Tuberculosis trends in the Pacific: 2000-2006

The objective in this manuscript is to describe the epidemiology of tuberculosis in 19 Pacific Island countries and territories by analysing routine surveillance data from 2000 to 2006. In addition, progress against World Health Organization targets is described. The setting is National Tuberculosis Programmes in 19 Pacific Island countries and territories served by the Secretariat of the Pacific Community. The study is a descriptive study of routinely collected surveillance data from 19 Pacific Island countries and territories. In 2006 there were 1585 cases of TB notified in the Pacific region. The case notification rate in the Pacific was 54/100,000 population. Almost half (49%) of all TB notifications were in the subregion of Micronesia, with 42% in Melanesia and 9% in Polynesia. Micronesia had the highest rate of TB in the region with a case notification rate of 145/100,000 population. The TB case notification rate in the Pacific increased by 10% between 2000 and 2006, from 49/100,000 to 54/100,000 population. The highest increase in rates has been in Micronesia, where the TB case notification rate rose by 39% between 2000 and 2006. In the Pacific in 2006, 71% of all TB notifications were pulmonary, and just over one third (36%) of all TB notifications were sputum smear positive. One quarter (25%) of sputum smear positive cases were in people aged 15-24 years and slightly more than half of all sputum smear positive cases were in males (52%). In Micronesia this pattern was different; 61% of all sputum smear positive cases were in males. In 2005, the treatment success rate of new sputum smear positive cases in the Pacific was 85%, equivalent to the WHO target. The treatment success rate of sputum smear positive cases rose from 78% in 2000 to 85% in 2005, an increase of 7%. In 2005, 4% of all people with TB died, and of those with sputum smear positive TB, 8% died. In 2005 in Polynesia, 13% of all people with sputum smear positive TB died. Since the year 2000, the rates of TB have increased in the Pacific region, with a relatively large increase in the subregion of Micronesia. Treatment success rates in the same time period have improved and are now at the WHO target of 85%. The conclusion is that to continue to make progress toward TB control in the region, intensified efforts may be needed in the sub-region of Micronesia while support is also maintained at current or increased levels in Melanesia and Polynesia.