Health

What Countries have the Highest Cases of Tuberculosis?



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World map depicting the rate of tuberculosis per 100,000 people across the countries

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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