Editing Tuberculosis (section)

=== Geographical epidemiology ===

The distribution of tuberculosis is not uniform across the globe; about 80% of the population in many African, Caribbean, South Asian, and eastern European countries test positive in tuberculin tests, while only 5–10% of the U.S. population test positive.<ref name="Kumar-2007" /> Hopes of totally controlling the disease have been dramatically dampened because of many factors, including the difficulty of developing an effective vaccine, the expensive and time-consuming diagnostic process, the necessity of many months of treatment, the increase in HIV-associated tuberculosis, and the emergence of drug-resistant cases in the 1980s.<ref name="Lawn-2011" />

In developed countries, tuberculosis is less common and is found mainly in urban areas. In Europe, deaths from TB fell from 500 out of 100,000 in 1850 to 50 out of 100,000 by 1950. Improvements in public health were reducing tuberculosis even before the arrival of antibiotics, although the disease remained a significant threat to public health, such that when the [[Medical Research Council (UK)|Medical Research Council]] was formed in Britain in 1913 its initial focus was tuberculosis research.<ref>{{cite web | work = [[Medical Research Council (UK)|Medical Research Council]] | url = http://www.mrc.ac.uk/index/about/about-history/about-history-2.htm | title = Origins of the MRC. | archive-url = https://web.archive.org/web/20080411164838/http://www.mrc.ac.uk/index/about/about-history/about-history-2.htm | archive-date=11 April 2008 | access-date = 7 October 2006 }}</ref>

In 2010, rates per 100,000 people in different areas of the world were: globally 178, Africa 332, the Americas 36, Eastern Mediterranean 173, Europe 63, Southeast Asia 278, and Western Pacific 139.<ref name="WHO_Control_2011" />

In 2023, tuberculosis overtook [[COVID-19]] as the leading cause of infectious disease-related deaths globally, according to a [[World Health Organization]].<ref name="Who_Global_2024">{{Cite book |year=2024 |title=Global Tuberculosis Report 2024 |url=https://www.who.int/teams/global-tuberculosis-programme/tb-reports/global-tuberculosis-report-2024 |access-date=2024-10-31 |website=World Health Organization |language=en |publication-place=Geneva |isbn=978-92-4-010153-1 | vauthors = Organization WH }}</ref> Around 8.2 million people were newly diagnosed with TB last year, allowing them access to treatment—a record high since WHO's tracking began in 1995 and an increase from 7.5 million cases in 2022.<ref>{{Cite web |date=2024-10-29 |title=WHO report shows global tuberculosis cases are rising {{!}} CIDRAP |url=https://www.cidrap.umn.edu/tuberculosis/who-report-shows-global-tuberculosis-cases-are-rising |access-date=2024-10-31 |website=www.cidrap.umn.edu |language=en}}</ref> The report highlights ongoing obstacles in combating TB, including severe funding shortages that hinder efforts toward eradication. Although TB-related deaths decreased slightly to 1.25 million in 2023 from 1.32 million in 2022, the overall number of new cases rose marginally to an estimated 10.8 million.

==== Russia ====

Russia has achieved particularly dramatic progress with a decline in its TB mortality rate—from 61.9 per 100,000 in 1965 to 2.7 per 100,000 in 1993;<ref>{{Cite book |vauthors=Shkolnikov VM, Meslé F |chapter=The Russian Epidemiological Crisis as Mirrored by Mortality Trends |page=142 |year=1996 |url=https://www.rand.org/pubs/conf_proceedings/CF124.html |language=en |veditors=DaVanzo J, Farnsworth G |title=Russia's Demographic "Crisis" |publisher=RAND Corporation |isbn=0-8330-2446-9 |access-date=20 February 2023 |archive-date=20 February 2023 |archive-url=https://web.archive.org/web/20230220171629/https://www.rand.org/pubs/conf_proceedings/CF124.html |url-status=live }}</ref><ref name="WHO_Control_2011a">{{cite web | url = https://www.who.int/tb/publications/global_report/en/index.html | title = Global Tuberculosis Control | archive-url = https://web.archive.org/web/20061212123736/http://www.who.int/tb/publications/global_report/en/index.html | archive-date=12 December 2006 | publisher = World Health Organization | date = 2011 }}</ref> however, mortality rate increased to 24 per 100,000 in 2005 and then recoiled to 11 per 100,000 by 2015.<ref>{{Cite web|url=https://extranet.who.int/sree/Reports?op=Replet&name=%2FWHO_HQ_Reports%2FG2%2FPROD%2FEXT%2FTBCountryProfile&ISO2=RU&LAN=EN&outtype=html|title=WHO global tuberculosis report 2016. Annex 2. Country profiles: Russian Federation|access-date=22 August 2020|archive-date=14 July 2017|archive-url=https://web.archive.org/web/20170714043942/https://extranet.who.int/sree/Reports?op=Replet&name=%2FWHO_HQ_Reports%2FG2%2FPROD%2FEXT%2FTBCountryProfile&ISO2=RU&LAN=EN&outtype=html}}</ref>

==== China ====

China has achieved particularly dramatic progress, with about an 80% reduction in its TB mortality rate between 1990 and 2010.<ref name="WHO_Control_2011" /> The number of new cases has declined by 17% between 2004 and 2014.<ref name="Kielstra-2014" />

==== Africa ====

In 2007, the country with the highest estimated incidence rate of TB was [[Eswatini]], with 1,200 cases per 100,000 people. In 2017, the country with the highest estimated [[Incidence (epidemiology)|incidence rate]] as a % of the population was [[Lesotho]], with 665 cases per 100,000 people.<ref name="WHO_Global_2018">{{cite web|title=Global Tuberculosis Report 2018|url=http://apps.who.int/iris/bitstream/handle/10665/274453/9789241565646-eng.pdf?ua=1|access-date=27 September 2019|archive-date=7 August 2020|archive-url=https://web.archive.org/web/20200807121356/https://apps.who.int/iris/bitstream/handle/10665/274453/9789241565646-eng.pdf?ua=1|url-status=live}}</ref>

In South Africa, 54,200 people died in 2022 from TB. The incidence rate was 468 per 100,000 people; in 2015, this was 988 per 100,000. The total incidence was 280,000 in 2022; in 2015, this was 552,000.<ref>{{Cite web | vauthors = Tomlinson C |date=2023-11-10 |title=In-depth: What new WHO TB numbers mean for South Africa |url=https://www.spotlightnsp.co.za/2023/11/10/in-depth-what-new-who-tb-numbers-mean-for-sa/ |access-date=2024-03-27 |website=Spotlight |language=en-US}}</ref>

==== India ====

As of 2017, India had the largest total incidence, with an estimated 2,740,000 cases.<ref name="WHO_Global_2018" /> According to the [[World Health Organization]] (WHO), in 2000–2015, India's estimated mortality rate dropped from 55 to 36 per 100,000 population per year with estimated 480 thousand people died of TB in 2015.<ref>{{Cite web|url=https://extranet.who.int/sree/Reports?op=Replet&name=%2FWHO_HQ_Reports%2FG2%2FPROD%2FEXT%2FTBCountryProfile&ISO2=IN&LAN=EN&outtype=html|title=WHO Global tuberculosis report 2016: India|access-date=22 August 2020|archive-date=6 February 2018|archive-url=https://web.archive.org/web/20180206193815/https://extranet.who.int/sree/Reports?op=Replet&name=%2FWHO_HQ_Reports%2FG2%2FPROD%2FEXT%2FTBCountryProfile&ISO2=IN&LAN=EN&outtype=html}}</ref><ref>{{cite web|url=http://www.dnaindia.com/health/report-govt-revisits-strategy-to-combat-tuberculosis-nadda-2388967|title=Govt revisits strategy to combat tuberculosis|work=Daily News and Analysis|date=8 April 2017|access-date=22 August 2020|archive-date=3 June 2021|archive-url=https://web.archive.org/web/20210603072417/https://www.dnaindia.com/health/report-govt-revisits-strategy-to-combat-tuberculosis-nadda-2388967|url-status=live}}</ref> In India a major proportion of tuberculosis patients are being treated by private partners and private hospitals. Evidence indicates that the tuberculosis national survey does not represent the number of cases that are diagnosed and recorded by private clinics and hospitals in India.<ref>{{cite journal | vauthors = Mahla RS | title = Prevalence of drug-resistant tuberculosis in South Africa | journal = The Lancet. Infectious Diseases | volume = 18 | issue = 8 | page = 836 | date = August 2018 | pmid = 30064674 | doi = 10.1016/S1473-3099(18)30401-8 | doi-access = free }}</ref>

==== North America ====

In Canada, tuberculosis was endemic in some rural areas as of 1998.<ref>{{cite journal|url=http://gateway.nlm.nih.gov/MeetingAbstracts/ma?f=102188560.html|title=Rural outbreaks of ''Mycobacterium tuberculosis'' in a Canadian province|journal=Abstr Intersci Conf Antimicrob Agents Chemother|year=1998|volume=38|page=555 |id=abstract no. L-27|vauthors=Al-Azem A, Kaushal Sharma M, Turenne C, Hoban D, Hershfield E, MacMorran J, Kabani A|archive-url=https://web.archive.org/web/20111118161808/http://gateway.nlm.nih.gov/MeetingAbstracts/ma?f=102188560.html |archive-date=18 November 2011 }}</ref> The tuberculosis case rate in Canada in 2021 was 4.8 per 100,000 persons. The rates were highest among Inuit (135.1 per 100,000), First Nations (16.1 per 100,000) and people born outside of Canada (12.3 per 100,000).<ref>{{cite web |url=https://www.canada.ca/en/public-health/services/diseases/tuberculosis/surveillance.html|title=Tuberculosis (TB): Monitoring|publisher=Government of Canada|access-date=30 October 2024|date=4 March 2024|archive-url=https://web.archive.org/web/20240326030538/https://www.canada.ca/en/public-health/services/diseases/tuberculosis/surveillance.html|url-status=live|archive-date=26 March 2024}}</ref>

In the United States, [[Native Americans in the United States|Native Americans]] have a fivefold greater mortality from TB,<ref>{{cite book | vauthors = Birn AE |title= Textbook of International Health: Global Health in a Dynamic World |year= 2009 |page= 261 |publisher= Oxford University Press |isbn= 978-0-19-988521-3 |url= https://books.google.com/books?id=2XBB4-eYGZIC&pg=PT261 |url-status=live |archive-url= https://web.archive.org/web/20150906213750/https://books.google.com/books?id=2XBB4-eYGZIC&pg=PT261 |archive-date= 6 September 2015 }}</ref> and racial and ethnic minorities accounted for 88% of all reported TB cases.<ref name="Williams-2024">{{cite journal|vauthors=Williams PM, Pratt RH, Walker WL, Price SF, Stewart RJ, Feng PI| title= Tuberculosis — United States, 2023 | journal= MMWR. Morbidity and Mortality Weekly Report | date= 2024 |volume=73 |issue=12|pages=265–270|doi=10.15585/mmwr.mm7312a4| pmid= 38547024 |url=https://www.cdc.gov/mmwr/volumes/73/wr/mm7312a4.htm|pmc=10986816}}</ref> The overall tuberculosis case rate in the United States was 2.9 per 100,000 persons in
2023, representing a 16% increase in cases compared to 2022.<ref name="Williams-2024" />

In 2024, Long Beach, California authorized a [[Public health emergency (United States)|public health emergency]] in response to a local [[Disease outbreak|outbreak]] of TB.<ref>{{cite news | vauthors = Bendix A |title=California city declares a public health emergency after tuberculosis sickens 14 |url=https://www.nbcnews.com/health/health-news/tuberculosis-outbreak-california-city-health-emergency-rcna150881 |publisher=NBC News |date=7 May 2024}}</ref>

==== Western Europe ====

In 2017, in the United Kingdom, the national average was 9 per 100,000 and the highest incidence rates in [[Western Europe]] were 20 per 100,000 in Portugal.

==== India ====
India had the highest total number of TB cases worldwide in 2010, in part due to poor disease management within the private and public health care sector.<ref>{{Cite journal |vauthors=Sandhu GK |date=2011 |title=Tuberculosis: Current Situation, Challenges and Overview of its Control Programs in India |journal=Journal of Global Infectious Diseases |volume=3 |issue=2 |pages=143–150 |doi=10.4103/0974-777X.81691 |issn=0974-777X |pmc=3125027 |pmid=21731301 |doi-access=free}}</ref> Programs such as the [[Revised National Tuberculosis Control Program]] are working to reduce TB levels among people receiving public health care.<ref>{{cite journal |vauthors=Bhargava A, Pinto L, Pai M |year=2011 |title=Mismanagement of tuberculosis in India: Causes, consequences, and the way forward |url=https://www.paitbgroup.org/wp-content/uploads/Papers/2011/2011-XX-BhargavaA-Hyp.pdf |journal=Hypothesis |volume=9 |issue=1 |page=e7 |archive-url=https://web.archive.org/web/20221024060219/https://www.paitbgroup.org/wp-content/uploads/Papers/2011/2011-XX-BhargavaA-Hyp.pdf |archive-date=24 October 2022}}</ref><ref>{{cite journal |vauthors=Amdekar Y |date=July 2009 |title=Changes in the management of tuberculosis |journal=Indian Journal of Pediatrics |volume=76 |issue=7 |pages=739–42 |doi=10.1007/s12098-009-0164-4 |pmid=19693453 |s2cid=41788291}}</ref>