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TB Working Group_Kayt E_10.13.11
1. TB/HIV Why do we care about the intersection of the epidemics? Kayt Erdahl, Technical Officer HIV/AIDS & TB Global Programs, PATH CORE Group Fall Meeting October 13, 2011
7. Global Burden of TB and TB/HIV, 2010 *Including deaths among people living with HIV Data from WHO Global TB Report, 2011 Estimated number of cases Estimated number of deaths All forms of TB 8.8 million 1.4 million* All forms of TB, women only 3.2 million 320,000 HIV-Associated TB 1.1 million 350,000 Multidrug-resistant TB (MDR-TB) 650,000 ~150,000 (2008)
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9. Estimated HIV prevalence in new TB cases, 2010 WHO, Global TB Report 2011 1.1 million TB/HIV cases and 350,000 deaths
10. Countries with the highest number of deaths from HIV-associated TB Time to act - Save a million lives by 2015 Prevent and treat tuberculosis among people living with HIV. WHO 2011
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12. Estimated TB incidence vs. HIV prevalence in high burden countries 0 400 800 1200 1600 0.0 0.1 0.2 0.3 0.4 HIV prevalence, adults 15-49 years Estimated annual TB incidence (per 100K adults , 1999) As HIV prevalence increases by 1%, TB incidence increases by 26/100k/yr Williams B. 3rd Global TB/HIV Working Group Meeting; Montreux, 4-6 June 2003
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14. Global Plan to Stop TB 2011-2015 Summary of main TB/HIV indicators Data from WHO Global TB Report, 2011 TB/HIV indicators Baseline (2009) 2010 % TB patients tested for HIV 26% 34% % HIV+ TB patients treated with CPT 75% 77% % of HIV+ TB patients treated with ART 37% 46% % of PLHA attending HIV care services who were screened for TB at their last visit ~25% 58% % of PLHA attending HIV care services who were enrolled on IPT; among those eligible <1% 12%
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17. Reducing TB burden among PLWHA Isoniazid preventive therapy Infection control Intensified case finding Adapted from WHO; 2009 The 3 Is Antiretroviral therapy The 4 th I
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22. TB/HIV interventions scale-up by HIV/AIDS programmes In 2008 1.4 M PLHIV screened for TB (4% of PLHIV) 56,000 PLHIV enrolled on IPT (0.2% of PLHIV)
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Notas del editor
India and China do not have the highest rates of TB, but due to population numbers they contribute 40% of all TB cases globally
2009 (from 2010 report) All forms of TB, 9.4M cases, 1.7M deaths HIV-Associated TB: 1.1M cases, 380K deaths MDR-TB: 440K cases, ~150K deaths
The number of cases is the same estimate as last year, but mortality estimates have dropped from 400,000 in 2009 to 350,000 in 2010.
The geographical distribution of this tragedy is uneven, as sub-Saharan Africa has to suffer 80% of the burden, with several countries reporting over 10,000 deaths for the co-infection per year, and South Africa over 80,000. However, India has a large burden as well.
The estimated annual TB incidence per 100,000 adults increases in a proportional way with the HIV prevalence in adults, 15-49 years of age. When HIV prevalence increases by 1%, the TB incidence increases by 26/100,000 per year.
2010 All forms of TB, 9.4M cases, 1.7M deaths HIV-Associated TB: 1.1M cases, 380K deaths MDR-TB: 440K cases, ~150K deaths