# Presentation: 205895

## Global TB Problem.

- IUATLD AFB Microscopy Advanced Course-Silver Springs Hotel- Nairobi
- Presented by Dr J.Kangangi on behalf of Dr Peter Eriki-WR Kenya.

## What is tuberculosis?

- TB is an infectious disease,airborne disease primarily affecting the lungs.It is caused by a micro organism called mycobacterium tuberculosis, the TB bacillus.
- Untreated TB cases infect 10 –15 people every year and out of these, about two develop tuberculosis disease

## African TB Factfile

- TB closely related to poverty and HIV/AIDS with a devastating impact on development in the community.
- If a case of sputum smear positive TB is left untreated,each case will infect an average of 10-15 additional people each year.
- It is estimated that between 30-50% of newly diagnosed TB cases are also HIV carriers.
- Tb is the number one cause of death among HIV positive people. (up to 40% of all AIDS deaths is due to TB).
- In the African region, 3 out of four TB victims are between 15-54(bread winners)

## Global TB Burden

- A third of the world population is infected with tubercle bacillus.
- 8 million people progress to active tuberculosis.
- Death occurs in 2million TB patients every year.
- Aids related tuberculosis is a leading cause of adult mortality in the world.

## TB Burden

## TB in the HIV era.

- WHO African region, especially those with high prevalence of HIV,  have experienced huge increases in the incidence of TB cases
- The traditional TB treatment practices that rely on hospital in-patient care for the initial intensive phase of treatment for DOT are proving difficult if not impossible to sustain for the majority of affected countries (both in terms of human and logistic support).

## MAJOR ISSUES SURROUNDING TB CONTROL IN THE AFRICAN REGION

- Impact of HIV infection and AIDS on TB incidence (and unco-ordinated efforts between TB and AIDS control programmes to cater for common clients)
- Health policy environment (including effects of health sector reforms) as it related to  capacity to implement effective control activities
- Insufficient coverage with effective control strategies
- Scarcity of resources (human, drugs, logistics and other)
- Need for efficient and cost-effective strategies to deliver TB services under prevailing circumstances

## How common is tuberculosis in Africa?

- Every second,someone,somewhere in Africa is infected with TB.
- About 1 in every 3 persons in Africa is infected with TB.
- About 2 million of them develop active TB each year.
- Every day in Africa at least 1,600 people die of TB.

## Facts about Africa

- >200 million(1/3rd of the regions population)-healthy carriers of the TB Bacillus.
- 1.6 million new cases of TB are registered per year.
- >600,000 deaths occur as a result of TB.
- Last decade Africa witnessed huge TB increase mostly as a result of TB/HIV dual epidemic.
- HIV most important risk factor for developing TB in the African region.

## Regional strategy to stop TB

- Expand DOTS to detect at least 70% of sputum smear positive cases and to treat successfully 85% of the cases.
- Adapt DOTS to meet the challenge of threats such as HIV/AIDS and MDR-TB cases
- Improve TB control strategies by developing new drugs,vaccines,diagnostics and policy tools to accelerate TB elimination.
- Strengthen the regional partnership to stop TB by mobilizing partners at the national,regional and global,and levels developing structures to coordinate and accelerate effective action and mobilizing resources to control Tb.

## New interventions to address the TB Burden

- 3 by 5 initiatives
- TB/HIV collaboration
- Community based TB care
- Private sector involvement
- Development of Communication Strategies

## Conclusion

- Laboratory is one of the main players in the TB control and the success of the laboratory determines the success of TB control programs.
- Programs must put in place  budgets for laboratory developments,QA,Supervision etc.
- Training and surveillance should be part and parcel of the laboratory development.