Tuberculosis epidemiology in the Asia–Pacific region

Abstract

Tuberculosis epidemology in the Asia-Pacific region MORI T. Respirology 2008; 13: S56-S64 Abstract: The Asia-Pacific region accounts for about 20% of the global burden of tuberculosis (TB). However, there are a wide variety of TB problems between countries and areas. This variety could be described in three dimensions: (i) historical trends of the TB epidemics, closely related to the advent of industrialization or urbanization; (ii) success in modern TB control in the early days; and (iii) expansion of the directly observed therapy, short course (DOTS) strategy during the past 20 years. Moreover, these dimensions have been subject to the 'health infrastructure' based on such social goods as people's education, economic standards, and social security or stability. The Asia-Pacific Region offers very good examples to illustrate the roles of these factors in leading to such a variety of TB problems as seen today. Thus, this region was the first to achieve the global target of DOTS by the end of 2005, that is to detect 70% of patients and to treat them with DOTS, and to successfully cure 85% of those detected.However, we should remember that we are currently challenged by TB combined with HIV infection and AIDS; TB with drug-resistance, especially multidrug-resistant (MDR) or extensively drug resistant (XDR) forms; TB in people with special risk factors, for example diabetes and senility; and other medical and socioeconomic problems. At the same time, we have to be careful about the premature loss of people's interest in TB, due to illusion or unfounded optimism, especially among medical professionals and the government.

Respiratory health issues in the Asia–Pacific region: An overview

“…Rates of TB within the region vary widely (Fig. 2): from 10 per 100 000 population in low‐prevalence countries like Australia to over 500 per 100 000 in high‐prevalence countries like Cambodia 24 . With its large population, China accounts for approximately two‐thirds of reported cases within the region 24 .…”

“…which also discusses TB in infants 26 ). For example, in Japan, over 60% of reported TB cases are in those aged over 65 years, whereas in China over 80% occur in those aged less than 65 years and in Papua New Guinea (whose overall rate is high at 250 per 100 000), over 80% occur in those under 45 years 24 …”

“…Data on indigenous groups are often limited, although improving in many areas 2 . Figures for infections such as TB rely on notification, which may be incomplete, especially in isolated or impoverished areas 24,100 . Although there is increasing use of diagnostic and management guidelines for airways diseases such as Asthma and COPD, diagnostic strategies vary and these diseases are under‐reported in different degrees in different areas 77 .…”

“…The Asia-Pacific region accounts for about one-fifth of worldwide TB incidence. 1,24,25 Rates of TB within the region vary widely ( Fig. 2): from 10 per 100 000 population in low-prevalence countries like Australia to over 500 per 100 000 in high-prevalence countries like Cambodia.…”

Respirology: To unpathed waters and undreamed shores

“…The task of the new editor is to provide the leadership, vision and guidance for the journal to realize its full potential. My priorities are to build on the momentum to achieve higher academic standard, to cement Respirology 's status as a young and vibrant journal in the global arena, while serving an active role in promoting respiratory research and clinical care in Asian Pacific and Australasia 2,3 . Beginning from this issue of Respirology is a set of changes that can help propel us towards these objectives.…”