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Category 0 No Yes No Yes andlt;10% coverage? Category 2 andgt;90% coverage? Category 4 10-90% coverage? Category 3 Category 1 No Category 5 Yes Has the country reported to WHO on their TB control activities? Does the country accept a WHO 'standard' TB control strategy? Is the country’s case notification rate andlt; 10 per 100 000 pop? Categorization of Countries

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0 50 100 150 200 1990 1991 1992 1993 1994 1995 1996 1997 1998 Year Number of countries Total number of countries DOTS Expansion 1992-98

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TB Control Status of 211 Countries, 1998

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AFR 18% AMR 7% EMR 6% EUR 10% SEAR 36% WPR 23% All cases AFR 23% AMR 9% EMR 5% EUR 8% SEAR 28% WPR 27% Smear-positive Proportions of Cases by WHO Region, 1998

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1980 1982 1984 1986 1988 1990 1992 1994 1996 1998 Year Case notification rate (per 100 000) Global Notifications Trend 1980-98

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Incidence Rates by Age and Sex: high incidence countries in Latin America, 1998 0 50 100 150 200 0-14 15-24 25-34 35-44 45-54 55-64 65+ age (years) incidence rate (per 100 000) 0.0 0.5 1.0 1.5 2.0 ratio of incidence rates male:female incidence rate, males ratio of incidence rates, male:female

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0 50 100 150 200 250 300 0-14 15-24 25-34 35-44 45-54 55-64 65+ 0 1 2 3 4 incidence rate (per 100 000) ratio of incidence rates male:female age (years) Incidence Rates by Age and Sex: sub-Saharan Africa, 1998 ratio of incidence rates, male:female

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Incidence Rates by Age and Sex: Eastern Europe, 1998 0-14 15-24 25-34 35-44 45-54 55-64 65+

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0 10 20 30 40 0-14 15-24 25-34 35-44 45-54 55-64 65+ 0.0 0.5 1.0 1.5 2.0 2.5 incidence rate (per 100 000) ratio of incidence rates male:female age (years) Incidence Rates by Age and Sex: Eastern Mediterranean Region, 1998 ratio of incidence rates, male:female

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Incidence Rates by Age and Sex: South-East Asia, 1998 incidence rate (per 100 000) ratio of incidence rates male:female age (years)

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Incidence Rates by Age and Sex: Latin America (excl. high inc. countries), 1998 incidence rate (per 100 000) ratio of incidence rates male:female age (years)

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Incidence Rates by Age and Sex: Western Pacific (excl industrialized), 1998 incidence rate (per 100 000) ratio of incidence rates male:female age (years)

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Incidence Rates by Age and Sex: Industrialized countries, 1998

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0 10 20 30 40 50 60 70 80 90 100 Category 0 No report Category 1 Non-DOTS high incidence Category 2 DOTS pilot phase Category 3 DOTS expansion phase Category 4 DOTS full coverage Category 5 non-DOTS low incidence Number of countries 1995 1996 1997 1998 Categorization of Countries, 1995-98

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0 10 20 30 40 1995 1996 1997 1998 0 5 10 15 20 25 overall DOTS Overall case detection rate (%) DOTS detection rate (%) Progress in Case Detection

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0 20 40 60 80 100 AFR AMR EMR EUR SEAR WPR Treatment Success Rates: DOTS vs. non-DOTS 1997 Cohort

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0 20 40 60 80 100 AFR AMR EMR EUR SEAR WPR Percent of registered cases DOTS 0 20 40 60 80 100 AFR AMR EMR EUR SEAR WPR Percent of registered cases Non-DOTS Treatment Success for DOTS and Non-DOTS Programmes by WHO Region, 1997 Cohort

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0 200 400 600 800 1000 1200 1400 1600 1800 AFR AMR EMR EUR SEAR WPR Population (millions) 61 59 33 13 29 58 Numbers above bars are % of population covered by DOTS DOTS Population Coverage by WHO Region, 1998

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30 40 50 60 70 80 90 100 0 10 20 30 40 50 60 70 80 90 100 DOTS detection rate (%) Treatment success (%) Uganda DRCongo Kenya Tanzania Peru Vietnam Myanmar Bangladesh India Philippines Indonesia China Ethiopia Nigeria Russia Sth Africa Thailand Cambodia Pakistan Afghanistan Target zone DOTS progress in high burden countries, 1997-98

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Projected DOTS Case Detection

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High treatment success ( 70%) Progress in DOTS implementation: top 22 countries, 1996-98 Non-DOTS or incomplete data DOTS Low treatment success (andlt; 70%) Low case detection** (andlt; 10%) Intermediate case detection (10-49%) High case detection ( 50%) Brazil* Afghanistan India Bangladesh Cambodia Zimbabwe* D.R. Congo China Peru Indonesia Ethiopia Viet Nam Kenya Myanmar Tanzania Uganda Nigeria Pakistan Philippines Russian Federation South Africa Thailand

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