Harare, 21 March 2003 -- Tuberculosis (TB) infects 1.6 million people and kills 600,000 others in Africa every year, making the disease one of the most common preventable causes of death from a single infectious agent in the Region, according to a report issued Friday by the World Health Organization Regional Office for Africa. 
"The TB burden is an enormous challenge for the African Region. Even though Africa's population is only 10.1% of the world population the African region contributed at least 23.8% of infectious forms of lung TB," says the report titled WHO/AFRO Tuberculosis Surveillance Report 2001, released in Harare, Zimbabwe, as part of activities to mark World TB Day 2003 which falls on 24 March.

The report attributes the "huge upsurge" in the incidence of TB cases and deaths over the past several years largely to the impact of the HIV/AIDS pandemic, currently affecting many countries in the southern and eastern epidemiological blocs of the Region.

Other contributory factors, however, include demographic changes - especially population increase - and unfavorable socioeconomic conditions prevailing in many countries in the region.

According to the report, the southern epidemiological bloc (with approximately 23% of the Region's population) had been contributing 40% of annually notified TB cases over the past few years. This sub-region also has some of the highest TB notification rates in the world (up to 700 TB cases per 100,000 population).

The eastern and western epidemiological blocs, in that order, follow the southern bloc in TB notification, thus underlining the importance of the HIV/AIDS pandemic as the most important risk factor for the upsurge in TB cases. Indeed, the report adds, the southern and eastern sub-regions, with their known high or rising prevalence of HIV clearly bear the burden of the TB burden, in spite of their comparatively better developed TB control programmes.

Data in the report portray a new phenomenon in the distribution of infectious forms of lung TB cases by sex, hitherto not reported on either regionally or internationally.

For example, there is a consistently higher proportion of infectious forms of lung TB cases in females aged 0 - 24 years compared to males of the same age group in some areas in countries implementing the WHO-recommended Directly Observed Treatment, Short Course. (DOTS) strategy for the treatment of TB .

"For some countries, " the report says, "the distribution pointed to unsuspected or unknown significant or rising HIV/AIDS prevalence. The finding mirrors closely a generally known pattern of new HIV in the same age group in selected countries. It is thus compelling to hypothesize that this pattern of distribution is due to a direct impact of the HIV infection on TB epidemiology and should be looked at as having high predictive value for significant dual TB/HIV infection ."

The report concludes that current evidence demonstrated that current levels of effort to control TB in the African Region were inadequate.

It called for the adoption and intensified use of the DOTS strategy, the promotion of a mix of public-private partnerships in the delivery of TB services especially in large urban and peri-urban communities, and increased access to quality anti-TB drugs through the Global Drug Facility.

Other recommendations contained in the report include phased implementation of collaborative HIV/TB activities and community-based care initiatives.

For further information, please contact Samuel T. Ajibola
Public Information and Communication Unit 
World Health Organization - Regional Office for Africa 
P.O. Box 6 Brazzaville, Congo. 
E-mail: ajibolas [at] afro.who.int (ajibolas[at]afro[dot]who[dot]int) 
Tel:+ 47 241  39378; Fax: + 47 241 39513