Epidemiology of tuberculosis infection
Fariba shirvani, Associate Professor of pediatrics,Shaheed Beheshti University of Medical Sciences
Tuberculosis is an infectious contagious disease with global extension , its special ability to become latent causes its flare up in debilitating conditions.Tuberculosis (TB) is second only to HIV/AIDS as the greatest killer worldwide due to a single infectious agent. Over 95% of TB deaths occur in low- and middle-income countries, and it is among the top 5 causes of death for women aged 15 to 44. In 2013, 9 million people fell ill with TB and 1.5 million died from the disease. TB is a leading killer of HIV-positive people causing one fourth of all HIV-related deaths. In 2013, an estimated 550 000 children became ill with TB and 80 000 HIV-negative children died of TB. Globally in 2013, an estimated 480 000 people developed multidrug resistant TB (MDR-TB).Control of Tuberculosis infection is an important priority in WHO disease control program. An estimated 37 million lives were saved through TB diagnosis and treatment between 2000 and 2013. The TB death rate dropped 45% between 1990 and 2013. The estimated number of people falling ill with TB each year is declining, although very slowly, which means that the world is on track to achieve the Millennium Development Goal to reverse the spread of TB by 2015. 1/3 of the world’s population has LTBI.In IRAN TB control is an important task force. Deaths due to tuberculosis among HIV-negative people (per 100 000 population in IRAN declined from 1990 to 2015 from 3.8 to 302. In a study by Rafeii S (2009)they collected all data of patients with TB who registered in 2005 and 2006 in each of the 11 districts of Golestan province. There were 321 new smear-positive cases. The incidence and prevalence of TB were 20.88 and 38.15 per 100 000 population, respectively. which is higher than the whole country report of Tuberculosis infection. In a cross sectional study by Hasanzadeh J,(2013) all registered patients from 20 March 2009 to 20 March 2010 (one year) in all parts of the country were assessed. TB cases were defined according to WHO and Iran’s national TB guideline. Public hospitals, public and private outpatient clinics reported 4111 (39.1%), 3007 (28.6%) and 2839 (27%) cases of TB, respectively. The highest number of reported TB cases was from the public healthcare system. One third of TB cases were reported by private outpatient clinics.The brief glance on different reports of Tuberculosis incidence and prevalence in our country may reveal the fact of probable underestimation of statistical reports because of not optimized system of registry of this important disease. Although increase the socioeconomic statue of society may decrease the disease rate concomitantly,paying more attention and revision of Tuberculosis report and treatment protocols specially in children is recommended.