Tuberculosis-a World Health Organization Perspective

Abstract

Tuberculosis (TB) is an important cause of morbidity and mortality worldwide. The World Health Organization (WHO) has implemented and scaled-up three important global public health strategies (i.e., DOTS, Stop TB, and End TB) to improve the international scenario. Their epidemiological impact was relevant, as they decreased the number of potential new cases of disease and death. However, the emergence and spread of TB/HIV coinfection and multidrug-resistant TB have hindered the progress towards the elimination of TB by 2050. More efforts are required to increase the global annual decline of the TB incidence rate. Political commitment is necessary, with global and national strategies oriented to the adoption and adaptation of the international, evidence-based recommendations on diagnosis, treatment, and prevention. Research and development activities should be planned to improve the current tools adopted to fight the disease. New rapid diagnostics, an updated and effective therapeutic armamentarium, and an effective preventive vaccine could represent the solution to address the current epidemiological threats.

FIGURE 1

Estimated TB incidence rates, 2015. Reprinted from reference , with permission.

FIGURE 2

Estimated TB mortality rates in HIV-negative people, 2015. Reprinted from reference , with permission.

FIGURE 3

Estimated number of deaths from HIV/AIDS and TB in 2015. Deaths from TB among HIV-positive people are shown in gray. For HIV/AIDS, the latest estimates of the number of deaths in 2015 that have been published by UNAIDS are available at http://www.unaids.org/en/resources/documents/2016/HIV_estimates_with_uncertainty_bounds_1990-2015. Deaths from TB among HIV-positive people are officially classified as deaths caused by HIV/AIDS in the International Classification of Diseases. Reprinted from reference , with permission.

FIGURE 4

Estimated HIV prevalence in new and relapse cases, 2015. Reprinted from reference , with permission.

FIGURE 5

Estimated new TB cases with MDR/RR-TB. Figures are based on the most recent year for which data have been reported, which varies among countries. Data reported before the year 2001 are not shown. Reprinted from reference , with permission.

FIGURE 6

Percentage of previously treated TB cases with MDR/RR-TB. Figures are based on the most recent year for which data have been reported, which varies among countries. Data reported before the year 2001 are not shown. The high percentages of previously treated TB cases with MDR-TB in Bahamas, Bahrain, Belize, Bonaire-Saint Eustatius and Saba, French Polynesia, and São Tomé and Principe refer to only a small number of notified cases (range: 1 to 8 notified previously treated TB cases). Reprinted from reference , with permission.