 10 6.8 6.1 6.2 7.5 10 10 16 6.4 6 1.7 2 5 2.4 2.7 (326–1 220) (290–944) (270–840) (168–508) (87–323) (84–316) (67–288) (13–53) (9.3–42) (8.0–32) (4.9–20) (3.2–14) (3.5–14) (3.3–14) (6.8–25) (5.8–25) (3.6–18) (5.3–19) (1.8–11) (2.6–12) (2.8–11) (96–462) (96–463) (95–464) (98–463) (163–595) (163–596) (57–401) (22–96) (29–120) (22–94) (12–55) (13–45) (14–48) (14–48) (5.5–21) (2.2–13) (4.0–14) (2.4–9.3) (7.5–24) (1.4–8.4) (1.5–8.5) (10–51) (7.1–36) (6.2–29) (7.1–29) (5.5–25) (6.2–25) (4.0–21) (2.9–17) (3.6–21) (6.1–25) (3.1–16) (2.0–13) (3.5–15) (5.2–19) (5.6–22) (8.1–29) (3.0–18) (4.4–19) (2.6–15) (3.6–16) (4.1–17) (51–207) (347–1 190) (344–1 100) (149–608) (118–472) (154–526) (77–350) (86–283) (164–542) (227–747) (159–571) (89–367) (96–370) (101–376) (60–186) (125–385) (99–321) (45–183) (26–117) (25–111) (38–127) (32–118) (65–234) (78–265) (60–219) (46–181) (44–171) (42–164) (10–37) (3.7–22) (8.4–30) (5.7–23) (3.8–16) (2.5–14) (4.9–17) (2.2–14) (2.0–12) (2.7–11) (2.6–15) (3.4–20) (3.4–21) (7.5–28) (3.2–11) (3.0–10) (0.50–3.6) (1.0–3.3) (2.5–8.4) (0.73–5.2) (0.81–5.7) INCIDENCE (INCLUDING HIV) NUMBER (THOUSANDS) 15 13 12 7.8 5.6 5.5 5 17 14 10 6.6 4.7 4.7 4.6 1 1.1 0.81 0.8 0.51 0.52 0.5 0.11 0.11 0.11 0.11 0.13 0.13 0.097 4 4.9 3.8 2.2 1.7 1.8 1.8 0.021 0.014 0.015 0.012 0.025 <0.01 0.012 0.72 0.53 0.44 0.49 0.46 0.46 0.39 0.27 0.46 0.62 0.43 0.39 0.47 0.58 4.9 6.5 4 4.4 3.7 3.9 4.1 13 50 51 35 29 31 22 4 7.7 12 10 7.5 7.6 7.7 1.5 3.1 2.9 1.7 1 0.99 1.1 1.6 3.2 3.6 2.8 2.2 2.1 2 0.055 0.037 0.051 0.043 0.033 0.029 0.034 0.015 0.013 0.018 0.025 0.033 0.035 0.048 <0.01 <0.01 0 <0.01 <0.01 <0.01 <0.01 (14–17) (12–15) (11–14) (7.0–8.7) (5.0–6.2) (4.9–6.1) (4.5–5.6) (15–19) (12–16) (9.1–12) (5.7–7.4) (4.1–5.3) (4.1–5.3) (4.1–5.3) (0.880–1.1) (0.950–1.2) (0.710–0.920) (0.700–0.900) (0.450–0.580) (0.460–0.590) (0.440–0.570) (0.093–0.120) (0.093–0.120) (0.094–0.120) (0.095–0.120) (0.110–0.150) (0.120–0.150) (0.085–0.110) (3.5–4.5) (4.3–5.6) (3.3–4.3) (1.9–2.5) (1.5–2.0) (1.6–2.0) (1.6–2.0) (0.018–0.023) (0.012–0.016) (0.013–0.017) (0.010–0.013) (0.022–0.029) (<0.01–0.010) (0.010–0.013) (0.630–0.810) (0.460–0.600) (0.390–0.500) (0.430–0.550) (0.400–0.520) (0.400–0.520) (0.340–0.440) (0.240–0.300) (0.400–0.520) (0.540–0.700) (0.370–0.480) (0.340–0.440) (0.420–0.540) (0.510–0.660) (4.3–5.5) (5.7–7.3) (3.5–4.6) (3.9–5.0) (3.2–4.1) (3.4–4.5) (3.6–4.6) (11–15) (42–58) (43–60) (30–41) (24–34) (26–36) (19–26) (3.3–4.8) (6.4–9.2) (10–15) (8.6–12) (6.2–9.0) (6.3–9.1) (6.4–9.2) (1.3–1.7) (2.7–3.5) (2.5–3.2) (1.5–1.9) (0.930–1.2) (0.890–1.1) (1.0–1.2) (1.4–1.9) (2.8–3.7) (3.2–4.0) (2.5–3.2) (1.9–2.5) (1.8–2.4) (1.8–2.3) (0.048–0.062) (0.032–0.042) (0.044–0.057) (0.037–0.048) (0.029–0.038) (0.025–0.033) (0.030–0.039) (0.013–0.017) (0.011–0.014) (0.016–0.021) (0.022–0.029) (0.029–0.038) (0.030–0.039) (0.042–0.055) (<0.01–<0.01) (<0.01–<0.01) (0–0) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) RATEa 280 263 256 175 128 125 116 21 17 12 7.8 5.6 5.7 5.6 9.9 10 7.4 7.2 4.6 4.7 4.5 191 191 191 191 232 234 170 39 48 37 22 17 18 18 8.1 5.2 5.3 3.9 8 2.9 3.5 20 15 12 12 10 10 8.6 6 8.6 10 6.5 5.3 6.3 7.6 8.6 11 7.1 7.5 6 6.5 6.7 79 318 351 235 182 193 137 92 168 249 208 141 141 141 57 126 121 75 50 48 53 44 89 103 87 73 69 66 14 9 12 9.3 6.6 5.6 6.5 4 3.2 4.5 6.1 7.9 8.1 11 3.9 3.7 0 1.2 3.1 2.1 2.1 Rates are per 100 000 population. GLOBAL TUBERCULOSIS REPORT 2013 Data for all years can be downloaded from www.who.int/tb/data (250–312) (234–293) (228–285) (156–195) (114–142) (112–140) (103–130) (18–24) (15–19) (11–14) (6.9–8.8) (4.9–6.4) (5.0–6.4) (4.9–6.4) (8.7–11) (8.9–11) (6.4–8.3) (6.3–8.2) (4.0–5.2) (4.1–5.3) (3.9–5.1) (167–216) (167–216) (167–216) (167–216) (203–262) (205–264) (149–193) (34–44) (42–54) (33–42) (19–25) (15–19) (16–20) (16–20) (7.1–9.2) (4.5–5.8) (4.7–6.0) (3.4–4.4) (7.0–9.0) (2.5–3.2) (3.1–4.0) (18–23) (13–17) (10–13) (10–13) (8.9–12) (8.9–11) (7.5–9.7) (5.2–6.8) (7.5–9.7) (9.0–12) (5.7–7.3) (4.6–6.0) (5.5–7.1) (6.7–8.6) (7.5–9.7) (10–13) (6.2–8.0) (6.6–8.5) (5.3–6.8) (5.7–7.3) (5.8–7.5) (66–92) (269–372) (297–411) (199–275) (154–213) (163–225) (116–160) (76–109) (138–200) (205–296) (171–248) (116–168) (116–168) (116–168) (50–65) (111–142) (106–137) (66–85) (45–56) (43–53) (49–58) (37–52) (77–102) (92–114) (76–97) (63–82) (61–78) (58–75) (13–16) (7.9–10) (10–13) (8.1–11) (5.8–7.4) (4.9–6.3) (5.7–7.4) (3.5–4.5) (2.8–3.6) (4.0–5.1) (5.3–6.9) (6.9–8.9) (7.1–9.2) (9.9–13) (3.4–4.4) (3.3–4.2) (0–0) (1.0–1.3) (2.7–3.5) (1.8–2.4) (1.8–2.4) 7$%/($(VWLPDWHVRIWKHEXUGHQRIGLVHDVHFDXVHGE\7% ± Montenegro Netherlands Norway Poland Portugal Republic of Moldova Romania Russian Federation San Marino Serbia Serbia & Montenegro Slovakia Slovenia Spain Sweden Switzerland Tajikistan a 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 2005 2010 2011 2012 1990 1995 2000 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 POPULATION (MILLIONS) <1 <1 <1 <1 15 15 16 16 17 17 17 4 4 4 5 5 5 5 38 38 38 38 38 38 38 10 10 10 11 11 11 11 4 4 4 4 4 4 4 23 23 22 22 22 22 22 148 149 147 144 144 143 143 <1 <1 <1 <1 <1 <1 <1 10 10 10 10 10 11 11 5 5 5 5 5 5 5 2 2 2 2 2 2 2 39 39 40 43 46 47 47 9 9 9 9 9 9 10 7 7 7 7 8 8 8 5 6 6 7 8 8 8 NUMBER (THOUSANDS) <0.01 <0.01 <0.01 <0.01 0.034 0.044 0.034 0.033 0.032 0.019 0.028 0.026 0.019 0.01 <0.01 0.01 <0.01 <0.01 1.4 1.2 1.1 0.85 0.61 0.7 0.67 0.31 0.35 0.29 0.18 0.13 0.15 0.14 0.25 0.55 0.72 0.75 0.57 0.48 0.63 1.6 2.6 2.1 1.7 1.4 1.3 1.2 12 24 31 32 23 21 19 0 0 0 0 0 0 0 0.28 0.16 0.16 0.14 0.6 0.5 0.41 0.11 0.084 0.054 0.046 0.033 0.034 0.034 0.05 0.032 0.017 0.017 0.019 0.02 0.02 0.89 0.62 0.4 0.35 0.3 0.23 0.27 0.06 0.024 0.018 0.015 0.014 0.014 0.013 0.086 0.047 0.034 0.022 0.019 0.018 0.017 0.34 0.69 1.2 0.96 0.69 0.65 0.61 (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (0.033–0.035) (0.043–0.045) (0.033–0.035) (0.032–0.034) (0.031–0.032) (0.019–0.019) (0.028–0.029) (0.025–0.026) (0.019–0.020) (0.010–0.011) (<0.01–0.010) (<0.01–0.010) (<0.01–<0.01) (<0.01–<0.01) (1.4–1.5) (1.2–1.3) (1.1–1.2) (0.820–0.880) (0.580–0.630) (0.670–0.730) (0.640–0.700) (0.290–0.330) (0.330–0.370) (0.270–0.310) (0.170–0.190) (0.120–0.130) (0.140–0.160) (0.130–0.140) (0.230–0.260) (0.510–0.580) (0.660–0.780) (0.700–0.790) (0.550–0.590) (0.470–0.500) (0.620–0.640) (1.6–1.6) (2.6–2.6) (2.1–2.1) (1.7–1.7) (1.4–1.4) (1.3–1.3) (1.2–1.2) (12–12) (24–25) (31–32) (31–33) (22–24) (21–22) (18–20) (0–0) (0–0) (0–0) (0–0) (0–0) (0–0) (0–0) (0.250–0.300) (0.150–0.180) (0.140–0.170) (0.120–0.160) (0.580–0.620) (0.480–0.520) (0.400–0.430) (0.110–0.110) (0.084–0.085) (0.053–0.054) (0.045–0.046) (0.033–0.033) (0.034–0.035) (0.034–0.035) (0.049–0.051) (0.032–0.033) (0.017–0.017) (0.016–0.017) (0.018–0.019) (0.020–0.020) (0.020–0.020) (0.870–0.900) (0.610–0.620) (0.400–0.410) (0.350–0.360) (0.300–0.310) (0.230–0.230) (0.260–0.270) (0.060–0.061) (0.024–0.024) (0.018–0.018) (0.015–0.015) (0.014–0.014) (0.013–0.014) (0.013–0.013) (0.085–0.087) (0.046–0.047) (0.034–0.035) (0.021–0.022) (0.019–0.020) (0.017–0.018) (0.017–0.018) (0.240–0.460) (0.490–0.930) (0.690–1.9) (0.720–1.2) (0.520–0.880) (0.490–0.830) (0.460–0.780) RATEa 0.57 0.19 0.19 0.19 0.23 0.29 0.21 0.2 0.19 0.11 0.17 0.6 0.44 0.23 0.21 0.21 0.12 0.14 3.8 3.2 2.9 2.2 1.6 1.8 1.8 3.1 3.5 2.8 1.7 1.2 1.4 1.3 5.6 13 17 20 16 14 18 6.9 11 9.5 7.8 6.5 5.9 5.6 8.2 16 21 22 16 15 13 0 0 0 0 0 0 0 2.8 1.7 1.6 1.5 5.8 4.5 3.8 2.1 1.6 0.99 0.85 0.61 0.63 0.63 2.5 1.6 0.86 0.83 0.9 0.97 0.97 2.3 1.6 1 0.81 0.66 0.49 0.57 0.7 0.27 0.2 0.17 0.15 0.14 0.14 1.3 0.67 0.48 0.29 0.25 0.22 0.22 6.4 12 20 14 9 8.3 7.6 (0.52–0.62) (0.13–0.25) (0.13–0.25) (0.13–0.25) (0.22–0.23) (0.28–0.29) (0.21–0.22) (0.20–0.21) (0.19–0.20) (0.11–0.12) (0.17–0.17) (0.59–0.62) (0.43–0.45) (0.22–0.23) (0.21–0.22) (0.20–0.21) (0.12–0.13) (0.14–0.14) (3.6–3.9) (3.0–3.3) (2.8–3.0) (2.2–2.3) (1.5–1.6) (1.7–1.9) (1.7–1.8) (2.9–3.3) (3.2–3.7) (2.6–3.0) (1.6–1.8) (1.1–1.3) (1.3–1.5) (1.2–1.4) (5.2–6.1) (12–13) (16–19) (19–21) (15–16) (13–14) (18–18) (6.9–6.9) (11–11) (9.5–9.5) (7.8–7.8) (6.5–6.5) (5.9–6.0) (5.5–5.6) (8.1–8.3) (16–17) (21–22) (22–23) (16–16) (14–15) (13–14) (0–0) (0–0) (0–0) (0–0) (0–0) (0–0) (0–0) (2.5–3.1) (1.5–1.9) (1.4–1.8) (1.3–1.6) (5.6–5.9) (4.4–4.7) (3.6–4.0) (2.1–2.1) (1.6–1.6) (0.99–1.0) (0.84–0.85) (0.61–0.62) (0.63–0.63) (0.63–0.63) (2.5–2.5) (1.6–1.6) (0.85–0.88) (0.82–0.84) (0.90–0.91) (0.96–0.97) (0.96–0.97) (2.2–2.3) (1.5–1.6) (0.99–1.0) (0.80–0.82) (0.65–0.67) (0.49–0.50) (0.57–0.58) (0.70–0.71) (0.27–0.28) (0.20–0.21) (0.16–0.17) (0.14–0.15) (0.14–0.15) (0.13–0.14) (1.3–1.3) (0.66–0.68) (0.47–0.49) (0.29–0.30) (0.24–0.25) (0.22–0.23) (0.21–0.22) (4.5–8.6) (8.4–16) (11–31) (11–18) (6.8–12) (6.2–11) (5.7–9.7) PREVALENCE (INCLUDING HIV) NUMBER (THOUSANDS) 0.23 0.17 0.18 0.15 2.2 2.6 1.8 1.7 1.7 1.5 1.4 0.43 0.38 0.32 0.42 0.44 0.52 0.51 25 26 17 13 11 13 11 9.8 8.6 5.9 4.6 3.4 3.4 3.6 3.5 8.9 10 9.5 8.8 8.6 8.8 67 81 66 46 34 33 31 120 240 300 320 220 190 170 <0.01 <0.01 <0.01 <0.01 <0.01 <0.01 <0.01 5.1 3.7 3.5 3 11 12 7.7 1.9 2.4 1.5 1.1 0.62 0.61 0.52 1.2 0.81 0.56 0.46 0.27 0.31 0.19 11 13 12 11 10 9.6 8.1 0.87 0.94 0.66 0.97 1.1 0.79 0.92 2.1 1.3 0.83 0.82 0.85 0.9 0.57 6.4 20 30 27 16 14 13 (0.086–0.430) (0.073–0.320) (0.082–0.320) (0.065–0.280) (0.920–3.9) (1.1–4.6) (0.620–3.5) (0.700–3.2) (0.780–3.0) (0.670–2.8) (0.550–2.6) (0.160–0.820) (0.170–0.690) (0.110–0.630) (0.160–0.790) (0.170–0.850) (0.220–0.940) (0.220–0.940) (10–47) (11–46) (6.6–31) (5.1–24) (4.1–20) (6.2–23) (4.2–20) (4.2–18) (3.7–15) (2.2–11) (1.8–8.7) (1.4–6.4) (1.4–6.2) (1.6–6.4) (1.5–6.2) (4.5–15) (5.2–17) (4.1–17) (4.0–15) (4.0–15) (4.2–15) (34–110) (41–130) (32–110) (20–84) (15–62) (15–58) (15–55) (59–200) (120–400) (150–510) (160–540) (100–380) (85–340) (73–320) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (2.1–9.3) (1.5–6.8) (1.5–6.3) (1.2–5.4) (4.5–22) (5.8–20) (3.6–13) (0.600–4.0) (1.0–4.5) (0.590–2.9) (0.450–2.1) (0.250–1.2) (0.260–1.1) (0.220–0.930) (0.550–2.1) (0.330–1.5) (0.220–1.1) (0.210–0.790) (0.110–0.490) (0.150–0.540) (0.061–0.380) (3.8–21) (5.3–24) (5.1–22) (4.4–20) (4.4–18) (4.1–17) (3.2–15) (0.350–1.6) (0.430–1.7) (0.280–1.2) (0.480–1.6) (0.490–1.8) (0.280–1.6) (0.370–1.7) (0.940–3.7) (0.530–2.4) (0.290–1.6) (0.360–1.5) (0.390–1.5) (0.420–1.5) (0.190–1.2) (3.2–11) (9.5–35) (15–52) (13–44) (7.6–27) (6.6–25) (5.8–23) RATEa 37 28 29 25 15 17 11 10 10 9.2 8.2 10 8.8 7.1 9 9.1 10 10 66 67 44 33 28 35 28 99 85 57 44 32 32 34 79 206 254 252 245 242 249 287 351 295 209 158 151 144 81 163 206 223 152 135 121 7 15 8.5 1.8 2 2 2 51 38 36 31 111 108 71 36 46 28 21 11 11 9.5 60 41 28 23 13 15 9 28 33 30 25 22 21 17 10 11 7.5 11 11 8.4 9.6 31 18 12 11 11 11 7.1 121 350 493 393 206 181 160 (14–70) (12–51) (13–51) (10–45) (6.2–26) (7.4–30) (3.9–22) (4.3–19) (4.7–18) (4.0–17) (3.3–15) (3.8–19) (3.8–16) (2.5–14) (3.5–17) (3.4–17) (4.4–19) (4.3–19) (27–122) (29–121) (17–82) (13–62) (11–53) (16–61) (11–53) (43–180) (37–152) (21–110) (17–83) (13–61) (13–59) (15–61) (34–142) (104–342) (126–425) (108–454) (112–430) (113–419) (120–424) (145–478) (177–583) (142–504) (88–380) (69–282) (68–266) (67–251) (40–136) (82–271) (101–348) (112–372) (69–266) (59–240) (51–221) (2.1–15) (7.7–25) (4.2–14) (0.55–3.9) (0.82–3.7) (0.83–3.7) (0.79–3.7) (21–93) (16–70) (16–66) (13–57) (43–209) (53–183) (33–123) (11–75) (19–83) (11–54) (8.3–38) (4.5–22) (4.9–20) (4.1–17) (27–106) (16–76) (11–53) (11–40) (5.4–24) (7.3–26) (3.0–18) (9.8–54) (13–60) (13–54) (10–45) (9.5–40) (8.8–37) (6.8–33) (4.1–19) (4.9–19) (3.2–14) (5.3–18) (5.2–20) (3.0–16) (3.9–18) (14–56) (7.5–34) (4.1–23) (4.8–20) (5.0–19) (5.4–19) (2.3–15) (60–203) (164–604) (238–839) (198–654) (99–352) (85–315) (72–283) INCIDENCE (INCLUDING HIV) NUMBER (THOUSANDS) 0.18 0.13 0.13 0.11 1.6 1.9 1.4 1.3 1.2 1.1 1.1 0.33 0.27 0.25 0.32 0.34 0.37 0.37 19 18 13 9.4 8.1 9.1 8.1 7.1 6.4 4.9 3.8 2.9 2.8 2.8 2.3 4.7 6 6.6 5.9 5.7 5.6 34 43 41 32 24 22 20 70 140 190 190 150 140 130 <0.01 <0.01 <0.01 <0.01 <0.01 <0.01 <0.01 3.7 2.7 2.5 2.2 7 6.7 5 1.7 1.8 1.2 0.82 0.47 0.43 0.37 0.83 0.6 0.42 0.31 0.19 0.21 0.15 8.7 10 9.2 8.4 7.8 7.4 6.5 0.64 0.65 0.48 0.62 0.72 0.63 0.68 1.5 0.95 0.66 0.59 0.58 0.6 0.48 3.7 8.6 14 14 9.8 9.2 8.6 (0.160–0.200) (0.110–0.140) (0.110–0.140) (0.100–0.130) (1.4–1.8) (1.6–2.1) (1.3–1.6) (1.1–1.5) (1.1–1.4) (0.990–1.3) (0.930–1.2) (0.290–0.370) (0.240–0.310) (0.220–0.290) (0.280–0.360) (0.300–0.390) (0.330–0.420) (0.330–0.420) (16–21) (16–21) (11–14) (8.3–11) (7.1–9.1) (8.0–10) (7.1–9.2) (6.3–8.1) (5.6–7.3) (4.3–5.5) (3.3–4.3) (2.5–3.2) (2.4–3.1) (2.4–3.1) (1.9–2.8) (3.9–5.6) (5.0–7.2) (5.4–7.9) (4.9–7.1) (4.7–6.8) (4.6–6.7) (28–41) (36–52) (33–48) (27–39) (20–28) (18–26) (17–24) (59–81) (120–170) (160–220) (160–230) (130–180) (120–160) (110–150) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (3.2–4.2) (2.3–3.0) (2.2–2.8) (1.9–2.4) (5.0–9.4) (5.7–7.9) (4.2–5.8) (1.5–1.9) (1.6–2.0) (1.0–1.3) (0.720–0.920) (0.410–0.530) (0.380–0.490) (0.320–0.420) (0.730–0.940) (0.530–0.680) (0.370–0.480) (0.270–0.350) (0.170–0.220) (0.180–0.240) (0.140–0.170) (7.7–9.9) (8.8–11) (8.1–10) (7.3–9.5) (6.8–8.8) (6.4–8.3) (5.7–7.4) (0.560–0.720) (0.570–0.730) (0.420–0.540) (0.540–0.700) (0.630–0.810) (0.550–0.710) (0.600–0.770) (1.3–1.7) (0.840–1.1) (0.580–0.750) (0.520–0.670) (0.510–0.660) (0.530–0.680) (0.420–0.540) (3.0–4.4) (7.1–10) (11–16) (11–16) (8.1–12) (7.6–11) (7.1–10) RATEa 29 20 20 18 11 12 9 8 7.2 6.8 6.3 7.7 6.2 5.7 6.9 7 7.5 7.5 49 48 33 25 21 24 21 72 64 47 36 27 26 26 54 109 147 175 166 161 160 146 189 181 147 109 101 94 47 96 127 135 106 97 91 4.8 9 4.3 1.5 1.5 1.5 1.5 37 28 26 23 68 61 46 32 33 22 15 8.7 8 6.8 41 30 21 15 9.5 10 7.5 22 26 23 19 17 16 14 7.5 7.3 5.4 6.9 7.6 6.6 7.2 22 14 9.3 8 7.5 7.6 6 70 148 220 200 129 118 108 (26–33) (18–23) (18–23) (16–20) (9.3–12) (11–14) (7.9–10) (7.0–9.0) (6.3–8.2) (5.9–7.7) (5.5–7.2) (6.8–8.7) (5.5–7.0) (5.0–6.4) (6.0–7.8) (6.1–7.9) (6.6–8.5) (6.6–8.5) (43–55) (42–54) (29–37) (22–28) (18–24) (21–27) (19–24) (63–82) (56–72) (41–53) (32–41) (24–31) (23–30) (23–30) (44–64) (90–130) (121–175) (144–209) (137–198) (133–192) (132–190) (120–174) (155–226) (149–216) (121–175) (89–130) (83–121) (77–112) (40–55) (81–112) (108–149) (114–158) (89–123) (82–114) (77–106) (4.2–5.4) (7.8–10) (3.7–4.8) (1.3–1.7) (1.3–1.7) (1.3–1.7) (1.3–1.7) (32–42) (24–32) (23–30) (20–26) (48–91) (52–72) (38–54) (28–36) (29–37) (19–24) (13–17) (7.6–9.8) (7.0–9.0) (5.9–7.7) (36–47) (27–34) (19–24) (14–18) (8.3–11) (8.8–11) (6.5–8.4) (20–25) (22–29) (20–26) (17–22) (15–19) (14–18) (12–16) (6.6–8.5) (6.4–8.3) (4.7–6.1) (6.0–7.8) (6.7–8.6) (5.8–7.5) (6.3–8.1) (19–25) (12–15) (8.1–10) (7.0–9.0) (6.5–8.4) (6.7–8.6) (5.2–6.8) (58–83) (122–176) (182–263) (165–238) (106–153) (97–140) (89–128) EUROPEAN REGION MORTALITY (EXCLUDING HIV) YEAR Rates are per 100 000 population. Data for all years can be downloaded from www.who.int/tb/data GLOBAL TUBERCULOSIS REPORT 2013 229 7$%/($(VWLPDWHVRIWKHEXUGHQRIGLVHDVHFDXVHGE\7% ± MORTALITY (EXCLUDING HIV) YEAR The Former 1990 Yugoslav Republic 1995 of Macedonia 2000 2005 2010 2011 2012 Turkey 1990 1995 2000 2005 2010 2011 2012 Turkmenistan 1990 1995 2000 2005 2010 2011 2012 Ukraine 1990 1995 2000 2005 2010 2011 2012 United Kingdom of 1990 Great Britain and 1995 Northern Ireland 2000 2005 2010 2011 2012 Uzbekistan 1990 1995 2000 2005 2010 2011 2012 a POPULATION (MILLIONS) 2 2 2 2 2 2 2 54 59 63 68 72 73 74 4 4 5 5 5 5 5 52 51 49 47 46 46 46 57 58 59 60 62 62 63 21 23 25 26 28 28 29 NUMBER (THOUSANDS) 0.17 0.1 0.21 0.066 0.034 0.024 0.017 3.4 2.4 2 0.99 0.55 0.47 0.39 0.49 0.83 1.3 1.1 0.6 0.5 0.43 5 7.8 11 12 7.4 7.1 6.1 0.44 0.51 0.43 0.39 0.32 0.34 0.34 1.7 2.7 4.3 3.5 1.5 1.1 0.6 (0.160–0.180) (0.094–0.110) (0.200–0.230) (0.064–0.069) (0.033–0.035) (0.023–0.025) (0.016–0.018) (0.780–7.8) (0.860–4.6) (0.840–3.7) (0.590–1.5) (0.390–0.740) (0.340–0.610) (0.300–0.480) (0.400–0.590) (0.720–0.950) (0.820–1.8) (0.700–1.6) (0.390–0.860) (0.330–0.720) (0.260–0.660) (4.7–5.2) (7.5–8.0) (11–11) (12–12) (7.3–7.5) (7.0–7.2) (6.0–6.2) (0.440–0.450) (0.510–0.520) (0.420–0.440) (0.380–0.390) (0.320–0.330) (0.340–0.340) (0.340–0.340) (1.5–1.9) (2.4–3.1) (3.7–5.0) (3.1–4.0) (0.850–2.3) (0.600–1.6) (0.350–0.930) PREVALENCE (INCLUDING HIV) NUMBER (THOUSANDS) a RATE 8.4 5.1 10 3.2 1.6 1.1 0.82 6.2 4 3.2 1.5 0.76 0.64 0.52 13 20 28 23 12 9.9 8.4 9.6 15 23 25 16 16 13 0.78 0.88 0.73 0.64 0.52 0.54 0.54 8.3 12 17 14 5.3 3.7 2.1 (7.9–9.0) (4.8–5.4) (9.6–11) (3.1–3.3) (1.6–1.7) (1.1–1.2) (0.77–0.87) (1.4–14) (1.5–7.8) (1.3–5.8) (0.86–2.2) (0.53–1.0) (0.47–0.83) (0.41–0.65) (11–16) (17–23) (18–40) (15–33) (7.7–17) (6.4–14) (5.0–13) (9.2–10) (15–16) (23–23) (25–26) (16–16) (15–16) (13–14) (0.77–0.78) (0.87–0.89) (0.72–0.74) (0.63–0.65) (0.52–0.53) (0.54–0.55) (0.54–0.55) (7.2–9.4) (10–13) (15–20) (12–15) (3.1–8.3) (2.1–5.8) (1.2–3.3) 3.3 1.6 1.2 0.69 0.54 0.54 0.54 27 34 28 19 17 17 17 5.6 13 18 16 8.4 6.8 5.1 33 69 81 75 68 66 62 8.6 9.3 9.2 13 11 13 13 54 100 160 130 63 52 39 (0.990–7.1) (0.650–2.9) (0.540–2.2) (0.200–1.5) (0.190–1.1) (0.210–1.0) (0.240–0.970) (11–51) (16–57) (14–48) (8.6–33) (8.1–30) (8.0–30) (7.9–30) (2.5–9.7) (6.1–22) (8.6–31) (7.6–27) (4.0–14) (3.0–12) (1.8–10) (15–60) (35–110) (38–140) (31–140) (32–120) (31–110) (29–110) (3.5–16) (3.9–17) (3.9–17) (6.0–22) (4.2–21) (5.4–23) (5.4–23) (27–90) (50–170) (77–270) (63–210) (32–100) (26–86) (19–65) INCIDENCE (INCLUDING HIV) a RATE 167 81 61 33 26 25 26 51 58 45 28 24 24 23 152 302 400 333 166 133 99 65 135 164 159 149 144 137 15 16 16 21 18 20 20 262 447 647 485 227 183 135 (49–354) (33–150) (26–109) (9.8–70) (9.0–51) (10–48) (11–46) (20–95) (28–98) (22–76) (13–48) (11–42) (11–41) (11–40) (69–265) (145–515) (191–685) (160–569) (79–283) (58–238) (35–196) (28–116) (68–223) (77–284) (65–293) (70–257) (68–248) (65–236) (6.0–28) (6.8–29) (6.6–29) (10–37) (6.8–34) (8.6–36) (8.7–36) (130–438) (216–760) (310–1 100) (240–814) (115–376) (92–304) (67–227) NUMBER (THOUSANDS) 1.6 1.1 0.85 0.62 0.44 0.41 0.39 28 26 21 23 18 17 16 3.5 6.6 9.4 8.3 5.2 4.5 3.9 23 38 53 57 48 46 42 6.6 6.9 7 9.2 8.9 9.5 9.4 26 46 71 61 34 29 22 (1.0–2.4) (0.930–1.4) (0.690–1.0) (0.560–0.680) (0.380–0.510) (0.360–0.480) (0.330–0.450) (25–32) (23–30) (18–23) (20–26) (16–21) (15–20) (14–18) (2.8–4.2) (5.4–7.8) (7.6–11) (6.8–10) (4.3–6.1) (3.7–5.5) (3.1–4.8) (19–27) (31–45) (44–63) (48–68) (41–57) (38–54) (35–51) (6.2–7.1) (6.5–7.4) (6.5–7.4) (8.6–9.8) (8.3–9.4) (8.8–10) (8.8–10) (21–31) (38–55) (59–85) (50–72) (28–40) (24–34) (18–27) RATEa 81 58 41 30 21 20 18 52 45 33 34 25 24 22 95 157 209 175 103 89 75 45 74 108 121 105 99 93 12 12 12 15 14 15 15 125 200 287 233 122 101 78 Rates are per 100 000 population. 230 GLOBAL TUBERCULOSIS REPORT 2013 Data for all years can be downloaded from www.who.int/tb/data (50–119) (47–69) (34–50) (27–33) (18–24) (17–23) (16–21) (46–59) (40–51) (29–37) (29–38) (22–29) (21–27) (19–25) (76–115) (129–187) (170–252) (144–210) (86–121) (73–107) (59–94) (37–53) (62–88) (90–129) (101–144) (88–123) (83–118) (77–112) (11–12) (11–13) (11–13) (14–16) (13–15) (14–16) (14–16) (103–149) (165–238) (237–342) (193–278) (101–146) (84–121) (65–93) 7$%/($,QFLGHQFHQRWLILFDWLRQDQGFDVHGHWHFWLRQUDWHVDOOIRUPV ± Albania Andorra Armenia Austria Azerbaijan Belarus Belgium Bosnia and Herzegovina Bulgaria Croatia Cyprus Czech Republic Denmark Estonia Finland France a b 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 POPULATION (MILLIONS) 3 3 3 3 3 3 3 <1 <1 <1 <1 <1 <1 <1 4 3 3 3 3 3 3 8 8 8 8 8 8 8 7 8 8 9 9 9 9 10 10 10 10 9 9 9 10 10 10 11 11 11 11 5 4 4 4 4 4 4 9 8 8 8 7 7 7 5 5 4 4 4 4 4 <1 <1 <1 1 1 1 1 10 10 10 10 11 11 11 5 5 5 5 6 6 6 2 1 1 1 1 1 1 5 5 5 5 5 5 5 57 58 59 61 63 64 64 NUMBER (THOUSANDS) 0.84 0.82 0.75 0.63 0.53 0.52 0.51 0.026 0.023 0.014 0.012 <0.01 <0.01 0.01 0.63 1.2 1.9 2.3 1.8 1.6 1.5 1.7 1.7 1.4 1.1 0.76 0.77 0.67 22 49 55 29 12 10 8.9 3.5 6.9 8.4 6.9 6.7 6.6 6.6 1.8 1.6 1.5 1.2 1.2 1.1 1.1 4.2 3 2.4 2 1.9 1.9 1.9 2.9 5.2 4.6 4.1 2.8 2.6 2.3 3 2.4 1.9 1.2 0.79 0.71 0.62 0.033 0.041 0.038 0.039 0.07 0.059 0.061 2.2 2.1 1.6 1.1 0.72 0.65 0.57 0.4 0.52 0.68 0.45 0.36 0.41 0.41 0.49 0.72 0.91 0.55 0.33 0.34 0.3 0.89 0.76 0.61 0.39 0.36 0.36 0.3 11 11 7.7 6.3 6 5.9 5.3 (0.600–1.1) (0.680–0.970) (0.630–0.870) (0.530–0.730) (0.450–0.620) (0.440–0.610) (0.430–0.590) (0.023–0.030) (0.020–0.026) (0.012–0.016) (0.010–0.013) (<0.01–<0.01) (<0.01–<0.01) (<0.01–0.012) (0.470–0.810) (1.0–1.4) (1.6–2.1) (2.1–2.6) (1.6–2.2) (1.3–1.9) (1.3–1.8) (1.5–2.0) (1.5–1.9) (1.2–1.5) (0.940–1.2) (0.660–0.860) (0.680–0.870) (0.590–0.760) (18–26) (41–59) (46–66) (24–34) (9.8–14) (8.6–12) (7.3–11) (2.8–4.3) (5.9–8.1) (6.9–9.9) (5.3–8.8) (5.3–8.1) (5.4–8.0) (5.4–8.0) (1.6–2.1) (1.4–1.8) (1.3–1.7) (1.1–1.4) (1.0–1.3) (0.990–1.3) (0.940–1.2) (2.6–6.2) (2.4–3.6) (2.0–2.9) (1.7–2.4) (1.6–2.2) (1.6–2.2) (1.6–2.1) (2.5–3.3) (4.5–5.9) (4.0–5.3) (3.6–4.6) (2.5–3.2) (2.2–2.9) (2.0–2.6) (2.6–3.4) (2.1–2.8) (1.6–2.1) (1.1–1.4) (0.690–0.900) (0.620–0.810) (0.540–0.700) (0.029–0.038) (0.036–0.047) (0.033–0.043) (0.034–0.044) (0.061–0.079) (0.051–0.066) (0.053–0.069) (2.0–2.5) (1.8–2.4) (1.4–1.8) (0.980–1.3) (0.630–0.820) (0.570–0.740) (0.500–0.640) (0.350–0.460) (0.450–0.580) (0.590–0.760) (0.400–0.510) (0.320–0.410) (0.360–0.470) (0.360–0.470) (0.430–0.550) (0.630–0.810) (0.800–1.0) (0.480–0.620) (0.290–0.370) (0.300–0.390) (0.260–0.340) (0.780–1.0) (0.670–0.860) (0.530–0.690) (0.340–0.440) (0.310–0.410) (0.310–0.410) (0.260–0.340) (11–12) (10–12) (7.2–8.1) (5.9–6.7) (5.6–6.4) (5.5–6.2) (4.9–5.6) RATEa 24 24 23 20 17 17 16 49 37 21 14 10 4.4 13 18 38 61 77 62 55 52 23 21 17 13 9 9.2 7.9 305 637 682 335 131 113 95 34 68 84 72 70 70 70 18 16 14 12 11 10 9.7 94 84 63 52 50 49 49 33 62 58 53 38 35 32 62 52 42 28 18 16 14 4.4 4.8 4 3.8 6.4 5.3 5.4 22 20 16 11 6.8 6.2 5.3 7.8 9.8 13 8.4 6.5 7.4 7.4 31 50 67 42 25 26 23 18 15 12 7.4 6.7 6.7 5.5 20 19 13 10 9.5 9.2 8.2 (18–32) (20–29) (19–26) (17–23) (14–20) (14–19) (14–19) (43–55) (32–41) (18–24) (12–16) (9.1–12) (3.9–5.0) (12–15) (13–23) (32–44) (53–68) (68–87) (53–73) (45–65) (43–61) (20–26) (19–24) (15–19) (11–15) (7.9–10) (8.0–10) (6.9–8.9) (252–363) (526–759) (563–813) (276–398) (108–156) (93–135) (78–114) (27–42) (58–80) (69–100) (55–91) (56–86) (57–85) (57–85) (16–21) (14–18) (13–16) (10–13) (9.5–12) (9.0–12) (8.5–11) (58–138) (69–101) (51–75) (43–63) (43–57) (42–56) (42–56) (29–37) (54–71) (50–66) (46–61) (33–43) (30–40) (28–36) (54–70) (45–59) (37–47) (24–31) (16–21) (14–19) (13–16) (3.8–4.9) (4.2–5.5) (3.5–4.6) (3.3–4.3) (5.6–7.2) (4.6–5.9) (4.7–6.1) (19–24) (18–23) (14–18) (9.6–12) (6.0–7.7) (5.4–7.0) (4.7–6.0) (6.9–8.9) (8.6–11) (11–14) (7.3–9.5) (5.7–7.3) (6.5–8.4) (6.5–8.4) (27–35) (44–57) (58–75) (36–47) (22–28) (23–30) (20–26) (16–20) (13–17) (10–13) (6.5–8.4) (5.9–7.6) (5.8–7.5) (4.9–6.3) (19–21) (18–20) (12–14) (9.5–11) (8.9–10) (8.6–9.8) (7.7–8.7) INCIDENCE HIV-POSITIVE NUMBER (THOUSANDS) RATEa <0.01 <0.01 0.028 0.06 0.048 0.041 0.038 <0.01 <0.01 <0.01 <0.01 <0.01 <0.01 <0.01 <0.01 0.035 0.19 0.22 0.12 0.11 0.094 (<0.01–<0.01) (<0.01–<0.01) (0.025–0.032) (0.053–0.068) (0.040–0.056) (0.034–0.049) (0.032–0.045) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (0.029–0.041) (0.16–0.22) (0.18–0.26) (0.10–0.14) (0.089–0.13) (0.077–0.11) <0.01 0.017 0.13 0.26 0.27 0.28 0.01 0.038 0.041 0.041 0.044 0.042 0.041 (<0.01–<0.01) <0.1 (<0.1–<0.1) (0.014–0.020) 0.2 (0.14–0.20) (0.096–0.16) 1.3 (1.0–1.6) (0.20–0.31) 2.7 (2.2–3.3) (0.22–0.32) 2.8 (2.3–3.4) (0.23–0.34) 3 (2.4–3.6) (<0.01–0.011) 0.1 (<0.1–0.12) (0.033–0.043) 0.4 (0.33–0.42) (0.036–0.046) 0.4 (0.35–0.45) (0.036–0.047) 0.4 (0.34–0.45) (0.038–0.050) 0.4 (0.35–0.45) (0.037–0.048) 0.4 (0.34–0.44) (0.036–0.046) 0.4 (0.32–0.42) <0.01 <0.01 <0.01 <0.01 <0.01 <0.01 <0.01 <0.01 <0.01 <0.01 <0.01 <0.01 <0.01 <0.01 (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) <0.01 <0.01 <0.01 <0.01 <0.01 <0.01 <0.01 <0.01 0.011 <0.01 <0.01 <0.01 <0.01 <0.01 <0.01 <0.01 0.021 0.044 0.04 0.043 0.039 <0.01 <0.01 <0.01 <0.01 <0.01 <0.01 <0.01 0.87 0.76 0.41 0.42 0.42 0.4 0.37 (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–0.013) (<0.01–0.010) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (0.018–0.024) (0.038–0.050) (0.035–0.045) (0.038–0.048) (0.034–0.044) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (0.82–0.93) (0.72–0.81) (0.38–0.43) (0.39–0.44) (0.40–0.45) (0.38–0.43) (0.34–0.39) <0.1 0.2 0.9 2 1.6 1.4 1.3 <0.1 <0.1 <0.1 <0.1 <0.1 <0.1 <0.1 <0.1 0.5 2.3 2.5 1.3 1.2 1 0 <0.1 <0.1 <0.1 <0.1 <0.1 <0.1 <0.1 <0.1 <0.1 <0.1 <0.1 <0.1 <0.1 0 <0.1 <0.1 <0.1 <0.1 <0.1 <0.1 0.1 0.2 0.2 0.1 0.1 0.1 0.1 <0.1 0.2 1.5 3.3 3.1 3.3 3 <0.1 <0.1 <0.1 <0.1 <0.1 <0.1 <0.1 1.5 1.3 0.7 0.7 0.7 0.6 0.6 (<0.1–<0.1) (0.17–0.24) (0.81–1.0) (1.8–2.2) (1.4–1.9) (1.1–1.6) (1.1–1.5) (<0.1–<0.1) (<0.1–<0.1) (<0.1–<0.1) (<0.1–<0.1) (<0.1–<0.1) (<0.1–0.10) (<0.1–<0.1) (<0.1–<0.1) (0.37–0.53) (1.9–2.8) (2.1–3.0) (1.1–1.6) (0.97–1.4) (0.83–1.2) (0–0) (<0.1–<0.1) (<0.1–<0.1) (<0.1–<0.1) (<0.1–<0.1) (<0.1–<0.1) (<0.1–<0.1) (<0.1–<0.1) (<0.1–<0.1) (<0.1–<0.1) (<0.1–<0.1) (<0.1–<0.1) (<0.1–<0.1) (<0.1–<0.1) (0–0) (<0.1–<0.1) (<0.1–<0.1) (<0.1–<0.1) (<0.1–<0.1) (<0.1–<0.1) (<0.1–<0.1) (<0.1–0.12) (0.19–0.24) (0.15–0.20) (0.11–0.14) (<0.1–0.12) (0.11–0.14) (0.11–0.14) (<0.1–<0.1) (0.16–0.21) (1.4–1.7) (2.9–3.7) (2.7–3.5) (2.9–3.7) (2.7–3.4) (<0.1–<0.1) (<0.1–<0.1) (<0.1–<0.1) (<0.1–<0.1) (<0.1–<0.1) (<0.1–<0.1) (<0.1–<0.1) (1.4–1.6) (1.2–1.4) (0.64–0.73) (0.63–0.72) (0.63–0.71) (0.60–0.68) (0.54–0.61) NOTIFIED NEW AND RELAPSEb NUMBER RATEa CASE DETECTION PERCENT 653 641 604 506 431 422 408 23 19 19 18 16 14 13 13 42 78 78 81 81 81 81 81 87 (59–110) (66–94) (69–95) (69–95) (69–95) (69–95) (69–95) (77–99) 12 10 7 3 9 590 1 000 1 333 2 206 1 410 1 261 1 213 1 521 1 481 1 185 928 659 671 620 2 620 1 630 5 187 6 034 7 550 9 146 6 363 3 039 4 854 6 799 5 308 5 098 4 697 4 783 1 577 1 380 1 278 1 076 1 028 985 909 4 073 2 132 2 476 2 111 1 321 1 360 1 409 2 256 3 245 3 349 3 225 2 412 2 172 2 081 2 576 2 114 1 630 1 050 688 619 18 12 9 3.9 11 17 31 43 73 48 43 41 20 19 15 11 7.8 8 7.3 36 21 64 70 83 99 68 30 48 68 55 54 50 51 16 14 12 10 9.4 8.9 8.2 90 61 65 54 34 35 37 26 39 42 42 33 30 29 54 45 36 24 16 14 87 87 87 87 87 94 82 71 95 76 78 79 87 87 87 87 87 87 93 12 3.3 9.4 21 64 88 72 86 70 81 76 76 71 72 87 87 87 87 87 87 85 96 72 100 100 69 72 76 78 62 72 79 86 85 90 87 87 87 87 87 87 (77–99) (77–99) (77–99) (77–99) (77–99) (73–130) (70–98) (63–81) (84–110) (65–90) (65–94) (67–95) (77–99) (77–99) (77–99) (77–99) (77–99) (77–99) (82–110) (10–14) (2.8–4.0) (7.9–11) (18–26) (53–77) (74–110) (60–87) (70–110) (60–82) (68–98) (61–100) (63–96) (59–87) (60–89) (77–99) (77–99) (77–99) (77–99) (77–99) (77–99) (75–97) (65–160) (60–88) (86–130) (87–130) (60–81) (63–84) (66–88) (68–89) (55–71) (64–83) (69–91) (75–98) (74–97) (79–100) (77–99) (77–99) (77–99) (77–99) (77–99) (77–99) 29 36 33 34 61 51 63 1 937 1 834 1 414 973 627 569 565 350 448 587 395 313 359 3.8 4.2 3.5 3.3 5.5 4.6 5.6 19 18 14 9.5 5.9 5.4 5.3 6.8 8.6 11 7.3 5.6 6.4 87 87 87 87 87 87 100 87 87 87 87 87 87 99 87 87 87 87 87 87 (77–99) (77–99) (77–99) (77–99) (77–99) (77–99) (92–120) (77–99) (77–99) (77–99) (77–99) (77–99) (77–99) (88–110) (77–99) (77–99) (77–99) (77–99) (77–99) (77–99) 423 624 791 479 283 296 259 772 661 527 339 312 312 261 9 030 8 723 6 122 5 003 4 801 4 681 27 44 58 36 22 23 20 15 13 10 6.5 5.8 5.8 4.8 16 15 10 8.1 7.6 7.4 87 87 87 87 87 87 87 87 87 87 87 87 87 87 80 80 80 80 80 80 (77–99) (77–99) (77–99) (77–99) (77–99) (77–99) (77–99) (77–99) (77–99) (77–99) (77–99) (77–99) (77–99) (77–99) (75–85) (75–85) (75–85) (75–85) (75–85) (75–85) EUROPEAN REGION INCIDENCE (INCLUDING HIV) YEAR Rates are per 100 000 population. NOTIFIED NEW AND RELAPSE includes cases for which the treatment history is unknown. Data for all years can be downloaded from www.who.int/tb/data GLOBAL TUBERCULOSIS REPORT 2013 231 7$%/($,QFLGHQFHQRWLILFDWLRQDQGFDVHGHWHFWLRQUDWHVDOOIRUPV ± INCIDENCE (INCLUDING HIV) YEAR Georgia Germany Greece Greenland Hungary Iceland Ireland Israel Italy Kazakhstan Kyrgyzstan Latvia Lithuania Luxembourg Malta Monaco a b 232 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 POPULATION (MILLIONS) 5 5 5 4 4 4 4 80 83 84 84 83 83 83 10 11 11 11 11 11 11 <1 <1 <1 <1 <1 <1 <1 10 10 10 10 10 10 10 <1 <1 <1 <1 <1 <1 <1 4 4 4 4 4 5 5 4 5 6 7 7 8 8 57 57 57 59 61 61 61 16 16 15 15 16 16 16 4 5 5 5 5 5 5 3 2 2 2 2 2 2 4 4 3 3 3 3 3 <1 <1 <1 <1 <1 <1 <1 <1 <1 <1 <1 <1 <1 <1 <1 <1 <1 <1 <1 <1 <1 NUMBER (THOUSANDS) 15 13 12 7.8 5.6 5.5 5 17 14 10 6.6 4.7 4.7 4.6 1 1.1 0.81 0.8 0.51 0.52 0.5 0.11 0.11 0.11 0.11 0.13 0.13 0.097 4 4.9 3.8 2.2 1.7 1.8 1.8 0.021 0.014 0.015 0.012 0.025 <0.01 0.012 0.72 0.53 0.44 0.49 0.46 0.46 0.39 0.27 0.46 0.62 0.43 0.39 0.47 0.58 4.9 6.5 4 4.4 3.7 3.9 4.1 13 50 51 35 29 31 22 4 7.7 12 10 7.5 7.6 7.7 1.5 3.1 2.9 1.7 1 0.99 1.1 1.6 3.2 3.6 2.8 2.2 2.1 2 0.055 0.037 0.051 0.043 0.033 0.029 0.034 0.015 0.013 0.018 0.025 0.033 0.035 0.048 <0.01 <0.01 0 <0.01 <0.01 <0.01 <0.01 (14–17) (12–15) (11–14) (7.0–8.7) (5.0–6.2) (4.9–6.1) (4.5–5.6) (15–19) (12–16) (9.1–12) (5.7–7.4) (4.1–5.3) (4.1–5.3) (4.1–5.3) (0.880–1.1) (0.950–1.2) (0.710–0.920) (0.700–0.900) (0.450–0.580) (0.460–0.590) (0.440–0.570) (0.093–0.120) (0.093–0.120) (0.094–0.120) (0.095–0.120) (0.110–0.150) (0.120–0.150) (0.085–0.110) (3.5–4.5) (4.3–5.6) (3.3–4.3) (1.9–2.5) (1.5–2.0) (1.6–2.0) (1.6–2.0) (0.018–0.023) (0.012–0.016) (0.013–0.017) (0.010–0.013) (0.022–0.029) (<0.01–0.010) (0.010–0.013) (0.630–0.810) (0.460–0.600) (0.390–0.500) (0.430–0.550) (0.400–0.520) (0.400–0.520) (0.340–0.440) (0.240–0.300) (0.400–0.520) (0.540–0.700) (0.370–0.480) (0.340–0.440) (0.420–0.540) (0.510–0.660) (4.3–5.5) (5.7–7.3) (3.5–4.6) (3.9–5.0) (3.2–4.1) (3.4–4.5) (3.6–4.6) (11–15) (42–58) (43–60) (30–41) (24–34) (26–36) (19–26) (3.3–4.8) (6.4–9.2) (10–15) (8.6–12) (6.2–9.0) (6.3–9.1) (6.4–9.2) (1.3–1.7) (2.7–3.5) (2.5–3.2) (1.5–1.9) (0.930–1.2) (0.890–1.1) (1.0–1.2) (1.4–1.9) (2.8–3.7) (3.2–4.0) (2.5–3.2) (1.9–2.5) (1.8–2.4) (1.8–2.3) (0.048–0.062) (0.032–0.042) (0.044–0.057) (0.037–0.048) (0.029–0.038) (0.025–0.033) (0.030–0.039) (0.013–0.017) (0.011–0.014) (0.016–0.021) (0.022–0.029) (0.029–0.038) (0.030–0.039) (0.042–0.055) (<0.01–<0.01) (<0.01–<0.01) (0–0) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) a RATE 280 263 256 175 128 125 116 21 17 12 7.8 5.6 5.7 5.6 9.9 10 7.4 7.2 4.6 4.7 4.5 191 191 191 191 232 234 170 39 48 37 22 17 18 18 8.1 5.2 5.3 3.9 8 2.9 3.5 20 15 12 12 10 10 8.6 6 8.6 10 6.5 5.3 6.3 7.6 8.6 11 7.1 7.5 6 6.5 6.7 79 318 351 235 182 193 137 92 168 249 208 141 141 141 57 126 121 75 50 48 53 44 89 103 87 73 69 66 14 9 12 9.3 6.6 5.6 6.5 4 3.2 4.5 6.1 7.9 8.1 11 3.9 3.7 0 1.2 3.1 2.1 2.1 (250–312) (234–293) (228–285) (156–195) (114–142) (112–140) (103–130) (18–24) (15–19) (11–14) (6.9–8.8) (4.9–6.4) (5.0–6.4) (4.9–6.4) (8.7–11) (8.9–11) (6.4–8.3) (6.3–8.2) (4.0–5.2) (4.1–5.3) (3.9–5.1) (167–216) (167–216) (167–216) (167–216) (203–262) (205–264) (149–193) (34–44) (42–54) (33–42) (19–25) (15–19) (16–20) (16–20) (7.1–9.2) (4.5–5.8) (4.7–6.0) (3.4–4.4) (7.0–9.0) (2.5–3.2) (3.1–4.0) (18–23) (13–17) (10–13) (10–13) (8.9–12) (8.9–11) (7.5–9.7) (5.2–6.8) (7.5–9.7) (9.0–12) (5.7–7.3) (4.6–6.0) (5.5–7.1) (6.7–8.6) (7.5–9.7) (10–13) (6.2–8.0) (6.6–8.5) (5.3–6.8) (5.7–7.3) (5.8–7.5) (66–92) (269–372) (297–411) (199–275) (154–213) (163–225) (116–160) (76–109) (138–200) (205–296) (171–248) (116–168) (116–168) (116–168) (50–65) (111–142) (106–137) (66–85) (45–56) (43–53) (49–58) (37–52) (77–102) (92–114) (76–97) (63–82) (61–78) (58–75) (13–16) (7.9–10) (10–13) (8.1–11) (5.8–7.4) (4.9–6.3) (5.7–7.4) (3.5–4.5) (2.8–3.6) (4.0–5.1) (5.3–6.9) (6.9–8.9) (7.1–9.2) (9.9–13) (3.4–4.4) (3.3–4.2) (0–0) (1.0–1.3) (2.7–3.5) (1.8–2.4) (1.8–2.4) INCIDENCE HIV-POSITIVE NUMBER (THOUSANDS) <0.01 0.012 0.024 0.031 0.043 0.048 0.05 0.081 0.083 0.054 0.043 0.034 0.034 0.034 <0.01 <0.01 <0.01 <0.01 <0.01 <0.01 <0.01 0.024 0.028 0.015 <0.01 <0.01 <0.01 <0.01 <0.01 <0.01 <0.01 <0.01 <0.01 <0.01 <0.01 <0.01 <0.01 <0.01 <0.01 <0.01 <0.01 <0.01 <0.01 0.012 0.019 0.014 0.014 0.018 0.022 0.052 0.13 0.056 0.065 0.055 0.06 0.062 <0.01 0.03 0.23 0.28 0.3 0.35 0.26 <0.01 <0.01 0.016 0.059 0.17 0.22 0.29 <0.01 0.02 0.06 0.089 0.089 0.089 0.1 <0.01 0.013 0.037 0.058 0.067 0.07 0.071 <0.01 <0.01 <0.01 <0.01 <0.01 <0.01 <0.01 <0.01 <0.01 <0.01 <0.01 <0.01 <0.01 <0.01 (<0.01–<0.01) (0.011–0.013) (0.022–0.027) (0.028–0.035) (0.038–0.048) (0.043–0.054) (0.045–0.056) (0.071–0.092) (0.073–0.094) (0.047–0.061) (0.037–0.048) (0.029–0.038) (0.030–0.038) (0.030–0.039) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (0.021–0.027) (0.024–0.031) (0.013–0.017) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (0.010–0.013) (0.017–0.022) (0.012–0.016) (0.013–0.016) (0.016–0.020) (0.019–0.025) (0.046–0.059) (0.11–0.15) (0.049–0.064) (0.057–0.073) (0.049–0.063) (0.053–0.068) (0.055–0.071) (<0.01–<0.01) (0.025–0.035) (0.19–0.27) (0.24–0.33) (0.26–0.36) (0.29–0.41) (0.22–0.31) (<0.01–<0.01) (<0.01–<0.01) (0.013–0.019) (0.048–0.070) (0.14–0.21) (0.19–0.27) (0.24–0.34) (<0.01–<0.01) (0.018–0.023) (0.053–0.068) (0.078–0.10) (0.079–0.099) (0.079–0.099) (0.093–0.11) (<0.01–<0.01) (0.011–0.015) (0.033–0.041) (0.051–0.065) (0.058–0.076) (0.061–0.079) (0.062–0.080) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) a RATE <0.1 0.2 0.5 0.7 1 1.1 1.2 0.1 0.1 <0.1 <0.1 <0.1 <0.1 <0.1 <0.1 <0.1 <0.1 <0.1 <0.1 <0.1 <0.1 0.2 0.3 0.2 <0.1 <0.1 <0.1 <0.1 <0.1 0.1 0.2 0.2 0.6 0.2 0.2 <0.1 <0.1 <0.1 0.1 0.1 0.1 <0.1 <0.1 0.2 0.3 0.2 0.2 0.2 0.3 <0.1 0.2 0.1 0.1 <0.1 0.1 0.1 <0.1 0.2 1.6 1.9 1.9 2.2 1.6 <0.1 <0.1 0.3 1.2 3.2 4.2 5.3 0.1 0.8 2.6 4 4.3 4.3 5 <0.1 0.4 1.1 1.8 2.2 2.3 2.3 <0.1 <0.1 0.1 0.2 0.1 <0.1 0.1 <0.1 <0.1 <0.1 0.2 0.3 0.3 0.3 (<0.1–<0.1) (0.21–0.26) (0.46–0.57) (0.62–0.78) (0.88–1.1) (0.98–1.2) (1.0–1.3) (<0.1–0.11) (<0.1–0.11) (<0.1–<0.1) (<0.1–<0.1) (<0.1–<0.1) (<0.1–<0.1) (<0.1–<0.1) (<0.1–<0.1) (<0.1–<0.1) (<0.1–<0.1) (<0.1–<0.1) (<0.1–<0.1) (<0.1–<0.1) (<0.1–<0.1) (0.20–0.26) (0.23–0.30) (0.13–0.17) (<0.1–<0.1) (<0.1–<0.1) (<0.1–<0.1) (<0.1–<0.1) (<0.1–<0.1) (<0.1–0.12) (0.16–0.21) (0.21–0.27) (0.49–0.63) (0.17–0.22) (0.21–0.28) (<0.1–<0.1) (<0.1–<0.1) (<0.1–<0.1) (<0.1–0.11) (<0.1–0.11) (<0.1–0.11) (<0.1–0.10) (<0.1–<0.1) (0.19–0.25) (0.28–0.37) (0.19–0.24) (0.17–0.22) (0.21–0.27) (0.25–0.33) (<0.1–0.10) (0.20–0.26) (<0.1–0.11) (0.10–0.12) (<0.1–0.10) (<0.1–0.11) (<0.1–0.12) (0–<0.1) (0.16–0.22) (1.3–1.9) (1.6–2.2) (1.6–2.2) (1.8–2.5) (1.4–1.9) (<0.1–<0.1) (<0.1–<0.1) (0.27–0.38) (0.96–1.4) (2.7–3.8) (3.4–5.0) (4.4–6.3) (<0.1–0.12) (0.71–0.91) (2.2–2.9) (3.5–4.5) (3.8–4.8) (3.8–4.8) (4.5–5.4) (<0.1–<0.1) (0.31–0.41) (0.95–1.2) (1.6–2.0) (1.9–2.5) (2.0–2.6) (2.0–2.6) (<0.1–<0.1) (<0.1–<0.1) (<0.1–0.17) (0.10–0.21) (<0.1–0.15) (<0.1–0.13) (<0.1–0.15) (<0.1–<0.1) (<0.1–<0.1) (<0.1–0.10) (0.16–0.20) (0.22–0.28) (0.22–0.28) (0.30–0.39) NOTIFIED NEW AND RELAPSE a b CASE DETECTION NUMBER RATE PERCENT 1 537 1 625 4 397 4 503 4 678 4 547 3 940 14 653 12 198 9 064 5 700 4 059 4 089 4 043 877 939 703 693 445 454 28 32 93 101 107 104 90 18 15 11 6.8 4.9 4.9 4.9 8.6 8.8 6.4 6.3 4 4.1 10 12 36 58 83 83 78 87 87 87 87 87 87 87 87 87 87 87 87 87 (9.0–11) (11–14) (32–41) (52–65) (75–94) (74–93) (70–88) (77–99) (77–99) (77–99) (77–99) (77–99) (77–99) (77–99) (77–99) (77–99) (77–99) (77–99) (77–99) (77–99) 114 115 84 3 588 4 339 3 073 1 808 1 543 1 279 1 159 18 12 13 10 22 8 10 624 458 386 423 396 398 341 234 398 537 371 340 412 506 4 246 5 627 3 501 3 844 3 175 3 421 202 203 148 35 42 30 18 15 13 12 7.1 4.5 4.6 3.4 6.9 2.5 3.1 18 13 10 10 8.9 8.8 7.5 5.2 7.5 8.9 5.6 4.6 5.5 6.6 7.5 9.9 6.1 6.6 5.2 5.6 87 87 87 90 88 81 82 90 72 65 87 87 87 87 87 87 87 87 87 87 87 87 87 87 87 87 87 87 87 87 87 87 87 87 87 87 87 (77–99) (77–99) (77–99) (79–100) (78–100) (71–92) (72–93) (79–100) (63–82) (57–75) (77–99) (77–99) (77–99) (77–99) (77–99) (77–99) (77–99) (77–99) (77–99) (77–99) (77–99) (77–99) (77–99) (77–99) (77–99) (77–99) (77–99) (77–99) (77–99) (77–99) (77–99) (77–99) (77–99) (77–99) (77–99) (77–99) (77–99) 10 969 11 310 25 843 28 629 23 399 25 074 18 006 2 306 3 393 6 205 6 329 5 652 5 980 6 195 906 1 541 1 982 1 409 913 864 959 1 471 2 362 2 657 2 114 1 751 1 748 1 635 48 32 44 37 29 25 45 13 11 16 22 29 30 42 1 1 0 68 73 177 190 147 156 111 52 74 125 126 106 111 113 34 62 84 63 44 42 47 40 65 76 64 57 57 54 13 7.8 10 8.1 5.7 4.8 8.6 3.5 2.8 3.9 5.3 6.8 7 9.8 3.4 3.3 0 86 23 50 81 81 81 81 57 44 50 60 75 78 80 59 49 69 84 87 87 87 90 73 74 74 79 83 82 87 87 87 87 87 87 130 87 87 87 87 87 87 87 87 87 (74–100) (20–27) (43–60) (69–96) (69–96) (69–96) (69–96) (48–69) (37–53) (42–61) (51–73) (63–91) (66–95) (67–97) (52–68) (44–56) (61–79) (74–96) (78–98) (78–97) (80–95) (77–110) (64–85) (66–83) (66–84) (69–90) (73–95) (72–93) (77–99) (77–99) (77–99) (77–99) (77–99) (77–99) (120–150) (77–99) (77–99) (77–99) (77–99) (77–99) (77–99) (77–99) (77–99) (77–99) 1 2.7 87 (77–99) Rates are per 100 000 population. NOTIFIED NEW AND RELAPSE includes cases for which the treatment history is unknown. GLOBAL TUBERCULOSIS REPORT 2013 Data for all years can be downloaded from www.who.int/tb/data 7$%/($,QFLGHQFHQRWLILFDWLRQDQGFDVHGHWHFWLRQUDWHVDOOIRUPV ± Montenegro Netherlands Norway Poland Portugal Republic of Moldova Romania Russian Federation San Marino Serbia Serbia & Montenegro Slovakia Slovenia Spain Sweden Switzerland Tajikistan 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 2005 2010 2011 2012 1990 1995 2000 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 NUMBER (THOUSANDS) POPULATION (MILLIONS) <1 <1 <1 <1 15 15 16 16 17 17 17 4 4 4 5 5 5 5 38 38 38 38 38 38 38 10 10 10 11 11 11 11 4 4 4 4 4 4 4 23 23 22 22 22 22 22 148 149 147 144 144 143 143 <1 <1 <1 <1 <1 <1 <1 10 10 10 10 10 11 11 5 5 5 5 5 5 5 2 2 2 2 2 2 2 39 39 40 43 46 47 47 9 9 9 9 9 9 10 7 7 7 7 8 8 8 5 6 6 7 8 8 8 0.18 0.13 0.13 0.11 1.6 1.9 1.4 1.3 1.2 1.1 1.1 0.33 0.27 0.25 0.32 0.34 0.37 0.37 19 18 13 9.4 8.1 9.1 8.1 7.1 6.4 4.9 3.8 2.9 2.8 2.8 2.3 4.7 6 6.6 5.9 5.7 5.6 34 43 41 32 24 22 20 70 140 190 190 150 140 130 <0.01 <0.01 <0.01 <0.01 <0.01 <0.01 <0.01 3.7 2.7 2.5 2.2 7 6.7 5 1.7 1.8 1.2 0.82 0.47 0.43 0.37 0.83 0.6 0.42 0.31 0.19 0.21 0.15 8.7 10 9.2 8.4 7.8 7.4 6.5 0.64 0.65 0.48 0.62 0.72 0.63 0.68 1.5 0.95 0.66 0.59 0.58 0.6 0.48 3.7 8.6 14 14 9.8 9.2 8.6 (0.160–0.200) (0.110–0.140) (0.110–0.140) (0.100–0.130) (1.4–1.8) (1.6–2.1) (1.3–1.6) (1.1–1.5) (1.1–1.4) (0.990–1.3) (0.930–1.2) (0.290–0.370) (0.240–0.310) (0.220–0.290) (0.280–0.360) (0.300–0.390) (0.330–0.420) (0.330–0.420) (16–21) (16–21) (11–14) (8.3–11) (7.1–9.1) (8.0–10) (7.1–9.2) (6.3–8.1) (5.6–7.3) (4.3–5.5) (3.3–4.3) (2.5–3.2) (2.4–3.1) (2.4–3.1) (1.9–2.8) (3.9–5.6) (5.0–7.2) (5.4–7.9) (4.9–7.1) (4.7–6.8) (4.6–6.7) (28–41) (36–52) (33–48) (27–39) (20–28) (18–26) (17–24) (59–81) (120–170) (160–220) (160–230) (130–180) (120–160) (110–150) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (3.2–4.2) (2.3–3.0) (2.2–2.8) (1.9–2.4) (5.0–9.4) (5.7–7.9) (4.2–5.8) (1.5–1.9) (1.6–2.0) (1.0–1.3) (0.720–0.920) (0.410–0.530) (0.380–0.490) (0.320–0.420) (0.730–0.940) (0.530–0.680) (0.370–0.480) (0.270–0.350) (0.170–0.220) (0.180–0.240) (0.140–0.170) (7.7–9.9) (8.8–11) (8.1–10) (7.3–9.5) (6.8–8.8) (6.4–8.3) (5.7–7.4) (0.560–0.720) (0.570–0.730) (0.420–0.540) (0.540–0.700) (0.630–0.810) (0.550–0.710) (0.600–0.770) (1.3–1.7) (0.840–1.1) (0.580–0.750) (0.520–0.670) (0.510–0.660) (0.530–0.680) (0.420–0.540) (3.0–4.4) (7.1–10) (11–16) (11–16) (8.1–12) (7.6–11) (7.1–10) RATEa 29 20 20 18 11 12 9 8 7.2 6.8 6.3 7.7 6.2 5.7 6.9 7 7.5 7.5 49 48 33 25 21 24 21 72 64 47 36 27 26 26 54 109 147 175 166 161 160 146 189 181 147 109 101 94 47 96 127 135 106 97 91 4.8 9 4.3 1.5 1.5 1.5 1.5 37 28 26 23 68 61 46 32 33 22 15 8.7 8 6.8 41 30 21 15 9.5 10 7.5 22 26 23 19 17 16 14 7.5 7.3 5.4 6.9 7.6 6.6 7.2 22 14 9.3 8 7.5 7.6 6 70 148 220 200 129 118 108 (26–33) (18–23) (18–23) (16–20) (9.3–12) (11–14) (7.9–10) (7.0–9.0) (6.3–8.2) (5.9–7.7) (5.5–7.2) (6.8–8.7) (5.5–7.0) (5.0–6.4) (6.0–7.8) (6.1–7.9) (6.6–8.5) (6.6–8.5) (43–55) (42–54) (29–37) (22–28) (18–24) (21–27) (19–24) (63–82) (56–72) (41–53) (32–41) (24–31) (23–30) (23–30) (44–64) (90–130) (121–175) (144–209) (137–198) (133–192) (132–190) (120–174) (155–226) (149–216) (121–175) (89–130) (83–121) (77–112) (40–55) (81–112) (108–149) (114–158) (89–123) (82–114) (77–106) (4.2–5.4) (7.8–10) (3.7–4.8) (1.3–1.7) (1.3–1.7) (1.3–1.7) (1.3–1.7) (32–42) (24–32) (23–30) (20–26) (48–91) (52–72) (38–54) (28–36) (29–37) (19–24) (13–17) (7.6–9.8) (7.0–9.0) (5.9–7.7) (36–47) (27–34) (19–24) (14–18) (8.3–11) (8.8–11) (6.5–8.4) (20–25) (22–29) (20–26) (17–22) (15–19) (14–18) (12–16) (6.6–8.5) (6.4–8.3) (4.7–6.1) (6.0–7.8) (6.7–8.6) (5.8–7.5) (6.3–8.1) (19–25) (12–15) (8.1–10) (7.0–9.0) (6.5–8.4) (6.7–8.6) (5.2–6.8) (58–83) (122–176) (182–263) (165–238) (106–153) (97–140) (89–128) INCIDENCE HIV-POSITIVE NUMBER (THOUSANDS) <0.01 (0–<0.01) RATEa 0.2 (0–1.2) <0.01 0.013 0.058 0.05 0.046 0.048 0.046 0.043 <0.01 <0.01 <0.01 <0.01 <0.01 <0.01 <0.01 0.019 0.051 0.039 0.034 0.031 0.037 0.032 0.11 0.37 0.35 0.38 0.33 0.32 0.33 <0.01 0.018 0.061 0.18 0.31 0.33 0.34 0.075 0.36 0.47 0.66 0.76 0.67 0.6 (0–<0.01) (0.012–0.015) (0.051–0.065) (0.044–0.057) (0.040–0.052) (0.042–0.054) (0.040–0.052) (0.038–0.049) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (0.016–0.021) (0.045–0.058) (0.034–0.044) (0.030–0.038) (0.028–0.036) (0.032–0.041) (0.028–0.037) (0.094–0.12) (0.33–0.42) (0.31–0.40) (0.33–0.43) (0.29–0.37) (0.28–0.36) (0.29–0.37) (<0.01–<0.01) (0.015–0.022) (0.051–0.073) (0.14–0.21) (0.26–0.37) (0.27–0.40) (0.28–0.40) (0.062–0.089) (0.30–0.43) (0.38–0.56) (0.55–0.79) (0.63–0.91) (0.55–0.80) (0.49–0.72) 0.014 0.41 5.8 8.7 9.1 9.3 (0.012–0.017) <0.1 (<0.1–<0.1) (0.35–0.48) 0.3 (0.24–0.33) (4.9–6.8) 4 (3.4–4.7) (7.4–10) 6.1 (5.1–7.1) (7.7–11) 6.3 (5.3–7.4) (7.9–11) 6.5 (5.5–7.5) <0.01 <0.01 <0.01 <0.01 (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) <0.1 <0.1 <0.1 <0.1 (<0.1–<0.1) (<0.1–<0.1) (<0.1–<0.1) (<0.1–<0.1) <0.01 <0.01 <0.01 <0.01 <0.01 <0.01 <0.01 <0.01 <0.01 <0.01 <0.01 <0.01 <0.01 0.4 0.84 0.71 0.77 0.7 0.66 0.58 <0.01 <0.01 <0.01 <0.01 <0.01 <0.01 <0.01 0.011 0.015 <0.01 <0.01 <0.01 <0.01 <0.01 <0.01 0.03 0.14 0.25 0.22 0.21 0.2 (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (0.35–0.45) (0.73–0.95) (0.62–0.81) (0.67–0.87) (0.61–0.79) (0.58–0.75) (0.51–0.66) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–0.013) (0.013–0.017) (<0.01–<0.01) (<0.01–<0.01) (<0.01–0.010) (<0.01–0.011) (<0.01–<0.01) (<0.01–<0.01) (0.025–0.036) (0.11–0.16) (0.20–0.30) (0.18–0.26) (0.17–0.25) (0.16–0.24) <0.1 <0.1 <0.1 <0.1 <0.1 <0.1 <0.1 <0.1 <0.1 <0.1 <0.1 <0.1 <0.1 1 2.1 1.8 1.8 1.5 1.4 1.3 <0.1 <0.1 <0.1 <0.1 <0.1 <0.1 <0.1 0.2 0.2 0.1 0.1 0.1 0.1 <0.1 0.1 0.5 2.2 3.6 2.8 2.7 2.5 (<0.1–<0.1) (<0.1–<0.1) (<0.1–<0.1) (<0.1–<0.1) (<0.1–<0.1) (<0.1–<0.1) (<0.1–<0.1) (<0.1–<0.1) (<0.1–<0.1) (<0.1–0.10) (<0.1–<0.1) (<0.1–<0.1) (<0.1–<0.1) (0.90–1.2) (1.9–2.4) (1.5–2.0) (1.6–2.0) (1.3–1.7) (1.2–1.6) (1.1–1.4) (<0.1–<0.1) (<0.1–<0.1) (<0.1–<0.1) (<0.1–<0.1) (<0.1–<0.1) (<0.1–<0.1) (<0.1–<0.1) (0.15–0.19) (0.18–0.24) (0.11–0.14) (<0.1–0.12) (0.10–0.13) (0.10–0.13) (<0.1–0.11) (<0.1–0.12) (0.42–0.62) (1.8–2.7) (3.0–4.3) (2.3–3.4) (2.2–3.2) (2.0–3.0) a Rates are per 100 000 population. b NOTIFIED NEW AND RELAPSE includes cases for which the treatment history is unknown. <0.1 <0.1 0.4 0.3 0.3 0.3 0.3 0.3 <0.1 <0.1 <0.1 <0.1 <0.1 <0.1 <0.1 <0.1 0.1 0.1 <0.1 <0.1 0.1 <0.1 1.1 3.7 3.4 3.6 3.1 3 3.1 <0.1 0.4 1.5 4.7 8.7 9.4 9.6 0.3 1.6 2.1 3 3.5 3.1 2.8 (0–0.54) (<0.1–0.10) (0.33–0.42) (0.28–0.36) (0.25–0.32) (0.25–0.33) (0.24–0.31) (0.23–0.29) (<0.1–<0.1) (<0.1–<0.1) (<0.1–<0.1) (<0.1–<0.1) (<0.1–<0.1) (<0.1–<0.1) (<0.1–<0.1) (<0.1–<0.1) (0.12–0.15) (<0.1–0.12) (<0.1–0.10) (<0.1–<0.1) (<0.1–0.11) (<0.1–0.10) (0.95–1.2) (3.2–4.2) (3.0–3.9) (3.1–4.1) (2.7–3.5) (2.7–3.4) (2.7–3.5) (<0.1–0.11) (0.35–0.51) (1.2–1.8) (3.8–5.6) (7.1–10) (7.7–11) (7.9–11) (0.26–0.38) (1.3–1.9) (1.7–2.5) (2.5–3.6) (2.9–4.2) (2.5–3.7) (2.3–3.3) NOTIFIED NEW AND RELAPSEb CASE DETECTION NUMBER RATEa 156 110 110 98 1 369 1 619 1 244 1 127 1 046 981 920 285 236 221 276 297 324 25 18 18 16 9.2 10 7.8 6.9 6.3 5.9 5.5 6.7 5.4 4.9 6 6.1 6.6 87 87 87 87 87 87 87 87 87 87 87 87 87 87 87 87 87 (77–99) (78–98) (78–97) (78–97) (77–99) (77–99) (77–99) (77–99) (77–99) (77–99) (77–99) (77–99) (77–99) (77–99) (77–99) (77–99) (77–99) 16 136 15 958 10 931 8 203 7 002 7 946 7 054 6 214 5 577 4 227 3 308 2 487 2 406 2 490 1 728 2 925 2 935 5 141 4 135 4 233 4 409 16 256 23 271 27 470 26 106 18 379 16 992 16 036 50 641 84 980 140 677 127 930 125 310 112 910 105 753 1 2 1 42 41 29 21 18 21 18 63 55 41 31 23 23 23 40 67 71 136 116 119 125 70 101 123 118 84 78 74 34 57 96 89 87 79 74 4.1 7.8 3.7 87 87 87 87 87 87 87 87 87 87 87 87 87 89 74 62 49 78 70 74 79 48 54 68 81 77 77 79 73 60 75 66 83 81 81 87 87 87 (77–99) (77–99) (77–99) (77–99) (77–99) (77–99) (77–99) (77–99) (77–99) (77–99) (77–99) (77–99) (77–99) (79–100) (62–89) (52–75) (41–59) (65–95) (59–85) (62–90) (66–95) (40–58) (45–65) (57–82) (67–98) (65–94) (64–93) (66–95) (62–86) (51–70) (65–89) (56–78) (71–98) (69–95) (70–96) (77–99) (77–99) (77–99) 3 208 2 333 2 174 1 872 4 194 2 798 2 864 1 448 1 540 1 010 710 409 378 321 722 525 368 269 169 181 134 7 600 8 764 7 993 7 281 6 765 6 392 5 677 557 564 417 539 623 544 593 1 278 830 577 514 508 524 416 2 460 2 029 2 779 5 460 6 994 7 035 6 508 32 24 23 20 41 25 26 27 29 19 13 7.5 6.9 5.9 36 26 18 13 8.2 8.8 6.5 20 22 20 17 15 14 12 6.5 6.4 4.7 6 6.6 5.8 6.2 19 12 8.1 6.9 6.5 6.6 5.2 46 35 45 80 92 90 81 87 87 87 87 60 41 58 87 87 87 87 87 87 87 87 87 87 87 87 87 87 87 87 87 87 87 87 87 87 87 87 87 87 87 87 87 87 87 87 87 87 87 67 24 20 40 71 76 75 (77–100) (77–100) (77–100) (77–100) (45–84) (35–49) (49–69) (77–99) (77–99) (77–99) (77–99) (77–99) (77–99) (77–99) (77–99) (77–99) (77–99) (77–99) (77–99) (77–99) (77–99) (77–99) (77–99) (77–99) (77–99) (77–99) (77–99) (77–99) (77–99) (77–99) (77–99) (77–99) (77–99) (77–99) (77–99) (77–99) (77–99) (77–99) (77–99) (77–99) (77–99) (77–99) (56–81) (20–29) (17–25) (34–49) (60–86) (64–93) (63–91) Data for all years can be downloaded from www.who.int/tb/data PERCENT GLOBAL TUBERCULOSIS REPORT 2013 EUROPEAN REGION INCIDENCE (INCLUDING HIV) YEAR 233 7$%/($,QFLGHQFHQRWLILFDWLRQDQGFDVHGHWHFWLRQUDWHVDOOIRUPV ± INCIDENCE (INCLUDING HIV) YEAR The Former 1990 Yugoslav Republic 1995 of Macedonia 2000 2005 2010 2011 2012 Turkey 1990 1995 2000 2005 2010 2011 2012 Turkmenistan 1990 1995 2000 2005 2010 2011 2012 Ukraine 1990 1995 2000 2005 2010 2011 2012 United Kingdom of 1990 Great Britain and 1995 Northern Ireland 2000 2005 2010 2011 2012 Uzbekistan 1990 1995 2000 2005 2010 2011 2012 a b POPULATION (MILLIONS) 2 2 2 2 2 2 2 54 59 63 68 72 73 74 4 4 5 5 5 5 5 52 51 49 47 46 46 46 57 58 59 60 62 62 63 21 23 25 26 28 28 29 NUMBER (THOUSANDS) 1.6 1.1 0.85 0.62 0.44 0.41 0.39 28 26 21 23 18 17 16 3.5 6.6 9.4 8.3 5.2 4.5 3.9 23 38 53 57 48 46 42 6.6 6.9 7 9.2 8.9 9.5 9.4 26 46 71 61 34 29 22 (1.0–2.4) (0.930–1.4) (0.690–1.0) (0.560–0.680) (0.380–0.510) (0.360–0.480) (0.330–0.450) (25–32) (23–30) (18–23) (20–26) (16–21) (15–20) (14–18) (2.8–4.2) (5.4–7.8) (7.6–11) (6.8–10) (4.3–6.1) (3.7–5.5) (3.1–4.8) (19–27) (31–45) (44–63) (48–68) (41–57) (38–54) (35–51) (6.2–7.1) (6.5–7.4) (6.5–7.4) (8.6–9.8) (8.3–9.4) (8.8–10) (8.8–10) (21–31) (38–55) (59–85) (50–72) (28–40) (24–34) (18–27) INCIDENCE HIV-POSITIVE NUMBER (THOUSANDS) a RATE 81 58 41 30 21 20 18 52 45 33 34 25 24 22 95 157 209 175 103 89 75 45 74 108 121 105 99 93 12 12 12 15 14 15 15 125 200 287 233 122 101 78 (50–119) (47–69) (34–50) (27–33) (18–24) (17–23) (16–21) (46–59) (40–51) (29–37) (29–38) (22–29) (21–27) (19–25) (76–115) (129–187) (170–252) (144–210) (86–121) (73–107) (59–94) (37–53) (62–88) (90–129) (101–144) (88–123) (83–118) (77–112) (11–12) (11–13) (11–13) (14–16) (13–15) (14–16) (14–16) (103–149) (165–238) (237–342) (193–278) (101–146) (84–121) (65–93) a RATE <0.01 0.019 0.05 0.033 0.033 0.033 (<0.01–<0.01) (0.016–0.021) (0.044–0.057) (0.029–0.037) (0.029–0.037) (0.028–0.037) <0.1 <0.1 <0.1 <0.1 <0.1 <0.1 (<0.1–<0.1) (<0.1–<0.1) (<0.1–<0.1) (<0.1–<0.1) (<0.1–<0.1) (<0.1–<0.1) 0.15 2.5 5.8 5.7 5.3 4.8 0.071 0.087 0.12 0.25 0.3 0.32 0.33 0.057 0.22 0.57 0.69 0.56 0.51 0.44 (0.12–0.18) (2.0–2.9) (4.8–6.9) (4.8–6.7) (4.4–6.3) (3.9–5.7) (0.066–0.077) (0.061–0.12) (0.088–0.16) (0.19–0.32) (0.23–0.38) (0.25–0.41) (0.25–0.41) (0.047–0.067) (0.18–0.26) (0.47–0.68) (0.57–0.82) (0.46–0.67) (0.42–0.61) (0.37–0.53) 0.3 5 12 12 12 10 0.1 0.2 0.2 0.4 0.5 0.5 0.5 0.3 1 2.3 2.7 2 1.8 1.6 (0.24–0.34) (4.1–5.9) (10–15) (10–15) (9.6–14) (8.6–13) (0.11–0.13) (0.10–0.20) (0.15–0.27) (0.31–0.53) (0.37–0.62) (0.40–0.66) (0.40–0.66) (0.23–0.33) (0.79–1.1) (1.9–2.7) (2.2–3.2) (1.7–2.4) (1.5–2.2) (1.3–1.9) NOTIFIED NEW AND RELAPSE NUMBER b a RATE GLOBAL TUBERCULOSIS REPORT 2013 PERCENT 786 641 598 384 335 346 24 468 22 981 18 038 19 744 15 879 15 054 14 139 2 325 1 939 4 038 3 191 3 230 40 31 29 18 16 16 45 39 29 29 22 21 19 63 46 90 67 64 69 75 97 87 81 89 87 87 87 87 87 87 87 67 30 43 38 62 (58–85) (63–92) (88–110) (75–100) (70–94) (78–100) (77–99) (77–99) (77–99) (77–99) (77–99) (77–99) (77–99) (55–83) (25–36) (36–53) (32–47) (53–74) 16 465 21 459 32 945 39 608 33 857 34 237 40 990 5 908 6 176 6 220 8 173 7 907 8 439 8 269 9 414 9 866 15 750 21 513 16 883 15 345 14 832 32 42 67 84 74 75 90 10 11 11 14 13 14 13 46 43 63 83 61 55 52 71 57 62 69 70 75 96 89 89 89 89 89 89 88 37 22 22 35 50 54 66 (60–86) (48–68) (52–75) (58–83) (60–83) (63–90) (81–120) (84–95) (84–95) (84–95) (84–95) (84–95) (84–95) (82–94) (31–44) (18–26) (19–27) (30–43) (42–60) (45–65) (56–80) Rates are per 100 000 population. NOTIFIED NEW AND RELAPSE includes cases for which the treatment history is unknown. 234 CASE DETECTION Data for all years can be downloaded from www.who.int/tb/data 7$%/($&DVHQRWLILFDWLRQV ± YEAR Albania • 19 13 • Andorra • 42 11 • Armenia • 17 41 • Austria • 20 7• Azerbaijan • 36 68 • Belarus • 30 51 • Belgium • 16 8• Bosnia and Herzegovina • 90 37 • Bulgaria • 26 29 • Croatia • 54 0• Cyprus •4 6• Czech Republic • 19 5• Denmark •7 0• Estonia • 27 20 • Finland • 15 a b 5• 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 NEW AND RELAPSEb 653 641 604 506 431 422 408 23 12 10 7 3 9 590 1 000 1 333 2 206 1 410 1 261 1 213 1 521 1 481 1 185 928 659 671 620 2 620 1 630 5 187 6 034 7 550 9 146 6 363 3 039 4 854 6 799 5 308 5 098 4 697 4 783 1 577 1 380 1 278 1 076 1 028 985 909 4 073 2 132 2 476 2 111 1 321 1 360 1 409 2 256 3 245 3 349 3 225 2 412 2 172 2 081 2 576 2 114 1 630 1 050 688 619 29 36 33 34 61 51 63 1 937 1 834 1 414 973 627 569 565 350 448 587 395 313 359 423 624 791 479 283 296 259 772 661 527 339 312 312 261 NEW CASES % SMEARRE-TREAT EXCL. TOTAL SMEAR- SMEAR-NEGATIVE/ EXTRAHISTORY POS AMONG OTHER RELAPSE NEW PULM POSITIVE UNKNOWN PULMONARY RELAPSE RETREAT UNKNOWN 139 171 196 145 180 185 223 188 134 105 105 100 226 234 167 165 128 106 1 5 0 1 2 9 1 4 2 3 2 4 3 0 3 436 621 581 339 329 315 451 505 1 049 639 582 553 75 153 365 351 289 255 467 324 234 76 94 95 765 652 519 213 217 218 249 209 175 69 85 97 669 890 1 561 1 997 1 426 1 301 620 3 978 2 508 2 275 2 740 2 313 93 245 651 965 1 130 1 002 1 845 2 547 1 235 1 269 1 217 1 277 2 148 2 985 3 710 2 647 2 439 2 184 518 442 363 429 387 381 400 409 380 244 240 235 534 454 406 340 273 237 366 326 290 230 192 179 865 759 640 441 547 569 997 1 287 1 106 529 611 554 140 261 258 161 162 176 1 087 2 524 1 214 806 716 741 1 709 0 1 511 748 708 618 449 442 376 747 628 606 0 0 0 53 11 9 16 9 17 8 34 14 9 12 53 19 43 30 18 29 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1 0 0 0 1 0 0 0 38 54 211 81 61 90 22 116 370 321 305 38 76 327 451 382 395 0 0 0 0 0 0 0 0 0 4 12 30 26 29 16 28 30 26 29 20 40 301 271 198 47 74 1 314 1 153 1 201 1 747 0 1 886 844 954 1 777 47 74 3 200 1 997 2 155 3 524 0 1 049 456 421 463 343 825 1 049 1 114 1 075 1 404 0 68 87 59 78 80 89 68 87 59 78 214 280 258 158 0 2 130 169 107 32 40 108 24 49 69 25 11 130 193 156 101 65 119 0 0 0 0 0 0 1 383 124 111 120 115 0 77 237 235 199 383 201 348 355 314 0 0 0 0 0 343 825 0 658 654 941 80 89 0 0 0 1 160 2 649 95 1 204 703 165 42 372 183 201 575 382 343 103 87 75 0 36 94 7 94 43 6 4 9 8 11 15 11 10 13 12 14 28 13 17 12 13 5 11 0 1 0 0 0 0 0 0 0 3 0 3 6 0 0 3 0 3 6 28 20 9 487 420 308 200 188 208 1 026 679 461 333 307 268 300 290 204 94 74 89 0 0 0 21 25 0 0 0 0 0 34 51 31 40 21 25 34 51 31 40 0 0 0 128 171 129 115 124 186 244 145 102 100 128 144 121 39 45 0 29 46 22 6 28 29 46 22 0 0 369 255 162 99 123 105 124 320 217 134 124 110 60 67 46 17 18 19 0 0 0 71 116 54 33 31 25 0 40 46 45 31 71 116 94 79 76 56 0 0 0 244 205 130 82 82 78 193 136 114 146 143 104 224 157 95 84 87 70 0 0 0 29 0 0 0 5 0 22 15 13 13 29 22 15 13 18 0 0 0 4 6 28 0 57 90 42 – 38 48 59 58 63 65 – – 10 83 0 33 40 – 49 55 36 35 36 36 – 38 33 31 26 30 30 – 52 18 38 47 34 36 – 46 46 25 32 33 37 – 43 47 48 42 47 50 – 46 37 37 45 47 51 – 39 100 45 52 50 55 – 63 – 39 32 37 – – 35 29 41 40 44 35 – 32 38 40 38 38 44 – 41 41 47 53 55 – – 75 44 43 42 50 49 – 56 60 53 36 36 43 EUROPEAN REGION NEW AND RELAPSE NOTIFICATION RATEa 1990–2012 Rates are per 100 000 population. NEW AND RELAPSE includes cases for which the treatment history is unknown. Data for all years can be downloaded from www.who.int/tb/data GLOBAL TUBERCULOSIS REPORT 2013 235 7$%/($&DVHQRWLILFDWLRQV ± NEW AND RELAPSE a NOTIFICATION RATE 1990–2012 YEAR France • 16 0• Georgia • 28 90 • Germany • 18 5• Greece •9 0• Greenland •0 148 • Hungary • 35 12 • Iceland •7 3• Ireland • 18 7• Israel •5 7• Italy •7 0• Kazakhstan • 68 111 • Kyrgyzstan • 52 113 • Latvia • 34 47 • Lithuania • 40 54 • Luxembourg • 13 a b 9• 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 NEW AND b RELAPSE 9 030 8 723 6 122 5 003 4 801 4 681 NEW CASES % SMEARRE-TREAT EXCL. TOTAL SMEAR- SMEAR-NEGATIVE/ EXTRAHISTORY POS AMONG OTHER RELAPSE POSITIVE UNKNOWN PULMONARY RELAPSE RETREAT UNKNOWN NEW PULM 1 537 1 625 4 397 4 503 4 678 4 547 3 940 14 653 12 198 9 064 5 700 4 059 4 089 4 043 877 939 703 693 445 454 114 115 84 3 588 4 339 3 073 1 808 1 543 1 279 1 159 18 12 13 10 22 8 10 624 458 386 423 396 398 341 234 398 537 371 340 412 506 4 246 5 627 3 501 3 844 3 175 3 421 10 969 11 310 25 843 28 629 23 399 25 074 18 006 2 306 3 393 6 205 6 329 5 652 5 980 6 195 906 1 541 1 982 1 409 913 864 959 1 471 2 362 2 657 2 114 1 751 1 748 1 635 48 32 44 37 29 25 45 3 449 1 815 1 941 960 906 2 969 1 364 1 557 1 015 1 016 2 305 1 665 1 389 765 710 221 601 1 509 2 140 2 026 1 648 1 087 2 213 1 524 1 088 1 141 1 186 121 1 324 1 261 1 155 1 056 944 12 7 0 0 0 0 371 315 261 0 371 315 261 116 2 049 2 042 0 0 0 196 259 207 291 324 161 422 1 945 1 118 986 1 034 196 681 2 152 1 409 1 310 1 195 2 4 0 1 3 852 6 473 1 873 1 379 910 951 928 2 801 1 713 1 787 1 580 1 211 789 735 812 16 17 10 148 96 73 52 345 271 227 195 493 367 300 247 161 535 526 661 235 197 178 236 339 322 129 156 81 107 49 57 0 3 48 0 0 0 74 44 35 48 74 44 35 67 89 2 38 34 33 59 73 44 7 5 5 796 412 423 270 260 273 3 292 2 361 1 137 1 147 910 831 251 221 117 70 53 35 2 1 2 6 1 2 3 7 3 12 2 5 138 130 84 85 77 10 3 2 2 12 3 2 0 0 0 79 131 56 55 20 292 216 198 166 64 371 347 254 221 84 0 1 0 7 4 5 4 5 3 0 0 0 0 1 0 0 0 0 0 1 0 1 1 0 1 1 0 1 1 0 0 0 150 156 122 110 97 96 99 112 82 75 2 2 1 3 1 20 38 31 27 25 22 40 31 27 25 36 77 118 91 216 142 103 135 142 213 168 162 207 254 100 55 74 66 102 0 0 0 0 0 8 6 1 4 8 0 1 3 6 3 8 7 4 10 11 0 0 0 0 0 1 413 687 1 275 586 587 2 700 891 1 506 779 790 1 514 522 1 047 328 641 0 0 269 0 0 0 356 293 74 100 625 293 74 100 16 1 482 1 403 3 022 8 903 6 911 4 769 4 157 3 884 5 966 11 324 14 472 8 745 8 242 7 892 1 002 2 555 920 2 127 1 997 1 844 0 0 9 1 320 3 061 3 209 4 062 4 739 4 377 2 032 11 800 5 151 1 230 3 517 1 320 5 093 15 009 9 213 5 969 7 894 3 117 3 696 5 939 0 832 1 296 1 972 1 645 1 537 1 594 1 685 2 929 2 141 2 028 2 125 2 448 749 1 683 1 805 1 635 1 518 1 809 127 297 411 344 349 344 258 436 643 686 721 127 555 847 987 1 035 1 065 451 0 504 637 536 339 293 342 693 793 554 400 410 438 226 285 148 86 85 100 0 0 0 118 267 171 88 76 79 108 34 21 21 34 118 375 205 109 97 113 0 0 0 979 776 964 719 681 726 1 049 1 051 793 633 664 548 206 503 357 221 187 156 0 0 0 128 327 0 177 213 204 182 460 187 156 146 128 509 460 364 369 350 1 3 1 21 14 0 4 0 19 20 18 4 0 0 3 6 3 0 0 0 0 4 0 0 0 1 0 0 1 0 4 0 0 1 1 5 14 44 0 0 Rates are per 100 000 population. NEW AND RELAPSE includes cases for which the treatment history is unknown. 236 GLOBAL TUBERCULOSIS REPORT 2013 Data for all years can be downloaded from www.who.int/tb/data 0 – 54 57 55 49 47 – – 17 21 50 66 64 58 – 37 – 33 35 35 37 – – 41 38 58 60 – – – – – 39 32 43 – 19 15 27 19 22 25 – 40 12 40 33 33 29 – – 48 45 41 44 44 – – 50 46 39 39 36 – 34 44 46 43 43 – – 34 44 32 35 34 33 – 33 31 48 45 42 39 – 42 45 49 46 42 44 – 48 42 55 53 51 57 – – 52 41 0 50 7$%/($&DVHQRWLILFDWLRQV ± a YEAR Malta •3 10 • Monaco •3 0• Montenegro 16 • Netherlands •9 6• Norway •7 0• Poland • 42 18 • Portugal • 63 23 • Republic of Moldova • 40 125 • Romania • 70 74 • Russian Federation • 34 74 • San Marino •4 0• Serbia 20 • Serbia (without Kosovo) Kosovo Serbia & Montenegro •0 Slovakia • 27 6• Slovenia • 36 a b 6• 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 1990 1995 2000 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 NEW AND b RELAPSE 13 11 16 22 29 30 42 1 1 0 NEW CASES % SMEARRE-TREAT EXCL. TOTAL SMEAR- SMEAR-NEGATIVE/ EXTRAHISTORY POS AMONG OTHER RELAPSE POSITIVE UNKNOWN PULMONARY RELAPSE RETREAT UNKNOWN NEW PULM 5 5 5 4 7 9 4 9 10 6 8 20 0 0 1 156 110 110 98 1 369 1 619 1 244 1 127 1 046 981 920 285 236 221 276 297 324 16 136 15 958 10 931 8 203 7 002 7 946 7 054 6 214 5 577 4 227 3 308 2 487 2 406 2 490 1 728 2 925 2 935 5 141 4 135 4 233 4 409 16 256 23 271 27 470 26 106 18 379 16 992 16 036 50 641 84 980 140 677 127 930 125 310 112 910 105 753 1 2 1 3 208 2 333 2 174 1 872 2 146 1 449 1 299 1 170 1 062 884 875 702 4 194 2 798 2 864 1 448 1 540 1 010 710 409 378 321 722 525 368 269 169 181 134 2 2 6 10 7 12 0 0 0 0 0 0 0 0 0 0 0 1 3 3 1 0 0 1 3 3 1 0 0 0 1 9 8 1 1 64 39 48 45 66 49 40 36 13 14 12 13 0 0 0 13 8 10 4 14 4 2 9 27 12 12 13 0 0 0 575 289 237 176 177 163 1 522 528 491 370 353 300 513 427 385 463 425 444 4 3 0 0 14 16 12 11 70 30 27 26 38 70 44 43 38 49 17 11 2 62 37 48 49 40 57 103 119 110 134 89 79 102 115 139 10 14 42 37 28 12 14 42 37 7 23 10 6 955 3 180 2 823 2 484 2 587 2 433 7 285 6 392 4 591 3 625 4 344 3 729 647 477 789 501 584 503 0 0 0 1 071 882 0 392 431 389 0 1 077 507 532 488 1 071 882 1 077 899 963 877 0 0 0 2 019 1 863 1 302 912 876 920 1 531 1 005 974 791 813 805 1 759 1 178 905 679 629 670 16 7 7 268 177 122 89 81 88 304 228 139 134 100 268 481 350 228 215 188 5 0 0 0 665 651 1 696 1 267 1 272 1 346 1 958 1 788 2 237 2 073 2 140 2 062 154 122 568 405 424 396 0 0 0 148 374 640 377 372 559 0 1 137 1 312 1 108 932 148 374 1 777 1 689 1 480 1 491 13 25 46 10 469 10 202 10 801 7 951 7 386 7 077 8 303 10 180 8 038 5 113 4 528 4 342 3 422 3 474 3 568 2 899 2 629 2 481 0 0 0 1 077 3 614 3 697 2 416 2 449 2 136 156 3 241 2 699 2 220 2 188 1 077 3 770 6 938 5 115 4 669 4 324 2 0 0 0 37 512 27 467 32 605 31 416 29 191 27 467 42 241 102 228 74 301 67 894 65 106 60 058 5 227 5 313 12 320 3 513 10 023 10 017 5 669 8 704 8 737 8 590 8 211 12 478 26 449 37 243 46 569 44 168 18 147 35 153 45 980 55 159 52 379 1 0 0 0 0 0 1 105 977 905 819 873 690 654 569 232 287 251 250 1 584 700 745 787 714 431 372 369 596 269 349 404 479 501 401 130 245 202 155 40 148 120 134 260 52 42 45 300 200 162 179 1 497 0 930 2 486 173 175 198 203 0 198 203 788 236 162 112 96 96 555 469 356 190 170 144 177 203 134 59 57 39 20 102 58 25 29 25 18 50 30 21 24 20 120 108 55 50 49 23 26 17 303 145 109 64 82 47 83 133 110 67 73 64 109 59 30 30 26 13 16 9 3 11 4 30 47 29 11 11 14 0 0 0 28 2 0 0 1 7 081 0 0 0 0 234 299 246 0 0 0 0 0 0 119 91 86 119 91 86 29 29 48 29 29 48 30 31 20 8 10 6 669 0 0 7 3 2 – 56 36 33 40 47 31 – – – – – – 49 44 55 56 – 27 35 33 32 33 35 – 52 26 29 31 23 – – 49 33 38 41 37 39 – 57 65 57 54 52 53 – 25 27 43 38 37 39 – 56 50 57 61 62 62 – 47 21 30 32 31 31 – – 100 – – – – 41 58 55 51 55 62 64 61 28 52 42 38 – 62 0 – 59 33 31 37 36 40 – 78 52 50 49 53 42 EUROPEAN REGION NEW AND RELAPSE NOTIFICATION RATE 1990–2012 Rates are per 100 000 population. NEW AND RELAPSE includes cases for which the treatment history is unknown. Data for all years can be downloaded from www.who.int/tb/data GLOBAL TUBERCULOSIS REPORT 2013 237 7$%/($&DVHQRWLILFDWLRQV ± NEW AND RELAPSE a NOTIFICATION RATE 1990–2012 YEAR Spain • 20 12 • Sweden •7 6• Switzerland • 19 5• Tajikistan • 46 81 • The Former Yugoslav Republic of Macedonia •0 16 • Turkey • 45 19 • Turkmenistan • 63 0• Ukraine • 32 United Kingdom of Great Britain and Northern Ireland • 10 90 • 13 • Uzbekistan • 46 a b 52 • 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 NEW AND b RELAPSE 7 600 8 764 7 993 7 281 6 765 6 392 5 677 557 564 417 539 623 544 593 1 278 830 577 514 508 524 416 2 460 2 029 2 779 5 460 6 994 7 035 6 508 NEW CASES % SMEARRE-TREAT EXCL. TOTAL SMEAR- SMEAR-NEGATIVE/ EXTRAHISTORY POS AMONG OTHER RELAPSE POSITIVE UNKNOWN PULMONARY RELAPSE RETREAT UNKNOWN NEW PULM 786 641 598 384 335 346 24 468 22 981 18 038 19 744 15 879 15 054 14 139 2 325 1 939 4 038 3 191 3 230 16 465 21 459 32 945 39 608 33 857 34 237 40 990 5 908 6 176 6 220 8 173 7 907 8 439 8 269 9 414 9 866 15 750 21 513 16 883 15 345 14 832 2 605 3 423 2 511 2 076 2 186 1 984 6 159 4 446 3 880 2 621 2 242 1 855 124 890 1 680 1 616 1 508 102 118 134 117 99 101 235 147 208 226 182 233 216 152 197 209 173 229 185 86 84 82 90 87 515 216 187 149 170 124 126 102 110 91 119 84 1 042 434 1 745 2 290 2 174 2 041 617 1 918 2 175 2 038 2 148 1 911 427 1 417 1 631 1 613 1 532 319 167 178 141 132 147 376 308 236 135 99 95 4 383 4 315 7 450 5 375 4 927 4 585 0 0 0 0 0 0 0 0 0 1 078 324 370 314 0 1 078 324 370 314 388 348 330 0 0 0 11 0 0 0 3 0 40 30 52 42 39 11 40 30 52 45 39 71 87 30 63 49 40 54 47 5 63 49 40 54 47 173 133 186 145 121 5 370 370 0 0 0 123 338 355 327 2 066 647 574 421 2 189 985 929 748 697 745 697 66 150 141 92 76 78 0 0 0 25 16 43 16 28 22 0 60 36 27 9 25 16 103 52 55 31 0 0 4 17 534 8 544 5 944 4 191 3 925 3 829 1 064 4 371 5 359 5 617 5 565 5 121 0 0 0 808 991 696 637 604 1 559 672 625 552 808 2 550 1 368 1 262 1 156 0 0 0 544 1 017 995 1 153 1 327 2 709 1 498 1 248 1 241 656 473 274 67 71 42 82 8 263 10 738 9 793 17 258 1 514 1 739 9 976 10 502 11 030 17 599 14 106 17 398 3 355 3 367 3 344 1 204 1 821 1 201 1 204 1 251 4 162 2 037 2 752 2 551 2 827 2 751 2 014 2 478 3 600 3 443 3 783 3 676 24 36 53 2 735 3 825 5 695 4 711 4 198 4 030 5 798 10 142 7 857 6 735 5 958 6 137 1 333 1 760 6 324 4 288 3 839 3 965 0 0 0 365 3 213 1 894 100 67 1 965 142 82 1 889 3 210 0 1 889 3 210 2 562 3 049 3 650 2 552 8 439 4 579 5 114 11 488 8 229 5 568 0 0 0 460 576 524 482 0 460 576 524 482 688 589 538 324 7 378 3 447 568 1 978 347 9 015 4 596 1 074 2 633 0 844 45 23 1 637 1 149 506 655 Rates are per 100 000 population. NEW AND RELAPSE includes cases for which the treatment history is unknown. GLOBAL TUBERCULOSIS REPORT 2013 Data for all years can be downloaded from www.who.int/tb/data – 30 43 39 44 49 52 – 30 45 39 34 35 30 – 26 28 31 35 35 41 – 63 18 45 53 50 52 – 46 35 43 51 57 61 – 20 34 56 56 56 54 – 29 27 40 48 – – – 46 38 – 36 43 39 – – 37 40 32 30 31 – 32 27 42 41 41 40 7$%/($7UHDWPHQWRXWFRPHVQHZVPHDUSRVLWLYHFDVHV ± % OF COHORT Albania •0 93 • Andorra •0 100 • • 55 63 • • 82 71 • Armenia Austria Azerbaijan • 65 78 • •0 60 • Belarus Belgium •0 77 • • 97 70 • Bosnia and Herzegovina Bulgaria •0 86 • Croatia •0 0• Cyprus • 100 64 • • 60 69 • Czech Republic Denmark •0 0• Estonia •0 59 • •0 67 • •0 0• Finland France Georgia • 58 76 • Germany •0 a 70 • YEAR 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 NUMBER NOTIFIED 139 171 196 171 145 180 1 5 2 0 1 436 621 581 440 339 329 467 324 234 90 76 94 669 890 1 561 1 487 1 997 1 426 1 845 2 547 1 235 1 201 1 269 1 217 400 409 380 280 244 240 865 759 640 609 441 547 1 087 2 524 1 214 894 806 716 1 204 372 302 183 201 6 4 9 14 8 11 487 420 308 218 200 188 128 171 129 101 115 124 369 255 162 135 99 123 244 205 130 93 82 82 3 449 1 815 1 941 1 019 960 906 221 601 1 509 2 055 2 140 2 026 3 852 1 379 1 025 910 951 SIZE OF COHORT 196 171 145 180 2 5 3 0 1 507 447 581 440 339 329 383 298 230 226 206 221 538 890 1 561 1 480 1 919 2 208 2 160 2 184 2 169 358 304 485 473 405 865 756 1 035 852 441 693 1 342 1 055 946 853 391 234 181 6 8 28 20 22 487 396 315 402 361 377 110 128 175 217 257 162 240 191 202 227 184 181 221 807 1 489 2 352 2 500 2 513 454 1 199 2 220 2 064 2 113 COHORT AS % NOTIFIED – – 100 100 100 100 – 200 100 150 – 100 116 72 100 100 100 100 82 92 98 251 271 235 80 100 100 100 96 155 – – – 180 172 178 – 88 80 173 194 169 100 100 162 140 100 127 – – 111 118 117 119 – – 105 77 99 – 100 – 89 200 250 200 100 94 102 184 180 201 – 64 99 173 189 – – 101 100 178 193 164 – – – 244 224 221 – – – – – – 100 134 99 114 117 124 – – 87 217 227 222 DIED FAILED DEFAULTED NOT EVALUATED CURED COMPLETED 43 64 49 65 35 25 42 28 4 2 3 2 2 1 0 0 5 4 3 4 11 4 3 1 80 33 50 0 67 0 0 0 0 50 0 0 0 20 0 0 52 81 59 60 55 44 2 0 17 8 6 7 58 89 48 47 47 33 100 2 6 13 12 16 19 81 73 58 59 59 64 7 0 11 15 30 44 0 8 4 3 7 4 6 10 9 7 9 6 6 1 4 3 3 3 0 36 3 5 3 15 25 0 0 0 0 0 0 12 2 4 7 4 6 0 1 7 14 8 8 6 7 6 7 8 6 7 19 3 12 16 10 10 0 0 0 4 10 1 0 1 11 11 16 23 15 4 4 22 12 6 4 64 66 59 0 0 1 10 8 6 4 22 31 1 1 1 20 2 1 25 21 14 15 28 97 77 93 97 91 43 41 45 62 61 50 1 18 3 2 7 27 10 10 8 7 7 0 1 1 0 1 5 1 0 0 0 0 1 1 0 0 0 1 17 0 11 11 10 1 2 0 0 0 1 6 24 4 7 6 1 1 2 0 0 24 82 78 84 84 3 7 2 2 4 9 8 8 2 2 2 1 7 4 3 3 1 1 1 2 40 48 58 7 15 17 7 26 14 0 0 0 1 3 4 45 7 7 100 0 0 0 0 0 38 29 25 55 57 59 62 66 66 66 25 0 0 9 3 11 10 2 3 3 12 0 0 14 0 17 6 21 17 17 0 0 0 0 3 1 0 0 0 0 0 0 0 0 2 1 2 7 7 9 25 71 75 23 35 11 20 4 7 5 37 44 22 31 49 39 31 33 5 6 4 11 0 1 1 2 0 2 1 0 9 8 42 22 67 70 57 65 57 2 2 1 3 2 11 8 15 10 11 1 1 2 2 1 6 10 6 4 5 12 10 18 17 23 33 48 39 34 27 29 17 9 18 0 0 1 1 2 0 14 15 14 41 38 60 57 59 57 18 25 13 19 17 19 8 3 3 3 3 2 3 9 5 12 12 15 29 25 13 7 7 5 2 0 7 3 2 2 61 39 33 32 29 16 32 44 44 42 16 9 12 12 11 1 0 0 0 0 2 2 1 2 2 4 18 9 9 17 EUROPEAN REGION TREATMENT SUCCESS (%)a 1995–2011 TREATMENT SUCCESS = percent cured + percent completed then rounded to the nearest digit. Data for all years can be downloaded from www.who.int/tb/data GLOBAL TUBERCULOSIS REPORT 2013 239 7$%/($7UHDWPHQWRXWFRPHVQHZVPHDUSRVLWLYHFDVHV ± % OF COHORT TREATMENT SUCCESS (%)a 1995–2011 Greece •0 0• •0 0• Greenland Hungary •0 0• Iceland • 100 0• Ireland •0 64 • Israel •0 77 • • 80 0• Italy Kazakhstan •0 61 • Kyrgyzstan •0 78 • • 61 73 • Latvia Lithuania •0 73 • Luxembourg • 100 0• • 100 58 • Malta Monaco •0 0• Montenegro 86 • Netherlands • 72 81 • • 77 0• Norway Poland •0 a 240 60 • YEAR 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 NUMBER NOTIFIED SIZE OF COHORT 235 197 198 178 236 24 38 34 796 412 423 363 270 260 2 1 2 3 6 1 651 412 597 515 0 2 2 2 4 16 0 138 130 95 84 85 73 107 188 164 153 216 142 119 103 135 1 413 687 1 275 885 586 587 3 022 8 903 6 911 5 213 4 769 4 157 832 1 296 1 972 1 609 1 645 1 537 504 637 536 367 339 293 979 776 964 742 719 681 336 227 202 99 242 295 223 8 781 6 884 5 355 4 919 4 306 1 233 1 897 1 543 1 537 475 637 536 592 596 559 776 958 1 033 959 1 000 37 21 14 0 0 4 5 5 5 12 4 7 14 6 5 4 5 10 5 12 0 64 53 39 48 575 289 237 203 176 177 62 37 48 42 49 40 6 955 3 180 2 823 2 658 2 484 2 587 63 78 39 56 715 301 208 454 469 437 87 37 47 146 139 214 2 823 4 391 3 998 4 699 COHORT AS % NOTIFIED – – – – – – – – – – – – – 158 97 164 191 0 100 200 100 133 267 0 – 53 82 198 195 180 – 156 160 170 96 179 21 32 – – – – – 99 100 103 103 104 – 95 96 96 – 100 94 100 100 161 176 191 – 100 99 139 133 147 – – 0 – – 150 100 80 100 83 125 171 – – – – – – 98 147 100 117 124 104 88 224 266 247 140 100 98 348 284 – – 7 100 165 161 182 CURED COMPLETED DIED FAILED DEFAULTED NOT EVALUATED 28 32 45 64 36 13 12 5 10 13 10 12 3 12 19 0 12 9 7 10 11 20 7 9 0 0 0 0 0 100 100 100 75 88 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 25 6 33 3 5 0 54 51 62 62 73 10 12 9 9 7 5 0 3 0 0 0 4 1 1 1 3 0 22 23 19 29 65 69 72 69 69 73 37 18 15 14 7 9 6 36 15 11 10 11 10 3 1 0 0 0 0 0 2 0 0 3 1 0 2 11 9 1 2 3 13 10 4 16 76 70 62 61 61 3 1 0 0 0 5 5 4 3 4 10 12 30 7 6 3 5 3 2 2 3 8 2 27 27 73 81 79 9 4 4 3 3 3 4 5 4 5 5 6 6 2 4 75 61 68 72 72 72 72 3 0 4 1 3 3 1 3 9 12 11 9 8 10 11 3 3 1 1 1 0 5 21 7 7 5 6 5 3 7 7 8 11 10 11 73 70 73 68 73 100 0 0 0 0 0 10 11 10 11 11 0 4 3 2 1 1 0 12 11 9 11 8 0 2 6 6 8 7 0 0 0 80 0 0 0 0 0 0 0 20 100 100 80 80 58 7 17 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 93 83 0 0 0 20 20 33 10 49 46 25 17 23 9 11 1 1 43 49 62 45 68 21 37 41 61 55 53 75 69 76 81 34 22 30 37 24 8 5 12 8 6 7 9 7 5 14 14 2 4 3 0 0 0 0 0 0 0 0 1 3 0 1 1 4 3 0 5 3 1 3 4 3 8 3 4 0 0 70 3 5 2 15 15 8 8 12 11 0 11 2 13 5 50 65 48 47 43 22 12 19 19 17 11 5 5 6 9 6 1 0 0 0 6 9 10 9 9 5 8 17 19 22 TREATMENT SUCCESS = percent cured + percent completed then rounded to the nearest digit. GLOBAL TUBERCULOSIS REPORT 2013 Data for all years can be downloaded from www.who.int/tb/data 7$%/($7UHDWPHQWRXWFRPHVQHZVPHDUSRVLWLYHFDVHV ± % OF COHORT Portugal • 69 80 • Republic of Moldova •0 62 • • 51 85 • • 65 54 • Romania Russian Federation San Marino •0 0• Serbia 87 • Serbia & Montenegro Slovakia • 64 91 • • 90 81 • •0 73 • Slovenia Spain Sweden •0 83 • •0 0• Switzerland Tajikistan • 88 80 • • 70 95 • The Former Yugoslav Republic of Macedonia Turkey •0 90 • • 73 0• Turkmenistan Ukraine • 83 58 • United Kingdom of Great Britain and Northern Ireland •0 80 • • 78 78 • Uzbekistan a YEAR 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 2005 2009 2010 2011 1995 2000 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 NUMBER NOTIFIED SIZE OF COHORT COHORT AS % NOTIFIED 2 019 1 863 1 302 1 043 912 876 665 651 1 696 1 318 1 267 1 272 10 469 10 202 10 801 8 987 7 951 7 386 37 512 27 467 32 605 33 351 31 416 29 191 1 240 1 924 1 393 1 565 651 1 690 1 318 1 267 1 272 11 597 10 158 10 929 10 737 9 445 8 886 54 3 616 25 692 32 316 30 123 36 747 1 1 1 105 1 055 977 905 1 497 0 788 236 162 121 112 96 303 145 109 85 64 82 2 605 3 423 2 511 2 236 2 076 2 186 102 118 134 107 117 99 185 86 84 74 82 90 1 042 434 1 745 1 972 2 290 2 174 319 167 178 198 141 132 4 383 4 315 7 450 6 007 5 375 4 927 544 1 017 995 1 370 1 153 1 154 1 392 988 894 1 956 267 807 238 158 174 177 138 270 145 109 149 123 151 61 103 107 150 – 158 – 100 100 100 100 100 111 100 101 119 119 120 0 13 79 97 96 126 – 100 – – – – 104 132 101 99 131 – 102 101 98 144 158 144 89 100 100 175 192 184 – – – – 172 153 – 95 99 238 247 249 – – – – – – 33 153 99 100 100 100 70 91 101 101 101 98 – 80 100 100 100 100 100 100 100 100 – – 116 – – 96 133 131 – – 74 205 217 245 95 27 94 100 100 100 1 387 3 574 3 335 112 133 255 289 247 348 665 1 729 1 972 2 290 2 174 222 152 179 199 143 130 3 461 7 450 6 007 5 375 4 927 544 1 017 995 1 375 8 263 10 738 9 564 13 632 9 976 10 502 13 111 13 279 13 714 1 204 1 821 1 256 1 201 1 204 2 735 3 825 5 695 4 959 4 711 4 198 1 348 2 569 2 602 2 952 2 598 1 030 5 336 4 959 4 711 4 198 COMPLETED 45 9 13 9 23 71 76 75 4 6 6 6 4 0 0 0 4 5 4 3 19 9 2 7 9 72 5 0 3 12 1 60 49 52 57 38 28 71 72 70 71 54 64 55 52 50 48 62 2 5 5 5 13 42 11 14 14 14 11 4 3 3 3 5 0 9 10 11 9 6 4 5 4 5 5 15 6 13 11 12 9 0 11 17 5 18 7 8 4 4 4 3 6 13 14 20 23 10 0 11 14 13 10 6 8 6 6 6 5 11 9 11 8 7 7 37 7 5 13 1 31 9 4 1 2 1 4 4 4 5 5 20 0 0 100 0 0 0 72 80 79 80 34 82 64 81 66 82 84 91 64 33 47 24 28 37 13 6 8 7 18 7 1 1 1 0 3 0 0 26 0 0 1 26 51 38 63 57 44 5 6 6 7 2 4 16 14 6 14 12 7 4 8 12 9 11 18 1 0 0 0 0 2 0 0 1 0 0 5 4 4 4 10 6 4 2 1 2 3 0 1 5 1 1 1 1 4 2 2 2 33 1 16 1 1 2 1 2 3 3 3 3 3 1 39 42 32 31 6 7 0 0 1 1 23 19 0 0 0 70 51 79 74 85 15 32 11 6 6 5 5 0 1 0 0 1 2 1 1 1 2 8 18 8 9 9 69 74 74 75 76 74 61 51 62 85 83 78 18 3 9 6 4 6 9 35 22 5 7 16 7 15 4 4 5 5 13 4 2 4 4 3 3 8 6 8 11 11 9 2 0 2 3 0 2 0 7 5 3 3 9 7 14 5 2 2 0 0 0 1 1 1 0 1 0 0 1 0 0 45 61 63 60 55 79 70 83 73 44 30 29 31 18 2 14 1 3 2 3 3 3 11 9 6 5 0 0 1 1 1 7 6 4 6 6 5 2 3 3 2 3 5 5 19 3 3 2 3 7 1 1 1 6 7 83 DIED FAILED DEFAULTED NOT EVALUATED CURED EUROPEAN REGION TREATMENT SUCCESS (%)a 1995–2011 4 52 51 48 7 9 10 13 13 13 16 17 18 8 8 7 3 3 4 0 0 0 0 78 27 72 77 76 73 68 82 81 80 0 53 9 5 5 5 7 6 5 6 9 3 6 6 6 6 0 0 0 0 7 6 6 5 6 6 1 5 6 6 4 5 7 5 5 6 24 7 8 8 3 6 1 3 3 4 TREATMENT SUCCESS = percent cured + percent completed then rounded to the nearest digit. Data for all years can be downloaded from www.who.int/tb/data GLOBAL TUBERCULOSIS REPORT 2013 241 7$%/($7UHDWPHQWRXWFRPHVUHWUHDWPHQWFDVHV ± % OF COHORT a TREATMENT SUCCESS (%) 1995–2011 Albania •0 83 • Andorra •0 0• • 50 68 • Armenia Austria •0 43 • Azerbaijan •0 71 • •0 29 • Belarus Belgium •0 61 • Bosnia and Herzegovina •0 63 • Bulgaria •0 66 • Croatia •0 0• Cyprus •0 100 • Czech Republic •0 75 • Denmark •0 0• Estonia •0 31 • Finland •0 25 • France •0 0• Georgia • 32 61 • Germany •0 a 242 58 • YEAR 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 NUMBER NOTIFIED SIZE OF COHORT 53 19 43 21 30 18 30 21 30 18 0 0 2 0 1 38 76 327 542 451 382 2 0 1 6 54 327 542 451 382 30 26 25 29 20 47 74 3 200 2 384 1 997 2 155 343 825 1 049 878 1 114 1 075 80 89 68 87 59 130 193 156 113 101 65 10 27 37 29 21 74 1 314 1 687 4 194 4 005 616 792 1 020 55 47 76 85 56 122 106 116 101 104 383 201 372 348 355 42 198 384 348 355 94 62 43 92 22 37 0 0 3 3 0 3 21 25 34 51 31 6 28 29 10 46 22 71 116 94 80 79 76 2 6 0 3 38 31 62 49 32 15 22 42 35 59 89 82 81 75 29 22 15 13 14 13 12 0 371 315 261 196 681 2 152 566 1 409 1 310 298 470 2 037 1 521 1 421 1 321 493 252 367 300 63 432 344 364 289 COHORT AS % NOTIFIED – – 70 100 100 100 – – – 100 – 100 16 71 100 100 100 100 – 33 104 148 100 105 – 100 41 71 210 186 – – – 70 71 95 – 62 69 – 98 95 – 63 68 103 100 160 – – 99 103 100 100 – – 98 35 86 – – – 67 200 – 100 – 152 91 – 96 103 – 54 76 420 76 – – 51 95 102 103 99 – – – – 87 92 – – – – – – 152 69 95 269 101 101 – – 88 137 99 96 DEFAULTED NOT EVALUATED 0 0 0 0 10 10 7 6 13 5 0 6 0 0 0 0 0 0 7 7 8 6 4 0 17 7 12 4 10 9 0 33 19 37 15 13 15 100 0 0 4 10 4 3 80 56 38 45 43 0 11 5 0 14 0 0 0 0 5 0 11 30 0 5 20 11 24 41 33 59 28 39 14 8 7 9 14 49 63 5 6 6 3 3 11 6 9 4 5 14 13 19 15 12 4 38 13 15 8 38 20 21 4 28 8 13 10 7 7 36 59 1 1 3 37 5 3 16 17 11 8 16 45 21 57 55 45 13 19 9 6 9 0 0 0 0 0 15 0 12 12 16 11 43 12 19 14 79 85 52 83 19 15 8 32 12 43 3 4 5 2 7 1 1 3 1 0 2 2 3 1 3 0 1 5 1 28 57 32 32 30 10 38 31 36 7 12 13 9 11 5 6 5 14 8 12 11 2 5 5 8 20 27 59 13 23 16 9 36 14 1 5 1 5 3 57 5 8 0 17 100 0 0 0 0 0 0 0 0 83 67 33 0 0 0 0 53 16 34 41 44 11 39 34 33 31 8 3 18 16 12 3 0 0 0 0 0 3 2 0 9 26 39 13 10 3 27 27 12 20 60 64 40 40 7 5 2 11 0 0 2 3 0 5 0 0 7 0 43 26 54 21 34 28 15 2 20 17 11 16 3 3 15 11 21 0 4 6 2 1 3 26 9 15 11 37 25 20 32 36 29 38 25 7 8 0 0 0 8 0 0 0 0 0 0 64 54 67 8 23 19 26 26 27 24 31 35 34 35 34 12 10 7 5 5 4 9 8 10 17 17 23 45 29 23 15 11 8 2 0 6 3 4 4 51 30 21 25 17 21 36 44 47 41 16 9 12 12 10 3 0 0 1 0 5 7 5 6 6 5 18 17 10 27 CURED COMPLETED DIED 37 38 43 28 37 38 47 56 3 10 3 6 0 100 0 50 52 13 9 5 5 0 0 15 28 54 62 63 0 11 3 14 0 FAILED TREATMENT SUCCESS = percent cured + percent completed then rounded to the nearest digit. GLOBAL TUBERCULOSIS REPORT 2013 Data for all years can be downloaded from www.who.int/tb/data 7$%/($7UHDWPHQWRXWFRPHVUHWUHDWPHQWFDVHV ± Greece •0 0• •0 0• Greenland Hungary •0 0• Iceland •0 100 • Ireland •0 54 • Israel •0 50 • Italy • 48 0• Kazakhstan •0 36 • Kyrgyzstan •0 56 • Latvia •0 51 • Lithuania •0 33 • Luxembourg •0 0• Malta •0 100 • Monaco •0 0• Montenegro 83 • Netherlands •0 80 • Norway •0 0• Poland •0 a 53 • YEAR 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 NUMBER NOTIFIED SIZE OF COHORT 48 74 3 44 35 6 12 3 371 347 211 254 221 0 1 1 1 0 1 122 333 208 254 0 22 40 16 31 27 10 14 52 33 26 8 7 9 4 10 8 7 9 5 10 31 26 625 293 74 100 1 320 5 093 15 009 9 371 9 213 5 969 127 555 847 758 987 1 035 118 375 205 147 109 97 128 509 460 404 364 369 1 1 0 1 2 901 4 085 9 392 8 734 5 026 278 845 924 523 205 205 148 110 97 282 455 404 364 369 4 0 0 1 0 0 1 2 3 3 0 0 1 1 2 3 3 0 27 11 12 12 10 11 14 12 70 44 46 43 38 28 12 14 18 28 49 44 46 42 37 1 071 882 1 077 688 899 963 3 9 30 40 56 985 942 899 963 COHORT AS % NOTIFIED – – – – – – – – – – – – – 33 96 99 100 0 – 100 – 100 – 100 – 45 35 325 106 96 – 100 100 100 125 100 – 4 – – – – – 57 27 100 95 84 – 50 100 122 – 51 – 55 100 101 101 100 – 55 99 100 100 100 – – – – – 0 – – 100 100 100 100 – – – – – – 37 100 117 100 – 26 64 107 102 121 – 25 64 – 95 – – 6 91 137 100 100 CURED COMPLETED DIED FAILED DEFAULTED NOT EVALUATED 16 12 35 13 20 37 26 49 15 13 13 11 9 8 12 0 11 11 6 17 30 18 8 9 0 100 0 0 0 0 0 100 0 0 0 0 0 100 0 0 0 0 40 7 4 0 50 0 57 58 55 4 10 7 8 15 15 10 0 0 0 0 40 0 0 3 0 0 29 31 27 31 12 71 56 80 40 42 31 25 14 11 0 10 6 15 62 14 11 20 10 26 4 0 0 0 0 0 10 12 0 0 0 0 20 13 8 0 0 22 0 20 3 31 62 46 22 23 36 4 1 27 24 0 10 13 9 9 11 14 14 34 4 4 5 6 6 5 5 5 19 3 35 44 59 40 28 15 31 43 8 8 7 8 9 6 6 11 7 4 1 9 49 6 9 22 8 5 39 50 43 60 45 2 1 1 2 5 19 10 14 6 10 3 1 0 0 1 8 9 14 12 12 29 29 28 20 26 45 27 30 31 33 0 2 0 1 0 21 25 24 18 16 8 4 5 4 2 22 22 22 22 23 5 19 20 25 25 0 0 0 0 0 100 100 50 67 100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 50 33 0 45 50 67 20 27 36 17 20 9 0 8 0 0 0 0 0 0 60 18 14 8 28 11 4 5 0 22 68 67 61 80 6 4 2 9 0 0 0 0 0 0 6 7 4 7 2 39 11 22 18 17 33 44 33 20 0 33 47 52 67 22 13 15 0 0 0 5 0 0 0 0 0 0 7 8 64 22 30 28 25 12 31 32 33 28 14 6 5 8 10 0 0 0 0 0 4 32 14 10 12 5 9 18 21 24 EUROPEAN REGION % OF COHORT a TREATMENT SUCCESS (%) 1995–2011 TREATMENT SUCCESS = percent cured + percent completed then rounded to the nearest digit. Data for all years can be downloaded from www.who.int/tb/data GLOBAL TUBERCULOSIS REPORT 2013 243 7$%/($7UHDWPHQWRXWFRPHVUHWUHDWPHQWFDVHV ± % OF COHORT TREATMENT SUCCESS (%)a 1995–2011 Portugal • 55 61 • Republic of Moldova •0 38 • Romania •0 58 • Russian Federation • 58 42 • San Marino •0 0• Serbia 78 • Serbia & Montenegro Slovakia •0 88 • Slovenia •0 100 • Spain •0 56 • Sweden •0 78 • •0 0• Switzerland Tajikistan •0 71 • The Former Yugoslav Republic of Macedonia •0 78 • Turkey •0 68 • Turkmenistan •0 0• Ukraine •0 34 • United Kingdom of Great Britain and Northern Ireland •0 80 • Uzbekistan •0 a 244 72 • YEAR 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 2005 2009 2010 2011 1995 2000 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 NUMBER NOTIFIED SIZE OF COHORT COHORT AS % NOTIFIED 268 481 350 271 228 215 148 374 1 777 1 663 1 689 1 480 1 077 3 770 6 938 5 401 5 115 4 669 133 209 293 265 50 43 84 98 – 95 – 0 96 100 101 101 – 69 97 100 100 100 – 9 31 51 32 47 – – – – – – 95 120 101 101 – 10 – 38 94 100 100 100 – 51 93 100 100 100 – – – – 108 105 – 22 53 – 100 100 – – – – – – – – 80 304 176 180 – – 94 100 100 100 – – 62 101 100 100 – 25 100 – – – – – – 190 192 56 – – 32 – 100 94 – 220 44 100 98 100 18 147 35 153 32 569 45 980 55 159 204 1 1 713 1 663 1 702 1 500 2 605 6 737 5 391 5 118 4 667 12 1 694 10 855 16 726 14 609 26 062 0 300 203 200 162 198 203 20 120 108 79 55 50 30 47 29 8 11 11 284 244 203 164 21 46 101 79 55 50 24 27 8 11 11 0 1 078 324 370 11 40 30 52 45 5 63 49 51 40 54 370 2 189 533 985 929 25 16 103 56 52 55 808 2 550 1 445 1 368 1 262 67 1 965 142 351 388 9 16 45 52 45 1 762 1 618 1 732 1 674 97 56 52 55 1 593 1 459 1 368 1 262 495 142 82 1 889 3 210 5 477 5 114 11 488 0 460 10 424 9 812 6 413 576 524 147 791 576 492 347 9 015 2 451 4 596 1 074 764 3 999 2 451 4 527 1 074 CURED COMPLETED DIED 38 10 8 7 17 66 66 62 6 4 10 7 FAILED 6 0 1 0 DEFAULTED 9 7 9 8 24 14 6 16 3 58 4 0 2 32 0 22 15 15 18 0 19 20 17 20 0 13 15 14 13 100 16 26 5 28 0 17 20 17 17 0 13 4 32 4 24 39 38 37 39 42 25 33 31 31 20 20 13 19 18 19 17 24 4 3 4 22 9 10 10 11 11 25 10 16 13 12 10 20 10 12 12 11 8 21 26 32 33 15 17 14 16 17 15 8 9 16 12 12 10 11 14 4 6 5 0 11 5 9 9 23 46 61 55 60 26 13 21 18 10 9 9 5 2 0 1 1 12 12 10 8 3 5 3 9 67 10 10 0 14 0 78 50 34 44 48 0 38 48 40 40 11 7 14 15 2 2 0 1 0 4 4 3 0 0 2 4 3 3 2 4 29 44 12 18 27 46 41 75 45 73 4 4 0 36 0 0 0 0 0 0 12 4 0 0 0 8 7 12 0 0 25 26 31 30 9 13 0 0 2 2 33 28 0 0 0 21 22 78 75 69 54 56 0 0 13 2 2 0 0 0 0 0 11 0 7 0 4 11 25 11 23 16 29 29 33 29 47 43 38 41 9 11 11 10 8 10 11 13 6 6 4 5 1 1 1 1 24 39 29 38 33 39 37 40 7 7 17 9 2 2 4 4 32 11 12 7 2 2 2 2 24 29 25 22 46 44 43 46 5 3 5 4 2 2 2 2 12 9 7 10 11 13 17 16 66 42 9 26 7 13 11 10 6 9 1 0 18 17 26 29 29 8 14 14 16 22 23 33 12 10 9 5 7 7 0 0 0 0 57 79 74 80 4 7 7 6 0 0 0 0 3 5 7 6 36 9 12 8 20 28 30 25 40 55 41 39 48 32 8 9 11 10 9 8 7 7 5 10 9 14 9 9 8 0 1 5 4 1 TREATMENT SUCCESS = percent cured + percent completed then rounded to the nearest digit. GLOBAL TUBERCULOSIS REPORT 2013 NOT EVALUATED Data for all years can be downloaded from www.who.int/tb/data 7$%/($+,9WHVWLQJDQGSURYLVLRQRI&37$57DQG,37– Albania • 15 55 • Andorra – 11 • Armenia • 12 100 • Austria – – – 96 • – 100 • Azerbaijan Belarus Belgium • 82 56 • Bosnia and Herzegovina – 4• Bulgaria •1 66 • Croatia – – Cyprus •0 – Czech Republic • 19 22 • Denmark – – Estonia • 94 93 • Finland •1 – – – France Georgia • 10 38 • Germany – – – – – – – – Greece Greenland Hungary Iceland • 91 100 • •6 27 • • 85 99 • Ireland Israel Italy – – Kazakhstan • 77 98 • Kyrgyzstan – 100 • 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 NUMBER OF TB % OF TB PATIENTS WITH PATIENTS WITH KNOWN HIV KNOWN HIV STATUS STATUS 15 42 39 55 81 186 170 233 0 0 11 12 70 95 100 0 0 1 270 1 242 1 499 1 518 75 74 96 6 290 7 448 7 849 93 100 100 82 87 81 56 5 153 5 118 5 246 937 969 845 556 0 4.7 3.9 0.7 67 71 66 0 65 56 23 1 773 1 698 1 513 0 0 19 26 26 22 189 177 153 136 0 73 0 277 94 91 92 93 0.83 0.92 0.92 490 298 315 271 3 3 3 24 27 1 233 1 354 10 32 46 38 674 1 841 2 550 1 881 <0.1 <0.1 1 1 91 95 100 100 6.1 23 30 27 85 90 92 99 10 21 9 11 28 98 128 97 316 308 384 503 77 84 85 98 31 187 23 854 22 480 21 184 2.9 100 100 183 6 666 6 916 PATIENTS NOTIFIED (NEW AND RETREAT) 540 445 431 420 10 7 4 9 2 322 1 780 1 582 1 518 954 688 687 648 7 920 8 394 10 100 8 140 6 357 5 554 5 118 5 246 1 144 1 115 1 044 987 2 160 1 390 1 385 1 420 3 302 2 649 2 407 2 280 1 144 695 619 37 61 54 69 1 007 678 600 605 424 359 381 519 329 341 290 361 327 325 274 5 374 5 116 4 942 6 448 5 796 5 533 4 974 6 045 4 330 4 316 4 238 767 489 489 116 115 84 2 024 1 741 1 445 1 223 11 22 9 11 461 427 425 366 372 343 418 509 4 137 3 249 3 521 40 429 28 550 26 304 21 523 6 765 6 295 6 666 6 916 NUMBER OF HIV-POSITIVE TB PATIENTS % OF TESTED TB PATIENTS HIV-POSITIVE % OF HIV% OF HIVNUMBER OF POSITIVE TB POSITIVE TB HIV-POSITIVE PATIENTS ON PATIENTS ON PEOPLE CPT ART PROVIDED IPT 1 0 2 7 1.2 0 1.2 3 100 100 100 100 2 0 0 0 6 17 49 79 0 2.2 1.4 3.3 5.2 83 47 80 70 33 41 80 70 0 61 49 62 41 21 29 67 257 32 258 48 36 129 139 190 217 229 52 66 44 43 5 0.76 0.48 1.6 3.7 4.2 4.4 5.5 6.8 5.2 7.7 0 0 0 0 0 2 5 3 0.11 0.29 0.2 EUROPEAN REGION % OF TB PATIENTS WITH KNOWN HIV STATUS YEAR 2005–2012 0 0 0 0 100 100 100 1 4 1 3 0 1 2 5 4 6 8 0 10 1.1 2.8 2.6 4.4 3.6 33 34 46 45 3 3 3 6.7 11 15 17 100 100 100 121 95 9.8 7 13 35 50 33 1.9 1.9 2 1.8 1 1 100 100 1 1 0 0 11 15 21 14 17 13 24 16 10 4.8 0 0 39 15 16 14 5.4 4.2 6.2 3.2 100 0 100 0 183 333 352 441 0.59 1.4 1.6 2.1 41 26 20 16 7.7 7.5 9.1 58 1 063 1 329 862 183 153 151 100 2.3 2.2 68 60 67 37 86 78 4 5 Data for all years can be downloaded from www.who.int/tb/data 0 47 61 62 54 63 56 79 100 77 76 79 61 97 100 100 GLOBAL TUBERCULOSIS REPORT 2013 245 7$%/($+,9WHVWLQJDQGSURYLVLRQRI&37$57DQG,37– % OF TB PATIENTS WITH KNOWN HIV STATUS YEAR 2005–2012 Latvia • 85 85 • Lithuania – – – – Luxembourg Malta •4 98 • Monaco – – Montenegro •5 77 • • 22 42 • Netherlands Norway •0 – Poland – 0• Portugal • 70 65 • • 103 100 • • 37 53 • • 55 – – – Republic of Moldova Romania Russian Federation San Marino Serbia •0 2• • 95 93 • • 38 75 • – 70 • Slovakia Slovenia Spain Sweden •0 – – – Switzerland Tajikistan •9 92 • •0 41 • •0 59 • The Former Yugoslav Republic of Macedonia Turkey Turkmenistan – – Ukraine – 75 • – – United Kingdom of Great Britain and Northern Ireland Uzbekistan • 124 246 100 • 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 NUMBER OF TB % OF TB PATIENTS WITH PATIENTS WITH KNOWN HIV KNOWN HIV STATUS STATUS 85 85 85 85 1 226 794 752 844 4.3 81 91 98 1 26 30 42 PATIENTS NOTIFIED (NEW AND RETREAT) 1 443 934 885 993 2 574 1 938 1 904 1 781 37 29 26 45 23 32 33 43 NUMBER OF HIV-POSITIVE TB PATIENTS % OF TESTED TB PATIENTS HIV-POSITIVE 53 71 71 114 7 19 4.3 8.9 9.4 14 0 3 5 4 0 12 17 9.5 0 1 0 0 61 48 31 28 0 1.2 0 0 24 12 6.3 6.9 % OF HIV% OF HIVNUMBER OF POSITIVE TB POSITIVE TB HIV-POSITIVE PATIENTS ON PATIENTS ON PEOPLE CPT ART PROVIDED IPT 41 39 55 76 66 57 0 4 1 4.7 74 82 77 22 38 49 42 0 8 84 92 82 252 413 490 407 0 0.29 0.31 0.34 70 65 86 65 100 95 94 100 37 37 50 53 55 22 26 26 2 485 1 720 2 185 1 672 6 469 5 192 5 017 5 348 10 860 7 833 9 608 9 699 85 537 84 669 79 494 75 995 170 114 112 107 1 157 1 073 1 007 958 290 339 361 0 100 21 3 <0.1 0.67 3.2 2 95 100 99 93 38 76 77 75 3 16 72 39 720 439 395 322 107 130 147 104 69 68 70 0 4 909 4 569 4 179 0 8.9 53 82 92 0.3 9.3 12 41 0 3.5 46 59 670 4 049 6 241 6 375 2 39 45 145 0 581 7 241 8 646 100 3 230 95 74 75 34 621 31 776 34 181 120 100 100 100 GLOBAL TUBERCULOSIS REPORT 2013 35 801 20 330 15 913 16 810 9 280 7 509 8 478 7 542 3 536 2 626 2 540 2 590 6 278 5 447 5 341 5 341 29 347 21 078 19 212 18 224 154 379 162 553 159 479 149 921 3 468 2 385 2 216 1 917 760 439 399 345 278 172 192 138 8 359 7 089 6 762 5 991 569 675 586 632 563 548 578 463 7 526 7 641 7 609 6 929 658 420 362 355 21 303 16 551 15 679 14 691 3 291 3 230 39 608 36 409 42 676 45 569 8 633 8 483 8 963 8 751 28 891 20 330 15 913 16 810 22 26 100 100 571 303 315 291 9 308 285 303 160 241 244 229 3 533 3 633 4 104 4 880 23 18 14 17 0.14 5.9 5.7 5.7 1.5 3.1 2.5 2.4 4.1 3 12 6 6 1 1 0 0 0 1 0 0 100 75 8.3 15 0.14 0.23 0 0 0 0.77 0 0 456 414 370 9.3 9.1 8.9 1 100 115 88 2 0 0 0 0 14 29 45 0.15 2.5 1.8 1.4 100 0 0 0 0 73 70 80 0 2.4 0.4 0.52 36 48 49 0 0 1 526 5 752 4 157 4 726 17 13 14 72 39 63 71 14 352 0.41 2.1 3.4 4.9 0 92 96 95 0 37 32 13 2 630 2 010 100 9.7 100 31 0 34 41 59 76 89 90 90 133 145 174 200 430 0 0 0 0 100 400 100 100 100 100 100 4 0 0 0 54 57 89 100 0 315 157 0 0 0 64 93 78 0 5 029 378 326 147 427 546 820 Data for all years can be downloaded from www.who.int/tb/data 7$%/($7HVWLQJIRU0'57%DQGQXPEHURIFRQILUPHGFDVHVRI0'57%± a MDR-TB Albania Andorra Armenia Austria Azerbaijan Belarus Belgium Bosnia and Herzegovina Bulgaria Croatia Cyprus Czech Republic Denmark Estonia Finland France Georgia Germany Greece Greenland Hungary Iceland Ireland Israel Italy Kazakhstan Kyrgyzstan 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 1 2 5 1 0 0 0 0 162 177 79 92 13 15 19 27 800 552 811 596 1576 1594 1604 11 19 15 20 11 2 7 7 47 56 55 49 6 0 8 NEW PULMONARY CASES ESTIMATED CASES OF MDR-TB AMONG NOTIFIED 1.7 (0–4.9) 1.7 (<0.1–9.1) 0 (0–4.9) 0 (0–4.9) 250 (220–280) 82 (61–110) 18 (6.7–30) 11 (5.1–20) 2 800 (2 600–3 000) 2 200 (2 100–2 200) 1 200 (1 100–1 300) 6.3 (2.5–13) 13 (2.0–24) 1.6 (<0.1–8.9) 100 (78–130) NUMBER OF b BACT+VE TESTED FOR MDR-TB 161 186 194 172 9 4 1 4 576 361 439 420 570 203 257 254 453 801 569 810 (670–960) 15 (5.8–25) 32 (18–51) 1972 2084 2164 588 466 524 503 1035 600 704 724 482 801 588 687 586 353 – 1 0 1 0 13 9 7 4 5 2 3 1 79 63 78 62 3 6 5 3 24 23 40 39 195 359 475 346 105 48 56 64 12 2 5 ESTIMATED CASES OF MDR-TB AMONG NOTIFIED – 1.7 (0–5.0) 1.7 (<0.1–8.8) 9.8 (2.3–17) 7.3 (2.7–16) – 70 (56–85) 2.7 (0–5.6) – – 42 (31–56) 2.7 (0.55–7.6) 316 197 210 193 198 184 237 206 1291 1187 1232 – 630 (570–690) 260 (220–300) 62 (44–81) 37 (25–52) – 16 14 25 40 562 352 392 371 307 209 257 799 1987 2197 1931 3094 2215 2382 2198 497 115 148 – 1 1.6 (1.0–2.2) 26 19 30 12 0 0 0 1 3 2 3 5 16 12 11 17 31 (15–46) 23 (11–42) 1.0 (1.0–1.0) 0 (0–4.2) 1.8 (0–4.4) 22 (12–32) – 7387 7408 7608 989 566 806 958 1.4 (0.69–2.0) 1.8 (0.22–6.6) 19 (11–30) 442 474 411 411 7 19 4 4 200 200 176 190 259 245 275 318 – 7 000 (6 900–7 200) 2 700 (2 600–2 800) 5214 5293 8154 837 225 1 800 (1 600–2 000) 1 100 (910–1 200) 1659 PREVIOUSLY TREATED CASES % OF b BACT+VE TESTED FOR MDR-TB 75 76 87 76 150 100 100 100 99 87 96 94 110 99 95 93 29 19 25 – – 90 94 90 89 97 94 95 100 100 99 97 40 85 62 71 100 – 96 – 84 70 96 93 100 97 96 93 140 98 100 – 110 100 100 100 85 96 97 99 47 120 73 – 53 80 83 84 98 110 91 89 170 37 44 – – – – – 62 92 73 79 140 120 80 100 110 130 85 97 110 120 99 98 – – – – – 100 83 140 20 14 – 99 ESTIMATED CASES OF MDR-TB AMONG NOTIFIED 0 (0–6.3) 0 (0–0) 170 (150–190) 7.3 (0.91–21) 2 000 (1 800–2 200) 960 (920–1 000) 8.9 (2.5–21) 12 (3.2–28) 73 (52–98) – 0 (0–5.1) 2.5 (<0.1–12) – 28 (20–36) 0 (0–4.2) – 370 (330–420) 26 (13–43) – 0.24 (0.18–0.29) 7.3 (3.0–14) 1.0 (<0.1–1.0) 0 (0–4.9) 3.7 (0.48–8.5) – 4 300 (4 300–4 400) 730 (690–770) NUMBER OF % OF NOTIFIED NOTIFIED TESTED FOR TESTED FOR MDR-TB MDR-TB 12 28 19 63 11 61 15 52 – 0 – 1 100 0 – 182 56 99 22 90 24 91 23 16 62 15 52 11 55 25 62 366 11 960 48 151 7.0 – – 1697 150 948 88 1183 84 41 60 52 60 35 59 53 68 106 68 47 47 41 63 66 55 691 340 165 47 145 41 142 45 61 65 – 40 – – 0 0 – 0 2 67 2 33 20 59 28 55 16 52 26 65 18 62 30 65 14 64 – 71 76 61 77 52 68 46 82 22 100 7 47 8 62 14 78 112 30 91 29 110 42 – 515 24 558 40 675 52 541 45 251 51 184 50 148 49 116 47 0 0 15 34 11 31 – – – – – 88 25 80 31 68 31 31 37 1 100 0 – 0 0 1 100 10 25 22 71 15 56 17 68 6 86 2 50 9 90 6 55 – – – – – 4655 51 4790 80 10443 130 152 18 264 27 – 831 78 EUROPEAN REGION YEAR TOTAL CONFIRMED CASES OF a TOTAL CONFIRMED CASES OF MDR-TB includes cases with unknown previous treatment history (i.e. not included under NEW CASES or PREVIOUSLY TREATED CASES). b BACT+VE = bacteriologically positive cases. Data for all years can be downloaded from www.who.int/tb/data GLOBAL TUBERCULOSIS REPORT 2013 247 7$%/($7HVWLQJIRU0'57%DQGQXPEHURIFRQILUPHGFDVHVRI0'57%± YEAR TOTAL CONFIRMED CASES OF a MDR-TB Latvia 2005 2010 2011 2012 Lithuania 2005 2010 2011 2012 2005 Luxembourg 2010 2011 2012 Malta 2005 2010 2011 2012 Monaco 2005 2010 2011 2012 Montenegro 2005 2010 2011 2012 Netherlands 2005 2010 2011 2012 2005 Norway 2010 2011 2012 Poland 2005 2010 2011 2012 Portugal 2005 2010 2011 2012 2005 Republic of Moldova 2010 2011 2012 Romania 2005 2010 2011 2012 Russian 2005 Federation 2010 2011 2012 San Marino 2005 2010 2011 2012 Serbia 2005 2010 2011 2012 Slovakia 2005 2010 2011 2012 Slovenia 2005 2010 2011 2012 Spain 2005 2010 2011 2012 Sweden 2005 2010 2011 2012 Switzerland 2005 2010 2011 2012 Tajikistan 2005 2010 2011 2012 The Former 2005 Yugoslav Republic 2010 of Macedonia 2011 2012 Turkey 2005 2010 2011 2012 Turkmenistan 2005 2010 2011 2012 Ukraine 2005 2010 2011 2012 United Kingdom of 2005 Great Britain and 2010 Northern Ireland 2011 2012 Uzbekistan 2005 2010 2011 2012 160 87 105 110 338 310 296 271 0 0 2 0 0 1 0 0 NEW PULMONARY CASES ESTIMATED CASES OF MDR-TB AMONG NOTIFIED ESTIMATED CASES OF MDR-TB AMONG NOTIFIED 120 (100–140) 87 (69–110) 300 (270–330) 150 (120–170) 0 (0–0.98) 0 (0–0) 0 (0–0) 0 (0–7.2) NUMBER OF b BACT+VE TESTED FOR MDR-TB 873 613 562 666 1293 959 1031 1017 36 17 7 0 11 11 17 13 1 – 2 0 1 0 7 11 15 11 3 8 4 6 72 30 41 31 28 19 22 17 338 1082 1001 894 530 502 530 500 13692 13785 13612 0 (0–0) 0 (0–5.0) 9.1 (3.5–15) 7.4 (3.5–13) – 30 (18–47) 35 (21–50) 25 (15–41) 1 700 (1 600–1 800) 800 (610–980) 46 000 (43 000–49 000) 49 41 37 4 18 17 14 5 9 8 8 333 604 694 4 7 1 4 191 250 262 291 20 (7.0–33) 810 (730–890) 320 (210–480) 20 000 (18 000–22 000) 5409 3238 4416 4073 1407 982 1155 1219 536 1381 1379 1264 1594 3338 3855 3645 35862 34007 32647 – 13 (4.9–29) 1.8 (0–5.3) 0 (0–6.2) 0 (0–0) 0 (0–3.5) 31 (13–49) 8.5 (1.0–31) 11 (5.0–18) 8.1 (4.1–14) 8.6 (2.4–15) 2.6 (0.53–7.4) 910 (800–1 000) 490 (390–620) 4.8 (0.47–9.1) 0 (0–5.7) 520 (460–580) 270 (230–310) 38 158 1112 811 863 716 248 185 147 142 217 123 171 114 1009 1013 802 425 288 375 453 326 270 304 246 160 161 919 106 153 130 155 3237 4342 4221 4742 81 306 – 5336 4305 6934 39 60 81 81 86 1023 1385 1728 82 61 57 58 709 741 695 628 193 139 229 – 48 (31–65) – 9 12 9 9 8 1 5 4 1 0 0 0 – 6 800 (6 500–7 000) 69 (54–85) 4 000 (3 700–4 300) – 4 100 (3 900–4 300) 54 (42–70) 2 400 (1 800–3 000) 9194 10352 11185 3428 3970 4549 4570 0 2845 484 2703 PREVIOUSLY TREATED CASES % OF b BACT+VE TESTED FOR MDR-TB 100 100 96 97 100 100 100 100 110 120 100 – 140 220 89 81 – – – – 88 100 100 98 130 160 99 99 150 100 97 – 120 81 88 90 77 77 73 72 32 49 74 67 13 39 41 40 – 72 78 79 – – – – 76 67 91 84 82 100 92 95 110 100 100 100 – 34 24 21 150 100 100 100 150 130 98 98 – 7.0 7.4 45 51 110 72 81 38 64 63 71 – 7.0 – – – 66 61 77 100 150 95 97 0 60 9.5 56 ESTIMATED CASES OF MDR-TB AMONG NOTIFIED 36 (26–48) 150 (140–170) 0 (0–0.98) 0 (0–0.98) – 0 (0–6.8) 1.8 (<0.1–9.0) – 18 (9.0–32) 9.7 (3.2–22) 930 (880–980) 480 (350–630) 25 000 (23 000–28 000) – 6.5 (1.3–18) 1.8 (<0.1–9.3) 0 (0–3.7) 22 (10–41) 3.2 (0.40–11) 6.1 (1.7–14) 420 (390–450) 4.8 (1.4–11) 250 (220–290) – 2 600 (2 600–2 700) 15 (8.1–25) 1 600 (1 400–1 900) NUMBER OF % OF NOTIFIED NOTIFIED TESTED FOR TESTED FOR MDR-TB MDR-TB 182 89 102 94 82 85 100 88 440 96 360 99 369 100 350 100 – 0 – 1 100 1 100 – 2 67 0 0 1 100 – – – – 14 52 12 100 13 110 5 38 30 68 29 67 22 58 28 57 8 57 21 50 22 59 – – 468 52 577 60 535 61 172 49 94 41 97 45 102 54 652 37 1140 67 1006 68 933 63 1300 19 2011 39 2171 46 1864 43 – 13405 29 13620 25 12324 24 – – – – 121 40 113 56 100 62 83 46 56 52 32 58 29 58 27 55 28 97 9 82 11 100 12 86 – 110 34 96 26 69 22 17 57 24 46 31 69 24 62 30 61 33 82 40 74 31 66 – 223 23 415 45 496 66 19 18 28 54 25 45 26 84 508 20 615 45 602 48 641 55 – 63 77 156 – – – 4840 95 4413 38 5925 72 271 59 247 43 234 45 244 51 435 4.8 1180 26 123 11 798 30 a TOTAL CONFIRMED CASES OF MDR-TB includes cases with unknown previous treatment history (i.e. not included under NEW CASES or PREVIOUSLY TREATED CASES). b BACT+VE = bacteriologically positive cases. GLOBAL TUBERCULOSIS REPORT 2013 Data for all years can be downloaded from www.who.int/tb/data 7$%/($1HZVPHDUSRVLWLYHFDVHQRWLILFDWLRQE\DJHDQGVH[ ± Albania Andorra Armenia Austria Azerbaijan Belarus Belgium Bosnia and Herzegovina Bulgaria Croatia Cyprus Czech Republic Denmark Estonia Finland France Georgia Germany FEMALE 0–14 15–24 25–34 35–44 45–54 55–64 65+ 1995 2000 2005 2010 2011 2012 1995 2000 2005 2010 2011 2012 1995 2000 2005 2010 2011 2012 1995 2000 2005 2010 2011 2012 1995 2000 2005 2010 2011 2012 1995 2000 2005 2010 2011 2012 1995 2000 2005 2010 2011 2012 1995 2000 2005 2010 2011 2012 1995 2000 2005 2010 2011 2012 1995 2000 2005 2010 2011 2012 1995 2000 2005 2010 2011 2012 1995 2000 2005 2010 2011 2012 1995 2000 2005 2010 2011 2012 1995 2000 2005 2010 2011 2012 1995 2000 2005 2010 2011 2012 1995 2000 2005 2010 2011 2012 1995 2000 2005 2010 2011 2012 1995 2000 2005 2010 2011 2012 0 2 0 0 0 0 0 19 26 28 29 33 0 21 21 17 26 34 0 14 16 14 18 16 19 24 31 16 30 15 40 19 20 16 9 11 30 16 37 15 22 23 0 0 0 0 0 1 2 3 0 0 1 4 1 1 0 0 1 0 0 77 0 0 0 0 0 0 18 152 170 36 28 23 37 17 32 4 8 5 13 9 109 328 1 1 0 0 0 16 130 104 75 65 67 95 30 23 4 11 8 29 24 297 371 0 1 0 0 0 11 131 83 49 52 60 82 59 22 12 9 7 14 33 215 267 0 0 0 1 0 10 63 84 68 71 56 89 42 41 13 13 19 6 42 209 280 0 0 0 0 1 8 26 30 27 42 34 71 23 24 8 11 9 4 30 187 30 0 0 0 0 1 1 21 24 15 8 18 73 41 30 10 13 13 1 0 88 27 4 230 223 170 176 95 48 0 1 0 3 3 1 4 8 3 0 4 1 1 2 1 71 65 53 44 23 20 26 20 25 25 15 56 22 27 33 23 180 173 156 174 49 57 50 39 50 33 61 82 58 37 32 32 273 224 228 250 63 39 32 30 33 18 90 99 61 34 52 58 287 293 290 266 52 55 27 29 25 27 140 66 78 61 75 74 118 163 138 158 54 32 15 21 18 22 139 58 44 46 61 62 62 58 48 73 102 56 47 19 27 18 100 77 80 51 62 92 0 9 1 2 0 6 13 98 40 38 46 38 16 150 115 100 89 97 20 195 143 110 130 210 3 195 133 122 131 132 9 150 90 92 82 178 10 136 65 61 57 141 1 0 0 24 10 12 27 19 5 48 18 20 72 38 31 47 25 31 34 24 21 0 1 1 0 1 1 2 0 0 0 0 2 0 0 0 0 0 0 5 0 0 0 3 2 0 0 10 7 8 12 10 7 7 10 12 8 5 1 1 3 4 22 31 24 19 29 21 16 20 12 22 14 1 0 4 2 83 52 57 36 20 24 28 24 18 10 18 1 0 0 1 88 89 55 29 38 42 18 16 23 13 32 0 0 0 1 53 61 45 29 28 33 9 11 9 16 16 1 0 1 0 90 59 46 19 24 22 11 14 7 2 4 0 0 0 0 0 1 0 1 0 0 0 30 10 12 10 12 6 9 3 4 6 1 3 5 10 1 2 156 136 127 60 88 31 25 7 22 15 10 8 4 6 4 9 431 248 212 139 112 53 19 21 16 13 25 22 3 8 4 7 502 247 222 114 116 56 40 25 14 21 28 19 14 9 7 5 414 211 196 99 94 35 12 12 18 17 24 28 11 8 11 9 297 125 134 76 73 15 7 8 13 9 61 53 25 18 27 21 496 244 205 110 101 2 4 0 5 5 4 14 20 76 226 340 271 200 179 30 111 272 529 478 314 453 25 113 268 341 333 248 539 40 63 207 264 251 235 460 18 45 76 143 139 150 442 12 28 60 77 93 81 625 6 1 1 4 59 43 43 43 113 92 96 99 171 97 106 113 167 141 141 147 92 87 69 105 167 136 131 99 UNKNOWN UNKNOWN 0–14 15–24 25–34 35–44 45–54 55–64 65+ 0 3 0 2 1 0 1 11 3 11 14 17 0 10 9 7 10 9 0 8 5 6 6 6 13 8 5 3 2 3 20 5 5 2 1 6 16 11 18 8 12 12 0 0 0 0 0 0 0 0 1 1 3 1 0 0 6 1 0 1 0 1 0 0 90 3 1 0 0 0 1 24 27 24 19 13 22 11 13 5 11 10 5 3 64 141 1 0 0 0 7 27 21 17 16 19 52 22 11 4 6 8 18 3 98 100 1 0 0 0 2 24 10 4 9 12 32 12 8 2 4 4 0 6 47 57 0 0 0 0 1 8 11 7 7 2 21 11 3 2 1 4 0 3 32 73 0 0 0 0 1 8 4 8 7 5 18 6 5 5 3 1 0 0 24 9 0 0 0 0 0 0 0 0 4 7 8 5 5 59 22 10 6 4 5 0 0 24 18 0 8 115 89 35 50 35 23 0 1 3 1 3 6 2 6 3 5 0 4 2 0 3 0 25 28 37 34 12 15 27 13 13 23 40 30 35 27 17 33 53 52 67 64 24 15 31 18 14 23 67 46 39 19 27 26 50 56 47 47 32 19 15 19 9 17 64 29 33 16 17 21 43 37 39 45 17 4 12 11 3 9 49 29 28 10 13 10 11 28 27 28 10 13 4 5 5 7 77 48 28 18 25 25 62 91 83 93 34 27 23 10 7 5 23 124 130 94 128 116 0 9 3 2 0 10 11 90 42 41 37 50 14 111 59 40 50 57 7 59 43 36 44 57 3 29 23 28 24 38 4 37 15 14 16 60 6 70 34 30 35 130 1 1 0 12 3 12 18 8 14 15 4 14 11 2 8 6 1 7 56 30 26 0 1 1 1 2 0 1 0 0 0 0 0 0 0 0 0 1 2 5 2 0 0 1 0 1 3 9 15 3 6 4 3 7 16 11 4 5 0 3 0 2 11 13 14 10 9 11 13 15 5 5 5 0 1 2 1 20 9 16 11 4 8 8 14 13 15 9 0 0 0 0 13 10 7 7 4 3 4 6 9 8 7 0 0 0 0 19 7 5 2 3 7 3 7 3 8 2 0 0 0 1 88 57 28 20 15 26 2 8 5 4 7 0 0 0 0 0 1 0 0 0 1 1 36 18 16 10 7 9 6 3 4 5 1 1 3 3 2 4 138 108 104 47 58 11 11 5 8 7 6 5 4 2 3 0 226 127 134 76 67 14 8 3 12 2 7 3 1 4 5 4 176 89 82 49 48 11 11 3 3 4 4 4 0 1 3 2 90 46 56 45 36 4 6 6 3 1 10 6 6 2 1 3 92 43 38 25 23 10 8 3 6 5 65 49 20 11 13 11 365 155 180 97 65 2 1 4 5 8 5 17 8 49 109 135 136 101 115 17 37 105 118 132 116 251 17 33 58 62 59 72 167 18 17 46 52 32 43 89 7 10 17 28 35 32 104 5 5 47 41 54 47 397 4 3 2 5 51 44 44 49 104 63 92 99 73 61 59 37 43 38 54 47 37 26 26 24 103 76 86 55 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Data for all years can be downloaded from www.who.int/tb/data 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 MALE:FEMALE RATIO 1.8 2.1 3.4 2.7 2.9 2.5 – – 0.67 – – – 5.0 5.5 6.0 3.9 4.2 4.6 2.1 2.5 3.5 2.0 2.2 1.9 2.9 9.2 3.1 3.2 – 2.7 – – 4.1 3.3 3.0 3.1 2.6 2.6 1.7 2.0 3.4 1.6 1.7 1.4 1.2 1.4 1.4 1.5 – 1.6 2.3 2.7 2.7 2.6 2.0 – 2.1 2.7 1.5 – 1.0 – 7.0 0.60 2.7 1.1 2.2 2.7 3.2 2.6 3.8 2.5 2.3 1.4 1.7 1.6 2.5 – – 3.3 2.2 3.3 2.4 3.4 1.6 2.0 1.9 2.6 1.9 2.1 2.1 2.1 1.8 1.7 2.0 – 2.0 2.9 2.9 3.9 3.4 3.0 2.4 – 1.9 1.9 1.6 1.9 GLOBAL TUBERCULOSIS REPORT 2013 EUROPEAN REGION MALE YEAR 249 7$%/($1HZVPHDUSRVLWLYHFDVHQRWLILFDWLRQE\DJHDQGVH[ ± MALE YEAR Greece Greenland Hungary Iceland Ireland Israel Italy Kazakhstan Kyrgyzstan Latvia Lithuania Luxembourg Malta Monaco Montenegro Netherlands Norway Poland 250 1995 2000 2005 2010 2011 2012 1995 2000 2005 2010 2011 2012 1995 2000 2005 2010 2011 2012 1995 2000 2005 2010 2011 2012 1995 2000 2005 2010 2011 2012 1995 2000 2005 2010 2011 2012 1995 2000 2005 2010 2011 2012 1995 2000 2005 2010 2011 2012 1995 2000 2005 2010 2011 2012 1995 2000 2005 2010 2011 2012 1995 2000 2005 2010 2011 2012 1995 2000 2005 2010 2011 2012 1995 2000 2005 2010 2011 2012 1995 2000 2005 2010 2011 2012 2005 2010 2011 2012 1995 2000 2005 2010 2011 2012 1995 2000 2005 2010 2011 2012 1995 2000 2005 2010 2011 2012 FEMALE UNKNOWN 0–14 15–24 25–34 35–44 45–54 55–64 65+ 1 1 1 2 10 14 19 30 22 25 27 30 32 22 20 26 24 14 18 24 19 12 19 19 46 23 22 38 0 0 0 5 10 6 7 2 3 5 0 5 5 3 1 2 3 5 2 1 1 0 0 1 0 2 0 8 6 9 11 7 0 24 24 15 18 15 0 85 67 36 34 29 0 104 117 51 46 64 0 58 67 52 53 41 0 27 39 23 28 25 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1 0 0 0 0 3 0 1 0 0 0 0 1 0 0 0 0 1 0 0 1 10 6 8 7 7 7 10 18 9 9 7 21 4 10 9 6 10 11 11 9 4 7 5 7 12 12 6 11 8 4 0 1 1 0 0 9 12 8 14 0 20 4 13 29 9 59 63 93 40 51 26 15 28 30 33 202 96 191 75 88 23 18 12 11 20 157 75 137 66 81 23 15 8 5 3 94 58 101 32 52 13 5 4 9 6 124 54 61 31 24 38 26 6 9 13 289 112 115 58 59 36 31 15 6 9 3 4 1 5 6 4 0 0 1 0 0 0 4 1 0 1 1 0 1 057 917 675 602 508 109 128 247 261 225 210 20 53 22 20 11 19 46 38 42 34 25 35 1 409 1 142 754 716 586 171 227 303 260 204 255 44 106 71 44 42 62 132 97 118 75 52 73 1 379 983 595 516 514 165 205 269 188 179 207 71 124 104 65 58 67 225 145 186 128 126 143 923 795 511 515 479 65 115 194 141 168 184 70 111 117 71 50 59 176 155 187 157 158 148 439 274 251 235 233 38 52 66 64 77 86 40 64 55 39 33 36 90 74 108 89 77 91 218 175 127 91 98 30 46 84 48 41 30 30 34 34 15 18 15 77 68 67 54 55 60 0 0 0 0 0 0 0 0 0 1 0 0 1 0 0 1 1 0 2 2 2 0 0 0 0 0 1 3 4 2 2 0 0 0 1 1 1 0 0 2 1 0 1 0 0 1 1 0 0 0 1 0 1 0 0 0 1 0 0 0 2 0 0 0 0 1 0 0 0 0 0 0 0 0 22 0 0 0 2 1 0 0 0 0 0 3 1 1 3 79 34 23 22 22 15 4 1 9 9 3 5 1 2 4 119 63 42 29 35 31 8 9 4 9 7 7 4 8 5 75 41 23 22 19 14 6 3 6 7 3 15 4 11 10 28 25 26 20 23 18 3 6 4 1 3 4 7 7 3 9 10 14 9 14 9 5 2 4 4 1 8 1 3 4 10 21 19 17 13 15 12 4 3 2 1 3 1 3 3 5 1 122 99 109 70 69 82 295 303 199 205 187 183 795 812 389 310 314 306 565 782 639 574 560 471 369 361 292 393 439 438 377 434 310 237 275 267 GLOBAL TUBERCULOSIS REPORT 2013 UNKNOWN 0–14 15–24 25–34 35–44 45–54 55–64 65+ 0 0 3 1 2 13 2 9 9 18 13 14 10 8 4 9 5 7 4 3 6 2 4 5 25 17 15 20 1 0 2 5 8 3 0 1 0 0 1 3 4 2 1 2 3 0 0 0 3 7 5 9 3 8 0 22 22 9 9 11 0 10 15 15 12 14 0 30 33 20 29 28 1 0 0 0 0 0 0 0 0 17 13 16 9 14 0 1 0 1 0 1 19 11 14 8 15 0 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 13 9 7 8 5 8 10 8 7 6 13 3 2 7 6 6 3 3 8 4 7 0 2 2 2 15 8 5 1 2 0 0 0 0 3 0 0 0 0 7 6 3 25 5 10 6 1 10 4 52 38 80 41 41 16 14 8 10 20 93 58 145 57 73 6 7 10 7 11 57 33 56 41 37 3 7 2 4 4 40 13 25 22 18 3 5 0 4 2 51 19 19 22 14 32 19 10 7 17 168 39 70 54 43 84 46 33 15 16 1 6 15 5 13 8 0 2 0 0 0 1 5 0 1 1 0 1 999 751 566 439 415 70 128 215 223 200 195 22 25 17 6 7 14 6 20 25 20 20 8 1 079 767 520 495 411 94 146 236 199 191 173 49 41 31 19 16 15 53 37 41 36 31 28 599 436 263 260 241 34 100 141 98 84 108 55 27 31 25 19 14 45 39 57 31 37 55 275 286 205 190 177 18 41 70 71 60 55 47 28 23 12 14 16 32 32 49 43 38 36 202 121 122 109 97 15 30 33 40 50 42 27 7 18 10 12 15 16 22 23 18 16 20 204 187 132 117 100 19 29 98 42 39 37 29 15 12 13 13 9 42 48 54 32 45 28 0 0 0 0 0 0 0 0 0 0 0 1 0 0 2 0 0 0 1 1 0 0 0 0 1 0 0 0 0 1 0 0 0 1 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 4 4 56 29 14 9 13 7 4 3 4 5 14 7 3 2 5 50 22 19 14 13 18 7 1 7 7 6 3 2 4 1 13 16 11 13 7 15 2 4 3 3 2 10 9 9 5 7 4 0 2 3 0 1 2 1 0 1 1 1 8 5 1 4 4 6 3 2 0 0 0 8 8 1 3 7 10 4 11 3 6 8 5 3 0 1 0 0 0 0 0 0 0 0 1 1 0 24 4 3 1 2 4 0 1 0 0 0 0 0 0 0 4 1 3 2 1 1 129 99 95 59 67 54 163 158 142 118 96 96 225 211 112 82 90 106 111 170 151 104 130 102 107 82 63 82 99 100 414 421 316 245 255 226 5 3 2 0 0 0 0 0 0 24 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Data for all years can be downloaded from www.who.int/tb/data 0 1 1 0 0 0 0 0 0 9 6 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 MALE:FEMALE RATIO – 2.7 1.8 2.8 2.8 – – – – 2.2 1.3 1.8 – 2.9 3.2 2.3 2.7 2.0 1.0 – – 2.0 – 1.0 – 0.74 1.8 2.1 1.6 2.0 – 2.0 1.4 2.3 2.2 1.4 2.0 2.3 1.8 1.2 1.5 – – 1.6 1.7 1.6 1.6 1.7 2.3 1.6 1.4 1.4 1.4 1.6 1.2 3.4 3.1 3.0 2.6 3.1 3.8 2.9 2.8 3.0 2.6 3.1 – – 1.6 – 3.0 – 0.25 – – 3.0 6.0 3.5 – – – – – – 1.9 0.86 2.0 1.8 2.0 2.0 2.4 2.1 2.6 1.7 1.6 2.1 1.8 1.9 0.82 – 2.2 2.4 2.2 2.6 2.5 2.6 7$%/($1HZVPHDUSRVLWLYHFDVHQRWLILFDWLRQE\DJHDQGVH[ ± Portugal Republic of Moldova Romania Russian Federation San Marino Serbia Serbia & Montenegro Slovakia Slovenia Spain Sweden Switzerland Tajikistan The Former Yugoslav Republic of Macedonia Turkey Turkmenistan Ukraine United Kingdom of Great Britain and Northern Ireland Uzbekistan FEMALE YEAR 0–14 15–24 25–34 35–44 45–54 55–64 65+ 1995 2000 2005 2010 2011 2012 1995 2000 2005 2010 2011 2012 1995 2000 2005 2010 2011 2012 1995 2000 2005 2010 2011 2012 1995 2000 2005 2010 2011 2012 2005 2010 2011 2012 1995 2000 1995 2000 2005 2010 2011 2012 1995 2000 2005 2010 2011 2012 1995 2000 2005 2010 2011 2012 1995 2000 2005 2010 2011 2012 1995 2000 2005 2010 2011 2012 1995 2000 2005 2010 2011 2012 1995 2000 2005 2010 2011 2012 1995 2000 2005 2010 2011 2012 1995 2000 2005 2010 2011 2012 1995 2000 2005 2010 2011 2012 1995 2000 2005 2010 2011 2012 1995 2000 2005 2010 2011 2012 11 8 5 3 3 1 0 2 2 0 2 0 387 46 36 21 19 17 215 147 85 55 56 56 55 52 211 119 94 99 1 662 832 752 669 623 556 363 375 227 110 87 103 115 31 337 243 257 234 2 322 1 508 1 511 865 813 764 328 349 284 199 177 187 166 36 345 244 250 256 3 608 1 799 1 786 1 336 1 192 1 297 200 208 181 152 172 153 95 13 313 248 267 284 2 587 1 684 1 999 1 293 1 104 1 053 173 140 90 70 75 79 65 13 106 113 107 131 1 751 916 952 895 837 831 164 140 93 76 74 75 15 6 31 21 21 31 784 533 638 567 541 495 1 295 526 596 402 151 54 8 15 17 2 228 1 826 1 568 6 276 5 726 5 472 5 571 5 338 5 115 5 361 4 928 4 446 2 787 2 664 2 629 920 845 839 UNKNOWN 5 0 3 1 0 0 0 0 4 0 0 0 0 0 0–14 15–24 25–34 35–44 45–54 55–64 65+ 7 5 7 3 4 6 2 1 3 6 3 3 355 53 55 40 26 22 139 114 67 54 43 52 42 16 97 47 66 58 1 352 701 758 503 475 431 172 154 109 62 58 62 38 32 92 90 79 95 1 240 766 780 477 513 433 87 87 66 54 56 66 31 45 57 46 51 48 871 484 493 400 407 371 33 41 29 36 30 28 19 23 61 47 41 56 479 341 374 275 214 188 42 25 11 10 12 19 10 14 23 23 20 26 396 207 219 172 196 184 85 64 42 28 25 32 12 6 18 20 14 25 417 321 442 438 426 435 UNKNOWN 1 0 1 0 0 0 0 0 2 0 0 0 1 43 73 74 38 31 44 28 36 31 1 247 1 139 997 2 554 2 394 2 292 1 719 1 643 1 595 1 182 1 166 1 081 745 719 637 790 752 748 6 5 5 4 11 69 66 46 46 127 76 74 59 66 167 55 46 43 38 133 49 39 30 31 83 22 34 20 35 158 149 164 129 118 275 5 0 0 0 0 0 0 0 0 0 0 0 23 16 5 1 1 2 2 7 3 4 1 0 2 90 17 9 8 6 3 3 24 9 4 5 5 3 129 22 7 9 7 4 4 11 3 6 2 4 0 64 24 5 5 2 6 6 9 4 5 4 2 1 39 33 4 6 3 1 1 5 3 4 1 1 1 34 159 54 27 11 11 13 42 20 16 3 17 9 98 10 14 15 15 0 1 1 2 0 0 1 1 0 0 2 0 142 130 142 101 10 9 10 9 12 11 13 8 6 7 6 7 252 251 249 202 13 8 15 16 9 10 20 11 11 15 13 15 151 151 161 161 5 10 12 11 10 3 9 7 8 6 2 7 63 54 75 70 5 2 5 4 2 7 1 2 3 4 4 1 24 23 30 24 4 2 3 2 2 2 2 1 1 1 2 2 108 76 100 74 14 15 13 3 3 6 15 5 4 3 2 4 2 0 0 1 26 23 31 16 2 1 2 0 1 0 225 320 314 243 32 15 17 9 14 12 185 272 229 243 30 14 13 12 9 14 151 111 104 105 20 17 10 7 6 9 89 109 100 99 11 5 7 7 3 6 43 87 105 94 17 5 5 4 1 10 53 82 114 127 17 10 13 6 11 7 0 0 0 0 50 33 25 30 2 19 3 2 699 485 409 369 15 73 100 112 474 384 385 308 146 140 101 112 243 193 195 168 0 76 72 74 175 141 117 97 47 31 46 46 166 101 121 105 25 34 27 38 213 203 212 227 0 17 8 25 0 0 0 0 21 41 314 487 380 590 327 447 182 298 185 218 280 405 11 10 348 334 741 771 603 609 388 401 230 218 380 431 0 0 1 3 2 2 1 10 62 76 60 70 108 96 70 73 72 204 118 93 74 77 317 156 116 122 98 296 112 83 112 86 350 132 109 101 77 386 0 0 0 0 4 2 0 1 0 0 1 0 0 0 0 0 22 18 6 3 7 6 2 13 3 4 4 3 2 132 44 15 13 7 8 9 39 11 10 7 9 6 337 123 31 16 18 6 17 63 36 16 10 16 4 242 108 50 25 17 20 20 36 22 15 9 12 8 150 63 16 25 17 16 12 26 14 11 6 8 6 112 152 32 20 15 13 7 27 17 14 12 5 5 228 13 6 15 10 1 0 0 1 1 0 0 0 2 0 2 0 166 139 135 112 5 9 7 10 14 8 12 5 8 6 8 3 394 306 325 259 12 10 21 28 15 16 23 17 10 12 16 18 367 291 292 299 8 12 16 8 12 8 26 10 11 9 10 8 230 286 277 276 5 11 10 5 8 9 23 7 11 6 13 6 140 146 162 156 4 4 5 5 3 8 13 6 2 5 7 5 230 184 197 220 27 25 16 13 8 13 27 6 7 8 3 11 2 1 2 3 8 12 8 8 2 5 2 0 3 0 308 398 343 346 15 8 14 6 17 16 279 366 365 320 42 14 20 19 11 14 164 214 181 169 45 20 23 24 19 12 104 129 128 124 33 19 20 24 21 19 54 93 75 75 29 20 18 12 10 15 48 74 77 72 24 14 13 11 6 13 0 0 0 0 33 23 22 20 1 16 2 1 1 148 631 550 507 11 103 148 130 1 295 779 693 655 188 185 181 212 1 028 703 608 575 0 144 146 183 963 778 696 650 79 127 97 141 534 514 482 476 30 31 51 51 429 407 412 398 0 21 13 26 10 21 385 693 1 076 1 552 2 064 2 385 1 515 2 007 1 087 1 062 437 532 8 9 539 546 1 991 2 028 2 209 2 393 1 796 1 926 881 965 377 389 8 9 7 3 8 86 135 132 137 156 130 200 169 193 184 96 166 135 137 137 87 95 108 97 118 75 95 60 69 88 138 124 108 100 88 0 0 0 0 9 14 15 19 17 95 115 110 120 109 114 163 131 129 141 60 80 81 75 81 31 39 42 45 55 31 28 40 26 17 67 83 58 49 52 1 0 0 0 6 25 8 8 10 351 596 487 378 360 749 831 574 493 506 510 723 529 453 403 346 522 479 440 449 213 263 293 306 313 107 313 297 253 273 0 0 0 11 40 22 11 9 261 538 365 335 319 547 597 512 418 367 288 375 308 233 237 213 288 248 245 201 112 217 239 293 261 111 367 350 332 322 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 7 417 0 Data for all years can be downloaded from www.who.int/tb/data 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 559 0 MALE:FEMALE RATIO 2.6 2.8 2.9 2.7 2.8 2.5 3.3 1.1 3.8 3.5 3.6 3.3 2.6 2.5 2.5 2.4 2.3 2.4 – 6.7 – 2.8 2.7 2.7 – – – – – – 1.6 1.3 1.6 1.4 1.8 – 1.9 1.8 1.8 2.7 2.6 2.3 2.1 2.5 1.8 3.0 1.8 1.9 2.6 – 2.1 1.9 1.8 2.1 1.2 1.5 1.3 1.5 1.6 1.6 2.0 1.5 1.5 1.3 1.9 1.4 – – 1.2 1.3 1.2 1.2 1.5 1.5 1.7 2.1 1.9 1.5 – – 2.7 2.5 2.4 2.5 1.3 1.6 1.8 1.8 – – 3.9 3.3 – 2.9 2.9 3.0 – 1.5 1.6 1.5 1.6 1.7 – 1.5 1.4 1.3 1.2 1.3 GLOBAL TUBERCULOSIS REPORT 2013 EUROPEAN REGION MALE 251 7$%/($ /DERUDWRULHV173VHUYLFHVGUXJPDQDJHPHQWDQGLQIHFWLRQFRQWURO LABORATORIES FREE THROUGH NTP SECONDNUMBER OF SMEAR LABS % OF SMEAR CULTURE DST b LABS LPAc LABS LABS USING LABS PER 5M LINE DST LABS USING PER 100K PER 5M PER 5M a POPULATION POPULATION POPULATION POPULATION XPERT MTB/RIF AVAILABLE LED NRLd TB NOTIF. RIFAMPICIN RATE PER USED 100 000 THROUGHOUT HEALTH-CARE TREATMENT WORKERS TB DIAGNOSIS FIRSTLINE DRUGS Yes (all suspects) Yes Yes Yes (all suspects) Yes Yes Yes (all suspects) Yes Yes Albania 0.5 0 1.6 1.6 1.6 0 Andorra 10.2 0 510.5 510.5 0 0 1.0 1.7 1.7 1.7 0 No Yes In and out Yes of country In country Yes 3.8 15.4 1.6 4.3 0.5 4.3 7 8 Yes In country Yes Yes (all suspects) Yes (all suspects) Yes Yes Yes Yes 3.6 19 Yes Yes (other criteria) Yes Yes Out of Yes country In country Yes Yes (all suspects) Yes Yes Yes (all suspects) Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes (all suspects) Yes (all suspects) Yes (all suspects) Yes (all suspects) Yes (all suspects) Yes (all suspects) Yes (all suspects) Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Out of Yes country Out of Yes country In country Yes Yes (all suspects) Yes (if TB is confirmed) Yes Yes Yes Yes Yes (all suspects) No Yes Yes (all suspects) Yes Yes In country In and out of country In country In and out of country Out of country Out of country Yes Yes (all suspects) Yes Yes 204 Yes Yes (all suspects) Yes Yes 34 Yes Yes (all suspects) Yes (if TB is confirmed) Yes Yes Yes Yes Armenia Austria Azerbaijan Belarus 0.8 2.1 0 – 4 2 Belgium 1.0 – 51.5 6.3 Bosnia and Herzegovina 0.4 100 17.0 3.9 0 0 Bulgaria Croatia Cyprus Czech Republic Denmark Estonia Finland France Georgia Germany Greece Greenland Hungary 0.5 21.3 9.6 2.7 0 21.6 0.9 7.7 10.2 18.0 2.3 11.4 8.9 0.9 7.7 0.9 5.5 1.1 5.1 8.9 0.9 7.7 2.8 1.6 2.3 4.5 2 1 20 1 141 0.1 0 – – – – 100 100 – 9 – – – 0 6.0 3.5 1 3 Iceland 0.3 100 15.3 15.3 15.3 0 Ireland 0.2 27 10.9 3.3 2.2 3 Israel Italy Kazakhstan 0.2 – – 0 12.4 1.3 0.7 1 2.9 6.8 6.8 3.4 4 Kyrgyzstan 2.2 0 10.0 2.7 1.8 7 Latvia 0.8 0 9.7 2.4 2.4 2 Lithuania 0.4 8 9.9 9.9 3.3 7 Luxembourg 0.2 100 9.5 9.5 9.5 0 Malta 0.2 0 11.7 0 0 0 0.4 0.2 0.4 0.2 0.4 0.3 0.3 Monaco Yes (all suspects) Yes Yes Yes (all suspects) Yes Yes Out of Yes country In country Yes In and out Yes of country Yes Yes Yes In and out Yes of country In country No Yes (if TB is confirmed) Yes (all suspects) Yes (if TB is confirmed) Yes Yes Yes (all suspects) Yes Yes Yes (all suspects) Yes Yes 0 14 Out of Yes country In and out Yes of country In and out Yes of country Yes In country Yes In country Yes Yes Yes No Yes Yes Yes In country Yes Yes (all suspects) Yes (all suspects) Yes (all suspects) Yes (if TB is confirmed) Yes (if TB is confirmed) Yes (all suspects) Yes Yes Yes Yes 22 Yes Yes 25 61 – 0.2 0 8.1 8.1 0 0 0.3 – 11.1 1.5 1.2 2 Norway 0.3 0 9.0 3 4 3 Poland Portugal Republic of Moldova 0.2 0.5 1.7 0 – 0 10.6 22.2 5.7 6 10.4 5.7 1.4 3 4.3 24 Romania 0.5 1 20.9 9.9 0.9 0 Russian Federation San Marino 0.7 – – 4.1 3.8 Serbia 0.3 0 15.2 2.1 0.5 0 Slovakia 0.1 14 6.4 1.8 1.8 2 Slovenia 0.1 67 7.3 2.4 2.4 1 <0.1 0.5 – – – Spain Sweden Switzerland Tajikistan The Former Yugoslav Republic of Macedonia Turkey Turkmenistan Ukraine United Kingdom of Great Britain and Northern Ireland Uzbekistan c d 2.6 14.4 2.6 6.3 2.6 1.1 4 1.9 0.6 0.6 3 0.3 0 7.1 2.4 0 0 0.5 – – 5 10.7 5.1 0.6 18 9.4 4.5 0 15 1.8 – 1.0 1 1.2 0.5 0.5 7 Out of Yes country In country Yes Yes Yes No Yes Yes (all suspects) Yes Yes Yes (all suspects) Yes (all suspects) Yes (all suspects) Yes Yes Yes Yes Yes Yes Yes (all suspects) Yes Yes Yes (all suspects) Yes Yes Yes Yes (all suspects) Yes Yes Yes Yes (all suspects) Yes Yes In country Yes Yes (all suspects) Yes Yes LED = Light emitting diode microscopes DST = Drug susceptibility testing LPA = Line probe assay NRL = National Reference Laboratory 252 107 No Montenegro b Yes 12 Yes Netherlands a In country In country In country In country In country In country 25 GLOBAL TUBERCULOSIS REPORT 2013 Data for all years can be downloaded from www.who.int/tb/data 56 51 8 34 29 D 7$%/($0HDVXUHGSHUFHQWDJHRI7%FDVHVZLWK0'57% PRVWUHFHQW\HDUDYDLODEOH Albania Andorra Armenia Austria Azerbaijan Belarus Belgium Bosnia and Herzegovina Bulgaria Croatia Cyprus Czech Republic Denmark Estonia Finland France Georgia Germany Greece Greenland Hungary Iceland Ireland Israel Italy Kazakhstan Kyrgyzstan Latvia Lithuania Luxembourg Malta Monaco Montenegro Netherlands Norway Poland Portugal Republic of Moldova Romania Russian Federation San Marino Serbia Slovakia Slovenia Spain Sweden Switzerland Tajikistan The Former Yugoslav Republic of Macedonia Turkey Turkmenistan Ukraine United Kingdom of Great Britain and Northern Ireland Uzbekistan a Previously treated TB cases Source Coverage Percentage Year Source 2012 2011 2007 2011 2007 2012 2011 2011 2012 2011 2011 2011 2011 2012 2012 2009 2012 2012 2010 Surveillance Surveillance Survey Surveillance Survey Surveillance Surveillance Surveillance Surveillance Surveillance Surveillance Surveillance Surveillance Surveillance Surveillance Surveillance Surveillance Surveillance Surveillance National National National National Sub-national National National National National National National National National National National National National National National 0.58 0 9.4 3.5 22 35 1.3 0.14 2.3 0.28 4 1.5 1.2 20 1.5 0.45 9.2 1.5 0.87 Coverage (<0.1–3.2) (0–98) (7.0–12) (1.6–6.5) (19–27) (33–37) (0.54–2.7) (0–0.79) (1.3–3.8) (<0.1–1.6) (0.10–20) (0.56–3.3) (0.24–3.4) (14–26) (0.30–4.2) (0.24–0.77) (7.9–11) (1.0–2.0) (<0.1–4.7) 2012 2011 2007 2011 2007 2012 2011 2011 2012 2011 2011 2011 2011 2012 2012 2009 2012 2012 2010 Surveillance Surveillance Survey Surveillance Survey Surveillance Surveillance Surveillance Surveillance Surveillance Surveillance Surveillance Surveillance Surveillance Surveillance Surveillance Surveillance Surveillance Surveillance National National National National Sub-national National National National National National National National National National National National National National National 0 0 43 18 56 69 11 9.8 23 2.5 0 6.3 0 50 0 13 31 10 6.7 2010 2012 2012 2012 2011 2012 2011 2012 2012 2011 2012 Surveillance Surveillance Surveillance Surveillance Surveillance Surveillance Survey Surveillance Surveillance Surveillance Surveillance National National National National Sub-national National National National National National National 2012 2012 2011 2012 2011 2012 2004 2011 Surveillance Surveillance Surveillance Surveillance Surveillance Surveillance Survey Surveillance 2012 2012 2012 2001, 2005 2012 2012 2011 Percentage (0–22) (0–98) (38–49) (2.3–52) (50–62) (66–71) (3.2–27) (2.7–23) (17–31) (<0.1–13) (0–84) (0.16–30) (0–23) (35–65) (0–23) (7.4–21) (27–35) (5.5–17) (0.17–32) 2.1 0 1.1 4.7 3.9 23 26 11 11 0 0 (1.0–3.8) (0–60) (0.13–3.8) (2.7–7.7) (2.7–5.6) (22–24) (23–30) (8.8–14) (9.5–14) (0–41) (0–25) 2010 2012 2012 2012 2011 2012 2012 2012 2012 2011 2012 Surveillance Surveillance Surveillance Surveillance Surveillance Surveillance Surveillance Surveillance Surveillance Surveillance Surveillance National National National National Sub-national National National National National National National 8.8 100 0 33 5.4 55 68 32 44 0 0 (3.6–17) (2.5–100) (0–20) (4.3–78) (3.5–8.0) (54–56) (65–72) (23–42) (39–49) (0–98) (0–98) National National National National National National National Sub-national 0 1.6 1.3 0.49 1.5 24 2.8 23 (0–6.2) (0.77–2.9) (0.27–3.8) (0.30–0.76) (0.86–2.3) (21–26) (1.8–4.2) (21–25) 2012 2012 2011 2012 2011 2012 2004 2011 Surveillance Surveillance Surveillance Surveillance Surveillance Surveillance Survey Surveillance National National National National National National National Sub-national 0 3.6 0 2.1 5.2 62 11 49 (0–52) (<0.1–18) (0–15) (1.0–3.6) (1.7–12) (59–65) (8.0–15) (44–53) Surveillance Surveillance Surveillance Surveillance Surveillance Surveillance Survey National National National Sub-national National National National 0.84 0 0 0.22 2.4 1.2 13 (0.31–1.8) (0–2.6) (0–3.2) (<0.1–0.80) (1.2–4.3) (0.25–3.5) (9.8–16) 2012 2012 2012 2001, 2005 2012 2012 2012 Surveillance Surveillance Surveillance Surveillance Surveillance Surveillance Surveillance National National National Sub-national National National National 3.6 3.7 0 7.1 8.3 13 56 (0.75–10) (<0.1–19) (0–26) (3.3–13) (1.0–27) (3.6–30) (52–60) 2012 Surveillance National 0 (0–2.4) 2012 Surveillance National 15 (4.4–35) 2012 2002 2012 Surveillance Survey Surveillance National Sub-national National 3.2 (2.7–3.7) 3.8 (1.1–9.5) 14 (14–15) 2012 2002 2012 Surveillance Survey Surveillance National Sub-national National 22 (19–25) 18 (11–27) 32 (31–33) 2011 Surveillance National 1.3 (1.0–1.7) 2011 Surveillance National 5.6 (3.0–9.3) 2011 Survey National 23 (18–29) 2011 Survey National 62 (52–71) EUROPEAN REGION New TB cases Year Empty rows indicate an absence of high-quality survey or surveillance data. In the absence of high-quality national data, high-quality sub-national data are used. Data for all years can be downloaded from www.who.int/tb/data GLOBAL TUBERCULOSIS REPORT 2013 253 5176*'#56#5+#4')+10 Table A4.1 Estimates of the burden of disease caused by TB, 1990–2012 257 6CDNG# +PEKFGPEGPQVKßECVKQPCPFECUGFGVGEVKQPTCVGUCNNHQTOU¿ 6CDNG# %CUGPQVKßECVKQPU¿ Table A4.4 Treatment outcomes, new smear-positive cases, 1995–2011 260 Table A4.5 Treatment outcomes, retreatment cases, 1995–2011 261 6CDNG# *+8VGUVKPICPFRTQXKUKQPQH%26#46CPF+26¿ 6CDNG# 6GUVKPIHQT/&46$CPFPWODGTQHEQPßTOGFECUGUQH/&46$¿ 6CDNG# 0GYUOGCTRQUKVKXGECUGPQVKßECVKQPD[CIGCPFUGZ¿ Table A4.9 Laboratories, NTP services, drug management and infection control, 2012 265 6CDNG# /GCUWTGFRGTEGPVCIGQH6$ECUGUYKVJ/&46$OQUVTGEGPV[GCTCXCKNCDNG Estimates of mortality, prevalence and incidence Estimated values are shown as best estimates followed by lower and upper bounds. The lower and upper bounds are defined as the 2.5th and 97.5th centiles of outcome distributions produced in simulations. See ANNEX 1 for further details. Estimated numbers are shown rounded to two significant figures. Estimated rates are shown rounded to three significant figures unless the value is under 100, in which case rates are shown rounded to two significant figures. Estimates for all years are recalculated as new information becomes available and techniques are refined, so they may differ from those published in previous reports in this series. The main updates implemented in this report are explained in Box 2.1 of Chapter 2. Estimates published in previous global TB control reports should no longer be used. Data source Data shown in this annex are taken from the WHO global TB database on 1 October 2013. Data shown in the main part of the report were taken from the database in July 2013. As a result, data in this annex may differ slightly from those in the main part of the report. Data for all years can be downloaded from www.who.int/tb/data. Country notes Bangladesh Estimates of TB disease burden have not been officially approved by the national TB programme (NTP) in Bangladesh. A joint reassessment by WHO and the NTP will be undertaken following the completion of the prevalence survey planned for 2014. India Estimates of TB disease burden for India have not yet been officially approved by the Ministry of Health & Family Welfare, Government of India and should therefore be considered provisional. 256 GLOBAL TUBERCULOSIS REPORT 2013 Data for all years can be downloaded from www.who.int/tb/data 7$%/($(VWLPDWHVRIWKHEXUGHQRIGLVHDVHFDXVHGE\7% ± Bangladesh Bhutan Democratic People's Republic of Korea India Indonesia Maldives Myanmar Nepal Sri Lanka Thailand Timor-Leste a 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 2005 2010 2011 2012 POPULATION (MILLIONS) 107 120 132 143 151 153 155 <1 <1 <1 <1 <1 <1 <1 20 22 23 24 25 25 25 869 956 1 042 1 127 1 206 1 221 1 237 179 194 209 224 241 244 247 <1 <1 <1 <1 <1 <1 <1 42 45 48 50 52 52 53 18 21 23 25 27 27 27 17 18 19 20 21 21 21 57 59 62 66 66 67 67 <1 1 1 1 NUMBER (THOUSANDS) 66 72 77 74 69 70 70 1 0.55 0.41 0.35 0.11 0.11 0.1 4.7 4.6 4 3 2.5 2.5 2.2 330 370 400 400 320 300 270 95 120 120 84 67 67 67 0.059 0.033 0.015 <0.01 <0.01 <0.01 <0.01 48 53 51 35 26 26 25 7.5 6.1 5 4.9 5.3 5.4 5.5 1.3 1.6 1.9 1.4 0.59 0.41 0.24 11 11 20 15 10 9.5 9.2 0.67 0.62 0.67 0.82 (20–140) (27–140) (29–150) (29–140) (28–130) (28–130) (29–130) (0.410–2.0) (0.230–1.0) (0.180–0.740) (0.160–0.600) (0.068–0.160) (0.068–0.160) (0.062–0.150) (4.3–5.0) (4.2–5.0) (3.7–4.3) (2.7–3.2) (2.3–2.6) (2.4–2.6) (2.1–2.4) (220–480) (240–520) (260–570) (290–530) (210–460) (190–420) (170–390) (33–190) (42–230) (42–220) (34–160) (30–120) (30–120) (30–120) (0.052–0.067) (0.027–0.040) (0.010–0.019) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (17–97) (19–110) (19–100) (15–65) (12–46) (12–45) (12–44) (2.2–16) (2.5–11) (2.2–8.9) (2.1–8.9) (2.4–9.4) (2.4–9.6) (2.5–9.8) (0.750–2.0) (0.970–2.5) (1.1–2.8) (1.0–1.8) (0.480–0.710) (0.330–0.500) (0.180–0.310) (4.9–20) (4.7–20) (7.9–37) (6.6–27) (4.5–18) (4.1–17) (3.8–17) (0.290–1.2) (0.280–1.1) (0.300–1.2) (0.360–1.5) RATEa 61 60 58 52 46 46 45 194 109 73 53 15 15 14 23 21 17 12 10 10 9 38 38 39 36 27 24 22 53 61 55 38 28 27 27 27 14 5.4 2 2.3 1.9 2 115 118 106 70 51 49 48 41 29 21 20 20 20 20 7.5 9 10 6.9 2.8 2 1.1 20 19 31 23 16 14 14 67 57 62 74 (18–130) (22–116) (22–111) (20–98) (19–85) (19–84) (19–84) (77–365) (45–200) (31–132) (25–92) (9.5–22) (9.4–22) (8.4–21) (21–25) (19–23) (16–19) (12–13) (9.5–11) (9.6–11) (8.6–9.5) (25–55) (25–55) (25–55) (26–47) (17–38) (16–35) (14–32) (18–106) (21–120) (20–107) (15–70) (12–50) (12–49) (12–48) (24–31) (11–17) (3.8–7.1) (1.6–2.5) (2.0–2.5) (1.7–2.1) (1.8–2.2) (39–230) (41–234) (39–207) (29–129) (23–89) (23–86) (23–84) (12–88) (12–54) (9.4–38) (8.4–35) (8.8–35) (8.8–35) (9.0–36) (4.3–12) (5.3–14) (6.0–15) (5.2–8.8) (2.3–3.4) (1.6–2.4) (0.84–1.4) (8.6–35) (8.0–34) (13–59) (10–42) (6.8–28) (6.2–26) (5.8–25) (29–121) (26–102) (28–109) (33–132) PREVALENCE (INCLUDING HIV) NUMBER (THOUSANDS) 560 620 670 670 660 660 670 10 6 4.3 3.5 2.2 2 1.7 97 100 110 110 120 120 130 4 000 4 400 4 600 4 100 3 200 3 000 2 800 790 940 990 830 740 730 730 0.67 0.48 0.22 0.23 0.17 0.14 0.22 380 400 400 320 270 260 260 66 61 58 59 64 64 66 20 23 22 22 22 23 23 130 130 180 150 120 110 110 7.2 7.2 7.6 8.4 (220–1 100) (290–1 100) (320–1 100) (330–1 100) (330–1 100) (340–1 100) (340–1 100) (4.7–17) (3.0–10) (2.2–6.9) (1.8–5.7) (1.1–3.8) (0.840–3.5) (0.580–3.3) (26–210) (28–230) (30–240) (31–250) (33–270) (34–270) (34–280) (3 600–4 500) (4 000–5 000) (4 000–5 200) (3 300–5 000) (2 200–4 500) (2 100–4 200) (1 900–3 900) (330–1 400) (400–1 700) (460–1 700) (410–1 400) (360–1 300) (350–1 200) (350–1 200) (0.260–1.3) (0.230–0.820) (0.082–0.430) (0.100–0.410) (0.065–0.310) (0.051–0.280) (0.100–0.380) (170–650) (190–680) (200–670) (170–530) (210–340) (200–330) (200–320) (25–130) (30–100) (26–100) (26–110) (28–110) (28–110) (29–120) (7.4–40) (11–38) (11–36) (10–37) (11–38) (11–39) (11–39) (63–220) (64–210) (86–300) (77–260) (55–210) (51–200) (47–190) (3.1–13) (2.8–14) (3.1–14) (3.8–15) RATEa 525 518 507 469 437 435 434 1 860 1 180 754 536 313 269 225 479 479 479 479 494 505 511 465 465 438 365 269 249 230 442 483 474 369 306 301 297 311 197 81 78 51 43 65 894 881 831 647 525 506 489 364 295 248 235 238 236 241 118 125 115 108 108 108 109 227 217 286 236 179 168 159 722 666 689 758 (202–998) (244–893) (243–866) (231–790) (220–727) (220–722) (218–721) (881–3 190) (599–1 960) (392–1 230) (279–875) (149–536) (115–486) (79–446) (130–1 050) (130–1 050) (130–1 050) (130–1 050) (134–1 080) (137–1 110) (139–1 120) (415–518) (414–519) (382–498) (295–443) (181–374) (168–346) (155–319) (186–806) (205–878) (222–821) (183–621) (148–521) (145–512) (144–506) (119–593) (95–336) (30–157) (34–138) (20–96) (15–85) (30–113) (414–1 550) (421–1 500) (415–1 390) (333–1 060) (404–661) (390–637) (377–616) (140–692) (147–493) (113–436) (101–424) (105–425) (103–423) (106–429) (43–231) (63–207) (57–192) (52–185) (52–184) (52–184) (52–185) (111–383) (109–362) (139–487) (117–395) (83–309) (76–296) (71–282) (306–1 310) (259–1 260) (279–1 280) (342–1 340) INCIDENCE (INCLUDING HIV) NUMBER (THOUSANDS) 240 270 300 320 340 340 350 4.2 2.9 2.3 1.9 1.5 1.4 1.3 77 83 87 91 97 100 100 1 900 2 100 2 300 2 400 2 200 2 200 2 200 370 400 430 450 450 460 460 0.32 0.29 0.17 0.15 0.12 0.11 0.14 170 180 200 200 200 200 200 30 34 38 41 44 44 45 11 12 12 13 14 14 14 78 77 110 100 85 82 80 5 5.4 5.5 5.6 (150–360) (220–320) (240–360) (260–390) (280–410) (280–410) (290–410) (3.6–4.8) (2.5–3.3) (1.9–2.6) (1.6–2.2) (1.3–1.7) (1.2–1.6) (1.1–1.5) (44–120) (48–130) (50–140) (52–140) (85–110) (92–110) (92–110) (1 600–2 200) (1 800–2 300) (2 000–2 500) (2 100–2 600) (2 000–2 500) (2 000–2 400) (2 000–2 400) (270–480) (310–500) (340–520) (360–540) (380–540) (380–540) (380–540) (0.200–0.480) (0.230–0.350) (0.130–0.200) (0.120–0.180) (0.097–0.140) (0.088–0.130) (0.110–0.170) (120–220) (140–230) (160–240) (170–240) (170–230) (170–230) (170–230) (18–44) (27–40) (31–45) (34–50) (36–52) (37–53) (37–53) (7.2–17) (9.9–14) (10–15) (11–16) (11–16) (11–17) (12–17) (65–93) (63–91) (88–130) (84–120) (70–100) (68–98) (66–95) (4.0–6.0) (4.4–6.4) (4.5–6.5) (4.6–6.6) RATEa 225 225 225 225 225 225 225 784 561 402 287 206 192 180 383 383 383 383 395 404 409 216 216 216 209 185 181 176 206 205 204 199 189 187 185 150 118 60 51 36 33 41 393 404 412 403 384 381 377 163 163 163 163 163 163 163 66 66 66 66 66 66 66 138 130 171 154 128 124 119 498 498 498 498 (139–331) (184–270) (184–270) (184–270) (185–268) (185–268) (185–268) (673–903) (482–646) (345–463) (247–331) (177–237) (165–222) (154–207) (219–592) (219–592) (219–592) (219–592) (348–445) (372–437) (373–447) (182–254) (189–245) (195–239) (188–231) (167–204) (163–199) (159–193) (149–271) (159–256) (164–249) (160–242) (156–224) (155–222) (153–220) (92–221) (96–142) (49–73) (42–62) (30–44) (27–39) (33–49) (290–512) (314–505) (333–498) (340–472) (329–444) (326–439) (322–435) (101–241) (133–196) (133–196) (133–196) (135–194) (135–194) (135–195) (42–96) (54–79) (54–79) (54–79) (55–79) (55–79) (55–79) (114–164) (107–154) (141–203) (127–184) (106–153) (102–147) (98–142) (406–601) (409–596) (409–596) (409–596) SOUTH-EAST ASIA REGION MORTALITY (EXCLUDING HIV) YEAR Rates are per 100 000 population. Data for all years can be downloaded from www.who.int/tb/data GLOBAL TUBERCULOSIS REPORT 2013 257 7$%/($,QFLGHQFHQRWLILFDWLRQDQGFDVHGHWHFWLRQUDWHVDOOIRUPV ± INCIDENCE (INCLUDING HIV) Bangladesh Bhutan Democratic People's Republic of Korea India Indonesia Maldives Myanmar Nepal Sri Lanka Thailand Timor-Leste a b YEAR POPULATION (MILLIONS) 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 2005 2010 2011 2012 107 120 132 143 151 153 155 <1 <1 <1 <1 <1 <1 <1 20 22 23 24 25 25 25 869 956 1 042 1 127 1 206 1 221 1 237 179 194 209 224 241 244 247 <1 <1 <1 <1 <1 <1 <1 42 45 48 50 52 52 53 18 21 23 25 27 27 27 17 18 19 20 21 21 21 57 59 62 66 66 67 67 <1 1 1 1 NUMBER (THOUSANDS) 240 270 300 320 340 340 350 4.2 2.9 2.3 1.9 1.5 1.4 1.3 77 83 87 91 97 100 100 1 900 2 100 2 300 2 400 2 200 2 200 2 200 370 400 430 450 450 460 460 0.32 0.29 0.17 0.15 0.12 0.11 0.14 170 180 200 200 200 200 200 30 34 38 41 44 44 45 11 12 12 13 14 14 14 78 77 110 100 85 82 80 5 5.4 5.5 5.6 (150–360) (220–320) (240–360) (260–390) (280–410) (280–410) (290–410) (3.6–4.8) (2.5–3.3) (1.9–2.6) (1.6–2.2) (1.3–1.7) (1.2–1.6) (1.1–1.5) (44–120) (48–130) (50–140) (52–140) (85–110) (92–110) (92–110) (1 600–2 200) (1 800–2 300) (2 000–2 500) (2 100–2 600) (2 000–2 500) (2 000–2 400) (2 000–2 400) (270–480) (310–500) (340–520) (360–540) (380–540) (380–540) (380–540) (0.200–0.480) (0.230–0.350) (0.130–0.200) (0.120–0.180) (0.097–0.140) (0.088–0.130) (0.110–0.170) (120–220) (140–230) (160–240) (170–240) (170–230) (170–230) (170–230) (18–44) (27–40) (31–45) (34–50) (36–52) (37–53) (37–53) (7.2–17) (9.9–14) (10–15) (11–16) (11–16) (11–17) (12–17) (65–93) (63–91) (88–130) (84–120) (70–100) (68–98) (66–95) (4.0–6.0) (4.4–6.4) (4.5–6.5) (4.6–6.6) INCIDENCE HIV-POSITIVE NUMBER (THOUSANDS) RATEa 225 225 225 225 225 225 225 784 561 402 287 206 192 180 383 383 383 383 395 404 409 216 216 216 209 185 181 176 206 205 204 199 189 187 185 150 118 60 51 36 33 41 393 404 412 403 384 381 377 163 163 163 163 163 163 163 66 66 66 66 66 66 66 138 130 171 154 128 124 119 498 498 498 498 (139–331) (184–270) (184–270) (184–270) (185–268) (185–268) (185–268) (673–903) (482–646) (345–463) (247–331) (177–237) (165–222) (154–207) (219–592) (219–592) (219–592) (219–592) (348–445) (372–437) (373–447) (182–254) (189–245) (195–239) (188–231) (167–204) (163–199) (159–193) (149–271) (159–256) (164–249) (160–242) (156–224) (155–222) (153–220) (92–221) (96–142) (49–73) (42–62) (30–44) (27–39) (33–49) (290–512) (314–505) (333–498) (340–472) (329–444) (326–439) (322–435) (101–241) (133–196) (133–196) (133–196) (135–194) (135–194) (135–195) (42–96) (54–79) (54–79) (54–79) (55–79) (55–79) (55–79) (114–164) (107–154) (141–203) (127–184) (106–153) (102–147) (98–142) (406–601) (409–596) (409–596) (409–596) RATEa 0.048 0.054 0.089 0.19 0.31 0.34 0.24 <0.01 <0.01 <0.01 <0.01 0.019 0.021 0.024 (0.030–0.071) (0.044–0.065) (0.073–0.11) (0.16–0.23) (0.25–0.36) (0.28–0.41) (0.20–0.29) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (0.016–0.022) (0.018–0.025) (0.021–0.028) <0.1 <0.1 <0.1 0.1 0.2 0.2 0.2 <0.1 0.2 0.4 1.2 2.6 2.9 3.3 (<0.1–<0.1) (<0.1–<0.1) (<0.1–<0.1) (0.11–0.16) (0.17–0.24) (0.18–0.27) (0.13–0.19) (<0.1–<0.1) (0.14–0.19) (0.38–0.51) (1.0–1.4) (2.3–3.0) (2.5–3.4) (2.8–3.8) 0.033 0.087 0.11 0.13 0.13 0.13 19 90 170 170 130 130 130 (0.018–0.054) (0.043–0.15) (0.054–0.18) (0.085–0.18) (0.084–0.18) (0.086–0.19) (16–22) (78–100) (150–190) (160–190) (120–150) (120–140) (120–140) 0.2 0.4 0.5 0.5 0.5 0.5 2.2 9.4 16 16 11 11 10 (<0.1–0.25) (0.19–0.65) (0.23–0.77) (0.34–0.72) (0.34–0.75) (0.35–0.76) (1.8–2.6) (8.2–11) (14–18) (14–17) (10–12) (9.6–12) (9.4–12) 0.085 1.7 5.7 6.7 7.5 <0.01 <0.01 <0.01 <0.01 <0.01 <0.01 <0.01 0.9 6.2 15 22 21 20 19 <0.01 0.081 0.52 1.4 1.5 1.4 1.1 <0.01 <0.01 <0.01 0.011 0.014 0.015 0.017 2.4 12 25 19 13 13 12 (0.068–0.10) (1.3–2.1) (4.3–7.3) (5.0–8.5) (5.6–9.7) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (0.66–1.2) (4.8–7.7) (12–18) (18–25) (18–24) (17–23) (16–21) (<0.01–0.013) (0.066–0.097) (0.42–0.62) (1.1–1.6) (1.2–1.7) (1.1–1.7) (0.94–1.4) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–0.013) (0.011–0.016) (0.012–0.019) (0.014–0.020) (2.0–2.9) (9.7–14) (21–30) (16–23) (11–16) (11–15) (10–14) <0.1 0.8 2.4 2.7 3.1 0.2 0.3 0.1 <0.1 <0.1 <0.1 <0.1 2.1 14 30 43 40 38 35 <0.1 0.4 2.2 5.4 5.4 5.1 4.2 <0.1 <0.1 <0.1 <0.1 <0.1 <0.1 <0.1 4.3 20 40 29 20 19 18 (<0.1–<0.1) (0.59–0.94) (1.8–3.0) (2.1–3.5) (2.3–3.9) (0.10–0.43) (0.13–0.40) (<0.1–0.21) (<0.1–0.15) (<0.1–0.10) (<0.1–<0.1) (<0.1–<0.1) (1.6–2.8) (11–17) (24–36) (36–50) (34–46) (32–43) (30–41) (<0.1–<0.1) (0.32–0.47) (1.8–2.7) (4.4–6.5) (4.5–6.5) (4.2–6.1) (3.4–5.0) (<0.1–<0.1) (<0.1–<0.1) (<0.1–<0.1) (<0.1–<0.1) (<0.1–<0.1) (<0.1–<0.1) (<0.1–0.10) (3.5–5.1) (16–24) (33–48) (24–35) (17–24) (16–23) (15–22) NOTIFIED NEW AND RELAPSE b PERCENT 48 673 56 437 75 557 123 118 153 892 154 358 168 683 1 154 1 299 1 140 1 007 1 311 1 235 1 130 45 47 57 86 102 101 109 215 255 202 155 183 169 152 20 21 25 38 45 45 49 27 45 50 54 89 88 85 (14–33) (17–26) (21–31) (32–47) (38–55) (38–55) (41–59) (24–32) (39–53) (44–59) (47–63) (77–100) (76–100) (73–99) 34 131 42 722 84 648 91 433 91 885 1 519 182 1 218 183 1 115 718 1 156 248 1 339 866 1 323 949 1 289 836 74 470 35 529 84 591 254 601 300 659 318 949 328 824 152 231 132 122 95 87 110 12 416 18 229 30 840 107 009 131 590 136 737 141 170 10 142 19 804 29 519 33 448 35 114 35 434 35 195 6 666 5 956 8 413 9 451 9 934 10 181 9 155 46 510 45 428 34 187 57 895 67 128 65 824 60 304 3 767 149 179 345 371 371 175 127 107 103 111 108 104 42 18 40 113 125 131 133 70 94 48 41 29 26 33 29 40 64 213 253 261 267 56 96 127 132 131 130 128 38 33 45 47 48 49 43 82 77 55 88 101 99 90 378 39 47 87 92 91 81 59 49 49 60 60 59 20 8.9 20 57 66 70 72 47 80 80 80 80 80 80 7.5 10 15 53 66 69 71 34 59 78 81 80 80 78 58 49 67 72 72 73 66 60 59 32 57 79 80 76 76 (25–68) (30–82) (78–99) (85–100) (83–100) (69–96) (52–67) (45–55) (44–55) (54–66) (54–66) (54–66) (15–28) (7.1–12) (16–25) (47–71) (56–80) (59–85) (61–87) (32–76) (66–98) (66–98) (66–98) (66–98) (66–98) (66–98) (5.8–10) (8.0–13) (13–19) (45–63) (57–77) (59–80) (62–83) (23–56) (49–72) (65–95) (67–99) (67–97) (67–97) (66–95) (40–92) (41–60) (56–83) (60–88) (61–88) (62–89) (55–80) (50–72) (50–72) (27–39) (48–69) (66–95) (67–97) (64–92) (63–93) 4 386 3 828 400 344 80 (67–98) 69 (58–84) Rates are per 100 000 population. NOTIFIED NEW AND RELAPSE includes cases for which the treatment history is unknown. GLOBAL TUBERCULOSIS REPORT 2013 CASE DETECTION RATEa NUMBER Data for all years can be downloaded from www.who.int/tb/data 7$%/($&DVHQRWLILFDWLRQV ± YEAR Bangladesh • 45 109 • Bhutan • 215 152 • Democratic People's Republic of Korea •0 371 • India • 175 104 • Indonesia • 42 133 • Maldives • 70 33 • Myanmar • 29 267 • Nepal • 56 128 • Sri Lanka • 38 43 • Thailand • 82 90 • Timor-Leste 344 • a b 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 2005 2010 2011 2012 NEW AND b RELAPSE 48 673 56 437 75 557 123 118 153 892 154 358 168 683 1 154 1 299 1 140 1 007 1 311 1 235 1 130 34 131 42 722 84 648 91 433 91 885 1 519 182 1 218 183 1 115 718 1 156 248 1 339 866 1 323 949 1 289 836 74 470 35 529 84 591 254 601 300 659 318 949 328 824 152 231 132 122 95 87 110 12 416 18 229 30 840 107 009 131 590 136 737 141 170 10 142 19 804 29 519 33 448 35 114 35 434 35 195 6 666 5 956 8 413 9 451 9 934 10 181 9 155 46 510 45 428 34 187 57 895 67 128 65 824 60 304 3 767 4 386 3 828 NEW CASES % SMEARRE-TREAT EXCL. TOTAL SMEAR- SMEAR-NEGATIVE/ EXTRAHISTORY POS AMONG OTHER RELAPSE POSITIVE UNKNOWN PULMONARY RELAPSE RETREAT UNKNOWN NEW PULM 20 524 38 484 84 848 105 772 98 948 106 790 19 297 29 396 23 076 21 625 21 921 24 451 2 060 5 914 11 318 23 506 27 329 30 549 367 347 308 457 382 420 657 430 272 275 225 127 265 363 387 518 573 519 16 440 17 796 31 240 31 279 31 904 13 801 18 123 36 285 37 457 35 959 3 787 5 381 13 715 16 828 17 321 264 515 349 374 508 890 630 165 642 321 629 589 880 589 650 345 399 066 366 381 340 203 317 616 68 979 98 006 171 838 231 121 226 965 234 029 31 768 52 338 158 640 183 366 197 797 202 319 34 15 035 85 373 101 247 101 750 104 866 0 833 6 142 11 659 14 054 15 697 114 65 66 41 47 52 89 31 23 20 12 17 18 32 29 33 28 41 8 681 17 254 36 541 42 318 42 324 42 909 7 058 8 659 35 601 56 840 62 038 73 042 653 2 304 30 252 27 976 27 769 20 661 8 591 13 683 14 617 15 569 15 000 15 057 2 769 3 049 4 314 4 868 4 635 4 490 4 269 7 938 9 074 9 474 9 718 9 662 9 128 3 241 1 677 2 261 2 198 2 145 2 405 1 889 2 489 4 955 7 013 7 210 7 484 7 865 656 982 1 561 1 917 2 548 2 612 2 349 20 273 17 754 29 762 33 450 33 169 30 998 1 035 22 606 12 439 18 837 20 927 20 726 17 537 2 142 1 419 2 953 7 501 10 135 10 014 8 852 554 1 610 1 545 2 401 1 823 337 420 729 1 763 3 876 2 989 2 701 3 065 4 806 4 665 4 936 729 1 763 3 876 7 795 7 366 8 001 10 36 40 61 55 64 11 21 15 15 10 36 51 82 70 79 103 1 364 3 408 5 869 6 701 7 752 11 650 7 638 7 514 103 9 116 15 058 13 507 14 215 690 17 993 75 073 110 691 112 508 106 463 80 072 148 580 182 281 191 923 177 749 690 98 065 223 653 292 972 304 431 284 212 106 1 448 4 446 4 387 5 348 5 942 2 202 2 359 2 600 106 1 448 4 446 6 589 7 707 8 542 0 0 0 0 10 4 4 1 0 0 0 1 2 1 1 10 4 5 3 1 1 0 0 0 0 0 1 837 2 623 4 615 4 456 4 606 4 558 982 5 813 6 403 6 979 1 837 2 623 5 597 10 269 11 009 11 537 0 0 0 926 865 786 1 807 2 344 2 617 2 362 2 280 629 495 520 440 786 1 807 2 973 3 112 2 882 2 720 0 0 0 0 0 0 0 248 277 266 219 248 245 372 244 161 147 188 248 649 510 380 395 433 202 387 426 403 1 130 1 041 1 795 1 885 1 915 1 887 36 1 111 1 852 904 16 1 130 1 041 1 795 2 996 3 767 2 791 52 38 40 31 9 69 49 0 0 0 0 0 58 1 381 1 508 1 952 2 139 0 0 0 0 0 0 3 459 3 828 0 0 0 0 731 0 1 030 0 – 52 57 79 83 82 81 – 36 45 53 62 63 77 – – 54 50 46 46 47 – 23 35 56 63 65 66 – 100 78 65 64 66 66 – 56 68 74 67 80 75 – 55 67 51 43 41 37 – 52 60 61 62 61 62 46 65 66 69 68 65 69 – 47 59 61 62 62 64 33 – 40 46 SOUTH-EAST ASIA REGION NEW AND RELAPSE NOTIFICATION RATEa 1990–2012 Rates are per 100 000 population. NEW AND RELAPSE includes cases for which the treatment history is unknown. Data for all years can be downloaded from www.who.int/tb/data GLOBAL TUBERCULOSIS REPORT 2013 259 7$%/($7UHDWPHQWRXWFRPHVQHZVPHDUSRVLWLYHFDVHV ± % OF COHORT TREATMENT SUCCESS (%)a 1995–2011 Bangladesh • 71 92 • • 97 91 • Bhutan Democratic People's Republic of Korea •0 90 • • 25 88 • • 91 90 • • 97 81 • • 67 86 • • 73 90 • • 79 87 • • 64 85 • India Indonesia Maldives Myanmar Nepal Sri Lanka Thailand Timor-Leste 91 • a YEAR 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 2005 2009 2010 2011 NUMBER NOTIFIED SIZE OF COHORT 20 524 38 484 84 848 109 402 105 772 98 948 367 347 308 434 457 382 10 867 38 484 84 848 109 075 105 659 98 932 433 347 340 434 454 381 16 440 17 796 29 366 31 240 31 279 264 515 349 374 508 890 624 617 630 165 642 321 31 768 52 338 158 640 169 213 183 366 197 797 114 65 66 45 41 47 8 681 17 254 36 541 41 357 42 318 42 324 8 591 13 683 14 617 15 442 15 569 15 000 3 049 4 314 4 868 4 764 4 635 4 490 20 273 17 754 29 762 32 810 33 450 33 169 1 035 1 206 14 571 17 796 29 366 31 240 31 279 264 722 349 328 507 204 624 617 630 165 642 321 3 018 52 338 158 640 169 213 183 366 197 797 114 59 70 45 44 48 7 872 16 792 36 652 41 811 42 200 42 310 8 053 12 992 14 617 15 468 15 569 15 000 3 058 4 314 4 841 4 754 4 635 4 490 20 273 23 061 29 919 27 597 30 317 30 711 1 035 1 610 1 530 1 610 COHORT AS % NOTIFIED 53 100 100 100 100 100 118 100 110 100 99 100 – 89 100 100 100 100 100 100 100 100 100 100 10 100 100 100 100 100 100 91 106 100 107 102 91 97 100 101 100 100 94 95 100 100 100 100 100 100 99 100 100 100 100 130 101 84 91 93 100 – – 100 CURED COMPLETED DEFAULTED NOT EVALUATED 66 77 91 91 90 91 78 75 84 86 87 88 5 4 1 1 1 1 20 15 7 6 3 3 5 4 4 4 4 4 0 4 5 3 3 3 2 1 1 1 1 1 0 3 3 3 3 5 10 9 2 2 2 2 1 3 1 2 1 1 12 5 2 2 2 2 1 0 0 0 2 1 73 84 85 86 87 1 31 83 85 85 85 73 70 83 84 84 84 96 97 86 47 82 81 53 73 77 77 77 77 56 79 87 87 88 88 75 75 83 83 83 83 36 65 70 81 79 79 61 9 5 5 4 3 25 4 2 2 3 3 18 17 8 7 7 6 2 0 0 0 0 0 14 9 7 8 8 9 17 5 1 3 2 2 4 4 3 3 4 3 28 3 5 5 6 6 21 3 2 2 3 3 0 1 5 4 4 4 2 2 2 2 2 2 3 2 6 2 9 2 4 5 6 6 5 5 3 5 5 4 3 4 3 4 5 6 7 5 2 8 8 7 7 7 5 7 4 4 4 4 0 1 2 2 2 2 0 1 1 1 1 1 0 0 0 2 2 0 4 2 3 3 3 3 2 1 1 1 1 1 0 1 1 2 1 1 0 2 2 1 2 1 1 5 2 2 2 2 0 7 7 6 6 5 6 4 4 4 4 4 0 0 3 4 0 0 18 9 5 5 4 4 18 7 3 3 3 3 13 15 6 4 4 5 9 7 7 3 3 3 11 3 2 2 1 1 75 57 1 1 1 1 1 5 2 2 3 3 0 2 6 44 7 17 7 2 2 2 2 2 6 2 2 2 3 2 4 2 1 3 1 2 24 15 9 2 2 3 2 80 86 8 5 4 3 1 0 4 3 4 2 DIED FAILED TREATMENT SUCCESS = percent cured + percent completed then rounded to the nearest digit. 260 GLOBAL TUBERCULOSIS REPORT 2013 Data for all years can be downloaded from www.who.int/tb/data 7$%/($7UHDWPHQWRXWFRPHVUHWUHDWPHQWFDVHV ± Bangladesh • 75 82 • Bhutan • 59 76 • Democratic People's Republic of Korea •0 84 • • 70 75 • • 32 71 • India Indonesia Maldives •0 0• Myanmar • 64 72 • Nepal •0 85 • Sri Lanka •0 75 • Thailand •0 69 • Timor-Leste 77 • a YEAR 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 2005 2009 2010 2011 NUMBER NOTIFIED SIZE OF COHORT 729 1 763 3 876 4 099 7 795 7 366 10 36 51 76 82 70 1 179 1 815 3 876 6 637 7 814 7 369 22 103 9 116 14 576 15 058 13 507 690 98 065 223 653 289 756 292 972 304 431 106 1 448 4 446 5 688 6 589 7 707 10 4 5 5 3 1 1 837 2 623 5 597 9 717 10 269 11 009 786 1 807 2 973 3 117 3 112 2 882 248 649 510 409 380 395 1 130 1 041 1 795 3 929 2 996 3 767 52 52 1 285 9 116 14 576 15 058 13 507 551 48 133 224 143 289 756 292 972 304 431 76 2 530 4 812 5 687 6 589 7 707 69 52 76 81 67 5 5 1 0 0 1 443 3 001 6 556 9 540 10 106 11 087 2 047 2 973 3 063 3 112 2 882 521 504 408 380 395 2 285 2 542 2 580 2 737 56 56 69 COHORT AS % NOTIFIED 162 103 100 162 100 100 220 – 102 100 99 96 – 1 248 100 100 100 100 80 49 100 100 100 100 72 175 108 100 100 100 – 125 100 20 0 0 79 114 117 98 98 101 – 113 100 98 100 100 – 80 99 100 100 100 – – 127 65 86 73 108 – – 100 CURED COMPLETED FAILED DEFAULTED NOT EVALUATED 71 70 73 66 47 46 50 3 2 6 16 33 36 9 5 4 4 6 5 5 0 8 2 2 2 2 2 23 11 7 5 5 5 4 14 2 14 9 6 8 7 5 65 70 78 70 10 12 6 6 6 8 1 7 8 7 7 12 2 3 5 1 10 1 2 3 75 70 74 76 77 64 55 47 45 45 43 22 50 63 53 53 53 11 6 9 8 8 6 15 24 29 30 31 9 22 15 20 20 18 2 3 2 4 5 4 7 7 7 7 7 0 3 3 4 5 5 4 12 11 8 7 3 5 4 4 4 4 0 3 4 3 3 3 2 5 2 3 2 13 16 16 13 13 12 1 7 8 12 11 11 5 4 2 2 1 9 2 1 1 2 3 67 15 7 8 8 9 100 80 0 20 0 0 0 0 0 0 0 0 0 100 55 65 58 44 41 38 8 9 14 28 32 34 4 7 10 11 11 12 4 4 6 5 5 6 19 12 7 7 7 8 9 3 5 4 3 3 73 81 82 82 83 3 2 3 3 2 4 4 6 5 5 8 6 3 3 4 7 4 4 4 3 4 3 3 4 3 44 67 66 71 69 20 5 7 6 6 6 5 8 7 8 1 2 1 2 3 26 18 13 9 9 3 3 5 4 5 52 58 55 57 96 6 10 11 12 0 12 11 12 11 2 5 5 5 5 0 7 7 7 7 2 18 9 10 8 0 77 71 9 6 2 4 4 6 7 2 13 DIED SOUTH-EAST ASIA REGION % OF COHORT TREATMENT SUCCESS (%)a 1995–2011 TREATMENT SUCCESS = percent cured + percent completed then rounded to the nearest digit. Data for all years can be downloaded from www.who.int/tb/data GLOBAL TUBERCULOSIS REPORT 2013 261 7$%/($+,9WHVWLQJDQGSURYLVLRQRI&37$57DQG,37– % OF TB PATIENTS WITH KNOWN HIV STATUS YEAR 2005–2012 Bangladesh •0 1• •0 – – – Bhutan Democratic People's Republic of Korea India •2 56 • Indonesia – 1• – 1• Maldives Myanmar •2 13 • •0 42 • – 36 • – 72 • •0 20 • Nepal Sri Lanka Thailand Timor-Leste 262 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 NUMBER OF TB % OF TB PATIENTS WITH PATIENTS WITH KNOWN HIV KNOWN HIV STATUS STATUS PATIENTS NOTIFIED (NEW AND RETREAT) 0 1.1 1.2 1.2 0 0 1 778 1 900 2 086 0 0 0 0 0 2.3 32 45 56 29 488 480 752 688 530 821 807 0.91 1.9 0.81 2 751 6 003 2 676 0 6.8 0.9 2 3.2 3.1 13 0 0 42 42 0 6 1 2 109 4 362 4 496 19 219 0 0 15 000 15 057 10 18 36 1 015 1 832 3 379 82 74 72 0 55 692 49 770 44 035 0 123 118 158 698 159 023 173 619 1 018 1 332 1 250 1 145 50 474 96 298 99 071 99 399 1 304 828 1 522 147 1 515 872 1 467 585 254 601 302 861 321 308 331 424 123 97 88 111 107 991 137 403 143 140 148 149 34 077 35 609 35 954 35 635 9 695 10 095 10 328 9 343 57 895 68 239 67 676 61 208 3 783 6.2 20 276 766 4 417 3 837 GLOBAL TUBERCULOSIS REPORT 2013 NUMBER OF HIV-POSITIVE TB PATIENTS 4 53 63 1 % OF TESTED TB PATIENTS HIV-POSITIVE 0.22 2.8 3 NUMBER OF % OF HIV% OF HIVPOSITIVE TB POSITIVE TB HIV-POSITIVE PATIENTS ON PATIENTS ON PEOPLE PROVIDED IPT ART CPT 100 100 100 0 100 100 100 0 64 0 0 0 0 6 411 41 476 44 702 44 063 22 8.6 6.5 5.4 90 91 92 57 59 59 1 106 2 547 754 40 42 28 63 67 18 29 39 29 0 0 1 611 961 900 5 161 0 100 29 22 20 27 0 50 100 100 0 31 94 80 83 1.3 1.1 0.68 100 100 0 100 71 22 100 100 0 54 100 48 8 959 7 326 5 807 16 15 13 71 75 77 54 59 62 4 4 1.4 0.52 0 55 217 2 13 21 23 0 0.37 1.4 100 100 Data for all years can be downloaded from www.who.int/tb/data 0 0 514 361 3 7 8 7$%/($7HVWLQJIRU0'57%DQGQXPEHURIFRQILUPHGFDVHVRI0'57%± a MDR-TB Bangladesh Bhutan Democratic People's Republic of Korea India Indonesia Maldives Myanmar Nepal Sri Lanka Thailand Timor-Leste a b 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 339 509 513 2 17 21 16 37 25 34 2967 4237 16588 182 383 428 0 0 0 192 690 778 229 213 354 32 11 13 5 510 492 5 2 3 NEW PULMONARY CASES ESTIMATED CASES OF MDR-TB AMONG NOTIFIED 4 200 (3 100–5 200) 25 (20–30) ESTIMATED CASES OF MDR-TB AMONG NOTIFIED 1 900 (920–3 300) 12 (8.8–15) 3 800 (3 000–4 600) 1 500 (1 100–1 900) 64 000 (49 000–79 000) 21 000 (18 000–25 000) 6 900 (5 200–8 500) 1.7 (1.3–2.1) 6 000 (4 600–7 500) 990 (660–1 300) 21 (0–43) 1 800 (1 400–2 200) 5 800 (4 300–7 700) 1.5 (1.1–1.9) NUMBER OF b BACT+VE TESTED FOR MDR-TB 71 41 2 108 48 52 0 5 2 0 0 0 4 900 (3 600–6 500) 570 (320–950) 11 (0.28–61) 126 0 188 659 839 1080 1069 800 (480–1 200) 0 82 (62–100) 74 (54–94) PREVIOUSLY TREATED CASES % OF ESTIMATED CASES OF MDR-TB AMONG NOTIFIED b BACT+VE TESTED FOR MDR-TB – – <0.1 <0.1 0.65 24 13 12 – – – – – – – – – 0 <0.1 <0.1 – 0 0 0 – – – – – 0.81 0 1.2 12 18 24 23 – – – – – – 0 – 2 300 (1 900–2 700) 13 (8.8–17) 2 300 (1 600–3 000) 43 000 (32 000–54 000) 1 000 (690–1 500) 0.16 (0.11–0.21) 1 200 (790–1 600) 420 (270–620) 9.6 (4.4–18) 960 (780–1 200) 7.9 (5.4–10) NUMBER OF % OF NOTIFIED NOTIFIED TESTED FOR TESTED FOR MDR-TB MDR-TB – 339 4.3 761 10 557 7.0 3 5.9 30 37 26 37 2 2.5 – – 43 0.32 31 0.22 – – – – – 324 4.9 695 9.0 821 9.6 – 0 0 0 0 0 0 – – – – – 193 6.2 0 0 640 24 417 82 378 99 408 100 238 55 – – – – – – 2 2.9 3 6.1 SOUTH-EAST ASIA REGION YEAR TOTAL CONFIRMED CASES OF TOTAL CONFIRMED CASES OF MDR-TB includes cases with unknown previous treatment history (i.e. not included under NEW CASES or PREVIOUSLY TREATED CASES). BACT+VE = bacteriologically positive cases. Data for all years can be downloaded from www.who.int/tb/data GLOBAL TUBERCULOSIS REPORT 2013 263 7$%/($1HZVPHDUSRVLWLYHFDVHQRWLILFDWLRQE\DJHDQGVH[ ± MALE Bangladesh Bhutan Democratic People's Republic of Korea India Indonesia Maldives Myanmar Nepal Sri Lanka Thailand Timor-Leste 264 FEMALE YEAR 0–14 15–24 25–34 35–44 45–54 55–64 65+ 1995 2000 2005 2010 2011 2012 1995 2000 2005 2010 2011 2012 1995 2000 2005 2010 2011 2012 1995 2000 2005 2010 2011 2012 1995 2000 2005 2010 2011 2012 1995 2000 2005 2010 2011 2012 1995 2000 2005 2010 2011 2012 1995 2000 2005 2010 2011 2012 1995 2000 2005 2010 2011 2012 1995 2000 2005 2010 2011 2012 2005 2010 2011 2012 29 256 524 365 309 316 2 6 1 2 6 505 3 640 8 170 10 460 9 606 9 479 42 65 47 108 88 82 983 5 643 10 443 12 535 11 616 12 021 65 41 58 50 39 56 1 001 5 750 11 423 11 409 10 152 10 837 36 30 26 25 26 30 748 4 718 11 038 12 758 11 728 12 744 35 24 23 12 14 11 648 3 667 8 476 11 176 10 746 11 843 24 12 14 26 20 17 424 2 837 7 453 11 536 11 301 12 236 11 2 12 13 19 11 293 167 447 314 293 16 1 588 3 185 4 871 4 649 4 697 6 928 1 409 2 524 2 218 2 439 334 20 963 62 620 78 278 78 096 75 502 203 1 508 2 422 4 046 4 066 4 015 391 31 090 74 678 82 757 82 762 79 594 297 2 927 2 688 4 849 5 493 5 055 287 30 829 76 870 90 440 89 706 88 111 306 2 519 2 040 4 061 4 542 4 373 216 24 230 64 843 81 210 82 921 82 356 302 1 167 1 185 2 629 2 474 2 699 123 15 308 43 038 60 766 63 625 63 814 228 651 485 1 153 1 024 1 150 68 8 534 24 726 38 442 42 443 41 322 109 846 714 787 824 1 0 0 0 0 0 42 88 132 106 120 146 15 215 16 501 17 406 17 304 28 9 9 8 12 8 713 1 459 3 401 3 043 2 923 2 898 20 906 24 645 25 429 25 460 11 10 8 6 7 6 1 423 2 636 5 877 6 578 6 182 6 263 18 401 21 090 22 353 23 057 10 2 5 0 3 2 1 401 2 781 5 888 6 688 6 319 6 469 17 847 20 977 22 885 23 751 8 5 6 4 8 4 977 2 161 4 585 5 607 5 680 5 837 13 509 17 329 19 404 20 204 10 5 6 5 1 5 677 1 235 2 557 3 632 3 954 3 945 6 390 7 910 9 089 9 554 6 3 5 6 3 4 298 836 1 764 2 308 2 500 2 626 170 148 165 245 250 10 25 9 14 12 7 59 27 44 55 38 35 8 1 904 1 946 2 110 1 914 1 906 163 266 341 268 246 243 1 191 859 1 344 1 506 1 546 1 444 136 1 763 1 685 1 832 1 755 1 756 361 459 520 539 459 420 2 936 2 570 3 814 3 695 3 650 3 277 149 1 713 1 722 1 724 1 723 1 644 519 695 724 602 585 504 2 948 2 380 4 393 5 253 5 139 4 705 116 1 491 1 806 1 856 1 732 1 708 521 793 918 884 828 799 2 434 2 117 4 003 5 042 5 140 4 867 119 1 294 1 759 1 857 1 710 1 773 365 484 657 683 653 672 2 607 1 908 2 831 3 625 3 734 3 780 52 772 820 1 126 1 180 1 203 261 360 424 448 479 456 2 346 2 213 3 407 4 189 4 080 3 863 47 14 7 199 196 177 172 137 128 114 119 99 114 146 129 GLOBAL TUBERCULOSIS REPORT 2013 UNKNOWN 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0–14 15–24 25–34 35–44 45–54 55–64 65+ 64 495 751 653 623 650 12 7 9 17 2 6 309 3 029 6 776 9 221 8 849 9 355 43 57 45 104 92 92 546 3 238 6 785 8 279 7 679 8 175 44 34 38 45 40 58 360 2 247 5 538 6 185 5 683 6 342 25 31 13 18 19 14 236 1 315 3 960 5 458 4 946 6 044 12 23 11 18 12 18 132 778 2 281 3 484 3 457 4 043 9 3 9 10 4 9 38 370 1 230 2 250 2 253 2 705 8 2 2 9 5 10 167 166 407 227 227 32 2 250 6 292 8 544 8 336 8 260 16 683 1 127 1 493 1 390 1 447 179 14 495 45 136 53 415 53 958 53 975 160 1 121 1 756 2 461 2 264 2 475 169 17 287 45 629 49 425 49 227 47 511 244 2 004 1 890 2 910 3 093 3 005 80 11 768 28 577 34 035 34 698 33 378 282 1 524 1 381 2 276 2 409 2 623 49 7 516 17 042 22 719 23 977 23 267 192 591 764 1 347 1 271 1 527 30 4 594 10 513 15 527 17 182 17 300 90 357 336 637 494 576 11 2 697 5 408 9 735 10 731 10 502 33 946 816 927 879 1 0 1 1 0 0 58 72 147 196 187 192 13 916 14 800 15 840 15 875 13 11 10 2 4 7 535 1 040 2 376 2 452 2 401 2 357 16 393 17 838 18 703 18 484 8 4 7 3 3 6 729 1 592 3 047 3 454 3 317 3 368 13 022 14 629 15 900 16 146 4 5 1 4 1 3 729 1 397 2 563 2 752 2 760 2 721 10 927 13 142 14 533 15 215 6 4 2 1 2 3 450 987 2 101 2 525 2 554 2 600 7 539 9 524 10 556 11 321 6 5 2 0 1 2 343 592 1 218 1 838 2 010 2 023 2 783 3 451 3 985 4 245 2 2 4 1 2 2 154 378 885 1 139 1 407 1 464 176 195 192 247 210 15 23 19 15 13 17 52 32 57 82 76 82 8 1 267 1 208 1 177 1 182 1 227 207 312 295 255 270 242 741 624 907 1 087 1 214 995 127 1 078 1 111 1 036 978 1 036 206 264 261 233 217 200 888 1 035 1 662 1 930 1 773 1 491 90 833 797 819 752 666 142 176 189 171 191 162 782 780 1 334 1 749 1 658 1 613 76 575 658 681 624 638 122 202 200 183 192 211 936 873 1 367 1 467 1 586 1 424 60 419 532 642 604 643 81 144 154 186 191 200 1 175 1 016 1 259 1 494 1 402 1 364 18 228 230 352 354 397 56 113 130 154 154 136 1 178 1 321 1 938 2 276 2 133 2 058 29 16 12 176 154 182 143 113 120 85 75 77 84 75 92 UNKNOWN Data for all years can be downloaded from www.who.int/tb/data 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 MALE:FEMALE RATIO 2.6 2.3 2.1 2.0 2.0 1.9 1.4 1.1 1.4 1.1 1.2 1.0 – 1.6 1.4 1.7 1.8 1.7 2.6 2.2 2.2 2.3 2.2 2.2 1.4 – 1.4 1.5 1.5 1.5 1.8 1.1 1.4 2.4 2.6 1.3 1.8 1.8 2.0 1.9 1.9 1.9 – 2.0 2.1 2.2 2.2 2.1 2.7 2.5 2.9 2.9 2.7 2.7 2.5 2.1 2.3 2.3 2.4 2.4 1.5 – 1.2 1.3 7$%/($ /DERUDWRULHV173VHUYLFHVGUXJPDQDJHPHQWDQGLQIHFWLRQFRQWURO LABORATORIES FREE THROUGH NTP SECONDNUMBER OF SMEAR LABS % OF SMEAR CULTURE DST b LABS LPAc LABS LABS USING LABS PER 5M LINE DST LABS USING PER 100K PER 5M PER 5M a POPULATION POPULATION POPULATION POPULATION XPERT MTB/RIF AVAILABLE LED NRLd 1.1 2 0.3 0.2 0.1 32 Out of Yes country Out of Yes country Out of Yes country Yes Indonesia 2.3 0 0.9 0.1 <0.1 9 In country Yes Maldives 20.7 0 14.8 0 0 0 Myanmar 0.9 14 0.2 0.2 0.2 3 Bangladesh 0.7 2 <0.1 <0.1 Bhutan 4.7 0 6.7 6.7 1.3 0 0.2 0.2 Democratic People's Republic of Korea India <0.1 12 0 0 1.9 2 0.4 0.4 1.0 0 0.7 0.2 0.2 1 9 Thailand Timor-Leste 1.6 1.6 6 – 4.9 1.3 0.9 14 1 TB DIAGNOSIS Yes (all suspects) Yes Yes (if TB is confirmed) Yes Yes Yes Yes (all suspects) Yes Yes Yes (all suspects) Yes Yes Yes (other criteria) Yes Yes Yes Yes (all suspects) Yes Yes Yes Yes (all suspects) Yes Yes Yes Yes (all suspects) Yes Yes Yes Yes (all suspects) Yes Yes Yes Yes Yes (all suspects) Yes (all suspects) Yes Yes Yes No 53 SOUTH-EAST ASIA REGION Nepal Sri Lanka Out of country In and out of country In country Out of country In country No TB NOTIF. RIFAMPICIN RATE PER USED 100 000 THROUGHOUT HEALTH-CARE TREATMENT WORKERS FIRSTLINE DRUGS a b c d LED = Light emitting diode microscopes DST = Drug susceptibility testing LPA = Line probe assay NRL = National Reference Laboratory Data for all years can be downloaded from www.who.int/tb/data GLOBAL TUBERCULOSIS REPORT 2013 265 D 7$%/($0HDVXUHGSHUFHQWDJHRI7%FDVHVZLWK0'57% PRVWUHFHQW\HDUDYDLODEOH New TB cases Bangladesh Bhutan Democratic People's Republic of Korea India Indonesia Maldives Myanmar Nepal Sri Lanka Thailand Timor-Leste a Year Source Coverage 2011 Survey National 2001, 2004, 2006, 2009 Survey 2004, 2006, 2010 Survey Sub-national Sub-national 2008 2011 2006 2006 National National National National Survey Survey Survey Survey Previously treated TB cases Percentage Year Source Coverage Percentage 1.4 (0.70–2.5) 2011 Survey National 29 (24–34) 2.2 (1.9–2.6) 1.9 (1.4–2.5) 2006, 2009 2006, 2010 Survey Survey Sub-national Sub-national 15 (11–19) 12 (8.1–17) 2008 2011 2011 2006 Survey Survey Surveillance Survey National National National National 10 15 2.2 35 4.2 2.3 0.18 1.7 (3.1–5.6) (1.3–3.8) (0–0.99) (1.0–2.6) (6.9–14) (10–23) (1.0–4.1) (28–42) Empty rows indicate an absence of high-quality survey or surveillance data. In the absence of high-quality national data, high-quality sub-national data are used. 266 GLOBAL TUBERCULOSIS REPORT 2013 Data for all years can be downloaded from www.who.int/tb/data 9'56'402#%+(+%4')+10 Table A4.1 Estimates of the burden of disease caused by TB, 1990–2012 269 6CDNG# +PEKFGPEGPQVKßECVKQPCPFECUGFGVGEVKQPTCVGUCNNHQTOU¿ 6CDNG# %CUGPQVKßECVKQPU¿ 6CDNG# 6TGCVOGPVQWVEQOGUPGYUOGCTRQUKVKXGECUGU¿ 6CDNG# 6TGCVOGPVQWVEQOGUTGVTGCVOGPVECUGU¿ 6CDNG# *+8VGUVKPICPFRTQXKUKQPQH%26#46CPF+26¿ 6CDNG# 6GUVKPIHQT/&46$CPFPWODGTQHEQPßTOGFECUGUQH/&46$¿ 6CDNG# 0GYUOGCTRQUKVKXGECUGPQVKßECVKQPD[CIGCPFUGZ¿ 6CDNG# .CDQTCVQTKGU062UGTXKEGUFTWIOCPCIGOGPVCPFKPHGEVKQPEQPVTQN 6CDNG# /GCUWTGFRGTEGPVCIGQH6$ECUGUYKVJ/&46$OQUVTGEGPV[GCTCXCKNCDNG Estimates of mortality, prevalence and incidence Estimated values are shown as best estimates followed by lower and upper bounds. The lower and upper bounds are defined as the 2.5th and 97.5th centiles of outcome distributions produced in simulations. See ANNEX 1 for further details. Estimated numbers are shown rounded to two significant figures. Estimated rates are shown rounded to three significant figures unless the value is under 100, in which case rates are shown rounded to two significant figures. Estimates for all years are recalculated as new information becomes available and techniques are refined, so they may differ from those published in previous reports in this series. The main updates implemented in this report are explained in Box 2.1 of Chapter 2. Estimates published in previous global TB control reports should no longer be used. Data source Data shown in this annex are taken from the WHO global TB database on 1 October 2013. Data shown in the main part of the report were taken from the database in July 2013. As a result, data in this annex may differ slightly from those in the main part of the report. Data for all years can be downloaded from www.who.int/tb/data. GLOBAL TUBERCULOSIS REPORT 2013 Data for all years can be downloaded from www.who.int/tb/data 7$%/($(VWLPDWHVRIWKHEXUGHQRIGLVHDVHFDXVHGE\7% ± YEAR American Samoa 1990 1995 2000 2005 2010 2011 2012 Australia 1990 1995 2000 2005 2010 2011 2012 Brunei 1990 Darussalam 1995 2000 2005 2010 2011 2012 Cambodia 1990 1995 2000 2005 2010 2011 2012 China 1990 1995 2000 2005 2010 2011 2012 China, Hong Kong 1990 SAR 1995 2000 2005 2010 2011 2012 China, Macao 1990 SAR 1995 2000 2005 2010 2011 2012 Cook Islands 1990 1995 2000 2005 2010 2011 2012 Fiji 1990 1995 2000 2005 2010 2011 2012 French Polynesia 1990 1995 2000 2005 2010 2011 2012 Guam 1990 1995 2000 2005 2010 2011 2012 Japan 1990 1995 2000 2005 2010 2011 2012 Kiribati 1990 1995 2000 2005 2010 2011 2012 Lao People's 1990 Democratic 1995 Republic 2000 2005 2010 2011 2012 Malaysia 1990 1995 2000 2005 2010 2011 2012 Marshall Islands 1990 1995 2000 2005 2010 2011 2012 a <1 <1 <1 <1 <1 <1 <1 17 18 19 21 22 23 23 <1 <1 <1 <1 <1 <1 <1 9 11 12 13 14 15 15 1 165 1 238 1 280 1 318 1 360 1 368 1 377 6 6 7 7 7 7 7 <1 <1 <1 <1 <1 <1 <1 <1 <1 <1 <1 <1 <1 <1 <1 <1 <1 <1 <1 <1 <1 <1 <1 <1 <1 <1 <1 <1 <1 <1 <1 <1 <1 <1 <1 122 124 126 127 127 127 127 <1 <1 <1 <1 <1 <1 <1 4 5 5 6 6 7 7 18 21 23 26 28 29 29 <1 <1 <1 <1 <1 <1 <1 NUMBER (THOUSANDS) <0.01 <0.01 <0.01 <0.01 <0.01 <0.01 <0.01 0.061 0.027 0.036 0.041 0.051 0.04 0.045 <0.01 <0.01 0.014 0.011 0.012 0.012 0.013 14 15 16 13 9.8 9.5 9.3 220 170 110 75 52 48 44 0.37 0.38 0.27 0.24 0.19 0.19 0.19 0.036 0.022 0.02 0.015 0.015 0.015 0.015 <0.01 <0.01 <0.01 <0.01 <0.01 <0.01 <0.01 0.051 0.039 0.03 0.022 0.016 0.015 0.015 <0.01 <0.01 <0.01 <0.01 <0.01 <0.01 <0.01 <0.01 <0.01 <0.01 <0.01 <0.01 <0.01 <0.01 3.8 3.3 2.8 2.3 2.2 2.3 2.1 0.039 0.044 0.013 0.015 0.016 0.017 0.017 1.7 1.4 1.1 0.91 0.76 0.73 0.72 1.2 1.4 1.6 1.5 1.5 1.6 1.6 0.013 0.018 0.033 0.033 0.047 0.051 0.058 (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (0.061–0.062) (0.027–0.028) (0.035–0.036) (0.041–0.042) (0.050–0.051) (0.040–0.041) (0.044–0.045) (<0.01–<0.01) (<0.01–<0.01) (0.014–0.015) (0.010–0.011) (0.012–0.013) (0.012–0.013) (0.012–0.013) (4.9–28) (5.3–29) (5.7–31) (5.1–23) (4.5–17) (4.4–17) (4.3–16) (190–240) (140–200) (84–140) (72–77) (50–53) (46–50) (43–46) (0.360–0.370) (0.380–0.380) (0.270–0.280) (0.240–0.250) (0.180–0.190) (0.180–0.190) (0.190–0.190) (0.018–0.060) (<0.01–0.050) (<0.01–0.052) (<0.01–0.051) (<0.01–0.058) (<0.01–0.059) (<0.01–0.059) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (0–<0.01) (<0.01–<0.01) (0.020–0.097) (0.018–0.069) (0.021–0.040) (0.020–0.024) (0.016–0.017) (0.015–0.016) (0.014–0.015) (<0.01–0.016) (<0.01–0.015) (<0.01–<0.01) (<0.01–0.015) (<0.01–<0.01) (<0.01–0.022) (<0.01–<0.01) (<0.01–0.012) (<0.01–0.023) (<0.01–<0.01) (<0.01–0.022) (<0.01–0.036) (<0.01–0.012) (<0.01–<0.01) (3.7–3.9) (3.2–3.3) (2.7–2.8) (2.3–2.4) (2.1–2.3) (2.2–2.3) (2.0–2.2) (0.029–0.051) (0.031–0.058) (<0.01–0.016) (0.015–0.016) (<0.01–0.025) (<0.01–0.026) (<0.01–0.026) (1.1–2.6) (0.860–2.0) (0.700–1.7) (0.560–1.3) (0.470–1.1) (0.450–1.1) (0.430–1.1) (0.370–2.5) (0.480–2.7) (0.710–2.9) (0.810–2.4) (1.0–2.2) (1.1–2.1) (1.2–2.1) (<0.01–0.062) (<0.01–0.069) (<0.01–0.070) (<0.01–0.130) (<0.01–0.200) (<0.01–0.220) (<0.01–0.240) a RATE 5.1 2.4 0.82 2.4 0.9 0.95 0.88 0.36 0.15 0.19 0.2 0.23 0.18 0.19 3 3 4.3 2.9 3 3 3 157 139 128 94 68 65 63 19 13 8.7 5.7 3.8 3.5 3.2 6.3 6.2 4 3.5 2.6 2.6 2.6 10 5.4 4.6 3.3 2.8 2.8 2.8 0.79 1.1 0.51 0.62 0.4 0.53 0.6 7 5.1 3.7 2.7 1.9 1.8 1.7 1.9 2.3 1.2 1.6 0.78 1.7 0.98 2.7 3.9 1.9 2.9 4.6 2.7 2.2 3.1 2.6 2.2 1.8 1.7 1.8 1.7 55 57 15 17 17 17 17 41 29 21 16 12 11 11 6.6 6.6 6.9 5.8 5.4 5.4 5.4 28 35 62 64 89 98 111 (2.1–9.5) (0.95–4.4) (0.35–1.5) (0.99–4.5) (0.14–2.3) (0.17–2.4) (0.23–2.0) (0.35–0.36) (0.15–0.16) (0.18–0.19) (0.20–0.20) (0.23–0.23) (0.18–0.18) (0.19–0.19) (2.9–3.2) (2.9–3.2) (4.2–4.5) (2.8–3.0) (2.9–3.2) (2.9–3.2) (2.9–3.2) (54–314) (49–274) (47–251) (38–175) (31–120) (30–114) (29–110) (17–21) (11–16) (6.5–11) (5.5–5.9) (3.7–3.9) (3.4–3.6) (3.1–3.3) (6.2–6.4) (6.1–6.2) (4.0–4.0) (3.5–3.6) (2.6–2.7) (2.6–2.7) (2.6–2.7) (5.1–17) (1.3–12) (0.74–12) (0.16–11) (<0.1–11) (<0.1–11) (<0.1–11) (0.73–0.85) (0.63–1.7) (0.26–0.84) (0.34–0.98) (0.34–0.46) (<0.1–1.9) (0.33–0.97) (2.7–13) (2.3–8.9) (2.6–4.9) (2.4–2.9) (1.9–2.0) (1.7–1.8) (1.6–1.7) (<0.1–7.8) (0.19–6.8) (0.36–2.7) (<0.1–6.1) (0.25–1.6) (0–8.0) (0.12–2.7) (<0.1–9.5) (<0.1–16) (0.22–5.3) (0–14) (<0.1–23) (0.33–7.6) (0.68–4.5) (3.0–3.2) (2.6–2.7) (2.2–2.2) (1.8–1.9) (1.7–1.8) (1.7–1.8) (1.6–1.7) (41–72) (41–76) (11–20) (16–17) (9.5–26) (9.5–26) (9.5–26) (25–60) (18–42) (13–31) (9.7–23) (7.3–17) (6.9–17) (6.5–16) (2.0–14) (2.3–13) (3.0–12) (3.2–9.1) (3.6–7.6) (3.8–7.3) (4.1–7.0) (<0.1–130) (0.72–134) (18–135) (1.3–245) (0.54–385) (0.78–414) (1.4–448) PREVALENCE (INCLUDING HIV) NUMBER (THOUSANDS) 0.022 0.011 <0.01 0.013 <0.01 <0.01 <0.01 1.7 1.7 1.7 1.6 2 1.9 2 0.2 0.21 0.55 0.23 0.4 0.36 0.37 150 180 200 160 130 120 110 2 500 2 400 2 200 1 800 1 500 1 400 1 400 9.8 8.7 8.2 9 7.7 7.3 7.7 0.6 0.55 0.65 0.66 0.64 0.59 0.65 <0.01 <0.01 <0.01 <0.01 <0.01 <0.01 <0.01 1.8 1.3 0.91 0.66 0.39 0.32 0.26 0.095 0.13 0.083 0.099 0.059 0.11 0.071 0.088 0.14 0.077 0.12 0.19 0.13 0.11 83 66 64 43 37 35 33 0.18 0.59 0.4 0.68 0.47 0.66 0.63 63 60 52 43 36 35 34 44 39 35 33 32 31 29 0.12 0.17 0.28 0.34 0.47 0.51 0.57 (0.010–0.037) (<0.01–0.019) (<0.01–0.010) (<0.01–0.023) (<0.01–0.014) (<0.01–0.014) (<0.01–0.012) (0.750–2.9) (0.740–3.0) (0.740–3.0) (0.650–3.0) (0.830–3.6) (0.740–3.5) (0.860–3.7) (0.070–0.400) (0.064–0.440) (0.270–0.930) (0.080–0.470) (0.180–0.700) (0.140–0.660) (0.140–0.700) (96–220) (130–230) (160–240) (140–190) (110–150) (100–140) (96–130) (2 300–2 700) (2 200–2 700) (1 900–2 500) (1 600–2 100) (1 300–1 700) (1 200–1 600) (1 200–1 600) (4.0–18) (3.1–17) (2.8–17) (3.8–16) (3.2–14) (3.0–14) (3.4–14) (0.290–1.0) (0.180–1.1) (0.250–1.2) (0.300–1.2) (0.280–1.1) (0.240–1.1) (0.280–1.2) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (0.890–3.0) (0.650–2.1) (0.470–1.5) (0.340–1.1) (0.200–0.640) (0.140–0.570) (0.088–0.530) (0.042–0.170) (0.048–0.240) (0.025–0.180) (0.043–0.180) (0.018–0.120) (0.052–0.190) (0.026–0.140) (0.037–0.160) (0.062–0.250) (0.028–0.150) (0.059–0.200) (0.095–0.310) (0.049–0.240) (0.036–0.220) (35–150) (26–120) (28–110) (18–79) (16–66) (15–64) (13–61) (0.080–0.310) (0.260–1.0) (0.140–0.790) (0.300–1.2) (0.160–0.930) (0.300–1.2) (0.270–1.1) (32–110) (32–95) (30–79) (26–63) (23–52) (23–50) (22–48) (23–71) (21–63) (18–56) (18–54) (15–54) (14–54) (13–53) (<0.01–0.470) (<0.01–0.550) (0.099–0.540) (0.027–1.0) (0.019–1.6) (0.022–1.7) (0.028–1.9) INCIDENCE (INCLUDING HIV) a RATE 46 21 9.4 23 11 12 11 9.7 9.4 8.7 7.8 8.8 8.2 8.8 78 71 165 64 99 87 90 1 670 1 670 1 620 1 230 875 817 764 215 195 170 140 108 104 99 169 142 120 130 110 103 108 167 137 151 141 119 108 117 12 17 7.6 7.5 6 7.4 7.2 244 165 112 80 45 37 30 48 59 35 39 22 41 26 67 96 49 74 118 78 66 68 53 51 34 29 28 26 249 770 487 747 477 664 628 1 490 1 220 961 737 565 540 514 242 189 148 129 112 107 101 251 332 532 651 903 973 1 080 (22–79) (10–37) (3.6–18) (11–38) (3.0–25) (3.2–25) (3.6–22) (4.4–17) (4.1–17) (3.9–16) (3.2–14) (3.7–16) (3.3–15) (3.7–16) (27–154) (22–150) (81–280) (22–128) (45–174) (36–162) (35–169) (1 060–2 410) (1 220–2 180) (1 310–1 960) (1 020–1 460) (737–1 020) (690–954) (645–892) (201–230) (176–216) (146–196) (121–160) (94–123) (91–119) (86–113) (69–314) (50–280) (40–243) (55–237) (46–202) (42–191) (47–195) (81–285) (45–278) (57–289) (64–249) (52–214) (44–200) (50–211) (3.4–25) (5.0–35) (2.3–16) (2.9–14) (1.8–13) (1.1–20) (2.9–14) (123–407) (84–273) (58–184) (42–131) (23–75) (16–66) (10–61) (21–85) (22–113) (10–74) (17–70) (6.6–46) (19–70) (9.4–51) (28–124) (43–170) (18–96) (37–124) (59–196) (31–148) (22–134) (29–123) (21–99) (23–91) (14–62) (12–52) (12–50) (11–48) (113–437) (347–1 360) (174–957) (335–1 320) (166–949) (298–1 170) (270–1 130) (746–2 490) (664–1 950) (557–1 470) (453–1 090) (366–807) (353–767) (335–729) (128–392) (102–303) (79–239) (68–210) (54–190) (49–186) (43–183) (3.3–1 000) (19–1 080) (190–1 040) (53–1 980) (36–3 100) (43–3 290) (54–3 560) NUMBER (THOUSANDS) 0.012 <0.01 <0.01 <0.01 <0.01 <0.01 <0.01 1.2 1.2 1.2 1.2 1.4 1.4 1.5 0.16 0.18 0.35 0.19 0.27 0.26 0.28 53 62 71 68 63 62 61 1 800 1 600 1 400 1 200 1 100 1 000 1 000 7.5 7.1 6.9 6.5 5.7 5.4 5.5 0.39 0.46 0.52 0.46 0.45 0.44 0.46 0 <0.01 <0.01 <0.01 0 <0.01 <0.01 0.81 0.6 0.44 0.33 0.24 0.23 0.21 0.068 0.1 0.071 0.072 0.047 0.074 0.058 0.066 0.099 0.062 0.072 0.12 0.094 0.078 60 50 45 31 26 25 24 0.083 0.39 0.31 0.44 0.36 0.43 0.43 21 20 18 16 14 14 14 23 22 22 22 23 23 24 0.065 0.097 0.14 0.19 0.26 0.28 0.3 (<0.01–0.015) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (1.0–1.3) (1.1–1.4) (1.1–1.4) (1.1–1.4) (1.3–1.6) (1.2–1.6) (1.3–1.7) (0.140–0.190) (0.160–0.210) (0.310–0.400) (0.160–0.210) (0.240–0.310) (0.230–0.300) (0.240–0.320) (38–69) (48–78) (56–87) (57–81) (54–72) (53–71) (52–70) (1 400–2 200) (1 300–1 900) (1 200–1 600) (1 100–1 400) (930–1 200) (900–1 200) (880–1 100) (6.6–8.5) (6.3–8.1) (6.1–7.8) (5.7–7.4) (5.0–6.4) (4.8–6.2) (4.8–6.3) (0.350–0.450) (0.410–0.520) (0.450–0.580) (0.400–0.520) (0.400–0.510) (0.380–0.490) (0.410–0.530) (0–0) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (0–0) (<0.01–<0.01) (<0.01–<0.01) (0.710–0.920) (0.530–0.680) (0.390–0.500) (0.290–0.370) (0.210–0.270) (0.200–0.260) (0.190–0.240) (0.059–0.077) (0.088–0.110) (0.062–0.081) (0.063–0.082) (0.041–0.053) (0.064–0.083) (0.050–0.065) (0.058–0.075) (0.087–0.110) (0.054–0.070) (0.063–0.082) (0.100–0.130) (0.083–0.110) (0.069–0.089) (52–67) (43–56) (40–51) (27–35) (23–30) (22–29) (21–28) (0.066–0.100) (0.310–0.460) (0.250–0.380) (0.360–0.530) (0.290–0.430) (0.350–0.520) (0.350–0.520) (13–31) (12–29) (11–26) (9.7–23) (8.8–21) (8.6–20) (8.4–20) (21–26) (20–25) (20–24) (20–24) (21–25) (21–25) (22–26) (<0.01–0.190) (0.024–0.220) (0.084–0.200) (0.050–0.420) (0.051–0.650) (0.054–0.690) (0.058–0.740) RATEa 26 12 6.9 13 7.8 7.8 7.3 6.8 6.8 6.2 5.9 6.5 6.3 6.5 64 63 106 51 68 65 68 580 578 577 510 437 424 411 153 129 109 92 78 75 73 129 116 101 94 81 77 77 110 116 120 98 85 80 83 0 13 6.5 5.9 0 5.6 5.6 112 77 54 40 28 26 24 34 47 30 28 18 27 21 50 68 40 46 73 59 48 49 40 36 25 20 20 19 116 505 372 488 366 432 429 492 403 330 270 221 213 204 127 108 95 86 82 81 80 137 190 263 363 502 536 572 (21–31) (9.4–14) (5.6–8.4) (10–15) (6.3–9.4) (6.3–9.4) (5.9–8.9) (6.0–7.7) (6.0–7.7) (5.5–7.0) (5.1–6.6) (5.7–7.3) (5.5–7.1) (5.7–7.4) (56–72) (55–71) (93–120) (45–58) (60–77) (57–74) (59–77) (423–761) (448–724) (458–710) (424–604) (376–503) (364–489) (353–474) (121–189) (106–154) (92–126) (80–105) (68–88) (66–85) (64–82) (113–146) (102–132) (89–115) (83–107) (71–91) (67–87) (68–88) (96–124) (102–131) (105–135) (86–111) (74–96) (70–91) (73–94) (0–0) (11–14) (5.7–7.3) (5.2–6.7) (0–0) (4.9–6.4) (4.9–6.3) (98–126) (68–87) (48–62) (35–45) (24–32) (23–29) (21–27) (30–39) (41–53) (26–34) (25–32) (15–20) (24–31) (18–24) (44–57) (60–77) (35–45) (40–52) (64–82) (51–66) (42–54) (43–55) (35–45) (32–41) (22–28) (18–23) (18–23) (17–22) (93–143) (410–609) (296–456) (396–588) (298–441) (351–521) (349–517) (304–725) (249–593) (204–486) (167–398) (137–326) (131–313) (126–301) (113–142) (97–120) (86–103) (79–94) (75–89) (74–88) (74–87) (14–396) (46–432) (161–389) (96–803) (97–1 230) (103–1 320) (110–1 400) WESTERN PACIFIC REGION MORTALITY (EXCLUDING HIV) POPULATION (MILLIONS) Rates are per 100 000 population. Data for all years can be downloaded from www.who.int/tb/data GLOBAL TUBERCULOSIS REPORT 2013 269 7$%/($(VWLPDWHVRIWKHEXUGHQRIGLVHDVHFDXVHGE\7% ± MORTALITY (EXCLUDING HIV) YEAR Micronesia (Federated States of) Mongolia Nauru New Caledonia New Zealand Niue Northern Mariana Islands Palau Papua New Guinea Philippines Republic of Korea Samoa Singapore Solomon Islands Tokelau Tonga a 270 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 POPULATION (MILLIONS) <1 <1 <1 <1 <1 <1 <1 2 2 2 3 3 3 3 <1 <1 <1 <1 <1 <1 <1 <1 <1 <1 <1 <1 <1 <1 3 4 4 4 4 4 4 <1 <1 <1 <1 <1 <1 <1 <1 <1 <1 <1 <1 <1 <1 <1 <1 <1 <1 <1 <1 <1 4 5 5 6 7 7 7 62 70 78 86 93 95 97 43 45 46 47 48 49 49 <1 <1 <1 <1 <1 <1 <1 3 3 4 4 5 5 5 <1 <1 <1 <1 <1 <1 <1 <1 <1 <1 <1 <1 <1 <1 <1 <1 <1 <1 <1 <1 <1 NUMBER (THOUSANDS) 0.035 0.077 0.07 0.053 0.032 0.028 0.025 0.52 0.42 0.32 0.24 0.2 0.2 0.2 <0.01 <0.01 <0.01 <0.01 <0.01 <0.01 <0.01 <0.01 <0.01 <0.01 <0.01 <0.01 <0.01 <0.01 0.019 0.021 0.012 <0.01 <0.01 <0.01 <0.01 <0.01 <0.01 <0.01 <0.01 <0.01 <0.01 <0.01 <0.01 <0.01 <0.01 <0.01 <0.01 <0.01 <0.01 <0.01 <0.01 <0.01 <0.01 <0.01 <0.01 <0.01 3.4 3 2.8 3.4 3.7 3.7 3.9 34 35 31 30 25 24 23 3.7 2.7 1.2 2.7 2.5 2.7 2.6 <0.01 <0.01 <0.01 <0.01 <0.01 <0.01 <0.01 0.12 0.13 0.12 0.082 0.097 0.087 0.089 0.22 0.2 0.17 0.13 0.09 0.085 0.082 <0.01 <0.01 <0.01 0 0 0 0 <0.01 <0.01 <0.01 <0.01 <0.01 <0.01 <0.01 (0–0.220) (0.019–0.180) (0.024–0.140) (0.016–0.110) (<0.01–0.100) (<0.01–0.098) (<0.01–0.093) (0.400–0.650) (0.300–0.560) (0.190–0.470) (0.120–0.400) (0.079–0.390) (0.077–0.390) (0.075–0.390) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–0.024) (<0.01–<0.01) (<0.01–0.034) (<0.01–<0.01) (<0.01–0.011) (<0.01–0.014) (<0.01–<0.01) (0.018–0.019) (0.021–0.021) (0.012–0.012) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–0.018) (<0.01–0.019) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (1.2–6.9) (1.0–5.9) (0.910–5.8) (1.1–6.9) (1.2–7.5) (1.2–7.6) (1.3–7.8) (26–44) (30–40) (29–34) (28–32) (24–27) (23–26) (22–25) (0.170–13) (0.044–10) (0.460–2.4) (0.040–11) (0.190–7.5) (0.120–9.1) (0.160–8.5) (<0.01–0.015) (<0.01–0.013) (<0.01–0.011) (<0.01–<0.01) (<0.01–0.010) (<0.01–0.011) (<0.01–0.011) (0.120–0.120) (0.120–0.130) (0.110–0.140) (0.071–0.094) (0.082–0.110) (0.073–0.100) (0.075–0.110) (0.063–0.480) (0.077–0.370) (0.068–0.330) (0.053–0.240) (0.039–0.160) (0.038–0.150) (0.036–0.150) (<0.01–<0.01) (0–<0.01) (<0.01–<0.01) (0–0) (0–0) (0–0) (0–0) (<0.01–0.010) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) PREVALENCE (INCLUDING HIV) NUMBER (THOUSANDS) a RATE 36 72 65 50 31 27 24 24 18 13 9.4 7.5 7.4 7.2 9.1 4.7 7.2 23 3.7 8.1 9.5 4.7 2.1 3.3 1.1 1.2 1.3 0.74 0.55 0.58 0.32 0.15 0.12 0.1 <0.1 2.9 3 3.1 1.7 1.4 19 3.1 3.1 4.4 6.9 6.3 3.2 3.6 3.5 3.4 17 26 10 23 8.8 4.4 82 63 52 55 54 53 54 55 50 40 35 27 26 24 8.7 5.9 2.7 5.8 5.1 5.6 5.4 5 4.2 3.1 2.3 3 3.1 3.2 4 3.6 3.2 1.8 1.9 1.7 1.7 71 54 42 27 17 16 15 6.4 4.9 4.1 <0.1 0 0 0 5.9 4.2 3.6 3 2.6 2.6 2.5 (0–227) (18–163) (22–130) (15–104) (1.8–100) (1.1–95) (0.62–90) (18–30) (13–24) (8.1–20) (4.6–16) (2.9–14) (2.8–14) (2.7–14) (5.0–14) (2.5–7.5) (3.5–12) (10–41) (2.3–5.4) (4.1–14) (4.4–17) (0.40–14) (0.56–4.6) (0–16) (0.13–3.1) (<0.1–4.5) (<0.1–5.5) (0.23–1.6) (0.54–0.55) (0.57–0.58) (0.31–0.32) (0.15–0.15) (0.12–0.12) (0.10–0.10) (<0.1–<0.1) (2.8–3.0) (3.0–3.1) (3.1–3.2) (1.7–1.8) (1.3–1.4) (4.7–42) (1.7–4.9) (0.91–6.5) (1.5–8.8) (0.13–26) (<0.1–30) (0.37–8.9) (0.15–13) (0.17–12) (1.0–7.1) (7.3–31) (11–48) (3.8–20) (9.0–43) (3.8–16) (2.9–6.2) (28–165) (22–125) (17–107) (18–112) (18–110) (17–109) (18–109) (42–70) (43–58) (38–43) (32–37) (25–29) (24–28) (22–26) (0.40–29) (0.10–23) (1.0–5.2) (<0.1–23) (0.40–16) (0.25–19) (0.32–17) (2.1–9.0) (1.6–7.9) (1.1–6.3) (0.98–4.1) (1.2–5.6) (1.3–5.8) (1.3–6.0) (3.8–4.1) (3.4–3.8) (2.8–3.6) (1.6–2.1) (1.6–2.2) (1.4–1.9) (1.4–2.0) (20–154) (21–103) (16–79) (11–50) (7.5–30) (7.0–28) (6.6–27) (2.0–13) (<0.1–22) (0.57–11) (0–0.10) (0–<0.1) (0–<0.1) (0–<0.1) (2.7–10) (2.0–7.3) (1.4–6.8) (1.3–5.5) (1.0–5.0) (1.0–4.9) (1.1–4.6) INCIDENCE (INCLUDING HIV) a RATE 0.45 0.68 0.6 0.47 0.33 0.32 0.28 20 14 10 8.5 9.6 10 11 0.01 <0.01 <0.01 0.022 <0.01 <0.01 <0.01 0.21 0.11 0.17 0.067 0.076 0.084 0.053 0.58 0.67 0.49 0.51 0.48 0.5 0.47 <0.01 <0.01 <0.01 <0.01 <0.01 <0.01 <0.01 0.038 0.071 0.12 0.1 0.049 0.054 0.052 <0.01 0.034 0.049 0.022 0.045 0.021 0.014 30 29 32 37 39 38 39 620 630 600 540 470 460 450 96 90 85 79 73 72 71 0.086 0.075 0.059 0.045 0.053 0.055 0.057 2.5 2.9 2.7 2.1 2.3 2.3 3.9 1.9 1.7 1.5 1.2 0.9 0.86 0.83 <0.01 <0.01 <0.01 0 (<0.01–1.9) (0.220–1.4) (0.250–1.1) (0.180–0.900) (0.045–0.870) (0.046–0.870) (0.028–0.810) (9.3–36) (7.1–24) (5.3–17) (4.1–14) (4.9–16) (5.3–16) (5.7–17) (<0.01–0.019) (<0.01–<0.01) (<0.01–0.012) (0.011–0.036) (<0.01–0.012) (<0.01–0.015) (<0.01–0.015) (0.079–0.400) (0.033–0.240) (0.080–0.280) (0.024–0.130) (0.032–0.140) (0.037–0.150) (0.016–0.110) (0.270–1.0) (0.320–1.2) (0.170–0.980) (0.200–0.950) (0.210–0.870) (0.220–0.880) (0.200–0.840) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (0.011–0.081) (0.021–0.150) (0.050–0.210) (0.052–0.180) (0.019–0.093) (0.023–0.097) (0.022–0.094) (<0.01–0.017) (0.013–0.065) (0.023–0.085) (<0.01–0.039) (0.022–0.076) (<0.01–0.039) (<0.01–0.029) (12–55) (12–54) (12–61) (14–71) (14–76) (14–76) (13–77) (480–790) (480–800) (480–740) (470–630) (410–530) (400–520) (390–500) (78–110) (74–110) (69–100) (64–94) (60–88) (59–87) (58–86) (0.037–0.160) (0.030–0.140) (0.022–0.110) (0.018–0.083) (0.025–0.092) (0.026–0.095) (0.027–0.099) (1.0–4.6) (1.2–5.4) (1.1–4.9) (0.890–3.9) (0.850–4.4) (0.770–4.6) (1.9–6.6) (0.690–3.8) (0.810–2.9) (0.710–2.6) (0.560–2.0) (0.420–1.6) (0.400–1.5) (0.380–1.5) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (0–<0.01) 464 629 560 446 314 313 270 938 625 431 335 353 364 380 111 54 72 216 55 86 91 123 59 79 29 31 33 21 17 18 13 12 11 11 10 43 45 47 26 20 170 46 86 123 172 163 91 101 97 50 197 256 110 221 100 65 715 620 586 607 568 549 541 1 000 904 775 633 502 484 461 223 202 184 167 152 149 146 53 44 34 25 29 29 30 82 84 68 47 45 44 73 619 473 364 251 171 160 151 85 54 32 0.26 0.056 0.045 0.038 0.033 0.029 0.028 0.027 (0.027–0.097) (0.019–0.081) (0.015–0.073) (0.013–0.060) (0.013–0.052) (0.013–0.049) (0.014–0.045) 59 46 39 32 28 27 26 (2.8–2 010) (203–1 290) (237–1 020) (172–848) (44–844) (44–837) (27–782) (425–1 650) (308–1 050) (221–710) (162–569) (181–580) (191–591) (204–608) (43–213) (22–99) (35–122) (109–359) (17–116) (41–147) (46–151) (47–236) (18–125) (38–134) (11–57) (13–56) (15–60) (6.2–44) (7.9–30) (8.7–31) (4.5–25) (4.9–23) (4.8–20) (5.1–20) (4.5–19) (13–91) (13–96) (14–99) (7.6–54) (6.1–43) (59–341) (14–97) (26–183) (36–261) (74–312) (81–273) (35–172) (43–182) (42–175) (12–112) (76–376) (119–444) (48–198) (108–372) (40–187) (19–138) (289–1 330) (250–1 160) (219–1 130) (230–1 160) (208–1 100) (194–1 080) (187–1 080) (768–1 270) (692–1 140) (616–953) (544–729) (441–566) (425–546) (405–520) (182–267) (166–243) (150–221) (136–201) (124–182) (121–179) (119–175) (23–96) (18–81) (12–65) (10–46) (13–50) (14–51) (14–52) (33–152) (35–154) (29–125) (20–86) (17–86) (15–88) (35–125) (222–1 210) (225–810) (173–624) (120–429) (79–297) (74–279) (70–264) (24–185) (2.4–185) (5.3–82) (<0.1–0.54) (28–102) (20–84) (15–74) (13–60) (13–50) (12–47) (13–43) NUMBER (THOUSANDS) 0.36 0.35 0.3 0.25 0.21 0.21 0.2 8.8 7.2 6.1 5.7 6.1 6.1 6.2 <0.01 <0.01 <0.01 0.013 <0.01 <0.01 <0.01 0.16 0.1 0.11 0.054 0.056 0.06 0.044 0.4 0.45 0.4 0.38 0.35 0.35 0.34 0 0 0 0 0 <0.01 <0.01 0.032 0.055 0.086 0.066 0.037 0.038 0.037 <0.01 0.025 0.03 0.013 0.024 0.015 <0.01 13 15 19 22 24 24 25 240 250 260 260 260 260 260 73 48 25 49 51 53 53 0.059 0.051 0.041 0.032 0.031 0.032 0.033 1.8 2.2 2 1.6 1.8 1.9 2.6 0.97 0.86 0.76 0.67 0.57 0.55 0.54 <0.01 <0.01 <0.01 0 0 0 0 0.036 0.032 0.027 0.023 0.017 0.016 0.015 (0.100–0.800) (0.200–0.540) (0.210–0.400) (0.170–0.360) (0.092–0.380) (0.089–0.370) (0.086–0.360) (7.5–10) (6.3–8.2) (5.5–6.7) (5.2–6.1) (5.7–6.5) (5.7–6.6) (5.8–6.7) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (0.011–0.014) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (0.140–0.190) (0.088–0.110) (0.095–0.120) (0.047–0.061) (0.049–0.064) (0.052–0.068) (0.038–0.049) (0.350–0.450) (0.390–0.510) (0.350–0.450) (0.330–0.430) (0.300–0.390) (0.310–0.400) (0.300–0.380) (0–0) (0–0) (0–0) (0–0) (0–0) (<0.01–<0.01) (<0.01–<0.01) (0.028–0.036) (0.048–0.062) (0.076–0.098) (0.057–0.074) (0.032–0.042) (0.033–0.043) (0.032–0.042) (<0.01–<0.01) (0.021–0.031) (0.024–0.036) (0.011–0.016) (0.019–0.029) (0.012–0.018) (<0.01–<0.01) (8.5–18) (10–21) (12–26) (14–31) (16–34) (16–34) (16–35) (150–360) (200–300) (210–310) (210–310) (210–310) (210–310) (210–310) (64–83) (42–55) (22–28) (43–56) (44–57) (47–60) (46–60) (0.047–0.071) (0.039–0.063) (0.030–0.053) (0.026–0.039) (0.025–0.038) (0.026–0.039) (0.027–0.040) (1.6–2.1) (1.9–2.5) (1.7–2.2) (1.4–1.8) (1.6–2.0) (1.7–2.1) (2.3–3.0) (0.600–1.4) (0.710–1.0) (0.620–0.910) (0.540–0.800) (0.470–0.680) (0.460–0.660) (0.440–0.640) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (0–0) (0–0) (0–0) (0–0) (0.030–0.042) (0.027–0.037) (0.021–0.034) (0.018–0.028) (0.015–0.020) (0.014–0.019) (0.013–0.018) RATEa 379 325 279 240 206 200 194 405 314 254 225 224 223 223 88 40 46 125 34 57 54 98 53 51 24 23 24 17 12 12 10 9.2 7.9 7.9 7.6 0 0 0 0 0 81 37 73 96 126 102 68 71 69 45 147 156 67 116 73 24 308 322 349 358 348 346 348 393 360 329 301 275 270 265 171 108 54 105 105 109 108 36 30 23 18 17 17 18 61 62 51 35 35 36 50 312 240 185 142 108 103 97 72 39 13 0 0 0 0 38 33 28 22 17 16 14 Rates are per 100 000 population. GLOBAL TUBERCULOSIS REPORT 2013 Data for all years can be downloaded from www.who.int/tb/data (104–827) (185–505) (200–371) (158–338) (89–371) (86–360) (83–349) (345–470) (274–356) (228–281) (207–243) (209–240) (208–239) (208–239) (77–99) (35–46) (40–52) (110–142) (30–39) (50–65) (47–61) (85–110) (46–60) (45–58) (21–27) (20–26) (21–27) (15–20) (10–13) (11–14) (9.0–12) (8.1–10) (6.9–9.0) (7.0–9.0) (6.6–8.6) (0–0) (0–0) (0–0) (0–0) (0–0) (71–91) (32–42) (64–83) (84–109) (110–143) (89–115) (60–77) (62–81) (60–78) (36–54) (119–178) (127–189) (54–81) (94–140) (59–88) (20–29) (203–435) (212–453) (230–492) (236–505) (229–491) (228–488) (230–490) (243–580) (294–432) (269–395) (246–361) (227–328) (223–322) (219–316) (150–194) (95–123) (48–62) (92–119) (92–118) (96–124) (95–122) (29–44) (23–37) (17–30) (14–22) (13–21) (14–21) (14–21) (53–69) (55–71) (44–57) (31–40) (31–40) (32–41) (44–56) (193–460) (196–288) (151–222) (116–171) (89–129) (85–123) (80–116) (57–90) (13–80) (3.5–28) (0–0) (0–0) (0–0) (0–0) (32–45) (28–39) (22–35) (18–27) (14–20) (13–18) (12–17) 7$%/($(VWLPDWHVRIWKHEXUGHQRIGLVHDVHFDXVHGE\7% ± Tuvalu Vanuatu Viet Nam Wallis and Futuna Islands a 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 POPULATION (MILLIONS) <1 <1 <1 <1 <1 <1 <1 <1 <1 <1 <1 <1 <1 <1 69 76 81 85 89 90 91 <1 <1 <1 <1 <1 <1 <1 NUMBER (THOUSANDS) <0.01 <0.01 <0.01 <0.01 <0.01 <0.01 <0.01 0.016 0.011 0.03 0.029 0.024 0.022 0.02 36 32 27 23 19 19 18 <0.01 <0.01 <0.01 <0.01 <0.01 <0.01 <0.01 (<0.01–0.019) (<0.01–0.021) (<0.01–0.014) (<0.01–0.010) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–0.032) (<0.01–0.019) (0.013–0.054) (0.012–0.052) (0.011–0.043) (<0.01–0.039) (<0.01–0.035) (21–55) (20–47) (18–38) (16–31) (13–26) (13–25) (12–25) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) RATEa 98 73 68 50 18 12 37 11 6.5 16 14 10 9.1 7.9 52 42 33 27 22 21 20 17 4.2 4.2 4.7 2.8 2.6 13 (27–212) (5.1–227) (19–146) (15–105) (7.3–33) (3.8–24) (16–68) (3.9–22) (2.9–11) (6.9–29) (5.9–25) (4.5–18) (4.1–16) (3.6–14) (30–79) (26–61) (22–47) (19–37) (15–29) (14–28) (13–27) (9.2–27) (2.3–6.6) (3.6–4.9) (2.6–7.5) (1.4–4.6) (1.5–4.1) (5.6–23) PREVALENCE (INCLUDING HIV) NUMBER (THOUSANDS) 0.083 0.066 0.059 0.047 0.022 0.017 0.037 0.22 0.16 0.31 0.28 0.25 0.24 0.22 360 340 290 240 210 200 200 0.028 <0.01 <0.01 0.01 <0.01 <0.01 0.016 (0.029–0.160) (<0.01–0.170) (0.021–0.120) (0.017–0.089) (<0.01–0.044) (<0.01–0.036) (0.017–0.065) (0.062–0.470) (0.049–0.340) (0.140–0.550) (0.130–0.490) (0.110–0.440) (0.100–0.420) (0.090–0.410) (150–670) (150–610) (130–510) (110–440) (87–390) (82–380) (78–370) (0.011–0.052) (<0.01–0.019) (<0.01–0.019) (<0.01–0.021) (<0.01–0.012) (<0.01–0.011) (<0.01–0.026) RATEa 921 711 626 480 222 176 377 148 97 166 134 105 97 89 525 451 353 288 238 227 218 201 62 63 70 42 41 117 (327–1 820) (101–1 900) (226–1 230) (180–923) (75–448) (53–371) (172–658) (43–319) (29–204) (74–295) (63–232) (47–185) (42–175) (36–165) (212–976) (198–805) (156–629) (125–517) (97–440) (91–424) (86–410) (80–378) (19–132) (19–132) (21–148) (13–88) (13–85) (59–193) INCIDENCE (INCLUDING HIV) NUMBER (THOUSANDS) 0.048 0.04 0.034 0.028 0.018 0.015 0.024 0.19 0.11 0.2 0.17 0.16 0.16 0.16 170 170 160 150 140 140 130 0.022 <0.01 <0.01 <0.01 <0.01 <0.01 <0.01 (0.031–0.069) (0.017–0.074) (0.022–0.048) (0.019–0.039) (0.014–0.021) (0.012–0.018) (0.019–0.029) (0.150–0.230) (0.085–0.130) (0.160–0.250) (0.140–0.210) (0.130–0.200) (0.130–0.190) (0.130–0.190) (120–240) (120–220) (120–210) (110–190) (100–180) (100–180) (99–170) (0.019–0.024) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) RATEa 536 437 357 291 178 152 241 127 63 110 83 69 67 65 251 220 197 176 155 151 147 156 49 15 57 36 17 65 (347–766) (181–805) (231–510) (198–402) (145–215) (124–184) (196–290) (103–154) (51–76) (89–132) (68–99) (57–83) (55–80) (53–77) (172–344) (155–295) (142–260) (131–229) (115–201) (112–197) (109–192) (137–176) (43–55) (13–17) (50–64) (31–41) (15–19) (57–74) WESTERN PACIFIC REGION MORTALITY (EXCLUDING HIV) YEAR Rates are per 100 000 population. Data for all years can be downloaded from www.who.int/tb/data GLOBAL TUBERCULOSIS REPORT 2013 271 7$%/($,QFLGHQFHQRWLILFDWLRQDQGFDVHGHWHFWLRQUDWHVDOOIRUPV ± INCIDENCE (INCLUDING HIV) YEAR American Samoa 1990 1995 2000 2005 2010 2011 2012 Australia 1990 1995 2000 2005 2010 2011 2012 Brunei 1990 Darussalam 1995 2000 2005 2010 2011 2012 Cambodia 1990 1995 2000 2005 2010 2011 2012 China 1990 1995 2000 2005 2010 2011 2012 China, Hong Kong 1990 SAR 1995 2000 2005 2010 2011 2012 China, Macao 1990 SAR 1995 2000 2005 2010 2011 2012 Cook Islands 1990 1995 2000 2005 2010 2011 2012 Fiji 1990 1995 2000 2005 2010 2011 2012 French Polynesia 1990 1995 2000 2005 2010 2011 2012 Guam 1990 1995 2000 2005 2010 2011 2012 Japan 1990 1995 2000 2005 2010 2011 2012 Kiribati 1990 1995 2000 2005 2010 2011 2012 Lao People's 1990 Democratic 1995 Republic 2000 2005 2010 2011 2012 Malaysia 1990 1995 2000 2005 2010 2011 2012 Marshall Islands 1990 1995 2000 2005 2010 2011 2012 272 NUMBER (THOUSANDS) POPULATION (MILLIONS) <1 <1 <1 <1 <1 <1 <1 17 18 19 21 22 23 23 <1 <1 <1 <1 <1 <1 <1 9 11 12 13 14 15 15 1 165 1 238 1 280 1 318 1 360 1 368 1 377 6 6 7 7 7 7 7 <1 <1 <1 <1 <1 <1 <1 <1 <1 <1 <1 <1 <1 <1 <1 <1 <1 <1 <1 <1 <1 <1 <1 <1 <1 <1 <1 <1 <1 <1 <1 <1 <1 <1 <1 122 124 126 127 127 127 127 <1 <1 <1 <1 <1 <1 <1 4 5 5 6 6 7 7 18 21 23 26 28 29 29 <1 <1 <1 <1 <1 <1 <1 0.012 <0.01 <0.01 <0.01 <0.01 <0.01 <0.01 1.2 1.2 1.2 1.2 1.4 1.4 1.5 0.16 0.18 0.35 0.19 0.27 0.26 0.28 53 62 71 68 63 62 61 1 800 1 600 1 400 1 200 1 100 1 000 1 000 7.5 7.1 6.9 6.5 5.7 5.4 5.5 0.39 0.46 0.52 0.46 0.45 0.44 0.46 0 <0.01 <0.01 <0.01 0 <0.01 <0.01 0.81 0.6 0.44 0.33 0.24 0.23 0.21 0.068 0.1 0.071 0.072 0.047 0.074 0.058 0.066 0.099 0.062 0.072 0.12 0.094 0.078 60 50 45 31 26 25 24 0.083 0.39 0.31 0.44 0.36 0.43 0.43 21 20 18 16 14 14 14 23 22 22 22 23 23 24 0.065 0.097 0.14 0.19 0.26 0.28 0.3 (<0.01–0.015) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (1.0–1.3) (1.1–1.4) (1.1–1.4) (1.1–1.4) (1.3–1.6) (1.2–1.6) (1.3–1.7) (0.140–0.190) (0.160–0.210) (0.310–0.400) (0.160–0.210) (0.240–0.310) (0.230–0.300) (0.240–0.320) (38–69) (48–78) (56–87) (57–81) (54–72) (53–71) (52–70) (1 400–2 200) (1 300–1 900) (1 200–1 600) (1 100–1 400) (930–1 200) (900–1 200) (880–1 100) (6.6–8.5) (6.3–8.1) (6.1–7.8) (5.7–7.4) (5.0–6.4) (4.8–6.2) (4.8–6.3) (0.350–0.450) (0.410–0.520) (0.450–0.580) (0.400–0.520) (0.400–0.510) (0.380–0.490) (0.410–0.530) (0–0) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (0–0) (<0.01–<0.01) (<0.01–<0.01) (0.710–0.920) (0.530–0.680) (0.390–0.500) (0.290–0.370) (0.210–0.270) (0.200–0.260) (0.190–0.240) (0.059–0.077) (0.088–0.110) (0.062–0.081) (0.063–0.082) (0.041–0.053) (0.064–0.083) (0.050–0.065) (0.058–0.075) (0.087–0.110) (0.054–0.070) (0.063–0.082) (0.100–0.130) (0.083–0.110) (0.069–0.089) (52–67) (43–56) (40–51) (27–35) (23–30) (22–29) (21–28) (0.066–0.100) (0.310–0.460) (0.250–0.380) (0.360–0.530) (0.290–0.430) (0.350–0.520) (0.350–0.520) (13–31) (12–29) (11–26) (9.7–23) (8.8–21) (8.6–20) (8.4–20) (21–26) (20–25) (20–24) (20–24) (21–25) (21–25) (22–26) (<0.01–0.190) (0.024–0.220) (0.084–0.200) (0.050–0.420) (0.051–0.650) (0.054–0.690) (0.058–0.740) a RATE 26 12 6.9 13 7.8 7.8 7.3 6.8 6.8 6.2 5.9 6.5 6.3 6.5 64 63 106 51 68 65 68 580 578 577 510 437 424 411 153 129 109 92 78 75 73 129 116 101 94 81 77 77 110 116 120 98 85 80 83 0 13 6.5 5.9 0 5.6 5.6 112 77 54 40 28 26 24 34 47 30 28 18 27 21 50 68 40 46 73 59 48 49 40 36 25 20 20 19 116 505 372 488 366 432 429 492 403 330 270 221 213 204 127 108 95 86 82 81 80 137 190 263 363 502 536 572 (21–31) (9.4–14) (5.6–8.4) (10–15) (6.3–9.4) (6.3–9.4) (5.9–8.9) (6.0–7.7) (6.0–7.7) (5.5–7.0) (5.1–6.6) (5.7–7.3) (5.5–7.1) (5.7–7.4) (56–72) (55–71) (93–120) (45–58) (60–77) (57–74) (59–77) (423–761) (448–724) (458–710) (424–604) (376–503) (364–489) (353–474) (121–189) (106–154) (92–126) (80–105) (68–88) (66–85) (64–82) (113–146) (102–132) (89–115) (83–107) (71–91) (67–87) (68–88) (96–124) (102–131) (105–135) (86–111) (74–96) (70–91) (73–94) (0–0) (11–14) (5.7–7.3) (5.2–6.7) (0–0) (4.9–6.4) (4.9–6.3) (98–126) (68–87) (48–62) (35–45) (24–32) (23–29) (21–27) (30–39) (41–53) (26–34) (25–32) (15–20) (24–31) (18–24) (44–57) (60–77) (35–45) (40–52) (64–82) (51–66) (42–54) (43–55) (35–45) (32–41) (22–28) (18–23) (18–23) (17–22) (93–143) (410–609) (296–456) (396–588) (298–441) (351–521) (349–517) (304–725) (249–593) (204–486) (167–398) (137–326) (131–313) (126–301) (113–142) (97–120) (86–103) (79–94) (75–89) (74–88) (74–87) (14–396) (46–432) (161–389) (96–803) (97–1 230) (103–1 320) (110–1 400) INCIDENCE HIV-POSITIVE NUMBER (THOUSANDS) RATE 0.028 0.047 0.029 0.028 0.036 0.036 0.038 (0.024–0.031) (0.041–0.053) (0.026–0.033) (0.025–0.032) (0.031–0.041) (0.031–0.040) (0.033–0.043) <0.01 <0.01 <0.01 <0.01 0.99 5.1 7.9 5.8 3.1 3.1 2.7 0.18 1.4 4.2 6.3 7.6 7.6 7.3 (<0.01–<0.01) 0.6 (<0.1–2.0) (0–<0.01) 0.3 (0–1.4) (<0.01–<0.01) 0.9 (0.12–2.3) (0–<0.01) 0.4 (0–2.1) (0.72–1.3) 11 (8.0–14) (4.0–6.4) 48 (37–60) (6.3–9.7) 65 (51–80) (4.8–6.8) 43 (36–51) (2.7–3.6) 22 (19–25) (2.6–3.5) 21 (18–24) (2.3–3.1) 18 (15–21) (0.14–0.22) <0.1 (<0.1–<0.1) (1.2–1.7) 0.1 (0.10–0.14) (3.6–4.9) 0.3 (0.28–0.38) (5.5–7.2) 0.5 (0.42–0.54) (6.7–8.6) 0.6 (0.49–0.63) (6.7–8.6) 0.6 (0.49–0.63) (6.4–8.2) 0.5 (0.47–0.60) 0.054 0.036 0.049 0.044 (0.036–0.075) (0.022–0.053) (0.033–0.069) (0.026–0.067) 0.8 0.5 0.7 0.6 (0.53–1.1) (0.31–0.75) (0.46–0.97) (0.37–0.94) <0.01 <0.01 <0.01 <0.01 (0–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) 0.3 0.6 0.5 0.4 (0–1.3) (<0.1–1.7) (<0.1–1.5) (<0.1–1.5) <0.01 <0.01 <0.01 <0.01 <0.01 <0.01 <0.01 <0.01 (0–<0.01) <0.01 0.24 0.22 0.15 0.13 0.1 0.1 0.098 0.2 0.3 0.2 0.1 0.2 0.2 0.2 (0.14–0.18) (0.23–0.29) (0.13–0.17) (0.12–0.16) (0.14–0.18) (0.14–0.18) (0.14–0.19) (<0.01–<0.01) <0.1 (<0.1–<0.1) (<0.01–<0.01) <0.1 (<0.1–0.10) (<0.01–<0.01) 0.2 (0.14–0.18) (<0.01–<0.01) 0.2 (0.21–0.27) (<0.01–<0.01) 0.2 (0.13–0.17) (<0.01–<0.01) 0.2 (0.13–0.17) (<0.01–<0.01) 0.2 (0.13–0.17) (0–<0.01) (0.21–0.28) (0.20–0.25) (0.13–0.17) (0.11–0.15) (0.091–0.12) (0.089–0.12) (0.085–0.11) 1.2 (0–5.5) 0.3 0.2 0.2 0.1 0.1 <0.1 <0.1 <0.1 (0–2.9) (0.18–0.23) (0.16–0.20) (0.11–0.14) (<0.1–0.11) (<0.1–<0.1) (<0.1–<0.1) (<0.1–<0.1) <0.01 (<0.01–<0.01) 2.5 (1.7–3.4) <0.01 0.026 0.092 0.17 0.23 0.24 0.25 0.18 1.1 1.9 2.2 2.3 2.3 2.3 0.1 0.5 1.7 3 3.6 3.7 3.8 1 5.2 8 8.3 8.1 7.8 8 (<0.01–<0.01) (0.015–0.039) (0.051–0.15) (0.093–0.28) (0.12–0.37) (0.13–0.39) (0.13–0.41) (0.16–0.20) (0.96–1.2) (1.7–2.1) (2.0–2.3) (2.1–2.5) (2.1–2.5) (2.2–2.6) <0.01 (0–0.019) <0.01 (0–0.015) a Rates are per 100 000 population. b NOTIFIED NEW AND RELAPSE includes cases for which the treatment history is unknown. GLOBAL TUBERCULOSIS REPORT 2013 a (<0.1–0.15) (0.30–0.81) (0.95–2.7) (1.6–4.8) (1.9–5.8) (2.0–6.0) (2.0–6.2) (0.88–1.1) (4.6–5.7) (7.3–8.8) (7.6–9.1) (7.4–8.8) (7.2–8.5) (7.4–8.7) 6.1 (0–36) 2.6 (0–29) NOTIFIED NEW AND RELAPSE NUMBER a b CASE DETECTION RATE PERCENT 9 19 75 (62–93) 3 6 4 3 5.2 10 7.2 5.4 75 80 92 70 (62–93) (66–99) (76–110) (58–86) 1 016 1 073 1 043 1 046 1 257 1 239 1 305 143 5.9 5.9 5.4 5.1 5.6 5.4 5.7 56 87 87 87 87 87 87 87 87 (77–99) (77–99) (77–99) (77–99) (77–99) (77–99) (77–99) (77–99) 307 163 237 230 243 6 501 14 603 18 891 35 535 40 460 38 555 40 185 375 481 515 764 454 372 899 729 908 399 899 669 890 645 6 510 6 212 6 015 5 660 4 935 4 739 4 809 343 402 449 398 394 380 404 0 2 1 1 0 1 1 226 203 144 132 189 215 210 59 93 44 59 57 59 72 136 155 266 282 264 270 32 42 35 68 67 66 65 112 101 88 82 70 67 67 95 101 104 85 74 70 73 0 11 5.6 5.2 0 4.9 4.9 31 26 18 16 22 25 24 30 87 87 87 87 87 12 23 27 52 64 62 66 21 32 33 74 86 88 89 87 87 87 87 87 87 87 87 87 87 87 87 87 87 (77–99) (77–99) (77–99) (77–99) (77–99) (9.4–17) (19–30) (22–34) (44–63) (56–75) (54–73) (57–77) (17–27) (27–39) (28–38) (65–85) (76–98) (78–100) (79–100) (77–99) (77–99) (77–99) (77–99) (77–99) (77–99) (77–99) (77–99) (77–99) (77–99) (77–99) (77–99) (77–99) (77–99) 87 87 28 34 33 41 79 95 99 87 (77–99) (77–99) (25–32) (30–39) (29–37) (36–46) (70–90) (84–110) (87–110) (77–99) 62 63 41 64 50 26 25 15 24 18 87 87 87 87 87 (77–99) (77–99) (77–99) (77–99) (77–99) 54 63 101 82 68 51 821 43 078 39 384 27 194 22 693 22 119 20 857 68 35 40 63 51 42 42 35 31 21 18 17 16 96 87 87 87 87 87 87 87 87 87 87 87 86 82 (77–99) (77–99) (77–99) (77–99) (77–99) (77–99) (77–99) (77–99) (77–99) (77–99) (77–99) (76–98) (67–100) 252 332 286 343 346 1 826 830 2 227 3 766 4 061 4 360 4 118 11 702 11 778 15 057 15 415 18 517 19 808 21 851 304 367 293 346 343 43 17 41 65 63 67 62 64 57 64 60 65 69 75 82 75 80 80 80 8.7 4.2 13 24 29 31 30 51 53 68 69 80 85 93 (67–100) (62–93) (66–98) (66–98) (66–98) (5.9–14) (2.9–6.8) (8.5–20) (16–39) (19–46) (21–51) (21–49) (45–57) (47–58) (62–75) (64–76) (74–87) (78–93) (85–100) 34 111 193 139 145 65 213 368 265 276 25 59 73 49 48 (17–41) (27–220) (30–380) (20–260) (20–250) 87 (77–99) 87 (77–99) 87 (77–99) Data for all years can be downloaded from www.who.int/tb/data 7$%/($,QFLGHQFHQRWLILFDWLRQDQGFDVHGHWHFWLRQUDWHVDOOIRUPV ± Micronesia (Federated States of) Mongolia Nauru New Caledonia New Zealand Niue Northern Mariana Islands Palau Papua New Guinea Philippines Republic of Korea Samoa Singapore Solomon Islands Tokelau Tonga 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 NUMBER (THOUSANDS) POPULATION (MILLIONS) <1 <1 <1 <1 <1 <1 <1 2 2 2 3 3 3 3 <1 <1 <1 <1 <1 <1 <1 <1 <1 <1 <1 <1 <1 <1 3 4 4 4 4 4 4 <1 <1 <1 <1 <1 <1 <1 <1 <1 <1 <1 <1 <1 <1 <1 <1 <1 <1 <1 <1 <1 4 5 5 6 7 7 7 62 70 78 86 93 95 97 43 45 46 47 48 49 49 <1 <1 <1 <1 <1 <1 <1 3 3 4 4 5 5 5 <1 <1 <1 <1 <1 <1 <1 <1 <1 <1 <1 <1 <1 <1 <1 <1 <1 <1 <1 <1 <1 0.36 0.35 0.3 0.25 0.21 0.21 0.2 8.8 7.2 6.1 5.7 6.1 6.1 6.2 <0.01 <0.01 <0.01 0.013 <0.01 <0.01 <0.01 0.16 0.1 0.11 0.054 0.056 0.06 0.044 0.4 0.45 0.4 0.38 0.35 0.35 0.34 0 0 0 0 0 <0.01 <0.01 0.032 0.055 0.086 0.066 0.037 0.038 0.037 <0.01 0.025 0.03 0.013 0.024 0.015 <0.01 13 15 19 22 24 24 25 240 250 260 260 260 260 260 73 48 25 49 51 53 53 0.059 0.051 0.041 0.032 0.031 0.032 0.033 1.8 2.2 2 1.6 1.8 1.9 2.6 0.97 0.86 0.76 0.67 0.57 0.55 0.54 <0.01 <0.01 <0.01 0 0 0 0 0.036 0.032 0.027 0.023 0.017 0.016 0.015 (0.100–0.800) (0.200–0.540) (0.210–0.400) (0.170–0.360) (0.092–0.380) (0.089–0.370) (0.086–0.360) (7.5–10) (6.3–8.2) (5.5–6.7) (5.2–6.1) (5.7–6.5) (5.7–6.6) (5.8–6.7) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (0.011–0.014) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (0.140–0.190) (0.088–0.110) (0.095–0.120) (0.047–0.061) (0.049–0.064) (0.052–0.068) (0.038–0.049) (0.350–0.450) (0.390–0.510) (0.350–0.450) (0.330–0.430) (0.300–0.390) (0.310–0.400) (0.300–0.380) (0–0) (0–0) (0–0) (0–0) (0–0) (<0.01–<0.01) (<0.01–<0.01) (0.028–0.036) (0.048–0.062) (0.076–0.098) (0.057–0.074) (0.032–0.042) (0.033–0.043) (0.032–0.042) (<0.01–<0.01) (0.021–0.031) (0.024–0.036) (0.011–0.016) (0.019–0.029) (0.012–0.018) (<0.01–<0.01) (8.5–18) (10–21) (12–26) (14–31) (16–34) (16–34) (16–35) (150–360) (200–300) (210–310) (210–310) (210–310) (210–310) (210–310) (64–83) (42–55) (22–28) (43–56) (44–57) (47–60) (46–60) (0.047–0.071) (0.039–0.063) (0.030–0.053) (0.026–0.039) (0.025–0.038) (0.026–0.039) (0.027–0.040) (1.6–2.1) (1.9–2.5) (1.7–2.2) (1.4–1.8) (1.6–2.0) (1.7–2.1) (2.3–3.0) (0.600–1.4) (0.710–1.0) (0.620–0.910) (0.540–0.800) (0.470–0.680) (0.460–0.660) (0.440–0.640) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (0–0) (0–0) (0–0) (0–0) (0.030–0.042) (0.027–0.037) (0.021–0.034) (0.018–0.028) (0.015–0.020) (0.014–0.019) (0.013–0.018) a RATE 379 325 279 240 206 200 194 405 314 254 225 224 223 223 88 40 46 125 34 57 54 98 53 51 24 23 24 17 12 12 10 9.2 7.9 7.9 7.6 0 0 0 0 0 81 37 73 96 126 102 68 71 69 45 147 156 67 116 73 24 308 322 349 358 348 346 348 393 360 329 301 275 270 265 171 108 54 105 105 109 108 36 30 23 18 17 17 18 61 62 51 35 35 36 50 312 240 185 142 108 103 97 72 39 13 0 0 0 0 38 33 28 22 17 16 14 (104–827) (185–505) (200–371) (158–338) (89–371) (86–360) (83–349) (345–470) (274–356) (228–281) (207–243) (209–240) (208–239) (208–239) (77–99) (35–46) (40–52) (110–142) (30–39) (50–65) (47–61) (85–110) (46–60) (45–58) (21–27) (20–26) (21–27) (15–20) (10–13) (11–14) (9.0–12) (8.1–10) (6.9–9.0) (7.0–9.0) (6.6–8.6) (0–0) (0–0) (0–0) (0–0) (0–0) (71–91) (32–42) (64–83) (84–109) (110–143) (89–115) (60–77) (62–81) (60–78) (36–54) (119–178) (127–189) (54–81) (94–140) (59–88) (20–29) (203–435) (212–453) (230–492) (236–505) (229–491) (228–488) (230–490) (243–580) (294–432) (269–395) (246–361) (227–328) (223–322) (219–316) (150–194) (95–123) (48–62) (92–119) (92–118) (96–124) (95–122) (29–44) (23–37) (17–30) (14–22) (13–21) (14–21) (14–21) (53–69) (55–71) (44–57) (31–40) (31–40) (32–41) (44–56) (193–460) (196–288) (151–222) (116–171) (89–129) (85–123) (80–116) (57–90) (13–80) (3.5–28) (0–0) (0–0) (0–0) (0–0) (32–45) (28–39) (22–35) (18–27) (14–20) (13–18) (12–17) INCIDENCE HIV-POSITIVE NUMBER (THOUSANDS) <0.01 <0.01 <0.01 0.011 <0.01 <0.01 <0.01 <0.01 <0.01 <0.01 <0.01 a RATE (<0.01–<0.01) <0.1 (<0.1–<0.1) (<0.01–<0.01) 0.2 (0.21–0.24) (<0.01–<0.01) 0.3 (0.27–0.31) (<0.01–0.011) 0.4 (0.35–0.41) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) 0.1 0.2 0.2 0.1 0.1 0.1 0.1 (0.067–0.14) 2.4 (1.6–3.4) (0.30–0.65) 9.7 (6.4–14) (0.68–1.4) 19 (13–27) (0.92–2.0) 23 (15–32) (0.75–1.6) 17 (11–23) (0.76–1.6) 16 (11–23) (0.71–1.5) 15 (9.9–21) (0.015–0.036) <0.1 (<0.1–<0.1) (0.020–0.030) <0.1 (<0.1–<0.1) (0.063–0.092) 0.1 (<0.1–0.12) (0.15–0.22) 0.2 (0.17–0.25) (0.32–0.46) 0.4 (0.34–0.49) (0.38–0.55) 0.5 (0.40–0.58) (0.38–0.55) 0.5 (0.39–0.57) (0.045–0.058) 0.1 (0.10–0.14) (0.038–0.049) 0.1 (<0.1–0.11) (0.020–0.026) <0.1 (<0.1–<0.1) (0.078–0.10) 0.2 (0.17–0.21) (0.12–0.15) 0.3 (0.24–0.31) (0.13–0.16) 0.3 (0.26–0.33) (0.13–0.17) 0.3 (0.27–0.35) <0.01 0.044 0.06 0.06 0.07 0.072 0.098 (<0.01–<0.01) (0.038–0.049) (0.053–0.068) (0.052–0.068) (0.061–0.079) (0.063–0.081) (0.086–0.11) a Rates are per 100 000 population. b NOTIFIED NEW AND RELAPSE includes cases for which the treatment history is unknown. (0.21–0.27) (1.1–1.4) (1.3–1.7) (1.2–1.5) (1.2–1.6) (1.2–1.6) (1.6–2.1) a b CASE DETECTION NUMBER RATE 367 172 91 98 164 148 144 1 659 2 780 3 109 4 601 4 458 4 217 4 128 7 381 160 85 92 158 143 139 76 121 130 182 164 153 148 76 100 49 30 38 77 72 72 19 39 51 81 73 69 66 87 (46–370) (32–87) (23–42) (27–58) (43–180) (40–170) (40–170) (16–22) (34–44) (46–57) (75–88) (68–79) (64–74) (62–71) (77–99) 4 11 3 5 40 109 30 50 87 87 87 87 (77–99) (77–99) (77–99) (77–99) 143 87 94 47 49 52 38 348 391 344 332 301 305 293 0 0 0 0 0 1 0 28 48 75 57 32 33 32 85 46 45 21 20 21 15 10 11 8.9 8 6.9 6.9 6.6 0 0 0 0 0 70 0 64 83 110 89 59 62 60 87 87 87 87 87 87 87 87 87 87 87 87 87 87 (77–99) (77–99) (77–99) (77–99) (77–99) (77–99) (77–99) (77–99) (77–99) (77–99) (77–99) (77–99) (77–99) (77–99) 87 0 87 87 87 87 87 87 87 (77–99) (77–99) (77–99) (77–99) (77–99) (77–99) (77–99) (<0.1–0.11) (0.17–0.22) (0.13–0.17) (0.12–0.16) (0.11–0.15) (0.11–0.15) (0.11–0.14) 0.1 0.46 1 1.4 1.1 1.2 1.1 0.024 0.025 0.077 0.18 0.39 0.46 0.46 0.051 0.044 0.023 0.089 0.13 0.14 0.15 0.2 1.3 1.5 1.3 1.4 1.4 1.9 NOTIFIED NEW AND RELAPSE PERCENT 19 110 10 19 12 4 2 497 8 041 10 520 12 564 14 531 14 893 20 557 317 008 119 186 119 914 137 100 166 323 195 560 216 627 63 904 42 117 21 782 42 892 44 063 46 253 43 702 44 45 43 24 14 20 22 1 591 1 889 1 728 1 376 1 560 1 641 2 301 382 352 302 397 338 398 361 1 2 0 0 0 0 50 93 58 19 60 171 196 206 212 212 287 512 171 154 160 178 206 224 149 94 47 91 91 95 89 27 26 25 13 7.5 11 12 53 54 44 31 31 32 43 122 98 73 85 64 74 66 62 132 0 0 0 0 75 80 80 80 19 53 56 58 61 61 82 130 48 47 53 65 76 84 87 87 87 87 87 87 82 75 89 110 75 45 62 66 87 87 87 87 87 87 87 39 41 40 60 59 72 67 86 340 0 23 20 24 18 11 9 11 24 21 24 18 11 8.6 10 64 63 88 79 63 55 73 Data for all years can be downloaded from www.who.int/tb/data WESTERN PACIFIC REGION INCIDENCE (INCLUDING HIV) YEAR (77–99) 75 (62–93) (62–93) (66–98) (66–98) (66–98) (14–30) (38–80) (40–85) (41–87) (43–92) (44–93) (59–120) (88–210) (40–58) (39–57) (44–65) (54–79) (64–92) (71–100) (77–99) (77–99) (77–99) (77–99) (77–99) (77–99) (73–94) (62–93) (71–110) (82–140) (62–92) (37–56) (51–78) (55–82) (77–99) (77–99) (77–99) (77–99) (77–99) (77–99) (77–99) (27–64) (34–50) (33–49) (50–73) (50–72) (60–87) (57–82) (69–110) (160–1 000) (54–76) (54–75) (70–110) (65–99) (54–75) (47–66) (62–87) GLOBAL TUBERCULOSIS REPORT 2013 273 7$%/($,QFLGHQFHQRWLILFDWLRQDQGFDVHGHWHFWLRQUDWHVDOOIRUPV ± INCIDENCE (INCLUDING HIV) YEAR Tuvalu Vanuatu Viet Nam Wallis and Futuna Islands a b 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 POPULATION (MILLIONS) <1 <1 <1 <1 <1 <1 <1 <1 <1 <1 <1 <1 <1 <1 69 76 81 85 89 90 91 <1 <1 <1 <1 <1 <1 <1 NUMBER (THOUSANDS) 0.048 0.04 0.034 0.028 0.018 0.015 0.024 0.19 0.11 0.2 0.17 0.16 0.16 0.16 170 170 160 150 140 140 130 0.022 <0.01 <0.01 <0.01 <0.01 <0.01 <0.01 (0.031–0.069) (0.017–0.074) (0.022–0.048) (0.019–0.039) (0.014–0.021) (0.012–0.018) (0.019–0.029) (0.150–0.230) (0.085–0.130) (0.160–0.250) (0.140–0.210) (0.130–0.200) (0.130–0.190) (0.130–0.190) (120–240) (120–220) (120–210) (110–190) (100–180) (100–180) (99–170) (0.019–0.024) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) (<0.01–<0.01) INCIDENCE HIV-POSITIVE NUMBER (THOUSANDS) a RATE 536 437 357 291 178 152 241 127 63 110 83 69 67 65 251 220 197 176 155 151 147 156 49 15 57 36 17 65 (347–766) (181–805) (231–510) (198–402) (145–215) (124–184) (196–290) (103–154) (51–76) (89–132) (68–99) (57–83) (55–80) (53–77) (172–344) (155–295) (142–260) (131–229) (115–201) (112–197) (109–192) (137–176) (43–55) (13–17) (50–64) (31–41) (15–19) (57–74) 0.083 1.7 7.6 9.2 9.2 9.3 (0.059–0.11) (1.3–2.3) (5.6–9.9) (6.8–12) (6.8–12) (6.9–12) a RATE 0.1 2.2 8.9 10 10 10 (<0.1–0.15) (1.6–2.9) (6.6–12) (7.6–13) (7.6–13) (7.6–13) NOTIFIED NEW AND RELAPSE NUMBER 23 36 16 12 14 12 19 140 79 152 76 116 110 125 50 203 55 739 89 792 94 916 97 448 98 804 102 112 b CASE DETECTION a RATE PERCENT 255 390 170 124 142 122 193 95 47 82 36 49 45 51 73 73 111 112 109 110 112 48 89 48 43 80 80 80 75 75 75 44 71 68 78 29 33 56 63 70 73 76 6 42 87 (77–99) 7 49 87 (77–99) 2 15 87 (77–99) Rates are per 100 000 population. NOTIFIED NEW AND RELAPSE includes cases for which the treatment history is unknown. 274 GLOBAL TUBERCULOSIS REPORT 2013 (33–74) (48–220) (33–74) (31–63) (66–98) (66–98) (66–98) (62–93) (62–93) (62–93) (37–54) (59–86) (57–83) (66–95) (21–42) (25–47) (43–78) (49–86) (54–95) (56–98) (59–100) Data for all years can be downloaded from www.who.int/tb/data 7$%/($&DVHQRWLILFDWLRQV ± a YEAR American Samoa • 19 0• Australia •6 6• Brunei Darussalam • 56 59 • Cambodia • 72 270 • China • 32 65 • China, Hong Kong SAR • 112 67 • China, Macao SAR • 95 73 • Cook Islands •0 5• Fiji • 31 24 • French Polynesia • 30 18 • Guam •0 42 • Japan • 42 16 • Kiribati • 96 343 • Lao People's Democratic Republic • 43 62 • Malaysia • 64 a b 75 • 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 NEW AND b RELAPSE 9 3 6 4 3 NEW CASES % SMEARSMEAR- SMEAR-NEGATIVE/ EXTRARE-TREAT EXCL. TOTAL HISTORY POS AMONG OTHER RELAPSE NEW PULM POSITIVE UNKNOWN PULMONARY RELAPSE RETREAT UNKNOWN 0 0 0 0 1 0 0 0 0 0 5 2 63 17 16 41 20 26 27 24 29 20 17 43 65 49 46 70 17 20 13 13 0 15 5 5 8 14 0 0 0 0 15 5 5 8 14 0 0 0 0 0 0 0 605 814 718 466 367 446 588 1 168 1 115 73 605 814 1 306 1 634 1 482 519 0 0 1 102 42 845 6 325 6 540 6 479 0 0 0 18 693 19 664 49 707 39 307 34 610 31 784 53 480 90 780 14 909 12 215 10 033 18 693 73 144 140 487 54 216 46 825 41 817 5 301 0 0 0 3 115 3 179 2 352 2 244 2 206 772 701 792 815 817 0 0 0 0 188 219 316 300 323 594 500 197 187 160 782 719 513 487 483 0 0 0 0 141 160 136 123 148 156 0 2 0 1 0 1 0 84 68 62 63 89 107 111 94 180 162 175 126 139 0 0 1 0 0 0 0 105 99 42 29 45 62 54 70 50 43 49 46 31 0 0 0 0 0 0 0 37 34 40 40 45 44 40 0 0 0 0 0 0 0 0 0 0 0 49 12 14 21 21 26 0 0 0 0 0 0 1 17 39 2 2 0 0 0 0 0 0 0 49 12 31 60 23 28 0 0 0 0 0 0 1 43 26 39 52 0 0 0 0 0 0 0 2 0 0 0 2 0 0 0 0 10 2 5 2 5 8 12 7 13 0 0 0 62 63 41 64 50 29 21 13 22 26 19 25 18 27 10 10 14 6 13 8 0 0 0 1 3 4 2 6 0 0 0 0 1 3 4 2 6 0 0 0 0 54 63 101 82 68 51 821 43 078 39 384 27 194 22 693 22 119 20 857 68 43 27 39 28 23 5 26 51 39 37 6 9 9 11 8 0 0 0 0 1 1 2 3 0 1 0 0 0 1 2 2 3 0 0 0 1 0 14 367 11 853 10 931 8 237 7 937 7 663 25 172 19 118 10 056 8 630 8 231 7 675 2 803 7 046 5 340 4 632 4 826 4 609 0 0 0 736 1 367 867 1 194 1 125 910 1 125 568 562 426 736 1 367 1 992 1 762 1 687 1 336 54 124 118 140 134 47 79 91 109 122 106 126 71 87 73 0 0 9 3 3 6 7 8 7 8 11 2 3 10 14 18 10 0 0 0 478 1 526 2 801 3 119 3 271 3 062 404 457 484 394 516 484 95 180 275 323 349 351 2 64 139 163 170 168 41 22 27 38 2 64 180 185 197 206 67 62 54 53 6 688 8 156 8 446 11 135 11 862 13 311 4 021 5 517 4 862 4 338 4 501 4 993 1 069 1 384 1 702 2 545 2 888 2 945 210 0 332 499 557 602 651 820 858 859 210 0 983 1 319 1 415 1 461 73 0 0 0 1 016 1 073 1 043 1 046 1 257 1 239 1 305 143 307 163 237 230 243 6 501 14 603 18 891 35 535 40 460 38 555 40 185 375 481 515 764 454 372 899 729 908 399 899 669 890 645 6 510 6 212 6 015 5 660 4 935 4 739 4 809 343 402 449 398 394 380 404 0 2 1 1 0 1 1 226 203 144 132 189 215 210 59 252 332 286 343 346 1 826 830 2 227 3 766 4 061 4 360 4 118 11 702 11 778 15 057 15 415 18 517 19 808 21 851 2 3 0 0 0 2 3 3 1 0 1 0 0 0 0 0 1 0 0 251 241 274 301 290 362 339 410 436 408 369 450 457 463 498 84 101 146 109 119 166 30 30 52 79 42 27 43 48 31 11 101 14 822 21 001 17 454 15 812 14 838 1 465 1 108 7 057 8 301 7 686 8 509 1 428 2 147 6 759 14 239 14 690 15 290 134 488 204 765 472 719 429 899 377 005 316 332 203 088 229 943 329 157 432 868 481 514 536 050 1 940 1 561 1 475 1 380 1 463 1 560 0 0 0 0 0 – – 100 60 0 0 – – – 41 42 40 41 42 – – 34 77 83 68 60 – 88 93 75 68 67 64 – 40 47 59 50 44 37 – – 38 33 39 38 40 – 60 47 46 41 54 53 WESTERN PACIFIC REGION NEW AND RELAPSE NOTIFICATION RATE 1990–2012 100 0 100 100 44 41 60 68 66 63 67 – – 60 46 42 45 72 – – 90 51 43 42 38 – 36 38 52 49 49 50 – – 53 61 56 56 52 – 54 77 85 89 86 86 – 62 60 63 72 72 73 Rates are per 100 000 population. NEW AND RELAPSE includes cases for which the treatment history is unknown. Data for all years can be downloaded from www.who.int/tb/data GLOBAL TUBERCULOSIS REPORT 2013 275 7$%/($&DVHQRWLILFDWLRQV ± NEW AND RELAPSE a NOTIFICATION RATE 1990–2012 YEAR Marshall Islands •0 276 • Micronesia (Federated States of) • 381 139 • Mongolia • 76 148 • Nauru • 76 0• New Caledonia • 85 15 • New Zealand • 10 7• Niue •0 0• Northern Mariana Islands • 64 60 • Palau •0 19 • Papua New Guinea • 60 287 • Philippines • 512 224 • Republic of Korea • 149 89 • Samoa • 27 12 • Singapore • 53 43 • Solomon Islands • 122 a b 66 • 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 NEW AND RELAPSEb NEW CASES % SMEARRE-TREAT EXCL. TOTAL SMEAR- SMEAR-NEGATIVE/ EXTRAHISTORY POS AMONG OTHER RELAPSE NEW PULM POSITIVE UNKNOWN PULMONARY RELAPSE RETREAT UNKNOWN 34 111 193 139 145 367 172 91 98 164 148 144 1 659 2 780 3 109 4 601 4 458 4 217 4 128 7 4 11 3 5 143 87 94 47 49 52 38 348 391 344 332 301 305 293 0 0 0 0 0 1 0 28 48 75 57 32 33 32 11 48 59 44 54 25 31 64 30 53 9 28 65 57 29 0 0 0 0 4 2 8 4 9 15 32 53 45 43 79 69 35 79 73 77 455 1 389 1 868 1 837 1 723 1 716 18 4 19 25 28 22 5 0 0 0 1 330 732 897 701 684 617 976 862 1 620 1 675 1 578 1 611 4 0 1 3 0 11 1 1 0 21 20 16 20 13 13 81 15 15 16 18 11 9 29 15 13 19 12 0 0 1 78 74 83 86 88 68 222 133 114 68 81 99 34 130 95 134 121 112 29 6 13 3 0 0 0 0 0 0 1 0 0 0 0 0 0 0 14 27 15 17 15 10 26 37 35 13 16 17 8 11 7 2 2 4 1 1 1 8 12 2 0 5 10 20 6 0 3 0 5 2 3 7 3 2 2 14 10 2 2 2 3 21 13 4 4 4 0 0 0 0 0 0 82 126 216 245 232 184 125 343 316 325 82 126 341 588 548 509 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 1 6 8 0 0 4 4 7 8 2 1 0 0 0 0 4 7 11 7 2 11 0 8 4 4 4 4 7 19 11 6 15 0 0 4 4 1 0 0 0 1 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 2 0 0 0 0 0 0 1 0 0 0 0 1 582 1 431 1 931 273 955 1 456 1 824 1 575 2 154 0 0 0 0 0 0 19 9 6 4 0 3 9 4 3 6 10 6 1 1 0 1 0 0 0 0 0 0 1 0 0 1 652 1 933 1 805 2 584 1 882 2 862 3 767 4 405 5 105 5 907 6 494 9 195 2 349 3 227 4 198 5 798 6 373 8 277 0 0 273 955 1 456 242 144 223 94 768 67 056 81 647 89 198 93 580 94 006 140 712 52 858 50 347 72 440 96 529 115 263 8 8 1 149 1 610 2 234 3 274 0 0 0 0 3 957 3 075 3 217 4 084 8 066 10 528 13 535 3 957 11 141 13 745 17 619 0 0 0 11 754 8 216 11 638 11 596 11 714 12 137 19 360 11 304 18 460 18 660 18 386 18 938 5 171 8 795 9 457 8 470 0 0 0 0 2 082 2 262 3 021 2 838 3 032 4 157 4 077 4 038 4 238 5 830 2 082 2 262 7 098 6 876 7 270 9 987 4 602 2 174 3 664 0 15 13 11 6 6 15 30 18 8 5 12 4 6 12 5 3 2 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 455 248 552 530 592 678 1 187 869 570 735 717 1 219 127 165 174 213 224 306 0 0 0 0 120 55 60 82 108 98 93 48 54 63 120 55 153 130 162 161 20 0 0 0 109 109 169 133 159 157 133 128 161 98 108 87 97 65 62 105 127 112 0 0 0 0 13 0 5 2 4 5 0 3 7 11 13 0 5 5 11 16 0 0 0 0 Rates are per 100 000 population. NEW AND RELAPSE includes cases for which the treatment history is unknown. 276 0 0 0 10 19 12 4 2 497 8 041 10 520 12 564 14 531 14 893 20 557 317 008 119 186 119 914 137 100 166 323 195 560 216 627 63 904 42 117 21 782 42 892 44 063 46 253 43 702 44 45 43 24 14 20 22 1 591 1 889 1 728 1 376 1 560 1 641 2 301 382 352 302 397 338 398 361 8 GLOBAL TUBERCULOSIS REPORT 2013 Data for all years can be downloaded from www.who.int/tb/data – – 31 61 48 59 50 – 10 18 48 40 38 36 – 25 65 68 72 72 74 – – 100 0 50 75 – – 21 57 52 56 42 54 – 26 36 42 56 52 41 – 0 0 0 0 – 35 42 30 57 48 37 – 60 – 33 47 40 75 – 30 30 26 30 22 24 – 40 56 62 55 49 45 – 38 42 39 38 39 39 – 33 42 58 55 33 79 – 28 22 49 42 45 36 – 45 46 51 58 60 64 7$%/($&DVHQRWLILFDWLRQV ± a YEAR Tokelau • 62 0• Tonga • 24 10 • Tuvalu • 255 193 • Vanuatu • 95 51 • Viet Nam •0 0• Wallis and Futuna Islands •0 a b 0• 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 1990 1995 2000 2005 2010 2011 2012 NEW AND RELAPSEb 1 2 0 0 0 0 NEW CASES % SMEARRE-TREAT EXCL. TOTAL SMEAR- SMEAR-NEGATIVE/ EXTRAHISTORY POS AMONG OTHER RELAPSE NEW PULM POSITIVE UNKNOWN PULMONARY RELAPSE RETREAT UNKNOWN 1 0 0 0 0 1 0 0 0 0 0 0 0 0 0 9 15 11 6 6 9 2 5 3 3 3 1 9 3 4 2 0 1 6 0 5 5 4 8 13 7 3 2 4 2 16 7 4 7 4 9 0 0 0 23 20 24 18 11 9 11 23 36 16 12 14 12 19 140 79 152 76 116 110 125 50 203 55 739 89 792 94 916 97 448 98 804 102 112 30 63 35 44 49 51 27 56 21 33 14 22 21 28 17 35 46 51 37 550 53 169 55 492 52 145 50 751 51 033 8 379 17 993 16 429 18 237 20 373 21 706 6 194 13 137 16 670 17 651 18 077 18 904 6 3 2 0 7 1 6 2 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 – 50 0 0 0 0 1 0 0 0 0 0 0 0 0 0 3 0 1 1 3 0 1 1 0 0 0 0 3 0 0 1 5 3 1 1 1 5 0 2 1 1 5 8 1 3 2 0 0 0 0 0 0 2 678 3 210 3 616 5 493 6 325 6 834 6 925 7 259 976 1 574 1 714 1 794 3 616 5 493 7 301 8 408 8 639 9 053 1 1 1 0 0 0 0 0 0 2 581 1 0 0 0 – – 82 75 79 67 67 90 – 32 0 62 71 50 80 – 53 53 62 57 78 70 – 82 75 77 74 71 70 – 60 – 14 – 100 – WESTERN PACIFIC REGION NEW AND RELAPSE NOTIFICATION RATE 1990–2012 Rates are per 100 000 population. NEW AND RELAPSE includes cases for which the treatment history is unknown. Data for all years can be downloaded from www.who.int/tb/data GLOBAL TUBERCULOSIS REPORT 2013 277 7$%/($7UHDWPHQWRXWFRPHVQHZVPHDUSRVLWLYHFDVHV ± % OF COHORT TREATMENT SUCCESS (%)a 1995–2011 American Samoa • 100 0• Australia •0 77 • Brunei Darussalam •0 66 • • 91 93 • Cambodia China • 93 95 • China, Hong Kong SAR •0 69 • China, Macao SAR •0 86 • Cook Islands • 100 0• • 86 93 • Fiji French Polynesia • 67 80 • Guam •0 79 • Japan •0 0• Kiribati • 87 94 • • 70 92 • • 69 79 • Lao People's Democratic Republic Malaysia Marshall Islands • 25 88 • Micronesia (Federated States of) • 80 96 • • 74 86 • Mongolia a YEAR 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 NUMBER NOTIFIED 2 3 0 0 0 SIZE OF COHORT 4 2 4 3 0 251 241 267 274 301 238 241 606 629 527 84 101 140 146 109 11 101 14 822 21 001 17 863 17 454 15 812 134 488 204 765 472 719 449 152 429 899 377 005 84 101 164 176 109 4 363 14 775 21 001 17 863 17 454 15 884 131 413 213 766 472 719 449 039 429 790 377 005 1 940 1 561 1 444 1 475 1 380 141 160 136 116 123 148 2 0 1 1 0 1 68 62 63 83 89 107 1 940 1 561 1 441 1 487 1 378 29 21 17 13 22 43 27 31 39 28 14 367 11 853 10 931 8 853 8 237 7 937 54 124 145 118 140 478 1 526 2 801 3 034 3 119 3 271 6 688 8 156 8 446 9 981 11 135 11 862 11 48 52 59 44 9 15 32 61 53 45 455 1 389 1 868 1 809 1 837 1 723 160 136 115 219 147 2 1 0 0 1 73 62 68 79 89 107 33 62 18 18 13 20 43 27 47 51 28 10 348 10 931 8 772 8 242 31 54 123 144 117 140 343 1 588 2 802 3 034 3 119 3 271 13 398 7 915 8 446 9 981 11 135 11 862 163 11 47 58 71 50 10 14 20 60 59 51 455 1 389 1 868 1 809 1 837 1 723 COHORT AS % NOTIFIED – 100 133 – – – – 95 100 227 230 175 – 100 100 117 121 100 39 100 100 100 100 100 98 104 100 100 100 100 – 100 100 100 101 100 – 100 100 99 178 99 100 – 100 0 – 100 107 100 108 95 100 100 – 214 86 106 100 91 – 100 100 152 131 100 – 87 100 99 100 – – 100 99 99 99 100 72 104 100 100 100 100 200 97 100 100 100 100 – 100 98 112 120 114 111 93 62 98 111 113 100 100 100 100 100 100 DIED FAILED COMPLETED 100 0 75 0 0 100 0 0 0 0 0 0 100 0 0 0 0 0 25 0 27 12 6 8 7 45 68 73 72 70 9 10 3 3 6 0 0 0 0 3 2 1 2 1 16 8 16 15 16 42 66 63 61 66 83 88 89 92 91 90 72 93 92 93 94 94 21 5 8 20 0 8 4 4 3 3 4 22 2 2 2 2 17 7 9 7 9 2 4 3 2 2 2 2 1 2 1 1 1 0 0 0 0 0 1 0 0 0 0 0 1 2 1 1 1 1 4 2 0 0 0 4 4 2 1 1 1 1 1 1 1 0 1 17 20 20 12 25 2 1 2 1 2 3 3 3 3 2 2 2 55 60 59 57 59 5 3 11 11 10 5 5 15 15 14 6 9 0 0 0 4 3 3 4 4 24 20 12 13 13 81 93 86 93 86 100 8 0 2 0 0 0 6 4 3 3 5 0 0 0 0 0 0 0 4 1 2 1 1 0 1 3 7 3 7 0 100 0 0 0 0 0 0 78 81 71 89 65 81 67 0 92 80 0 8 5 0 5 2 12 0 97 89 89 0 0 0 7 5 10 4 6 1 3 2 11 6 8 5 0 0 0 0 0 0 0 0 2 0 0 0 0 0 3 8 10 1 24 3 21 0 0 6 0 15 100 4 2 9 1 3 3 9 0 0 0 0 0 93 85 96 84 79 0 0 0 0 0 7 11 2 16 14 0 0 0 0 0 0 0 0 0 0 0 4 2 0 7 30 38 21 20 15 22 31 32 5 11 19 21 4 3 1 1 1 1 4 3 44 26 24 24 45 83 62 84 88 74 62 68 85 91 89 87 69 0 69 78 79 78 3 64 85 71 63 86 80 93 75 65 97 80 66 83 82 84 83 82 42 7 31 13 5 21 8 9 5 2 3 5 0 78 1 1 1 1 21 27 2 14 17 2 0 0 5 23 0 16 7 4 6 4 3 3 13 7 7 3 5 4 6 7 5 4 6 0 6 8 9 9 9 9 7 0 2 9 8 6 10 7 10 3 3 4 8 3 3 2 2 2 2 0 0 2 1 2 0 1 1 0 5 2 0 0 0 0 0 0 0 0 1 0 0 1 19 9 3 2 2 2 8 10 5 4 4 4 67 9 2 3 1 0 0 0 0 0 5 2 0 0 6 3 5 7 8 7 DEFAULTED 10 0 0 0 0 0 10 4 3 2 3 4 TREATMENT SUCCESS = percent cured + percent completed then rounded to the nearest digit. GLOBAL TUBERCULOSIS REPORT 2013 NOT EVALUATED CURED Data for all years can be downloaded from www.who.int/tb/data 0 0 0 0 0 0 4 7 1 1 0 1 14 4 16 9 7 8 1 0 9 3 10 6 0 0 5 7 0 0 2 3 2 0 0 1 7$%/($7UHDWPHQWRXWFRPHVQHZVPHDUSRVLWLYHFDVHV ± % OF COHORT Nauru •0 0• New Caledonia • 75 35 • New Zealand •0 56 • Niue •0 0• Northern Mariana Islands •0 89 • Palau • 67 57 • Papua New Guinea • 56 69 • • 60 90 • • 76 80 • • 80 83 • • 86 83 • Philippines Republic of Korea Samoa Singapore Solomon Islands • 65 90 • •0 0• Tokelau Tonga • 75 100 • Tuvalu •0 75 • Vanuatu • 85 82 • • 89 93 • Viet Nam Wallis and Futuna Islands •0 a 0• YEAR 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 NUMBER NOTIFIED 4 0 1 1 3 21 20 16 15 20 13 78 74 83 90 86 88 0 0 0 0 0 0 14 27 15 16 17 15 9 3 6 9 4 1 652 1 933 1 805 2 238 2 584 1 882 94 768 67 056 81 647 88 806 89 198 93 580 11 754 8 216 11 638 11 285 11 596 11 714 15 13 11 8 6 6 455 248 552 552 530 592 109 109 169 138 133 159 1 0 0 0 0 0 9 15 11 6 6 6 6 0 5 8 5 4 30 63 35 47 44 49 37 550 53 169 55 492 51 291 52 145 50 751 3 SIZE OF COHORT 4 3 0 3 32 45 16 15 21 23 73 84 92 86 141 0 0 27 15 16 17 19 9 3 8 16 7 4 904 422 1 292 2 584 2 530 2 322 90 297 50 196 81 125 88 806 89 198 93 580 11 675 3 231 3 752 3 813 2 828 2 288 15 13 11 10 6 6 122 242 548 937 948 979 368 109 169 138 133 156 0 20 15 11 6 6 6 7 6 8 5 4 13 26 42 47 44 49 38 189 53 169 55 492 51 387 52 147 50 751 1 2 2 2 COHORT AS % NOTIFIED – 100 – 0 300 – 152 225 100 100 105 177 – 99 101 102 100 160 – – – – – – – 100 100 100 100 127 100 – 100 133 178 175 297 22 72 115 98 123 95 75 99 100 100 100 99 39 32 34 24 20 100 100 100 125 100 100 27 98 99 170 179 165 338 100 100 100 100 98 – – – – – – 222 100 100 100 100 100 – – 120 100 100 100 43 41 120 100 100 100 102 100 100 100 100 100 – – – – – – COMPLETED DIED 25 0 67 33 0 0 75 0 0 67 0 0 0 33 56 6 93 76 35 12 9 6 0 19 9 0 0 0 0 3 2 0 7 5 0 9 0 0 0 0 57 25 60 76 74 56 23 6 7 17 7 0 0 81 82 89 11 75 33 88 0 0 0 5 0 FAILED DEFAULTED NOT EVALUATED CURED 0 1 1 0 1 47 33 16 8 36 0 0 0 0 11 0 0 0 0 0 0 0 0 0 0 0 0 11 19 27 19 18 0 22 73 56 67 57 54 0 12 12 29 56 24 14 13 10 16 6 15 7 7 7 7 2 2 2 2 4 2 67 8 0 0 0 0 15 71 83 17 17 14 65 7 30 22 30 36 0 25 12 14 4 2 4 4 3 4 1 2 2 2 2 2 2 2 1 1 1 1 20 8 9 10 0 17 2 14 14 15 17 15 6 5 8 4 1 3 0 0 0 0 0 0 1 2 2 3 1 1 1 1 1 1 3 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 3 3 0 0 0 14 15 26 19 16 14 19 5 6 4 4 4 4 5 3 4 3 3 3 0 0 0 0 0 0 11 14 2 1 1 1 4 4 4 3 5 1 0 0 0 14 25 9 5 6 23 5 34 3 3 4 2 3 14 12 11 12 6 16 0 0 0 0 0 0 0 0 1 2 3 1 26 11 2 3 4 4 75 93 73 83 83 100 0 0 0 0 0 0 10 0 18 17 17 0 5 7 0 0 0 0 0 0 0 0 0 0 10 0 9 0 0 0 86 0 0 0 0 0 0 14 0 0 46 12 17 15 14 29 5 2 2 2 2 2 25 15 8 10 4 16 10 3 3 3 3 3 3 0 0 7 0 0 4 2 1 1 1 1 1 0 4 2 0 2 2 4 2 1 2 2 2 0 0 12 0 0 0 0 0 0 2 2 2 2 2 2 2 2 100 0 0 0 0 0 81 73 0 0 56 100 62 75 29 39 57 58 48 53 54 73 82 82 85 83 74 81 81 81 85 78 13 85 91 90 100 83 71 65 62 69 100 88 100 75 38 77 64 81 66 53 84 90 90 90 91 91 0 WESTERN PACIFIC REGION TREATMENT SUCCESS (%)a 1995–2011 TREATMENT SUCCESS = percent cured + percent completed then rounded to the nearest digit. Data for all years can be downloaded from www.who.int/tb/data GLOBAL TUBERCULOSIS REPORT 2013 279 7$%/($7UHDWPHQWRXWFRPHVUHWUHDWPHQWFDVHV ± % OF COHORT TREATMENT SUCCESS (%)a 1995–2011 American Samoa •0 0• Australia •0 66 • Brunei Darussalam •0 63 • • 85 74 • • 92 90 • Cambodia China China, Hong Kong SAR •0 62 • China, Macao SAR •0 96 • Cook Islands •0 0• Fiji •0 57 • French Polynesia • 50 100 • Guam •0 100 • Japan •0 0• Kiribati •0 74 • • 100 81 • Lao People's Democratic Republic Malaysia •0 54 • Marshall Islands •0 100 • • 100 100 • • 61 74 • Micronesia (Federated States of) Mongolia a YEAR 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 NUMBER NOTIFIED SIZE OF COHORT 0 1 0 0 0 1 0 0 17 43 61 65 49 11 43 65 58 67 15 5 0 5 8 605 814 1 306 1 429 1 634 1 482 18 693 73 144 140 487 59 583 54 216 46 825 5 0 5 8 436 827 1 306 1 429 1 524 409 54 052 43 252 89 239 59 853 54 469 46 825 782 719 509 513 487 49 12 31 45 60 23 0 0 0 0 0 0 2 0 2 12 7 1 3 5 4 2 1 2 1 2 3 736 1 367 1 992 1 751 1 762 1 687 218 716 481 512 453 37 37 46 35 28 0 0 0 0 0 5 12 7 2 4 5 4 4 2 1 2 3 1 169 1 992 1 452 1 466 3 10 4 14 18 2 64 180 184 185 197 210 0 983 1 181 1 319 1 415 9 3 6 20 19 1 64 181 184 184 170 1 056 1 181 1 319 1 415 0 5 2 10 20 2 3 21 9 13 4 82 126 341 569 588 548 20 8 4 20 9 20 9 16 10 1 23 126 443 380 234 548 COHORT AS % NOTIFIED – – 100 – – – – 65 100 107 89 137 – – 100 – 100 100 72 102 100 100 93 28 289 59 64 100 100 100 – 28 100 94 100 93 – 308 119 102 58 122 – – – – – – – – – 250 100 100 – – 133 100 100 200 – – 100 100 100 100 – 86 100 83 83 – – 300 30 150 143 106 50 100 101 100 99 86 – – 107 100 100 100 – – 400 400 40 100 450 667 43 178 77 25 28 100 130 67 40 100 CURED COMPLETED DIED FAILED DEFAULTED 100 0 9 16 6 5 1 73 56 60 64 64 9 5 3 5 6 0 2 0 0 0 5 8 3 3 9 19 22 22 25 40 40 20 0 0 0 100 62 59 85 49 34 30 66 90 86 85 86 86 87 0 0 26 5 27 45 44 8 2 2 5 4 4 4 0 25 5 6 9 3 4 7 2 1 3 2 2 2 0 0 3 1 2 1 1 5 3 1 3 2 2 3 0 0 3 4 3 1 1 5 1 1 1 1 1 1 0 12 4 0 11 15 20 10 1 8 4 4 5 4 27 40 26 34 27 26 18 38 34 35 4 4 15 12 15 17 9 0 0 0 18 7 6 4 7 8 22 14 16 16 68 51 43 51 79 16 24 35 14 18 11 11 11 14 4 0 0 0 0 0 5 0 7 11 0 0 14 4 9 0 40 50 29 50 40 17 29 0 20 17 14 50 0 0 14 0 0 17 14 0 0 0 0 0 0 0 75 75 100 75 25 25 0 25 0 0 0 0 0 0 0 0 0 0 0 50 100 100 67 0 0 0 33 0 0 0 0 0 0 0 0 50 0 0 0 0 0 0 0 31 29 15 14 15 16 32 32 5 8 15 17 6 2 1 1 1 2 6 5 41 43 31 31 89 100 83 25 21 100 41 75 85 76 72 0 11 0 0 17 45 53 0 8 12 3 7 9 0 30 5 0 11 6 8 12 2 0 0 0 0 8 2 2 3 8 0 0 21 0 11 5 1 3 3 0 0 0 0 0 0 22 1 0 0 6 46 33 35 34 9 27 24 20 8 9 12 9 1 1 1 1 9 6 12 8 27 23 17 28 60 12 25 30 100 25 11 0 20 0 61 57 39 60 19 39 10 75 25 70 0 60 89 19 10 100 0 14 34 13 61 35 0 50 0 0 5 0 0 0 0 10 12 0 0 0 0 75 10 0 9 8 9 4 9 5 0 0 0 13 8 11 17 6 15 0 20 0 13 7 4 4 2 4 TREATMENT SUCCESS = percent cured + percent completed then rounded to the nearest digit. GLOBAL TUBERCULOSIS REPORT 2013 NOT EVALUATED Data for all years can be downloaded from www.who.int/tb/data 30 0 0 0 0 0 0 6 40 0 4 6 3 2 4 2 7$%/($7UHDWPHQWRXWFRPHVUHWUHDWPHQWFDVHV ± % OF COHORT Nauru •0 0• New Caledonia • 100 0• New Zealand •0 50 • Niue •0 0• Northern Mariana Islands •0 0• Palau •0 0• Papua New Guinea •0 52 • Philippines •0 65 • • 40 74 • Republic of Korea Samoa •0 0• Singapore •0 76 • Solomon Islands •0 100 • •0 0• Tokelau Tonga • 100 0• Tuvalu •0 0• Vanuatu •0 100 • • 81 82 • •0 0• Viet Nam Wallis and Futuna Islands a YEAR 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 1995 2000 2005 2009 2010 2011 NUMBER NOTIFIED SIZE OF COHORT 0 0 0 0 4 4 7 9 8 2 4 7 19 9 11 6 0 0 1 0 4 7 9 8 1 23 18 9 11 6 0 0 0 0 0 0 0 0 0 0 0 0 0 1 273 955 1 456 1 388 1 824 1 575 8 3 957 9 575 11 141 13 745 2 082 2 262 7 098 6 880 6 876 7 270 0 0 0 0 0 0 120 55 153 132 130 162 13 0 5 2 5 11 0 0 0 0 0 0 0 1 0 0 0 1 3 0 0 1 1 5 8 3 1 3 3 616 5 493 7 301 8 131 8 408 8 639 1 0 0 0 0 0 0 0 0 0 68 65 530 444 398 4 362 4 554 4 583 2 004 131 3 331 2 420 1 813 1 346 0 0 0 0 149 130 127 160 5 2 5 10 0 9 1 0 0 0 0 0 0 0 0 5 0 3 1 3 2 384 8 806 7 374 357 398 8 641 0 0 0 COHORT AS % NOTIFIED – – – – – – 100 – 100 100 100 50 – 329 95 100 100 100 – – – – – – – – – – – – – – – – – 0 – 7 4 38 24 25 – – – 46 41 33 96 6 47 35 26 19 – – – – – – – – 97 98 98 99 – – 100 100 100 91 – – – – – – – 100 – – – – – – 0 – – 0 – 100 0 100 100 100 66 160 101 4 5 100 – – – – – – CURED COMPLETED DIED FAILED DEFAULTED 100 NOT EVALUATED 0 100 0 86 0 0 0 0 89 88 0 14 0 12 100 0 0 0 0 0 0 0 0 0 0 0 30 67 67 73 50 4 0 11 18 0 29 42 36 35 32 35 14 22 11 20 48 53 47 39 59 72 69 76 70 0 11 0 0 0 0 0 0 65 33 22 9 50 4 15 5 5 7 1 6 5 5 5 21 20 29 18 22 9 3 3 27 14 13 15 18 1 2 3 3 4 3 4 5 5 1 3 2 2 2 1 4 5 4 2 3 0 1 0 0 5 6 6 3 12 6 5 6 5 26 16 20 53 21 18 21 12 19 37 47 43 79 39 31 33 15 20 17 22 0 0 0 0 5 1 2 2 1 3 3 0 20 50 80 30 40 50 0 70 20 0 20 0 20 0 0 0 0 0 0 0 0 0 0 0 100 100 0 0 0 0 0 0 100 0 0 0 0 0 100 100 67 80 74 79 67 61 79 0 0 33 2 5 4 6 8 3 0 0 0 5 6 5 8 8 5 0 0 0 8 5 6 2 4 5 0 0 0 2 3 3 10 12 3 0 0 0 4 7 3 7 6 5 WESTERN PACIFIC REGION TREATMENT SUCCESS (%)a 1995–2011 TREATMENT SUCCESS = percent cured + percent completed then rounded to the nearest digit. Data for all years can be downloaded from www.who.int/tb/data GLOBAL TUBERCULOSIS REPORT 2013 7$%/($+,9WHVWLQJDQGSURYLVLRQRI&37$57DQG,37– % OF TB PATIENTS WITH KNOWN HIV STATUS YEAR 2005–2012 American Samoa •0 – Australia • 42 56 • Brunei Darussalam • 100 100 • Cambodia •3 80 • – 34 • China China, Hong Kong SAR • 68 75 • China, Macao SAR • 91 89 • •0 100 • Cook Islands Fiji • 100 58 • • 48 44 • • 72 68 • – 16 • French Polynesia Guam Japan Kiribati • 13 43 • – 48 • Lao People's Democratic Republic Malaysia • 73 97 • • 77 60 • •6 100 • Marshall Islands Micronesia (Federated States of) Mongolia •0 78 • •0 – Nauru New Caledonia • 40 – New Zealand • 41 58 • Niue – – Northern Mariana Islands • 98 79 • • 90 100 • Palau Papua New Guinea – 17 • – 1• Philippines 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 NUMBER OF TB % OF TB PATIENTS WITH PATIENTS WITH KNOWN HIV KNOWN HIV STATUS STATUS PATIENTS NOTIFIED (NEW AND RETREAT) 0 75 100 0 3 3 6 4 3 42 54 59 56 100 100 100 100 2.9 77 82 80 448 686 750 740 163 237 230 243 1 044 32 236 32 544 32 359 16 23 34 68 75 74 75 91 92 94 89 0 100 100 100 82 73 58 48 27 27 44 72 62 65 68 145 919 208 681 309 385 4 209 3 833 3 656 3 707 378 399 360 360 0 0 1 1 132 157 160 127 30 11 17 22 46 63 53 46 52 49 16 13 54 77 43 12 098 11 221 3 328 44 159 274 150 38 46 48 73 91 89 97 77 68 91 60 6.2 49 97 100 <0.1 89 80 78 0 0 0 1 533 2 012 1 999 11 661 17 577 18 472 22 124 86 137 137 88 7 85 145 146 1 4 256 3 612 3 465 0 0 0 1 073 1 281 1 268 1 325 163 237 230 243 36 123 41 628 39 670 40 258 990 509 923 308 911 884 900 678 6 160 5 132 4 926 4 969 415 433 382 406 1 0 1 1 132 191 220 218 63 41 64 50 64 101 82 68 28 319 23 261 22 681 21 283 339 294 354 348 3 807 4 083 4 387 4 156 16 066 19 337 20 666 22 710 112 201 151 147 112 174 150 146 4 726 4 801 4 533 4 453 11 3 5 40 0 0 21 0 0 41 60 57 58 100 140 183 175 171 0 0 1 98 100 94 79 90 95 83 100 56 32 31 27 9 18 10 4 13 29 17 2 122 4 671 3 713 0.94 1.9 0.89 1 634 3 917 2 040 GLOBAL TUBERCULOSIS REPORT 2013 53 57 52 38 340 305 309 297 0 0 1 0 57 32 33 34 10 19 12 4 12 564 16 113 16 324 22 488 137 100 174 389 206 088 230 162 NUMBER OF HIV-POSITIVE TB PATIENTS % OF TESTED TB PATIENTS HIV-POSITIVE 0 0 0 0 22 24 19 8 2 1 3 2 86 2 112 1 656 1 433 4.9 3.5 2.5 1.1 1.2 0.42 1.3 0.82 8.2 6.6 5.1 4.4 4 542 4 715 5 866 35 24 28 22 1 3 2 4 0 0 0 0 1 3 3 5 0 0 1 0 0 1 0 0 3.1 2.3 1.9 0.83 0.63 0.77 0.59 0.26 0.75 0.56 1.1 53 75 62 2 0 0 0 0.44 0.67 1.9 4.5 0 0 0 182 222 234 1 468 1 628 1 629 1 347 0 0 1 0 0 0 0 0 1 2 3 4 0 0 0 12 11 12 13 9.3 8.8 6.1 0 0 0.73 0 0 0 0 0 100 <0.1 <0.1 0.12 0 0 0 8 3 3 3 0 0 0 5.7 1.6 1.7 1.8 0 0 0 1 0 0 1 0 0 0 0 3.7 0 0 10 0 222 531 364 10 11 9.8 2 9 4 0.12 0.23 0.2 0 0 0.76 1.9 1.9 3.9 0 0 5.9 0 0 1.6 0 0 NUMBER OF % OF HIV% OF HIVPOSITIVE TB POSITIVE TB HIV-POSITIVE PATIENTS ON PATIENTS ON PEOPLE PROVIDED IPT ART CPT 9.1 0 0 100 100 100 0 100 100 100 2 0 0 65 88 98 45 79 88 491 1 305 1 145 49 17 45 36 59 54 29 0 33 50 0 100 33 50 25 0 100 100 100 0 100 100 60 100 100 100 100 0 0 0 1 2 100 76 78 22 48 303 22 48 32 0 100 100 100 100 75 100 100 100 75 0 0 0 0 1 120 0 0 0 0 0 89 0 0 Data for all years can be downloaded from www.who.int/tb/data 135 256 325 16 226 7$%/($+,9WHVWLQJDQGSURYLVLRQRI&37$57DQG,37– Republic of Korea – – Samoa •0 0• Singapore – 84 • •0 12 • Solomon Islands Tokelau – – Tonga – 100 • Tuvalu •0 45 • •0 52 • • 15 66 • Vanuatu Viet Nam Wallis and Futuna – – 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 NUMBER OF TB % OF TB PATIENTS WITH PATIENTS WITH KNOWN HIV KNOWN HIV STATUS STATUS 0 21 0 0 0 3 0 0 74 79 84 0 11 17 12 1 184 1 332 1 978 0 39 70 45 0 0 0 73 100 100 0 0 31 45 0 7.8 45 52 15 43 59 66 8 9 11 0 0 4 9 0 9 50 65 14 128 42 356 59 176 68 259 400 10 8 PATIENTS NOTIFIED (NEW AND RETREAT) 46 969 48 101 50 491 49 532 24 14 20 22 1 469 1 608 1 695 2 364 397 341 405 372 0 0 0 18 11 9 11 15 14 13 20 81 116 112 126 95 892 99 022 100 518 103 906 7 2 NUMBER OF HIV-POSITIVE TB PATIENTS % OF TESTED TB PATIENTS HIV-POSITIVE NUMBER OF % OF HIV% OF HIVPOSITIVE TB POSITIVE TB HIV-POSITIVE PATIENTS ON PATIENTS ON PEOPLE PROVIDED IPT ART CPT 135 129 0 0 0 0 0 50 61 47 0 0 0 0 0 0 0 4.2 4.6 2.4 0 0 0 0 0 0 0 0 0 0 0 595 3 515 4 703 4 775 0 0 0 0 0 0 0 0 0 0 0 WESTERN PACIFIC REGION % OF TB PATIENTS WITH KNOWN HIV STATUS YEAR 2005–2012 0 0 0 0 0 4.2 8.3 7.9 7 Data for all years can be downloaded from www.who.int/tb/data 62 72 73 43 48 47 1 317 5 663 0 0 GLOBAL TUBERCULOSIS REPORT 2013 7$%/($7HVWLQJIRU0'57%DQGQXPEHURIFRQILUPHGFDVHVRI0'57%± YEAR TOTAL CONFIRMED CASES OF a MDR-TB American Samoa Australia Brunei Darussalam Cambodia China China, Hong Kong SAR China, Macao SAR Cook Islands Fiji French Polynesia Guam Japan Kiribati Lao People's Democratic Republic Malaysia Marshall Islands Micronesia (Federated States of) Mongolia Nauru New Caledonia New Zealand Niue Northern Mariana Islands Palau Papua New Guinea Philippines a b 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 NEW PULMONARY CASES ESTIMATED CASES OF MDR-TB AMONG NOTIFIED ESTIMATED CASES OF MDR-TB AMONG NOTIFIED 0 0 12 33 28 18 0 0 0 31 56 75 2792 1601 3007 41 28 23 26 9 6 5 8 0 0 1 0 0 0 0 0 0 0 1 2 0 0 68 60 64 1 0 0 0 2 4 10 1 64 141 74 2 1 1 3 1 1 1 3 0 187 185 210 17 (9.2–25) 0 (0–0) 380 (190–580) 59 000 (52 000–66 000) 15 58 274 522 1148 679 BACT+VEb TESTED FOR MDR-TB – – – – – 160 99 130 – 100 130 100 – <0.1 <0.1 0.11 – – 2.6 3.6 96 61 79 76 190 89 110 110 – – 0 – – 4.5 17 9.1 – 87 110 91 110 110 110 100 – 54 51 66 0.81 0 – 0 – – – 0.46 180 – – – 110 96 100 140 110 70 98 8.6 0 2.2 9.1 11 – – 0 – – 62 140 120 150 180 160 150 – – – – 100 100 100 100 100 58 100 100 – – – – <0.1 <0.1 <0.1 <0.1 14 (8.1–23) 868 652 861 0 (0–4.4) 181 205 166 330 (160–590) 5 18 16 49 000 (38 000–60 000) 48 (30–66) 36 (22–55) 8.3 (3.0–14) 2.3 (0.27–8.1) 1.0 (<0.1–1.0) 0 (0–0) 9940 11472 3271 1897 1992 2061 265 221 258 261 0 (0–0) 0 0 0 0 (0–14) 4 18 15 0 (0–0) 0 (0–4.2) 0 (0–6.7) 0 (0–6.7) 27 47 30 39 56 43 31 240 (180–300) 110 (65–170) 7684 7400 8564 1 0 15 (12–18) 13 (9.5–16) 0 220 (180–260) 170 (130–220) 18 (0–54) 14 15010 18 (0.46–100) 4.4 (0–9.3) 4.4 (0.92–12) 6.8 (5.4–8.2) 5.9 (4.3–7.3) 170 (140–190) 33 (15–58) 52 68 50 73 35 50 44 5 0 40 157 196 0 – 0 0 0 2 0 0 0 0 0 1 0 BACT+VEb TESTED FOR MDR-TB – 0 0 0 0 4 4 2 4 % OF 0 1 – – 0 (0–0) 0 (0–3.1) 3.7 (0–9.2) 0.75 (<0.1–4.1) 0 (0–0) 0 (0–6.1) 0 (0–2.8) 0 (0–2.8) 1 100 (930–1 300) 590 (430–740) 12 000 (9 300–15 000) 20 24 28 247 243 229 221 0 (0–0) 0 (0–0) 8 500 (6 000–11 000) PREVIOUSLY TREATED CASES NUMBER OF 24 17 19 15 3 11 8 3 4 3 25 35 ESTIMATED CASES OF MDR-TB AMONG NOTIFIED – 3.0 (0.36–9.9) 0 (0–3.2) 56 (21–110) 11 000 (9 000–12 000) 12 (4.6–27) 6.0 (2.3–11) 1.0 (<0.1–1.0) 0 (0–13) 0 (0–3.6) 0 (0–0) 130 (96–180) 2.3 (1.9–2.7) 48 (40–56) 0 (0–250) 0 (0–5.9) 0.93 (0.78–1.1) 130 (120–150) – 0 (0–0.98) 3.0 (<0.1–11) 0 (0–0) 0 (0–2.0) 0 (0–0) 500 (420–590) 3 700 (2 500–5 100) NUMBER OF % OF NOTIFIED NOTIFIED TESTED FOR TESTED FOR MDR-TB MDR-TB – 0 – 0 – – – 48 74 26 53 31 67 – 5 100 8 100 14 100 – 93 5.7 190 13 86 17 – – – 4861 12 163 23 211 41 207 43 232 48 19 61 39 65 24 100 28 100 – 0 – 0 – 1 100 – 4 33 0 0 1 7.7 3 100 4 100 1 50 4 67 0 0 2 100 2 67 0 – – 694 39 670 40 583 44 – 0 0 – 0 0 – – – 48 23 1056 110 – – – 3 60 3 30 4 20 0 0 21 100 3 23 0 0 0 0 16 4.7 561 95 602 110 681 130 – – – – – 0 0 0 0 0 0 14 74 10 91 5 83 12 80 – – – – 1 – 0 – 0 – 0 0 0 – 0 – 0 0 0 – – – – – 138 3.5 297 2.7 2325 17 2038 12 TOTAL CONFIRMED CASES OF MDR-TB includes cases with unknown previous treatment history (i.e. not included under NEW CASES or PREVIOUSLY TREATED CASES). BACT+VE = bacteriologically positive cases. GLOBAL TUBERCULOSIS REPORT 2013 Data for all years can be downloaded from www.who.int/tb/data 7$%/($7HVWLQJIRU0'57%DQGQXPEHURIFRQILUPHGFDVHVRI0'57%± a MDR-TB Republic of Korea Samoa Singapore Solomon Islands Tokelau Tonga Tuvalu Vanuatu Viet Nam Wallis and Futuna Islands a b 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 2005 2010 2011 2012 450 516 1212 0 0 0 3 3 6 22 0 0 0 NEW PULMONARY CASES ESTIMATED CASES OF MDR-TB AMONG NOTIFIED ESTIMATED CASES OF MDR-TB AMONG NOTIFIED b BACT+VE TESTED FOR MDR-TB 3431 2 200 (1 800–2 700) 840 (660–1 100) 0 0 (0–4.1) 0 (0–4.1) 36 (21–51) 31 (18–48) 15 895 923 952 1178 12 (8.8–15) 1 0 9 12 (9.1–15) 0 0 – 0 0 0 NUMBER OF 0.49 (0.36–0.61) – 0.49 (0.36–0.61) 0 0 0 0 0 2 0.72 (0.60–0.85) 0.49 (0.36–0.61) 1 0 0 0 0.47 (0.39–0.54) 0 (0–8.7) 0 0 101 601 273 0 3 800 (3 000–4 600) 2 100 (1 500–2 800) 0 0 – – PREVIOUSLY TREATED CASES % OF b BACT+VE TESTED FOR MDR-TB – – 17 – – 0 – 79 96 97 97 98 – 0.75 0 5.7 – – – – – 0 0 0 – 0 – 11 – – 0 0 – – – – – – 0 – ESTIMATED CASES OF MDR-TB AMONG NOTIFIED 1 400 (1 000–1 900) 0 (0–0) 5.2 (1.1–15) 0 (0–3.3) – 0 (0–0) 0.23 (0.19–0.27) 0.47 (0.39–0.54) 1 700 (1 300–2 300) – NUMBER OF % OF NOTIFIED NOTIFIED TESTED FOR TESTED FOR MDR-TB MDR-TB – – 968 13 – – 0 – – – 105 69 79 61 104 64 93 58 – 1 20 0 0 16 100 – 0 – – – – 0 – 0 – 0 – – 0 – – – – – 0 0 0 0 – – – – – – 0 – – WESTERN PACIFIC REGION YEAR TOTAL CONFIRMED CASES OF TOTAL CONFIRMED CASES OF MDR-TB includes cases with unknown previous treatment history (i.e. not included under NEW CASES or PREVIOUSLY TREATED CASES). BACT+VE = bacteriologically positive cases. Data for all years can be downloaded from www.who.int/tb/data GLOBAL TUBERCULOSIS REPORT 2013 7$%/($1HZVPHDUSRVLWLYHFDVHQRWLILFDWLRQE\DJHDQGVH[ ± MALE YEAR American Samoa Australia Brunei Darussalam Cambodia China China, Hong Kong SAR China, Macao SAR Cook Islands Fiji French Polynesia Guam Japan Kiribati Lao People's Democratic Republic Malaysia Marshall Islands Micronesia (Federated States of) Mongolia 1995 2000 2005 2010 2011 2012 1995 2000 2005 2010 2011 2012 1995 2000 2005 2010 2011 2012 1995 2000 2005 2010 2011 2012 1995 2000 2005 2010 2011 2012 1995 2000 2005 2010 2011 2012 1995 2000 2005 2010 2011 2012 1995 2000 2005 2010 2011 2012 1995 2000 2005 2010 2011 2012 1995 2000 2005 2010 2011 2012 1995 2000 2005 2010 2011 2012 1995 2000 2005 2010 2011 2012 1995 2000 2005 2010 2011 2012 1995 2000 2005 2010 2011 2012 1995 2000 2005 2010 2011 2012 1995 2000 2005 2010 2011 2012 1995 2000 2005 2010 2011 2012 1995 2000 2005 2010 2011 2012 0–14 15–24 25–34 35–44 FEMALE 45–54 55–64 1 1 65+ UNKNOWN 0–14 15–24 25–34 55–64 65+ 45–54 0 1 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 3 0 2 2 3 16 32 42 38 26 35 27 33 44 40 25 23 22 26 17 24 11 25 19 25 19 12 9 12 16 49 30 27 37 37 0 0 0 0 2 4 3 1 15 18 36 26 27 19 26 43 40 48 12 11 12 23 15 15 10 2 7 11 5 6 5 7 9 14 14 12 17 15 0 0 0 0 0 161 26 49 39 34 31 1 102 1 131 1 416 759 645 511 6 9 17 11 10 453 519 894 750 791 673 12 791 19 111 43 005 42 851 37 514 29 018 4 19 15 11 13 1 244 1 323 1 600 1 564 1 469 1 256 18 306 29 399 49 558 38 880 34 597 28 324 15 19 13 11 15 1 147 1 618 2 349 1 760 1 557 1 414 15 487 25 206 55 400 50 246 43 087 34 505 5 12 18 10 13 1 253 1 456 2 043 2 105 1 972 1 904 13 105 25 593 54 872 52 925 47 949 40 428 7 9 7 11 8 1 257 1 373 1 964 1 531 1 439 1 434 13 489 21 429 53 822 56 754 51 315 44 821 15 0 18 13 19 707 1 058 1 811 1 599 1 339 1 526 10 130 21 771 69 779 64 514 55 881 49 413 0 0 2 2 0 123 38 45 60 39 22 1 169 1 420 1 864 926 733 580 4 9 7 5 5 388 457 790 752 690 612 10 890 14 536 31 180 27 064 22 859 17 786 6 11 15 9 6 1 133 1 157 1 413 1 321 1 211 1 088 13 250 18 496 27 759 21 022 18 347 15 549 9 8 12 6 9 1 435 1 649 2 089 1 303 1 092 957 8 376 12 377 24 728 20 422 17 119 13 485 6 3 8 7 10 1 426 1 798 2 323 1 732 1 528 1 424 5 679 9 899 19 889 16 075 14 103 11 981 3 2 4 3 6 1 180 1 459 2 058 1 607 1 473 1 302 4 579 7 102 18 203 17 441 15 218 13 384 4 0 10 10 5 578 892 1 573 1 331 1 242 1 198 2 841 6 296 21 244 20 020 17 638 16 547 4 3 2 2 4 0 0 3 0 0 0 0 0 0 0 0 0 0 0 7 1 0 2 78 76 52 72 63 7 10 6 17 20 10 0 0 1 0 0 0 8 8 9 7 12 14 102 84 84 52 67 19 8 9 5 22 12 0 0 0 0 0 0 10 6 18 15 16 12 160 108 99 63 95 20 25 21 7 22 13 0 0 0 0 0 0 9 13 18 11 8 9 211 200 184 172 174 13 22 23 22 47 22 0 0 0 0 0 0 4 5 14 6 9 12 236 168 166 189 178 12 9 17 20 39 32 1 0 0 0 0 0 2 4 16 2 9 5 578 453 413 384 430 16 17 22 11 24 17 0 0 0 0 0 0 3 2 6 4 4 7 0 0 0 5 3 3 3 1 0 0 0 0 0 1 0 0 0 0 0 0 1 0 7 1 1 2 65 67 49 56 45 9 10 5 7 28 12 0 0 0 0 1 0 10 7 7 11 13 11 115 81 101 89 110 18 4 9 6 25 11 0 0 0 0 0 0 9 5 9 12 17 10 86 92 76 69 76 12 6 7 10 17 13 0 0 0 0 0 0 2 7 6 5 7 7 44 57 64 60 51 4 6 8 5 18 3 1 0 0 0 0 0 3 1 4 1 5 6 45 34 49 53 54 5 3 1 7 6 7 0 0 0 0 0 0 4 4 6 8 2 7 211 135 133 116 115 6 13 5 6 6 3 0 0 0 0 0 0 3 0 5 5 3 7 1 0 0 0 0 3 2 3 3 1 3 2 1 1 2 4 2 0 1 2 4 0 1 5 3 4 4 1 1 3 3 2 1 3 3 0 0 0 1 0 0 0 0 4 2 1 3 2 1 3 1 3 3 0 0 0 0 0 1 1 3 1 3 0 1 0 0 4 0 3 1 1 0 2 0 0 0 0 15 2 9 1 0 2 1 2 2 1 1 342 246 197 128 96 94 6 4 3 0 0 627 572 488 252 215 209 6 4 5 2 4 995 676 605 382 367 309 9 2 5 7 5 1 847 1 494 868 469 465 415 6 2 7 4 2 2 059 1 509 1 418 911 812 741 9 4 3 4 6 4 089 3 816 3 867 3 326 3 256 3 230 0 0 1 0 0 14 5 5 6 5 2 3 3 0 1 0 258 222 187 89 94 79 1 1 4 1 0 476 464 428 232 213 180 2 1 3 1 0 298 213 249 194 203 169 5 2 3 0 2 476 292 224 155 148 111 2 0 0 3 1 637 384 309 183 223 175 2 2 3 4 2 2 234 1 958 2 077 1 909 1 840 1 947 2 3 3 4 4 6 7 13 8 8 10 59 32 244 129 63 74 9 15 27 17 19 56 92 136 157 145 144 640 694 1 179 884 948 1 060 3 15 13 9 12 71 128 223 254 275 236 879 1 138 2 218 1 438 1 564 1 575 3 12 10 3 16 68 166 296 287 323 326 775 1 177 2 277 1 599 1 559 1 677 3 17 9 10 17 78 201 373 416 474 424 788 908 1 980 1 453 1 594 1 762 8 4 6 9 11 90 177 300 385 416 381 374 814 1 427 967 1 245 1 409 2 1 2 3 5 55 176 352 380 375 365 1 072 891 1 507 981 1 054 1 260 2 5 5 6 4 3 10 7 13 14 11 58 41 208 152 77 105 5 22 15 26 15 49 59 101 133 141 119 446 464 1 044 704 837 903 6 12 7 12 11 49 95 186 152 204 197 448 564 1 061 881 876 1 010 3 7 4 9 10 69 131 205 215 208 192 345 424 947 592 584 710 4 7 8 16 7 54 122 244 269 267 246 316 367 816 542 599 693 1 3 5 12 2 52 91 192 225 215 210 149 356 586 425 459 590 3 1 4 4 1 26 71 178 225 206 201 339 286 572 388 403 483 3 2 0 1 0 0 0 5 4 10 7 3 1 2 4 4 1 2 8 0 0 1 5 4 3 6 3 1 3 6 6 3 9 1 0 5 1 6 3 2 0 0 3 1 2 1 2 0 1 7 1 5 1 0 0 4 7 9 9 5 5 0 3 3 2 2 8 7 1 1 0 4 2 2 2 0 1 2 3 4 5 5 0 0 2 4 8 2 3 0 1 0 2 0 1 2 1 1 3 4 3 37 6 7 3 2 7 8 8 8 99 181 271 285 246 257 1 5 5 111 260 253 255 289 268 2 6 4 68 171 232 231 205 191 4 2 2 19 68 147 154 170 184 4 0 0 13 38 52 50 71 63 0 1 1 15 23 36 40 41 37 5 5 5 30 32 15 12 10 11 8 5 6 70 200 320 296 250 250 9 2 2 78 213 270 246 192 208 3 3 3 33 113 145 112 121 97 4 1 1 15 41 63 83 61 82 2 2 3 9 26 32 42 40 28 0 1 0 25 17 25 28 25 33 GLOBAL TUBERCULOSIS REPORT 2013 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 UNKNOWN 35–44 Data for all years can be downloaded from www.who.int/tb/data 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 MALE:FEMALE RATIO – 2.0 – – – – – 2.1 1.6 1.4 1.4 1.3 – 1.6 2.1 1.5 1.6 1.9 0.99 0.99 1.0 1.2 1.2 1.2 1.8 2.0 2.3 2.5 2.6 2.5 – 2.4 2.3 2.1 2.1 2.2 1.6 2.2 2.9 2.0 1.7 2.1 1.0 – – – – – 1.1 1.6 2.0 1.1 1.2 1.2 – 3.1 1.2 1.2 1.8 1.2 – 2.6 2.0 1.8 1.8 3.6 2.3 2.4 2.1 2.0 1.9 1.9 – 1.2 1.2 1.5 0.65 1.7 1.4 1.6 1.5 1.5 1.6 1.6 2.2 2.3 2.1 2.0 2.1 2.0 – 1.1 0.92 0.97 0.83 1.2 2.5 0.36 – 0.71 1.4 1.2 1.4 1.2 1.1 1.2 1.5 1.4 7$%/($1HZVPHDUSRVLWLYHFDVHQRWLILFDWLRQE\DJHDQGVH[ ± Nauru New Caledonia New Zealand Niue Northern Mariana Islands Palau Papua New Guinea Philippines Republic of Korea Samoa Singapore Solomon Islands Tokelau Tonga Tuvalu Vanuatu Viet Nam Wallis and Futuna Islands 1995 2000 2005 2010 2011 2012 1995 2000 2005 2010 2011 2012 1995 2000 2005 2010 2011 2012 1995 2000 2005 2010 2011 2012 1995 2000 2005 2010 2011 2012 1995 2000 2005 2010 2011 2012 1995 2000 2005 2010 2011 2012 1995 2000 2005 2010 2011 2012 1995 2000 2005 2010 2011 2012 1995 2000 2005 2010 2011 2012 1995 2000 2005 2010 2011 2012 1995 2000 2005 2010 2011 2012 1995 2000 2005 2010 2011 2012 1995 2000 2005 2010 2011 2012 1995 2000 2005 2010 2011 2012 1995 2000 2005 2010 2011 2012 1995 2000 2005 2010 2011 2012 1995 2000 2005 2010 2011 2012 0–14 15–24 25–34 35–44 FEMALE 45–54 55–64 65+ UNKNOWN 0–14 15–24 25–34 35–44 1 0 0 0 0 0 0 0 1 0 1 0 0 0 0 3 1 0 0 0 2 1 2 1 0 4 4 0 3 3 0 0 4 0 1 0 4 6 6 6 12 7 3 3 1 2 0 2 3 5 10 13 5 9 3 6 6 4 5 2 2 2 0 1 1 3 5 8 6 6 7 4 2 3 3 4 2 2 7 10 5 5 7 6 3 4 0 3 3 1 7 7 10 11 11 14 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 1 4 0 2 0 0 2 0 3 8 1 0 0 0 3 0 5 9 3 0 0 3 0 0 10 9 4 3 1 1 2 0 3 3 1 3 5 1 1 0 3 2 2 0 3 0 0 0 0 0 1 0 0 2 2 0 0 1 1 0 1 0 0 1 2 0 1 1 0 0 8 28 37 50 54 2 87 183 279 278 415 43 70 205 260 265 387 56 30 108 196 152 250 61 21 94 135 122 182 46 12 48 87 71 121 47 5 12 27 18 37 26 482 511 573 583 27 19 22 22 13 11 0 0 0 11 275 12 224 12 804 12 576 1 613 1 085 1 171 705 712 699 1 1 0 1 0 3 40 9 25 21 21 36 6 4 18 18 22 19 13 253 13 716 14 474 14 140 1 425 988 1 326 1 049 1 019 956 1 1 1 12 531 13 651 14 002 13 996 1 207 853 1 336 1 496 1 414 1 562 0 1 1 0 1 60 34 61 38 44 54 5 8 9 16 12 10 0 1 62 51 94 105 108 106 7 8 15 8 7 12 7 646 8 923 9 568 9 676 1 307 731 1 005 1 029 1 145 1 238 3 2 0 1 0 1 70 26 96 86 119 124 9 10 12 3 8 8 4 279 4 742 4 845 5 097 1 225 901 1 669 1 997 2 132 2 255 2 1 0 0 0 0 1 0 0 0 1 2 3 4 4 3 3 7 358 9 320 9 725 9 754 1 131 821 687 537 491 500 1 3 4 1 1 4 9 8 8 11 21 31 14 13 14 16 15 20 0 0 0 0 0 0 0 0 1 2 2 0 0 0 0 0 1 1 0 1 0 1 0 1 0 1 0 0 0 0 2 0 0 2 0 1 1 1 1 0 0 1 2 5 0 3 1 2 0 0 0 1 1 1 2 1 0 2 1 4 2 0 1 1 1 6 7 4 6 3 4 2 5 5 3 4 3 1 5 1 5 1 6 4 1 3 10 0 5 5 2 51 54 59 61 58 2 367 3 408 3 205 3 099 2 993 6 147 7 105 7 036 6 677 6 689 8 209 8 738 7 851 7 763 7 680 6 713 8 606 8 564 8 474 8 481 0 0 0 0 1 0 1 45–54 55–64 1 1 65+ UNKNOWN 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 1 0 0 2 1 0 0 0 1 8 1 1 0 1 1 2 0 1 3 1 1 1 1 0 0 0 1 1 1 2 4 3 2 6 11 12 8 4 3 6 9 7 8 8 4 5 6 6 4 2 3 3 2 0 0 1 2 0 6 5 5 3 0 2 0 1 1 1 2 4 1 3 3 1 1 4 4 3 1 1 4 10 2 6 8 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 0 2 0 0 0 0 2 17 0 0 1 3 0 0 6 7 1 1 0 1 0 0 4 3 1 3 2 0 1 0 1 1 1 2 3 0 0 0 1 1 1 1 0 0 0 0 1 0 0 0 0 0 1 1 0 1 0 1 0 0 1 0 0 0 0 0 1 0 0 0 6 38 64 53 55 1 77 200 313 302 398 20 45 204 292 272 395 32 21 124 191 146 208 26 15 65 97 97 156 20 5 35 52 55 95 19 1 2 9 15 29 11 374 454 448 466 46 25 27 23 37 22 1 0 0 3 710 4 825 5 155 5 104 908 546 590 472 446 436 2 2 2 5 268 5 489 5 848 5 954 863 544 842 686 688 664 2 1 0 4 603 4 643 4 880 5 068 296 220 370 487 432 377 0 0 0 0 0 0 2 1 8 9 5 15 11 26 17 15 23 19 13 20 1 0 18 8 20 21 25 46 11 13 21 17 27 18 1 1 22 9 29 21 23 26 12 7 11 5 10 8 3 274 3 329 3 501 3 605 408 295 373 368 421 397 1 0 1 1 0 0 19 5 20 21 20 19 13 5 9 4 16 12 2 029 2 070 2 236 2 380 867 795 1 729 2 216 2 244 2 569 1 0 0 0 1 1 1 0 1 0 0 3 8 9 4 3 5 5 565 5 301 5 521 5 584 431 393 491 509 520 444 0 1 2 2 0 1 21 7 33 26 23 27 7 7 12 11 15 11 0 0 0 0 0 0 0 0 0 0 0 0 0 1 2 0 0 2 1 1 1 1 0 1 0 1 1 1 0 0 1 0 0 0 0 0 2 0 0 0 1 0 1 0 2 1 2 0 0 1 1 1 1 0 0 0 1 0 0 0 1 0 1 0 2 0 0 4 5 4 2 4 2 0 2 1 0 2 2 0 0 0 2 0 5 0 3 0 3 1 5 3 5 5 5 12 0 15 1 3 7 5 2 7 2 3 5 5 0 1 2 3 3 4 5 4 4 0 3 1 3 2 2 0 1 2 1 0 3 0 0 0 5 150 4 958 5 790 6 107 6 315 7 712 7 573 6 248 5 821 5 920 0 0 0 64 47 53 64 84 1 334 1 747 1 870 1 863 1 841 2 320 2 293 2 454 2 325 2 481 2 754 2 116 1 681 1 681 1 626 2 594 2 298 1 864 1 814 1 683 2 847 2 023 1 863 1 878 1 884 4 907 4 604 3 751 3 124 3 298 0 0 0 0 0 94 64 118 120 126 143 3 6 11 3 6 6 0 0 0 0 0 0 0 0 0 0 0 5 3 0 0 0 0 0 2 Data for all years can be downloaded from www.who.int/tb/data 1 1 31 16 43 44 51 39 0 2 1 5 2 5 0 0 0 0 0 0 0 0 0 0 80 0 0 0 2 3 0 0 0 0 0 0 0 0 0 0 0 0 MALE:FEMALE RATIO – 0.50 – – 2.0 – 1.7 0.90 0.60 2.3 2.2 2.7 1.6 1.3 1.3 1.1 1.2 1.6 – – – – – – 1.9 0.92 2.8 0.89 1.5 1.2 8.0 – – 2.3 3.0 – – 1.4 1.0 1.0 1.0 1.0 2.2 – 2.3 2.4 2.4 2.3 2.1 1.9 1.6 1.4 1.4 1.5 1.1 2.2 1.2 1.0 0.20 2.0 2.8 3.5 2.7 2.6 2.9 2.7 0.73 0.91 0.97 1.0 0.85 0.99 – – – – – – 0.80 2.0 1.2 5.0 0.50 0.80 1.0 – 0.67 4.0 3.0 0.60 2.0 0.86 1.3 0.91 1.1 0.50 – 2.2 2.7 2.9 3.0 3.0 – – – – – – GLOBAL TUBERCULOSIS REPORT 2013 WESTERN PACIFIC REGION MALE YEAR 7$%/($ /DERUDWRULHV173VHUYLFHVGUXJPDQDJHPHQWDQGLQIHFWLRQFRQWURO LABORATORIES FREE THROUGH NTP SECONDNUMBER OF SMEAR LABS % OF SMEAR CULTURE DST b LABS LPAc LABS LABS USING LABS PER 5M LINE DST LABS USING PER 100K PER 5M PER 5M a POPULATION POPULATION POPULATION POPULATION XPERT MTB/RIF AVAILABLE LED American Samoa Australia – – Brunei Darussalam 0.2 0 12.1 12.1 12.1 0 Cambodia China China, Hong Kong SAR China, Macao SAR 1.4 0.2 0.4 0.4 10 2 3 0 1.0 3.7 9.1 9.0 0.3 0.7 1.4 9 0 <0.1 1.4 0 6 16 9 0 5.7 0 0 3 Cook Islands Fiji – 0.5 0 French Polynesia – Guam – Japan Yes Yes Yes Yes No Yes (all suspects) Yes (all suspects) Yes (all suspects) Yes (all suspects) Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes (other criteria) No Yes Yes Yes (all suspects) Yes (if TB is confirmed) Yes Yes Yes Yes Yes Yes Yes Yes Yes 0 No Yes Yes (all suspects) Yes No In country Yes Out of No country In and out Yes of country In country Yes Yes (all suspects) Yes Yes Yes (all suspects) Yes Yes 2.4 0 2.3 0.8 0.8 2.6 4 6.2 0.2 0.3 0 Marshall Islands 5.7 33 95.1 95.1 95.1 1 3.9 0 0 0 0 0 1.4 8 – 3.6 1.8 1.8 0 Out of Yes country In country Yes – Out of No country Out of Yes country Palau 9.6 0 240.9 240.9 240.9 1 Papua New Guinea 1.6 0 0 0 0 6 Yes Philippines Republic of Korea 2.7 1.0 0 – 0.7 51.0 0.2 0.7 <0.1 2 17 2 In country Yes Yes Out of Yes country Samoa – Singapore – Solomon Islands 1.5 0 Tokelau – Tonga – Tuvalu – 0 0 0 0 Vanuatu 4.0 100 0 0 0 0 Viet Nam 0.9 0 1.4 0.1 0.1 22 Wallis and Futuna Islands a b c d Yes (all suspects) Yes Yes 0 Northern Mariana Islands Yes No 0 – – Yes Yes (all suspects) Yes 0 – Yes (all suspects) Yes No 49.6 New Caledonia Yes Yes (all suspects) 0 New Zealand Niue TB DIAGNOSIS Yes 2.0 Lao People's Democratic Republic Malaysia Micronesia (Federated States of) Mongolia Nauru NRLd Yes – Kiribati In country Out of country No In country In country In country Out of country No Out of country Out of country In and out of country Out of country TB NOTIF. RIFAMPICIN RATE PER USED 100 000 THROUGHOUT HEALTH-CARE TREATMENT WORKERS FIRSTLINE DRUGS In country Yes Out of Yes country Out of Yes country Out of Yes country Out of Yes country In country Yes Yes (all suspects) Yes Yes Yes (all suspects) Yes Yes Yes (all suspects) Yes Yes Yes (all suspects) Yes Yes Yes (all suspects) Yes Yes Yes (all suspects) Yes Yes Yes (if TB is confirmed) Yes (all suspects) Yes (all suspects) Yes Yes Yes Yes Yes Yes Yes (all suspects) Yes Yes No No Yes Yes (all suspects) Yes Yes Yes (all suspects) Yes Yes Yes (all suspects) Yes Yes Yes (all suspects) Yes Yes Yes (for smearpositive TB) Yes No – LED = Light emitting diode microscopes DST = Drug susceptibility testing LPA = Line probe assay NRL = National Reference Laboratory GLOBAL TUBERCULOSIS REPORT 2013 Data for all years can be downloaded from www.who.int/tb/data 26 41 93 106 53 0 204 0 111 7$%/($0HDVXUHGSHUFHQWDJHRI7%FDVHVZLWK0'57%DPRVWUHFHQW\HDUDYDLODEOH American Samoa Australia Brunei Darussalam Cambodia China China, Hong Kong SAR China, Macao SAR Cook Islands Fiji French Polynesia Guam Japan Kiribati Lao People's Democratic Republic Malaysia Marshall Islands Micronesia (Federated States of) Mongolia Nauru New Caledonia New Zealand Niue Northern Mariana Islands Palau Papua New Guinea Philippines Republic of Korea Samoa Singapore Solomon Islands Tokelau Tonga Tuvalu Vanuatu Viet Nam Wallis and Futuna Islands a Previously treated TB cases Source Coverage Percentage 2012 2012 2007 2007 2012 2012 2012 2006 2012 2012 2002 Surveillance Surveillance Survey Survey Surveillance Surveillance Surveillance Surveillance Surveillance Surveillance Surveillance National National National National National National National National National National National 1997 2012 Survey Surveillance Sub-national National 0.1 (0–0.56) 4.1 (0.86–12) 2007 Survey National 1.4 (0.66–2.5) 2012 Surveillance National 26 (23–30) 2012 2011 Surveillance Surveillance National National 0 (0–12) 0.44 (<0.1–2.4) 2012 2011 Surveillance Surveillance National National 0 (0–98) 20 (0.51–72) 2012 2012 Surveillance Surveillance National National 0 (0–22) 0 (0–71) 2012 2012 Surveillance Surveillance National National 0 (0–98) 23 (20–27) 2004 2004 2012 2012 Survey Survey Surveillance Surveillance National National National National 4 2.7 0 1.6 2004 2004 2012 2012 2012 Survey Survey Surveillance Surveillance Surveillance National National National National National 21 14 0 3.2 0 2006 2006 Surveillance Survey National National 0 (0–12) 2.7 (2.0–3.7) 2006 Survey National 19 (14–25) 1.9 0 1.4 5.7 0.97 0.77 0 0 0 0 0.7 (1.1–3.0) (0–2.2) (0.71–2.5) (4.5–7.0) (0.59–1.5) (<0.1–2.7) (0–98) (0–8.2) (0–12) (0–11) (0.42–1.1) (2.9–5.5) (2.1–3.4) (0–22) (0.97–2.5) Year Source Coverage 2012 2012 2007 2007 2012 2012 2012 2006 2012 2012 2002 Surveillance Surveillance Survey Survey Surveillance Surveillance Surveillance Surveillance Surveillance Surveillance Surveillance National National National National National National National National National National National 1997 2012 Survey Surveillance Sub-national National Percentage 6.5 0 11 26 2.6 21 100 0 0 12 9.8 (0.79–21) (0–23) (4.0–22) (22–30) (0.95–5.5) (8.3–41) (2.5–100) (0–98) (0–60) (9.2–15) (7.1–13) 0 (0–17) 0 (0–98) WESTERN PACIFIC REGION New TB cases Year (14–29) (10–19) (0–98) (0.67–9.1) (0–21) Empty rows indicate an absence of high-quality survey or surveillance data. In the absence of high-quality national data, high-quality sub-national data are used. Data for all years can be downloaded from www.who.int/tb/data GLOBAL TUBERCULOSIS REPORT 2013 The World Health Organization monitors the global tuberculosis epidemic in support of national TB control programmes. For further information about tuberculosis contact: Information Resource Centre HTM/GTB World Health Organization 20 Avenue Appia, 1211–Geneva–27, Switzerland Email: tbdocs@who.int Web site: www.who.int/tb ISBN 978 92 4 1564656
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Y=0 K=5, C=0 M=100 Y=100 K=0, C=0 M=75 Y=100 K=0, C=0 M=10 Y=95 K=0, C=85 M=10 Y=100 K=0, C=100 M=90 Y=0 K=0, C=60 M=90 Y=0 K=0, C=60 M=80 Y=80 K=0, C=20 M=80 Y=100 K=0, C=0 M=50 Y=100 K=0 , C=0 M=20 Y=100 K=0, C=50 M=20 Y=100 K=0, C=100 M=0 Y=80 K=0, C=100 M=30 Y=0 K=0, C=100 M=80 Y=0 K=0, C=30 M=100 Y=60 K=0 1, C=0 M=100 Y=80 K=0, C=0 M=0 Y=0 K=100 1 Swatch Colorant Mode : CMYK, CMYK, CMYK, CMYK, CMYK, CMYK, CMYK, CMYK, CMYK, CMYK, CMYK, CMYK, CMYK, CMYK, CMYK, CMYK, CMYK, CMYK, CMYK, CMYK, CMYK, CMYK, CMYK, CMYK, CMYK, CMYK, CMYK, CMYK, CMYK, CMYK, CMYK, CMYK, CMYK, CMYK, CMYK, CMYK, CMYK, CMYK, CMYK, CMYK, CMYK, CMYK, CMYK, CMYK, CMYK, CMYK, CMYK, CMYK, CMYK, CMYK, CMYK, CMYK, CMYK, CMYK, CMYK, CMYK, CMYK, CMYK, CMYK, CMYK, CMYK, CMYK, CMYK, CMYK, CMYK, CMYK, CMYK, CMYK, CMYK Swatch Colorant Type : PROCESS, PROCESS, PROCESS, PROCESS, PROCESS, PROCESS, PROCESS, PROCESS, PROCESS, PROCESS, PROCESS, PROCESS, PROCESS, PROCESS, PROCESS, PROCESS, PROCESS, PROCESS, PROCESS, PROCESS, 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/All/PDF/PageProperties/PageContent, /All/PDF/PageProperties/Annotations/AnnotationBoundingBoxes, /All/PDF/PageProperties/PageContent Sessions Tool desc : Enfocus CertifiedPDF2XMP Toolkit v1 Sessions Tool desc (en-US) : Enfocus CertifiedPDF2XMP Toolkit v1 Sessions Appl desc : Enfocus StatusCheck 10, update 3 Certificates Class id : Preflight Certificates Type id : com.enfocus.preflight Certificates Type version : 1.0 Certificates Impl id : com.enfocus.pitstop-pro Certificates Impl version : 10.3 Certificates Session id ref : 1 Certificates State : Unknown Certificates Fingerprint : 364ba4ca93c49f7f67a87ee46b870ab8 Certificates Time : 2013:10:21 14:17:20+02:00 Certificates Type desc : Certificat Enfocus Preflight v1.0 Certificates Impl desc : Enfocus PitStop Pro 10, update 3 Certificates Statement desc : Conforme au profil Preflight Chirat CMYK v10 01-2013_Impaire_Paire Certificates State desc : 2 echecs Certificates Zones : /All/PDF/Metadata, /All/PDF/PageProperties Certificates Data 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