Methods used by WHO to estimate the Global burden of TB disease

TL;DR

This paper details WHO's 2015 methods for estimating global TB burden, including incidence, prevalence, and mortality, using diverse data sources and statistical models to improve accuracy across countries.

Contribution

It introduces a comprehensive methodological framework combining multiple data sources and modeling techniques for more accurate global TB burden estimation.

Findings

Multiple data sources improve TB burden estimates.

Methods account for under-reporting and underdiagnosis.

Disaggregated data by HIV status, age, and sex enhance understanding.

Abstract

This paper describes methodological details used by WHO in 2015 to estimate TB incidence, prevalence and mortality. Incidence and mortality are disaggregated by HIV status, age and sex. Methods to derive MDR-TB burden indicators are detailed. Four main methods were used to derive incidence: (i) case notification data combined with expert opinion about case detection gaps (120 countries representing 51% of global incidence); (ii) results from national TB prevalence surveys (19 countries, 46% of global incidence); (iii) notifications in high-income countries adjusted by a standard factor to account for under-reporting and underdiagnosis (73 countries, 3% of global incidence) and (iv) capture-recapture modelling (5 countries, 0.5% of global incidence). Prevalence was obtained from results of national prevalence surveys in 21 countries, representing 69% of global prevalence). In other countries, prevalence was estimated from incidence and disease duration. Mortality was obtained from national vital registration systems of mortality surveys in 129 countries (43% of global HIV-negative TB mortality). In other countries, mortality was derived indirectly from incidence and case fatality ratio.