Transcript ss sudan

Current Aspects of TB in Egypt and
other EMR countries
Dr. Essam Elmoghazy
Chairman of Cairo Association against Smoking , Tuberculosis and
Lung diseases- Egypt (CASTLE)
Chairman of the Green Light Committee_EMR
2016
2015
The year 2015 is a watershed moment in the battle
against tuberculosis (TB).
It marks the deadline for global TB targets set in the
context of the Millennium Development Goals (MDGs),
and is a year of transitions: from the MDGs to a new era
of Sustainable Development Goals (SDGs), and from
the Stop TB Strategy to the End TB Strategy.
Global TB Burden: 2014 estimates
•In 2014, there were an estimated 9.6 million incident
cases of TB (range, 9.1 million–10.0 million)
globally, equivalent to 133 cases per 100 000 population
Most of the estimated number of cases in 2014 occurred in
•Asia (58%)
•African Region (28%);
•Eastern Mediterranean Region (8%),
•European Region (3%)
•Americas (3%).
Global TB cases
E. Mediterranean
Europe
Americas
4%
3%
8%
South-East Asia
38%
Africa
29%
34% in India + China
23% in India
Western Pacific
18%
TB Situation
in EMR
WHO Eastern Mediterranean Region
•
•
•
•
•
WHO MEMBER STATES: 21
Prevalence rate 160 (per 100 000 population)
Incidence rate 117 (per 100 000 population)
Case detection rate, all forms 61%
% of TB cases with MDR-TB: new 3.2% ,
retreatment 18%
WHO Eastern Mediterranean Region
• Nine countries contribute 95% of the TB
burden in the Region. These are Pakistan
Afghanistan, Sudan, Morocco, Somalia, Iraq,
Egypt, Iran and Yemen.
• Pakistan alone shoulders 61% the TB burden
of the Region.
The progress
• A significant decline in the regional rates of TB prevalence and
mortality has been reported. The Region has achieved the global
target of halving TB mortality compared to 1990.
• Reductions in prevalence have been considerable since 1990, and
appear to have accelerated since 2000. Nonetheless, current
forecasts suggest that the Region needs to do more to achieve the
2015 target of halving prevalence compared to 1990.
• However, the incidence of TB in the Region declined at a low rate of
less than 1% per year from 1990 to 2013.
• The Region has achieved a high treatment success rate of 88% for
more than 5 years.
• As for multidrug-resistant TB (MDR-TB), the Region has a low
burden of 3.5% of new TB cases and 32% of previously-treated
cases. Most countries in the Region have established MDR-TB
management in line with WHO guidance. However, it is estimated
that the Region has only detected 12% of MDR-TB cases and has
enrolled 72% of these cases on treatment.
TB Situation
in Egypt
Estimates of burden
Mortality (excludes HIV+TB)
Number (thousands)
Rate
(per 100 000 pop)
0.31 (0.29–0.34) 0.37 (0.35–0.4)
Prevalence (includes HIV+TB)
21
(11–34)
25
(13–41)
Incidence (includes HIV+TB)
12
(11–14)
15
(13 - 17)
Case detection, TB all forms
58%
(51% – 66%)
In terms of incidence of tuberculosis,
Egypt is ranked among the mid-level
incidence countries.
Tuberculosis in Egypt is considered an
important public health problem.
New SS+ve New SS-ve
Extra
Pulm.
Relapse
TTT
Failure
TAI
Others
Total
NTP
2740
729
1807
282
91
109
71
5829
Prison
154
5
3
4
2
2
3
173
HIO
249
76
159
17
1
1
3
506
University
204
45
202
0
0
0
0
451
Non National
27
2
17
2
1
3
1
53
African ref
19
4
12
1
2
0
0
38
Army chest
hospitals
177
0
21
0
0
0
0
198
Police
9
0
0
0
0
0
0
9
fever hospitals
0
0
0
0
0
0
0
0
Private sector
118
25
64
3
0
0
0
210
3697
886
2285
309
97
115
78
7467
Total
NTP
Non NTP
22%
78%
Burden of MDR
The prevalence rate of MDR is
•
2.2% among new TB patients
•
38.4% among retreated cases
(Drug resistance survey 2002).
• 3.4% in new
• 15% in retreated cases
(Drug resistance survey 2011).
MDR-TB management in Egypt
• The first MDR-TB center was established in Abbassia chest
hospital and patient enrolled in June 2006.
• Later on, another two centers were established, one in
Maamoura chest hospital in 2008 and a third one in
Mansoura chest hospital in 2012
• A fourth center is being prepared now in Asuit chest
hospital.
• Second line drugs used in management of theses cases are
funded from global fund grant.
• The average treatment course costs around 4000 US$ and
lasts up to two years compared to 6 months for susceptible
tuberculosis and less than a 1000 EP.
• From 2006 to 2015 ( 500 patients enrolled in the
treatment) with success treatment 68%
MDR-TB management in Egypt
• The first MDR-TB center was established in Abbassia chest
hospital and patient enrolled in June 2006.
• Later on, another two centers were established, one in
Maamoura chest hospital in 2008 and a third one in
Mansoura chest hospital in 2012
• A fourth center is being prepared now in Asuit chest
hospital.
• Second line drugs used in management of theses cases are
funded from global fund grant.
• The average treatment course costs around 4000 US$ and
lasts up to two years compared to 6 months for susceptible
tuberculosis and less than a 1000 EP.
• From 2006 to 2015 ( 500 patients enrolled in the
treatment) with success treatment 68%
Thank you