Abstract
In 2010, the World Health Organization (WHO) estimated that there were 8.8 million incident and 12 million prevalent cases of TB disease. It is estimated that tuberculosis (TB) killed 1.45 million people in 2010, including 320,000 women and 350,000 people with HIV, making it the leading cause of death among people with HIV. The global estimates for the 2009 cohort of patients showed a treatment success rate of 87% for smear-positive, DS-TB (World Health Organization 2011b). This statistic only applies to treatment of TB patients whose disease was detected via the sputum smear microscopy test, the most commonly used TB diagnostic. Omitted are treatment results for smear-negative pulmonary disease (in which there are too few bacteria in the sputum to be detected) and extrapulmonary disease (in which the disease occurs outside the lung). Extrapulmonary TB and smear-negative TB are more common among children and those who are HIV-positive. The treatment success rate is also much lower for DR-TB cases. Drug resistance cannot be identified by the smear test. In 2006, WHO estimated that only 20% of the TB cases worldwide were detected by sputum smear microscopy (World Health Organization 2006a). Thus, it is not surprising that in 2010 only 6.2 million cases of TB were reported to worldwide national TB programs (NTPs), leaving 30% of the world’s TB cases unreported (World Health Organization 2011b). 3 Executive summary Technical Report
TB treatment has challenges related to its duration, interactions with other medications, and ensuring treatment adherence. Many high-burden countries have treatment success rates lower than the global target of 85%, and the rate can be as low as 55% (World Health Organization 2011b). The current TB treatment regimens for DR-TB are less effective, and cure rates range from 30% to 80% depending on the severity of drug resistance (Orenstein 2009, Dheda 2010).
