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WHO Global Tuberculosis Report 2022
Top findings and messages in the 2022 report
The COVID-19 pandemic continues to
have a damaging impact on access to Tb diagnosis and treatment and the burden of TB disease. progress made in the years up
to 2019 has slowed, stalled or reversed, and global TB targets are off track.
The most obvious and immediate impact was a large global drop
in the reported number of people newly diagnosed with TB. From a peak of 7.1
million in 2019, this fell to 5.8 million in 2020 (–18%), back to the level last
seen in 2012. in 2021, there was a partial recovery, to 6.4 million (the level
of 2016–2017). The three countries that accounted for most of the reduction in
2020 were india, indonesia and the philippines (67% of the global total). They
made partial recoveries in 2021, but still accounted for 60% of the global
reduction compared with 2019. other high TB burden countries with large relative
year-to-year reductions (>20%) included bangladesh (2020), lesotho (2020 and
2021), Myanmar (2020 and 2021), Mongolia (2021) and Vietnam (2021). reductions
in the reported number of people diagnosed with TB in 2020 and 2021 suggest
that the number of people with
undiagnosed and untreated TB has grown, resulting first in an increased number
of TB deaths and more community transmission of infection and then, with some
lag-time, increased numbers of people developing Tb.
Globally, the estimated number of deaths from TB increased between 2019 and 2021, reversing years of decline between 2005 and 2019. in 2021, there were an estimated 1.4 million deaths among HIV-negative people (95% uncertainty interval [UI]: 1.3–1.5 million) and 187 000 deaths (95% UI: 158 000–218 000) among HIV-positive people,a for a combined total of 1.6 million .This was up from best estimates of 1.5 million in 2020 and 1.4 million in 2019, and back to the level of 2017. The net reduction from 2015 to 2021 was 5.9%, about one sixth of the way to the first milestone of the WHo end Tb strategy.
An estimated 10.6 million people (95% UI: 9.9–11 million) fell ill with TB in 2021, an increase of 4.5% from 10.1 million (95% UI: 9.5–10.7 million) in 2020. The TB incidence rate (new cases per 100000 population per year) rose by 3.6% between 2020 and 2021, reversing declines of about 2% per year for most of the previous 2 decades. The net reduction from 2015 to 2021 was 10%, only halfway to the first milestone of the end TB strategy.
The burden of
drug-resistant TB (DR-TB) is also estimated to have increased between 2020 and
2021, with 450 000 (95% ui: 399 000–501 000) new cases of rifampicinresistantb TB (RR-TB) in
2021. estimating TB disease burden during the coViD-19 pandemic is difficult and
relies heavily on country- and region-specific dynamic models for low- and
middleincome countries (LMICS). New national populationbased surveys of TB disease and up-to-date cause-ofdeath data from national vital registration
systems of high quality and coverage are needed for more accurate estimation in
the wake of the pandemic. other negative impacts on TB during the COVID-19 pandemic
include a fall between 2019 and 2020 in the number of people provided with
treatment for RR-TB and multidrug-resistant TB (MDR-TB) (–17%, from 181
533 to 150 469, about 1 in 3 of those in need), with a partial recovery (+7.5%)
to 161 746 in 2021; and a decline in global spending on essential TB services
(from USD 6.0 billion in 2019 to USD 5.4 billion in 2021, less than half of
what is needed). There is a strong and enduring relationship between TB incidence
rates per capita and indicators of development such as average income and
undernourishment. economic and financial barriers can affect access to health
care for TB diagnosis and completion of TB treatment; about half of TB patients
and their households face catastrophic total costsc due to TB disease.
progress towards universal health coverage (UHC), better levels of social
protection and multisectoral action on broader TB determinants are all essential
to reduce the burden of TB disease.
There are some positive findings and success stories.
▶ Globally, the success rate for people
treated for TB in 2020 was 86%, the same level as 2019, suggesting that the
quality of care was maintained in the first year of the COVID-19 pandemic.
▶ In the WHO african region, the impact
of COVID related disruptions on the reported number of people newly diagnosed
with Tb was limited. There was a relatively small decrease (–2.3%) from
2019–2020 and an increase in 2021.
▶ Following large falls in 2020, the
reported number of people newly diagnosed with TB in 2021 recovered to 2019
levels (or beyond) in five high TB burden countries: bangladesh, the congo,
pakistan, sierra leone and uganda.
▶ The global number of people provided
with TB preventive treatment recovered in 2021, to close to 2019 levels, and
the global target for provision of treatment to people living with HiV was
surpassed.
▶ Three high TB burden countries have
reached or passed the first milestones of the end TB strategy for both
reductions in TB incidence and TB deaths: Kenya (in 2018), the united republic
of Tanzania (in 2019) and Zambia (in 2021). ethiopia is very close. intensified
efforts backed by increased funding are urgently required to mitigate and
reverse the negative impacts of the COVID-19 pandemic on TB. The need for action
has become even more pressing in the context of war in ukraine, ongoing
conflicts in other parts of the world, a global energy crisis and associated
risks to food security, which are likely to worsen some of the broader determinants
of TB.
Figure below shows the global trend in case notifications of people newly diagnosed with TB from 2015–2021. It was higest in the year 2019 and least in 2020. It increased from 7.2 in 2020 to 6.4 in 2021.
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