India is the country with the highest burden of TB, with World Health Organisation (WHO) statistics for 2013 giving an estimated incidence figure of 2.1 million cases of TB for India out of a global incidence of 9 million. The estimated TB prevalence figure for 2013 is given as 2.6 million.1“Global Tuberculosis Control 2014, WHO, Geneva, 2014 www.who.int/tb/publications/global_report/
It is estimated that about 40% of the Indian population is infected with TB bacteria, the vast majority of whom have latent rather than active TB.
TB statistics will often refer to the incidence and prevalence of TB, and this will usually be referring to active TB. So the TB incidence for India is the number of new cases of active TB disease in India during a certain time period (usually a year). By contrast the TB prevalence is the number of people in India who are living with active TB. Prevalence is usually, but not always given as a percentage of the population.2“Basic Statistics: About Incidence, Prevalence, Morbidity, and Mortality – Statistics Teaching Tools”, Department of Health, New York State www.health.ny.gov/diseases/chronic/basicstat.htm
Most of the TB statistics for India come from the government Revised National Tuberculosis Control Programme (RNTCP) which was started in 1997, and which was then expanded across the country.
In 2012 India declared TB to be a notifiable disease, meaning that with immediate effect all private doctors, caregivers and clinics treating a TB patient had to report every case of TB to the government.3Sinha, K “Finally, tuberculosis declared a notifiable disease”, The Times of India, May 9, 2012 //articles.timesofindia.indiatimes.com/2012-05-09/india/31640562_1_mdr-tb-tb-cases-tb-diagnosis
|Year||Population of India covered under RNTCP||Total TB cases notified||Total smear positive TB cases notified||New smear positive TB cases notified||New smear negative TB cases notified||New extra pulmonary TB cases notified||Retreatment cases notified|
TB retreatment is when patients need TB treatment again after they have ended their first course of drug treatment. The treatment outcomes for retreatment are classified according to whether patients relapsed, failed or defaulted on their original treatment.
Patients are said to have relapsed if they become ill again after they have finished their first TB drug treatment which appeared to have been successful. Patients who experience only a short improvement whilst on drug treatment, or who never respond to treatment at all, are said to have failed their TB treatment. Patients are usually referred to as having defaulted on their treatment, and need retreatment, if they stopped taking their first course of drug treatment before they had finished the course.
In any retreatment situation it is possible that the person has got drug resistant TB. This is particularly likely to be the case if the person has never responded to and has failed their initial drug treatment. In this case they need drug susceptibility testing for drug resistance and they may need specific TB treatment for multi drug resistant TB.
In India in 2011 304,431 people needed TB retreatment because of initial treatment relapse, failure or default.
|Year||Treatment relapse retreatment success||Treatment relapse retreatment death, failure or default||Treatment failure retreatment success||Treatment failure retreatment death, failure or default||Treatment default retreatment success||Treatment default retreatment death, failure or default|
|Year||Retreatment success||Retreatment death, failure or default|
The statistics given above are the figures for retreatment outcomes amongst smear positive patients. They do not include the retreatment outcomes for smear negative patients, who are subsequently found to have TB, and many of the smear negative patients will have both HIV and TB.
With the statistics giving an overall retreatment success rate of only 71% there would seem to be considerable scope for improving the drug regimes that are provided for the retreatment of TB.
The main TB statistics for each state in India also come from the government Revised National Tuberculosis Control Programme (RNTCP).
|State||Population covered by RNTCP||Total patients registered for treatment (2011)||Smear positive patients diagnosed (2011)||Smear positive retreatment after relapse patients (2010)||Smear positive retreatment after failure patients (2010)||Smear positive retreatment after default patients (2010)|
|Andaman & Nicobar||400,000||908||367||56||6||29|
|D & H Haveli||300,000||419||298||28||4||29|
|Daman & Diu||200,000||313||216||25||6||12|
|Jammu & Kashmir||12,500,000||13,473||9,017||1,283||115||290|
TB India 2012 Revised National TB Control Programme Annual Status Report, New Delhi, 2012 www.tbcindia.nic.in/documents.html#
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|1.||↑||“Global Tuberculosis Control 2014, WHO, Geneva, 2014 www.who.int/tb/publications/global_report/|
|2.||↑||“Basic Statistics: About Incidence, Prevalence, Morbidity, and Mortality – Statistics Teaching Tools”, Department of Health, New York State www.health.ny.gov/diseases/chronic/basicstat.htm|
|3.||↑||Sinha, K “Finally, tuberculosis declared a notifiable disease”, The Times of India, May 9, 2012 //articles.timesofindia.indiatimes.com/2012-05-09/india/31640562_1_mdr-tb-tb-cases-tb-diagnosis|