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Epidemiology
Worldwide
Tuberculosis,
"the captain of death" or the "white plague" began to decline in
many countries during the mid to late 1800's. This was attributed
to improved socio-economic conditions, with changes in nutrition
and hygiene and accelerated with the introduction of chemotherapy
in the 1950's. However the decline in the trends of tuberculosis
was reversed in 1980's and 1990's leading the WHO to declare tuberculosis
a global emergency. Following are some of the epidemiological features
and trends that indicate the seriousness of the problem in the late
1990's.
Mortality:
- In 2003
there were 1.75 million deaths from tuberculosis.
- Tuberculosis
causes 1 in 4 preventable adult deaths.
- Tuberculosis
in the second most frequent cause of death from any infectious agent in adults, causing approximately 2 million death per year worldwide.
- It is a
leading cause of death in the age group 15-44 especially in women.
- Tuberculosis
kills about one third of all patients who die from AIDS in Africa.
Morbidity:
(Click
here to see the MAP)
- The largest number of cases occurs in South East Asia, which accounts for 33% of incident causes globally, but...
- The estimated incidence per capita in sub-Saharan Africa is nearly twice that of South East Asia, at 350 cases per 100,000 population in 2003.
- One third
of the world's population is currently infected with the TB bacillus.
- 5 to 10% of people who are infected with TB bacilli (but who are not infected with HIV) become sick or infectious at some time during their life.
Factors influencing global trends in tuberculosis:
- HIV/AIDS:
The HIV/AIDS pandemic is fuelling the TB burden with an estimated
one third of the 40 million people living with HIV / AIDS coinfected with TB.
- MDR-TB:
An additional feature of the tuberculosis problem is an increasing
number of multi drug resistant TB (MDR-TB), about 4% of new
cases. In Eastern Europe 7-14% of strains are multi drug resistant
- Aging
of the population: Extension of life expectancy, especially
in developed countries , but increasingly also in many developing
countries has become an important factor in the deterioration
of tuberculosis
- Tobacco:
Smoking has an important influence on the risk of tuberculosis
mortality
- Prisons:
Prisons have been identified as important reservoirs of tuberculosis,
particularly drug resistant strains.
- Provision
of treatment: An effective and affordable strategy
for TB treatment and control is available(DOTS), but is being
used to treat less than 15 % of the world's TB patients
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