title: The epidemiology of tuberculosis in the Pacific, 2000 to 2013.
abstract: OBJECTIVE
  Tuberculosis (TB) poses a significant public health challenge in the 22 Pacific island countries and territories. Using TB surveillance data and World Health Organization (WHO) estimates from 2000 to 2013, we summarize the epidemiology of TB in the Pacific.
  
  
  METHODS
  This was a descriptive study of incident TB cases reported annually by Pacific island national TB programmes to WHO. We counted cases and calculated proportions and case notification rates per 100,000 population. We calculated the proportion of TB patients who completed TB treatment and summed estimates of national incidence, prevalence and mortality, provided by WHO, to produce regional incidence, prevalence and mortality rates per 100,000 population.
  
  
  RESULTS
  Estimated TB incidence in the Pacific has remained high but stable from 2000 to 2013; estimated prevalence and mortality have fallen by 20% and 47%, respectively. The TB case notification rate increased by 58%, from 146 to 231 per 100,000 population in the same time period. In 2013, 24,145 TB cases were notified, most (94% or 22,657) were from Papua New Guinea. Kiribati had the highest TB case notification rate at 398 cases per 100,000 population. TB case notification rates were also high in Papua New Guinea, the Marshall Islands and Tuvalu (309, 283 and 182, respectively).
  
  
  CONCLUSIONS
  TB in the Pacific is improving in some areas; however, high rates affect many countries and the estimated regional incidence rate is stable. To further reduce the burden of TB, a combination of dedicated public health and system-wide approaches are required along with poverty reduction and social protection initiatives.
authors.affiliation: Australian National University, National Centre for Epidemiology and Population Health, Research School of Population Health, Canberra, Australia .
authors.forename: Kerri
authors.initials: K
authors.lastname: Viney
authors.affiliation: Research, Evidence and Information Programme, Public Health Division, Secretariat of the Pacific Community, Noumea, New Caledonia .
authors.forename: Damian
authors.initials: D
authors.lastname: Hoy
authors.affiliation: Research, Evidence and Information Programme, Public Health Division, Secretariat of the Pacific Community, Noumea, New Caledonia .
authors.forename: Adam
authors.initials: A
authors.lastname: Roth
authors.affiliation: Population Health Division, Australian Capital Territory Health, Canberra, Australia . ; Australian National University Medical School, Canberra, Australia .
authors.forename: Paul
authors.initials: P
authors.lastname: Kelly
authors.affiliation: Australian National University, National Centre for Epidemiology and Population Health, Research School of Population Health, Canberra, Australia .
authors.forename: David
authors.initials: D
authors.lastname: Harley
authors.affiliation: Australian National University, National Centre for Epidemiology and Population Health, Research School of Population Health, Canberra, Australia .
authors.forename: Adrian
authors.initials: A
authors.lastname: Sleigh
mesh_terms: D000293:Adolescent; D000995:Antitubercular Agents / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D023801:Directly Observed Therapy; D005260:Female; D015658:HIV Infections / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D007223:Infant; D008297:Male; D010139:Pacific Islands / Q000453:epidemiology; D011159:Population Surveillance; D015995:Prevalence; D012959:Socioeconomic Factors; D016896:Treatment Outcome; D014376:Tuberculosis / Q000188:drug therapy / Q000453:epidemiology*; D018088:Tuberculosis, Multidrug-Resistant / Q000188:drug therapy / Q000453:epidemiology
chemical_list: D000995:Antitubercular Agents