Tuberculosis Worldwide in 2018: 10 Million Cases, 1.5 Million Deaths

Tuberculosis (TB) is the world's leading cause of death from a single infectious agent, including among people living with HIV. The World Health Organization's End TB Strategy set targets measured against 2015:

Using data that 194 WHO member states report every year, CDC and WHO researchers assessed progress in 2018.

Key findings

• An estimated 10 million people fell ill with TB (132 per 100,000), down 2% from 2017.
• About 1.5 million died of TB, down 5%.
• The South-East Asia and African regions had the most cases; Europe was on track for its 2020 targets.
• 862,000 new TB cases were among people living with HIV.
• 1.8 million people with HIV started TB preventive treatment — an 88% jump from 960,000 in 2017.
• Rifampicin-resistant or multidrug-resistant TB affected 3.4% of new patients and 18% of those treated before — 4.8% overall.

By region, 2018

Data from WHO's Global Tuberculosis Report 2019.

• South-East Asia had 44% of all TB cases.
• Africa has the highest HIV prevalence, so much of its TB is HIV-related; TB is deadlier with HIV, which gives Africa the highest overall case fatality.
• Europe is on track for 2020 but faces a high share of drug-resistant TB. New regimens and updated WHO guidelines suggest everyone with rifampicin- or multidrug-resistant TB could benefit from effective all-oral treatment.

Preventive treatment

TB preventive treatment — most often daily isoniazid for at least 6 months — prevents TB disease in people who may be infected and at risk. WHO advises it for everyone living with HIV and all household contacts of people with bacteriologically confirmed lung TB.

The 2018 United Nations High-Level Meeting on TB set 2022 targets of treating 40 million people for TB and giving preventive treatment to 30 million, including 6 million people with HIV. Preventive treatment for people with HIV nearly doubled and looked on track, but overall numbers — including household contacts and young children — remained far short. A 12-dose, once-weekly isoniazid-rifapentine regimen works about as well as daily isoniazid with less toxicity, and was expected to be used more.

Outlook

Cases and deaths fell only modestly, in line with recent trends. At the current pace, the 2035 targets are unlikely to be met. The authors call for innovative case finding, scaled-up preventive treatment, newer treatment regimens and HIV prevention and control — and much more intensive efforts to find, cure and prevent every case.

Limits: data quality, especially from surveillance, may affect accuracy, and countries' different estimation methods make comparisons harder.

Sources

Based on MacNeil A, Glaziou P, Sismanidis C, Date A, Maloney S, Floyd K, "Global Epidemiology of Tuberculosis and Progress Toward Meeting Global Targets — Worldwide, 2018," Morbidity and Mortality Weekly Report 69(11), CDC; a work of the United States government in the public domain. Regional data originally from the World Health Organization's Global Tuberculosis Report 2019.