Tuberculosis is still killing continue – Miramar Health News

Tuberculosis surpassed HIV as the leading cause of death from infectious disease in the world in 2014, according to a report released Wednesday by the World Health Organization.

Tuberculosis Caused More Deaths than HIV in 2014

But it's not because more people are getting infected. Global health officials said on Wednesday that they are able to better track cases to report more accurate numbers. This year, 1 million new cases were reported in Indonesia, significantly revising data from last year, which showed half that number.

Cases also were higher among children than previously thought – nearly double the number reported last year. Data show 140,000 children died from TB and 1 million were infected.

WHO estimates overall totals could be even higher, with nearly 40 percent of cases undiagnosed worldwide.

Still, global health efforts have greatly reduced the incidence of the disease since the 1990s, shows the report, the 20th annual Tuberculosis Report.

TB mortality has fallen by nearly half since 1990, with nearly all improvement taking place since 2000, when the United Nations set Millennium Development Goals for reducing the incidence of the disease. From 2000 to 2014, about 43 million lives were saved because of better diagnosis and treatment.

"We can now begin to imagine the end of tuberculosis," said Dr. Ariel Pablos-Mendez, assistant administrator for global health at USAID, at a news conference Wednesday held in the District of Columbia at the National Press Club. "We never imagined we would be at this stage."

TB is caused by airborne bacteria that damage the lungs, resulting in fever and coughing up blood or mucus. It is curable through medication, but easily can be transmitted from one person to another.

Of the new TB cases in 2014, 58 percent were in the Southeast Asia and Western Pacific regions, with India having the largest percentage of cases at 23 percent. The African region had 28 percent of the world's cases in 2014, but the most severe burden relative to population: 281 cases for every 100,000 people – more than double the global average of 133. More than half of the world's TB cases (54 percent) occurred in China, India, Indonesia, Nigeria and Pakistan.

Despite advances, TB killed more than 1.5 million people in 2014.

This is slightly higher than HIV's death toll, estimated at 1.2 million, which included 400,000 deaths among people who had both TB and HIV, which is also treatable, through the use of antiretroviral drugs. People who are HIV-positive are more susceptible to TB because they have a weakened immune system. Worldwide, 9.6 million people contracted TB in 2014, 12 percent of whom were HIV positive.

Dr. Eric Goosby, United Nations special envoy on TB, called for more funding so that global health officials could reach their goals to reduce TB deaths by 90 percent and TB cases by 80 percent by 2030.

To do so, the report says, better detection systems need to be in place and tools developed to better diagnose people, and a vaccine should be developed. This will require more funding. WHO estimated a funding gap of $1.4 billion for interventions in 2015. For research, WHO estimates it is short $1.3 billion.

Dr. Mario Raviglione, director for WHO's global TB program, noted during the news conference that the U.S. had given the highest investment to combating TB. "Despite the gains, the progress is far from sufficient," he said.

Even with adequate investment, the world faces another looming threat: TB that has become resistant to the drugs used to treat it. The WHO report noted that about half of people who are infected with this type are effectively treated.

TB Is Now The Top Infectious Killer (Even Though Deaths Are Down)

Tuberculosis is now killing more people each year than HIV, according to new data from the World Health Organization.

WHO estimates there were almost 10 million new cases of TB last year; the disease caused 1.5 million deaths. By comparison, 1.2 million lives were claimed by HIV.

That makes TB the number one infectious killer.

But dig into the numbers and you'll find some surprises. TB deaths have actually been going down in recent years. The number of deaths from the disease each year has dropped by nearly half since 1990.

HIV deaths, however, are falling far faster.

And these death numbers are a bit complicated. Some 400,000 fatalities were double-counted — included under each disease — because the deceased had both infections.

There's another TB statistic that's particularly worrisome. The new report estimates that there were roughly half a million cases of multi-drug resistant TB last year, double the number from the year 2000. Conventional antibiotics can't cure MDR-TB. Treatment can take 2 years or more with drugs that cause severe side-effects; some patients are left completely deaf.

"MDR-TB is rampant in some parts of the world such as the former Soviet Union, where up to a third of all [TB] cases are MDR," says Dr. Mario Raviglione, the director of WHO's global TB program. "Something is not going well there."

Much of the rise in regular TB cases is the result of new diagnostic tools that make the disease far easier to diagnose and of better reporting. Those are the reasons behind an increase of hundreds of thousands of "new" cases from Indonesia and India. Indonesia's reported incidents of TB doubled last year to 1 million cases. India's tally was up 29 percent.

Maria Carmen Castro, 46, of Lima, Peru, is a survivor of MDR-TB — multidrug-resistant tuberculosis. Partners In Health treated her and loaned her money to open a small store. "Because of my TB and thanks to God and Partners In Health, now I have my own business," she says.
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Jenny Tenorio Gallegos, 35, in Lima, Peru, is being treated for drug-resistant TB. The treatment lasts two years and may rob her of her hearing.
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So public health officials are worried. Progress against TB is not moving as fast as progress against some other diseases — and not as fast as they'd like.

"The number of deaths caused by TB and HIV are pretty similar," says Raviglione. But he says TB doesn't attract nearly the funding for research or treatment that goes to HIV.

According to data gathered by WHO, roughly $6.6 billion was spent fighting TB last year compared to $20.2 billion invested to fight HIV/AIDS in low- and middle-income countries.

"Our point is that we should have the same type of investment going to TB and as of yet that hasn't been achieved," Raviglione says.

Patient advocates are not as diplomatic.

"We're in this dire situation because the vigorous community response, massive research effort and political leadership that distinguished the response to HIV are utterly absent from TB," said Mark Harrington, executive director of Treatment Action Group, in a statement.

Raviglione stresses that the world neglects TB at its peril: "After all it's airborne and can spread fairly easily."

Global fight against TB advancing, but disease still a leading cause of death

The global fight against tuberculosis is advancing, with this year's death rate nearly half of what it was in 1990. However, the disease is still a public health concern, ranking alongside HIV/AIDS as a major cause of global death, according to the World Health Organization.

The WHO released the Global Tuberculosis Report 2015 on Wednesday, giving a snapshot of how far the international health community has come in combating TB.

According to the report, close to 1.5 million people died from TB in 2014. By comparison, HIV's death toll in 2014 was estimated at 1.2 million, according to the WHO.

The report found that most of the gains in combating TB have come since 2000, the year the UN's Millennium Development Goals were established.

Between 2000 and 2015, effective diagnosis and treatment of TB resulted in 43 million lives saved, the report says. Globally, TB incidence has fallen 1.5 per cent per year since 2000, equalling a total reduction of 18 per cent.

But despite these advances, TB continues to be a major cause of death, says Dr. Mario Raviglione, director of WHO's Global TB Programme.

"We are still facing a burden of 4,400 people dying every day, which is unacceptable in an era when you can diagnose and cure nearly every person with TB," he said in a statement.

TB is an infectious disease caused by mycobacterium. The disease typically effects the lungs, and is spread through the air when infected patients transmit bodily fluids from their throat and lungs through coughing or sneezing.

Symptoms of active TB include a chronic cough, chest pains, weakness, fever, night sweats and weight loss. The disease is treatable with a course of antibiotics, however, if left untreated it can result in death.

This year's report found the global total for new TB cases to be 9.6 million cases. This is higher than in previous years, but it may reflect improvements in data collection rather than an actual increase, the WHO said.

Addressing treatment gaps and multi-drug resistant TB
The report shows the need to improve TB detection, close "treatment gaps," boost funding, and develop new drugs and vaccines, the WHO said.

Detection in particular remains a problem, with the WHO finding that about 37.5 per cent of the new TB cases in 2014 went undiagnosed or were not reported to national authorities.

This is especially serious for patients with multidrug-resistant TB (MDR-TB). The WHO estimates that 3.3 per cent of the new patients have MDR-TB, a level that has not changed over the years. MDR-TB is a form of TB infection caused by bacteria that are resistant to common drug treatments.

"Detection and treatment gaps are especially serious among people with MDR-TB, which remains a public health crisis," the WHO said in a statement. "Of the 480, 000 cases estimated to have occurred in 2014, only about a quarter – 123 000 – were detected and reported to national authorities."

The WHO report found that fewer people were diagnosed with MDR-TB globally in 2014 than in 2013, although the total estimated number of people who developed MDR-TB remained the same.

The WHO said 43 countries reported cure rates for MDR-TB patients of more than 75 per cent. However, global data shows an average cure rate of only 50 per cent for treated MDR-TB patients.

Dr. Grania Brigden, interim medical director from Doctors Without Borders Access Campaign, said the overall picture is "disheartening," and is particularly bleak when it comes to MDR-TB.

"We're losing ground in the battle to control drug-resistant forms of TB, and without considerable corrective action, the vast majority of people with MDR-TB won't ever be diagnosed, put on treatment, or cured," she said.
"Drug-resistant forms of TB will continue to spread unless the gap is narrowed between people with undiagnosed TB disease and people who are diagnosed."

Brigden called for a widespread rollout of existing rapid tests and drug-resistance testing.

The WHO said that in 2016, the global community's goal will shift from controlling TB to ending the epidemic. Its "End TB Strategy," adopted by all WHO member states, will aim to reduce TB incidence by 80 per cent and TB deaths by 90 per cent by 2030.

source: http://www.albanydailystar.com/