WASHINGTON — Progress in detecting new cases of tuberculosis is slowing, threatening to increase the risks of transmitting drug-resistant strains, the World Health Organization said Monday.
From 2005 to 2006, the rate of increase in detecting new cases fell to 3 percent from an average of 6 percent in the preceding five years (2001-5), the health organization said in its 12th annual report on global tuberculosis control. The agency, a unit of the United Nations, released the report in advance of World Tuberculosis Day, next Monday.
Globally, there were 9.2 million new cases and 1.7 million deaths from tuberculosis in 2006, the latest year for which statistics are available. Of these, 700,000 cases and 200,000 deaths were among people infected with H.I.V., the virus that causes AIDS. The figures are based on data that 202 countries and territories provided.
The African, Southeast Asian and Western Pacific regions accounted for 83 percent of total cases reported. India, China, Indonesia, South Africa and Nigeria rank as the top five countries in terms of absolute numbers of tuberculosis cases. The African region has the highest incidence rate per capita, 363 per 100,000.
The new statistics are worrisome because “the more cases that are detected early interrupt transmission and provide a better chance of cure, and that ultimately has a greater impact on the incidence of the disease,” Dr. Mario C. Raviglione, the agency’s director of tuberculosis control, said in an interview.
The slowing is partly a result of the inability of some national programs that had been making rapid strides to continue at the same pace, he said by telephone in a news conference from his agency’s headquarters in Geneva.
In most African countries, there has been no increase in the detection of tuberculosis cases through government programs. Also, nongovernmental faith-based and community groups detect and treat an unknown number of cases that they do not report to health officials.
Many cases of tuberculosis are not detected among people whose deaths are attributed to other diseases, like AIDS.
All such factors increase the work needed to reach the poorest people among whom transmission rates might be higher, Dr. Raviglione said.
Countries must either create facilities to detect more cases or “depend more and more on the private sector” because “more and more we are realizing that nongovernmental agencies and faith-based organizations that contribute to caring for AIDS cases now have an increased role in tuberculosis,” he said.
The W.H.O. said there was a shortfall of $2.5 billion of the $4.8 billion needed this year for overall tuberculosis control in low- and middle-income countries.
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