What Countries have the Highest Cases of Tuberculosis?

Tuberculosis (TB) is a contagious disease usually caused by bacteria (Mycobacterium tuberculosis). It infects the lungs of human beings and can spread to other organs of the body like bone, brain, spine, etc. TB was the leading cause of death all over the world in the 20th century. This deadly disease was incurable. Therefore TB was considered a terminal illness.

Studies of human skeletons reveal that it has affected humans for thousands of years – but its cause remained unknown until March 24, 1882, when Dr. Robert Koch made a significant breakthrough and announced the much-needed discovery of the bacillus subsequently named Mycobacterium tuberculosis. The new finding has made TB a curable disease. But it takes a lot of time in curing the patients. They need to take medicines for six to nine months.

Tuberculosis is a communicable disease that spreads from one person to another through the air. People who are sick with TB expel bacteria into the air through coughing, sneezing, or speaking. It usually affects the lungs (pulmonary TB) but can also affect other sites (extrapulmonary TB).

When a person develops active TB disease, the symptoms (such as cough, fever, night sweats, or weight loss) may be mild for many months. It can lead to a delay in seeking care and results in the transmission of the bacteria to others. People with active TB can infect 5–15 other people through close contact.

The most common tests that are usually taking place to find out TB bacteria in the body are the TB skin test and blood test. But the TB skin test is not 100% perfect.

Diagnostic tests for TB disease include sputum smear microscopy (developed more than 100 years ago), rapid molecular tests (first endorsed by WHO in 2010), and culture-based methods; the latter take up to 12 weeks to provide results but remain the reference standard. TB that is resistant to first-line and second-line anti-TB drugs can be detected using rapid tests, culture methods, and sequencing technologies. Without treatment, the mortality rate from TB is high.

The effective drugs of TB, first discovered in the 1940s and 50s, could kill TB bacteria. Currently, a TB patient has to take timely medicines at least 6 to 9 months for complete recovery. Apart from several other drugs, four major drugs have approval for the treatment of TB: isoniazid, rifampicin, ethambutol, and pyrazinamide. The only licensed vaccine for the prevention of TB disease is the Bacille Calmette-Guérin (BCG) vaccine. The BCG vaccine was developed almost 100 years ago, which prevents severe forms of TB in children. Currently, widely used all over the world.

In 2018, an estimated 1.5 million people died due to TB, while 10 million people fell ill with the disease worldwide. Overall 5.7 million men, 3.2 million women, and 1.1 million children were infected by tuberculosis. TB incidence is falling globally at about 2% per year (WHO report).

As per WHO data, in 2000, there were 172 incidences of tuberculosis per 100,000 people across the world. But by 2018, this figure had decreased to 132 per 100,000 people.

Lesotho reported the highest incidence of the disease in the world. In 2000, the nation reported 992 incidences of tuberculosis per 100,000 people. But by 2018, this figure had decreased to 611. The Philippines occupied second place with 554 incidences reported in 2018. Mozambique and the Central African Republic are the two other nations that had more than 500 incidences per 100,000 people. In both countries, the figures stood at 551 and 540 respectively.

Among regions, the Sub-Saharan African region, according to the 2018 data, was the worst affected by the disease where the incidence of tuberculosis per 100,000 people stood at 231. But this was a climbdown from the 344 figure that was reported in 2000. South Asia held second place reporting 206 incidences of tuberculosis per 100,000 people. Among the South Asian nations, Pakistan had the highest incidences of tuberculosis at 100,000 with the number standing at 265. Bangladesh and India reported figures of 221 and 199 respectively. The Maldives had the lowest figure in South Asia, with 33 incidences of tuberculosis per 100,000 people.

In Europe, tuberculosis was at one time the most dreaded disease but has been contained over the years. Still, Moldova and Ukraine had reported a little higher incidence of the disease at 86 and 80, respectively. On the other hand, a majority of the nations had reported figures of 10 and less. The two major nations of North America, the United States, and Canada – had even done better with just 3 and 5.6 incidences of tuberculosis per 100,000 people. In Australia and New Zealand, the figure stood at 6.6 and 7.3, respectively.

As per the WHO’s Global TB Report 2019, India had 2.69 million patients in 2018. In 2017, the number was 2.74 million. It means a 1.8% decline. In 2018, the 30 high TB burden countries accounted for 87% of new TB cases. India is the only country where TB cases are in a double-digit percentage of 27% of the total TB cases in the world. Eight countries account for two-thirds of the TB burden globally. India is on the number one spot, followed by China, Indonesia, Philippines, Pakistan, Bangladesh, South Africa, and the Democratic Republic of the Congo, Myanmar, Ethiopia, Russia, Nigeria, Vietnam, Kenya, North Korea, Mozambique, Brazil, Thailand, Tanzania, and Angola.

In 2018, the largest number of new TB cases took place in the South-East Asian region, with 44% of new cases followed by the African region, with 24%, and the Western Pacific with 18%.

Incidence of Tuberculosis (per 100,000 people) as per the Year 2018:

S. No.	Countries	Incidence of Tuberculosis (per 100,000 people), 2018
1	Lesotho	611
2	Philippines	554
3	Mozambique	551
4	Central African Republic	540
5	Gabon	525
6	Namibia	524
7	South Africa	520
8	Korea, North	513
9	Timor-Leste	498
10	Marshall Islands	434
11	Papua New Guinea	432
12	Mongolia	428
13	Republic of the Congo	375
14	Guinea-Bissau	361
15	Angola	355
16	Kiribati	349
17	Zambia	346
18	Myanmar	338
19	Eswatini	329
20	Democratic Republic of the Congo	321
21	Indonesia	316
22	Liberia	308
23	Cambodia	302
24	Sierra Leone	298
25	Kenya	292
26	Botswana	275
27	Tuvalu	270
28	Pakistan	265
29	Somalia	262
30	Djibouti	260
31	Tanzania	253
32	Madagascar	233
33	Bangladesh	221
34	Nigeria	219
35	Zimbabwe	210
36	Equatorial Guinea	201
37	Uganda	200
38	India	199
39	Afghanistan	189
40	Cameroon	186
41	Vietnam	182
42	Malawi	181
43	Guinea	176
44	Haiti	176
45	The Gambia	174
46	Laos	162
47	Thailand	153
48	Ethiopia	151
49	Nepal	151
50	Bhutan	149
51	Ghana	148
52	South Sudan	146
53	Chad	142
54	Cote D’Ivoire	142
55	Sao Tome and Principe	124
56	Peru	123
57	Senegal	118
58	Kyrgyzstan	116
59	Burundi	111
60	Palau	109
61	Bolivia	108
62	Federated States of Micronesia	108
63	Greenland	100
64	Morocco	99
65	Northern Mariana Islands	95
66	Mauritania	93
67	Malaysia	92
68	Eritrea	89
69	Niger	87
70	Moldova	86
71	Tajikistan	84
72	Guyana	83
73	Georgia	80
74	Ukraine	80
75	Solomon Islands	74
76	Sudan	71
77	El Salvador	70
78	Uzbekistan	70
79	Algeria	69
80	Brunei	68
81	Kazakhstan	68
82	Romania	68
83	Korea, South	66
84	Sri Lanka	64
85	Azerbaijan	63
86	China	61
87	Rwanda	59
88	Benin	56
89	Fiji	54
90	Nauru	54
91	Russia	54
92	Mali	53
93	Panama	52
94	Guam	49
95	Burkina Faso	48
96	Venezuela	48
97	Yemen	48
98	Singapore	47
99	Cabo Verde	46
100	Turkmenistan	46
101	Vanuatu	46
102	Brazil	45
103	Dominican Republic	45
104	Ecuador	44
105	Lithuania	44
106	Paraguay	43
107	Iraq	42
108	Nicaragua	41
109	Libya	40
110	Suriname	38
111	Honduras	37
112	Togo	36
113	Comoros	35
114	Tunisia	35
115	Colombia	33
116	Maldives	33
117	Uruguay	33
118	Armenia	31
119	Belarus	31
120	Qatar	31
121	Belize	30
122	Latvia	29
123	Argentina	27
124	Guatemala	26
125	Bosnia and Herzegovina	25
126	Portugal	24
127	Kuwait	23
128	Mexico	23
129	Bulgaria	22
130	French Polynesia	22
131	Trinidad and Tobago	21
132	Sint Maarten	19
133	Syria	19
134	Albania	18
135	Chile	18
136	Seychelles	18
137	Serbia	17
138	Poland	16
139	Turkey	16
140	Montenegro	15
141	New Caledonia	15
142	The Bahamas	14
143	Iran	14
144	Japan	14
145	Malta	14
146	Estonia	13
147	North Macedonia	13
148	Mauritius	13
149	Egypt	12
150	Bahrain	11
151	Lebanon	11
152	Costa Rica	10
153	Saudi Arabia	10
154	Tonga	10
155	Spain	9.4
156	Belgium	9
157	France	8.9
158	Croatia	8.4
159	Luxembourg	8
160	United Kingdom	8
161	Germany	7.3
162	New Zealand	7.3
163	Cuba	7.2
164	Austria	7.1
165	Ireland	7
166	Italy	7
167	Australia	6.6
168	Curaçao	6.4
169	Dominica	6.4
170	Hungary	6.4
171	Samoa	6.4
172	Switzerland	6.4
173	Saint Vincent and the Grenadines	6.3
174	Turks and Caicos Islands	6.1
175	Antigua	6
176	Slovakia	5.8
177	Canada	5.6
178	Sweden	5.5
179	Aruba	5.4
180	Cayman Islands	5.4
181	Cyprus	5.4
182	Czechia	5.4
183	Denmark	5.4
184	Netherlands	5.3
185	Slovenia	5.3
186	Jordan	5
187	Finland	4.7
188	Greece	4.5
189	Norway	4.1
190	Israel	4
191	British Virgin Islands	3.9
192	Bermuda	3.7
193	Saint Lucia	3.2
194	Andorra	3
195	United States of America	3
196	Jamaica	2.9
197	Iceland	2.7
198	Grenada	2.1
199	United Arab Emirates	1
200	Puerto Rico	0.95
201	Palestine	0.77
202	Barbados	0.4
203	American Samoa	0
204	Monaco	0
205	San Marino	0

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