title: Epidemiology and control of tuberculosis in the Western Pacific Region: analysis of 2012 case notification data.
abstract: Tuberculosis (TB) control in the World Health Organization (WHO) Western Pacific Region has seen substantial progress in the last decade, with a 33% reduction in prevalent TB cases since 2000. The burden remains immense, however, and national TB programmes must evolve and adapt to build upon these gains. Through routine surveillance, countries and areas in the Region reported 1.4 million TB cases in 2012. The case notification rate increased in the early 2000s, appears to have stabilized in recent years and is in decline for all forms and new smear-positive cases. The age and sex breakdown for smear-positive TB case rates by country shows generally higher rates with increased age and declining rates over time for all age groups. Treatment success remains high in the Region, with 15 countries reaching or maintaining an 85% success rate. HIV testing among TB patients has increased gradually along with a slow decline in the number of HIV-positive patients found. The trend of TB notification is heavily influenced by programmatic improvements in many countries and rapidly changing demographics. It appears that cases are being found earlier as reflected in declining rates of smear-positive TB and steady rates of TB in all forms. WHO estimates depict a decline in TB incidence in the Region. HIV testing, while still low, has increased substantially in recent years, with essential TB/HIV services expanding in many countries. TB surveillance data, within inherent limitations, is an important source of programmatic and epidemiological information. Careful interpretation of these findings can provide useful insight for programmatic decision-making.
authors.affiliation: Stop TB and Leprosy Elimination, Division of Combating Communicable Diseases, World Health Organization Regional Office for the Western Pacific, Manila, Philippines .
authors.forename: Tom
authors.initials: T
authors.lastname: Hiatt
authors.affiliation: Stop TB and Leprosy Elimination, Division of Combating Communicable Diseases, World Health Organization Regional Office for the Western Pacific, Manila, Philippines .
authors.forename: Nobuyuki
authors.initials: N
authors.lastname: Nishikiori
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D023801:Directly Observed Therapy; D018563:Disease Notification; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D010139:Pacific Islands / Q000453:epidemiology; D011159:Population Surveillance; D015995:Prevalence; D014376:Tuberculosis / Q000453:epidemiology* / Q000517:prevention & control; D055815:Young Adult
references.citation: Am J Epidemiol. 2006 May 1;163(9):783-9
references.pmid: 16510544
references.citation: Lancet. 2007 Feb 24;369(9562):691-6
references.pmid: 17321314
references.citation: Bull World Health Organ. 2007 May;85(5):360-3
references.pmid: 17639220
references.citation: BMJ. 2012 Jun 26;344:e4383
references.pmid: 22736475