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WHO|Tuberculosis

Campaignweek

Mediacentre
Tuberculosis
FactsheetN104
ReviewedMarch2016

Keyfacts
Tuberculosis(TB)isatopinfectiousdiseasekillerworldwide.
In2014,9.6millionpeoplefellillwithTBand1.5milliondiedfromthe
disease.
Over95%ofTBdeathsoccurinlowandmiddleincomecountries,
anditisamongthetop5causesofdeathforwomenaged15to44.
In2014,anestimated1millionchildrenbecameillwithTBand140
000childrendiedofTB.
TBisaleadingkillerofHIVpositivepeople:in2015,1in3HIV
deathswasduetoTB.
Globallyin2014,anestimated480000peopledevelopedmultidrug
resistantTB(MDRTB).
TheMillenniumDevelopmentGoaltargetofhaltingandreversingthe
TBepidemicby2015hasbeenmetglobally.TBincidencehasfallen
byanaverageof1.5%peryearsince2000andisnow18%lower
thanthelevelof2000.
TheTBdeathratedropped47%between1990and2015.
Anestimated43millionlivesweresavedthroughTBdiagnosisand
treatmentbetween2000and2014.
EndingtheTBepidemicby2030isamongthehealthtargetsofthe
newlyadoptedSustainableDevelopmentGoals.

Tuberculosis(TB)iscausedbybacteria(Mycobacteriumtuberculosis)
thatmostoftenaffectthelungs.Tuberculosisiscurableand
preventable.
TBisspreadfrompersontopersonthroughtheair.Whenpeoplewith
lungTBcough,sneezeorspit,theypropeltheTBgermsintotheair.A
personneedstoinhaleonlyafewofthesegermstobecomeinfected.
Aboutonethirdoftheworld'spopulationhaslatentTB,whichmeans
peoplehavebeeninfectedbyTBbacteriabutarenot(yet)illwiththe
diseaseandcannottransmitthedisease.
PeopleinfectedwithTBbacteriahavea10%lifetimeriskoffallingill
withTB.However,personswithcompromisedimmunesystems,such
aspeoplelivingwithHIV,malnutritionordiabetes,orpeoplewhouse
tobacco,haveamuchhigherriskoffallingill.
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WHO|Tuberculosis

WhenapersondevelopsactiveTBdisease,thesymptoms(cough,
fever,nightsweats,weightlossetc.)maybemildformanymonths.
Thiscanleadtodelaysinseekingcare,andresultsintransmissionof
thebacteriatoothers.PeoplewithactiveTBcaninfect1015other
peoplethroughclosecontactoverthecourseofayear.Withoutproper
treatment,45%ofHIVnegativepeoplewithTBonaverageandnearly
allHIVpositivepeoplewithTBwilldie.

Whoismostatrisk?
Tuberculosismostlyaffectsadultsintheirmostproductiveyears.
However,allagegroupsareatrisk.Over95%ofcasesanddeathsare
indevelopingcountries.
PeoplewhoareinfectedwithHIVare20to30timesmorelikelyto
developactiveTB(seeTBandHIVsection).TheriskofactiveTBis
alsogreaterinpersonssufferingfromotherconditionsthatimpairthe
immunesystem.
Onemillionchildren(014years)fellillwithTB,and140000children
diedfromthediseasein2014.
TobaccousegreatlyincreasestheriskofTBdiseaseanddeath.More
than20%ofTBcasesworldwideareattributabletosmoking.

GlobalimpactofTB
TBoccursineverypartoftheworld.In2014,thelargestnumberofnew
TBcasesoccurredintheSouthEastAsiaandWesternPacificRegions,
accountingfor58%ofnewcasesglobally.However,Africacarriedthe
mostsevereburden,with281casesper100000populationin2014
(comparedwithaglobalaverageof133).
In2014,about80%ofreportedTBcasesoccurredin22countries.The
6countriesthatstandoutashavingthelargestnumberofincident
casesin2014wereIndia,Indonesia,Nigeria,Pakistan,Peoples
RepublicofChinaandSouthAfrica.Somecountriesareexperiencinga
majordeclineincases,whileinothersthenumbersaredroppingvery
slowly.BrazilandChinaforexample,areamongthe22countrieswitha
sustaineddeclineinTBcasesoverthepast20years.

Symptomsanddiagnosis
CommonsymptomsofactivelungTBarecoughwithsputumandblood
attimes,chestpains,weakness,weightloss,feverandnightsweats.
Manycountriesstillrelyonalongusedmethodcalledsputumsmear
microscopytodiagnoseTB.Trainedlaboratorytechnicianslookat
sputumsamplesunderamicroscopetoseeifTBbacteriaarepresent.
With3suchtests,diagnosiscanbemadewithinaday,butthistest
doesnotdetectnumerouscasesoflessinfectiousformsofTB.
DiagnosingMDRTB(seeMultidrugresistantTBsectionbelow)andHIV
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DiagnosingMDRTB(seeMultidrugresistantTBsectionbelow)andHIV
associatedTBcanbemorecomplex.Anew2hourtestthathasproven
highlyeffectiveindiagnosingTBandthepresenceofdrugresistanceis
nowbeingrolledoutinmanycountries.
Tuberculosisisparticularlydifficulttodiagnoseinchildren.

Treatment
TBisatreatableandcurabledisease.Active,drugsusceptibleTB
diseaseistreatedwithastandard6monthcourseof4antimicrobial
drugsthatareprovidedwithinformation,supervisionandsupporttothe
patientbyahealthworkerortrainedvolunteer.Withoutsuchsupport,
treatmentadherencecanbedifficultandthediseasecanspread.The
vastmajorityofTBcasescanbecuredwhenmedicinesareprovided
andtakenproperly.
Between2000and2014,anestimated43millionlivesweresaved
throughTBdiagnosisandtreatment.

TBandHIV
AtleastonethirdofpeoplelivingwithHIVworldwidein2014were
infectedwithTBbacteria.PeoplelivingwithHIVare20to30times
morelikelytodevelopactiveTBdiseasethanpeoplewithoutHIV.
HIVandTBformalethalcombination,eachspeedingtheother's
progress.In2014about0.4millionpeoplediedofHIVassociatedTB.
ApproximatelyonethirdofdeathsamongHIVpositivepeopleweredue
toTBin2014.In2014therewereanestimated1.2millionnewcasesof
TBamongstpeoplewhowereHIVpositive,74%ofwhomwerelivingin
Africa.
WHOrecommendsa12componentapproachofcollaborativeTBHIV
activities,includingactionsforpreventionandtreatmentofinfectionand
disease,toreducedeaths.

MultidrugresistantTB
StandardantiTBdrugshavebeenusedfordecades,andresistanceto
themedicinesiswidespread.Diseasestrainsthatareresistanttoa
singleantiTBdrughavebeendocumentedineverycountrysurveyed.
Multidrugresistanttuberculosis(MDRTB)isaformofTBcausedby
bacteriathatdonotrespondto,atleast,isoniazidandrifampicin,the2
mostpowerful,firstline(orstandard)antiTBdrugs.
AprimarycauseofMDRTBisinappropriatetreatment.Inappropriateor
incorrectuseofantiTBdrugs,oruseofpoorqualitymedicines,can
causedrugresistance.
Diseasecausedbyresistantbacteriafailstorespondtoconventional,
firstlinetreatment.MDRTBistreatableandcurablebyusingsecond

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firstlinetreatment.MDRTBistreatableandcurablebyusingsecond
linedrugs.Howeversecondlinetreatmentoptionsarelimitedand
recommendedmedicinesmaynotbealwaysavailable.Theextensive
chemotherapyrequired(upto2yearsoftreatment)ismorecostlyand
canproducesevereadversedrugreactionsinpatients.

Insomecases,moreseveredrugresistancecandevelop.Extensively
drugresistantTB,XDRTB,isaformofmultidrugresistanttuberculosis
thatrespondstoevenfeweravailablemedicines,includingthemost
effectivesecondlineantiTBdrugs.
About480000peopledevelopedMDRTBintheworldin2014.More
thanhalfofthesecaseswereinIndia,thePeoplesRepublicofChina
andtheRussianFederation.Itisestimatedthatabout9.7%ofMDRTB
caseshadXDRTB.

WHOresponse
WHOpursues6corefunctionsinaddressingTB.
1.ProvidegloballeadershiponmatterscriticaltoTB.
2.Developevidencebasedpolicies,strategiesandstandardsforTB
prevention,careandcontrol,andmonitortheirimplementation.
3.ProvidetechnicalsupporttoMemberStates,catalyzechange,and
buildsustainablecapacity.
4.MonitortheglobalTBsituation,andmeasureprogressinTBcare,
control,andfinancing.
5.ShapetheTBresearchagendaandstimulatetheproduction,
translationanddisseminationofvaluableknowledge.
6.FacilitateandengageinpartnershipsforTBaction.
TheWHOEndTBStrategy,adoptedbytheWorldHealthAssemblyin
May2014,isablueprintforcountriestoendtheTBepidemicbydriving
downTBdeaths,incidenceandeliminatingcatastrophiccosts.It
outlinesglobalimpacttargetstoreduceTBdeathsby90%andtocut
newcasesby80%between2015and2030,andtoensurethatno
familyisburdenedwithcatastrophiccostsduetoTB.
EndingtheTBepidemicby2030isamongthehealthtargetsofthe
newlyadoptedSustainableDevelopmentGoals.WHOhasgoneone
stepfurtherandseta2035targetof95%reductionindeathsanda90%
declineinTBincidencesimilartocurrentlevelsinlowTBincidence
countriestoday.
TheStrategyoutlines3strategicpillarsthatneedtobeputinplaceto
effectivelyendtheepidemic:
Pillar1:integratedpatientcentredcareandprevention
Pillar2:boldpoliciesandsupportivesystems
Pillar3:intensifiedresearchandinnovation.
ThesuccessoftheStrategywilldependoncountriesrespectingthe
following4keyprinciplesastheyimplementtheinterventionsoutlinedin
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following4keyprinciplesastheyimplementtheinterventionsoutlinedin
eachpillar:
governmentstewardshipandaccountability,withmonitoringand
evaluation
strongcoalitionwithcivilsocietyorganizationsandcommunities
protectionandpromotionofhumanrights,ethicsandequity
adaptationofthestrategyandtargetsatcountrylevel,withglobal
collaboration

Features
Featurestoriesontuberculosis

Publications
Globaltuberculosisreport2015
EndTBStrategy

Data
DataandanalysisonTB
TBcountryprofiles

Relatedlinks
Drugresistanttuberculosis
WHO'sworkontuberculosis

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