TB Mortality – an analysis in the light of the Global Report


The illustration below (which is taken from the WHO Global Report for 2014) offers us a visual representation of where most TB deaths today are reckoned to be occurring.


Before taking a look at it an important caveat is in order


This caveat is that, for reasons best known to the WHO, the illustration below does not include representation of any of those who die from TB but who are known to be HIV positive. (If these deaths were included as they surely should be, then those darker areas in the southern half of Africa would be much darker still.)



Such incidence of death should surely be being used as a pointer to where most resource and effort should be being made, shouldn't it? - not just confront the disease but also to measure it in the first place. But now please take a look at this second illustration (also from the Report) which indicates where appropriate details of deaths are or aren’t being properly made:



Almost the entire African continent (along with Pakistan, Iran and Iraq) are coloured white and so have no Vital Registration data from which proper data on deaths from TB have been developed. For such countries the WHO employs "demographic techniques" in order to estimate the level of completeness of death recording in order to allow a calculation of mortality rates. 


What this means is that a tool which is normally used for getting to grips with any outbreak of lethal disease is effectively unavailable where this constant disease is causing most devastation. Where the disease is at its worst, in other words, it still seems to be ‘pin the tail on the donkey’ time - and the Nigerian prevalence survey has proved that in Africa mortality estimates can be out by a factor of 400%.

 

Can this possibly be the proper way to effectively fight humanity’s most devastating infectious disease where it’s most virulent 21 years into a global emergency? It's time things like this change!

For the other four analytical discussions of the 2014 Report:

    MDR-TB - two more questions