World TB Day minus one – Death Rates from TB “Globally, the TB mortality rate has fallen by 45% since 1990 and the Stop TB Partnership target of a 50% reduction by 2015 is within reach.” WHO Global TB report 2013. “Trends in TB mortality rates are restricted to TB deaths among HIV-negative people, given that TB deaths among HIV-positive people are classified as HIV deaths in ICD-10.” – the same report. This target is “within reach”? Honestly, how can it be if it doesn’t include deaths from TB in people diagnosed with HIV (which is possible as much as 70% of TB deaths in Africa). The ‘International Classification of Disease’ dictates that a death can only be counted against one disease, not two.. Fine, but does this mean that most TB deaths in Africa don’t get counted – or, even worse, that somehow they just don’t count? The target death rate (per 100,000 population) for 2015 for the world is 15/100,000. For Africa (without counting those annoying TB/HIV deaths) it’s currently 26 - but if they are included it’s a horrendous 54/100,000. (In fact, it could well be even higher). In contrast, the death rate for China (if it can possibly be true) is a tiny 3.2 - something which must surely be helping to get that global rate down towards the target of 15.... But there is another anomaly here. If we include those pesky HIV cases, the total number of deaths from TB is currently pegged at 1.3 million (making TB second to HIV as the most lethal infectious disease on the planet). Well, 13% of known cases are currently being recorded as having unsuccessful outcomes to their treatment, and if they all died of the disease as a result, then that would be more than half of the 1.3 million at a stroke. They probably don’t all die, however, but there must be a likelihood that 500,000 of these known treatment failures do die of TB.. but what of those 3 million ‘missing’ cases that the world needs to track down and treat (those ones highlighted by the call to “Find the 3 million!”)?. Normally, if left untreated (and without any additional help from HIV) 50-70% of those infected with TB can be expected to die of the disease. That means that between 1.5 and 2 million ‘missing’ cases must be dying each year from TB away from the radar. Add our two figures together (the known failures, and the unknown ones), and we can conclude that the annual number of deaths from TB is probably still running at over 2 million.. and just might be even higher. The death toll from HIV is currently 1.6 million – so if our guesstimate is true, then TB has quite easily snatched back its previous top-dog position in the death stakes while the world remains relatively oblivious. This higher figure suggests a global death rate of approaching 30/100,000. And if THIS is true, then the target reduction for 2015 is far from being within reach. So the question must be asked: is the current scale of the dangers from TB being ignored? Or, in Ms Roys words - are the victims of this disease remaining “preferably unheard” by the rest of the world?
Posted on: Sun, 23 Mar 2014 11:03:37 +0000
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