WHO Global Tuberculosis Research Articles

IJCM_311A: Epidemiological profile of tuberculosis cases at an urban slum in a metropolitan city a cross sectional study

Background: The WHO Global Tuberculosis Programme works towards the goal of a world free of TB, with zero deaths, disease and suffering due to the disease. Tuberculosis (TB) is a preventable and usually curable disease. Yet in 2022, TB was the worlds second leading cause of death from a single infectious agent, after coronavirus disease (COVID-19). The reported global number of people newly diagnosed with TB was 7.5 million in 2022; this is the highest number since WHO began global TB monitoring in 1995. Around 87% of new TB cases occurred in the 30 high TB burden countries, with more than two-thirds of the global total in Bangladesh, China, Democratic Republic of the Congo, India, Indonesia, Nigeria, Pakistan and the Philippines. Objective: To study the epidemiological profile of tuberculosis cases in an urban slum of Mumbai. Methodology: A retrospective record-based analysis of secondary data on tuberculosis (pulmonary and extrapulmonary) reported on the NIKSHAY portal between January to December 2022 at an urban health training center in an urban slum in Mumbai. Results: The total number of drug sensitive TB cases reported in 2022 was 519. Males constituted 42% and females 58%. The most common age group affected was 20-29 years. Pulmonary cases comprised 66.9% of the cases. The total number of Drug resistant TB cases reported were 75, 53 were pulmonary & 22 were extrapulmonary. Conclusion: In contrast to Male predominance (52.26%) of cases in Maharashtra, the urban slum had 42% males affected. India grapples with multiple challenges in combatting tuberculosis (TB), marked by a high disease burden, diagnostic delays, drug resistance, and socioeconomic barriers. While significant strides have been made through programs like the National Tuberculosis Elimination Program, the path to eradication demands continued efforts.

Roadmap for ending TB in China by 2035: The challenges and strategies.

Tuberculosis (TB) is one of the top ten causes of death worldwide, taking the lives of over a million people annually. In addition to being a serious health issue, TB is also closely linked to eradicating poverty according to the Sustainable Development Goals (SDGs) of the United Nations (UN). All UN members have committed to ending the TB epidemic by 2030. China has one of the highest TB loads worldwide, ranking third in the world on many TB burden indices. The national strategy for TB control is aimed at creating a collaborative network and integrating TB treatment into the medical system. According to the WHO's global TB report, China is expected to have 748,000 new cases of TB in 2022 and an incidence of 52 cases per 100,000 people. Ending TB remains a huge challenge and requires comprehensive control strategies in China. In this work, we have discussed the challenges of TB prevention and control in China and proposed specific measures to end TB.

Monoresistance to Rifampicin: An Uncharted Territory in The Management of Drug-Resistant Tuberculosis

Tuberculosis (TB) disease caused by the bacilli Mycobacterium tuberculosis (MTB) is a chronic disease, mostly involving the lungs but can also involve other parts of the body, which if left untreated may lead to severe illness which can be fatal. Worldwide, TB is the 13th leading cause of death. TB occurs in every part of the world but its distribution is heterogenous. As per WHO global TB report, the biggest quantum of cases occurs in the South and South-Eastern Asian region (46%). Africa contributes to 23% with Western pacific taking 18% of the burden of TB [1].

Drug-Induced Hypersensitivity Reaction and Re-Introduction of Anti-Tubercular Drugs (ATT): A Case Report and Review of Literature

Tuberculosis (TB) is a communicable disease caused by the bacillus Mycobacterium tuberculosis and is the leading cause of death by a single infectious agent overall. According to the WHO Global TB Report, India contributes to 26% of the global burden of TB. Currently, a four-drug regimen comprising Rifampicin, Isoniazid, Pyrazinamide, and Ethambutol is approved for the treatment of drug-sensitive TB. The management of cutaneous adverse drug reactions to anti-tubercular drugs is akin to a double-edged sword, with discontinuation of ATT increasing the risk of developing disseminated and drug-resistant tuberculosis, and continuation leading to persistence or exacerbation of the adverse drug reaction (ADR). The risk of developing an ADR to anti-tubercular therapy (ATT) varies from 8 to 85% in various studies [10]. The prevalence of rashes associated with ATT shows that the maculopapular rash (42.5%) is the most frequently observed type, followed by urticarial, lichenoid, DRESS, AGEP, and exfoliative dermatitis (17). The drugs associated with Cutaneous ADRs from the lowest to the highest risk are Isoniazid, Rifampicin, Pyrazinamide, Ethionamide, Cycloserine, Ethambutol, Para-aminosalicylic acid (PAS), and Streptomycin (25). We present a case and approach to the re-introduction of first-line anti-tubercular drugs after hypersensitivity with fixed-dose combinations.
 Keywords: Tuberculosis, Mycobacterium tuberculosis, adverse drug reaction, anti-tubercular therapy

Studying the efficacy of isolation as a control strategy and elimination of tuberculosis in India: A mathematical model

India has the highest burden of both tuberculosis (TB) and multidrug-resistant TB (MDR-TB) based on the WHO Global TB Report 2019. Although the available data suggest that the total TB incidence has declined, the absolute number of new cases is still increasing. The number of reported TB cases in India in 2018 was 2.2 million, which was 1.5 million in 2009. About 47% increment in TB case notification in India within a decade shows a persistent public health problem. India contributes about 22% of the World's TB burden. Indian National Strategic Plan 2017-2025, sets out the government plans to eliminate TB by 2025. However, the milestone seems unrealistic to achieve the TB eradication goal by 2025. We developed a five-dimensional mathematical model to understand the TB dynamics in India and investigate the possibility of the earliest TB eradication time frame. The model stratifies the entire TB class into three different classes as drug-sensitive (DS), MDR, and isolated classes. The effective reproduction number, equilibrium points, and stability analysis of the model were carried out. This model predicts the total estimated cases of DS-TB and MDR-TB from 2018 to 2035 through numerical simulation and suggests that TB may be eliminated by 2035 in India if the treatment success rate could be achieved to 95%, by contact tracing and isolating at least 50% of MDR-TB.

A study of analysis on prevalence, serological marker and prognosis of tuberculosis in tertiary care hospital

BackgroundTuberculosis is an infectious disease responsible for a significant cause of ill health. According to the WHO global tuberculosis report 2021. 9.9 million cases fell sick with TB in 2020. Significantly, the prevalence of tuberculosis in India is 25%. ObjectiveTo analyze the prevalence of tuberculosis in the suburban areas of the metropolitan city in South India. To analyze the serological marker and prognosis of tuberculosis among males and females. To determine the importance of molecular testing - PCR confirmation on TB after AFB smear. MethodsA retrospective study to analyze 462 patients enrolled by the respiratory medicine department on suspecting pulmonary- 356 (M−264 & F-92) and extra-pulmonary-106 (M-73&F-33) patients and diagnosed Zhiel-Neelsen staining, Mantoux test, Chip-based RT-PCR test, Erythrocyte sedimentation rate, and analyzed serological test such as C-Reactive Protein, Chemiluminescence immune assay. Results23 patients were positive in Ziehl-Neelsen staining, 65 were positive in molecular True-Nat PCR test, Mantoux skin test induration in 10 patients, 98 TB Positive patients examined in the serological analysis, 1 & 3 patients reacted in HIV/HBsAg, and HBsAg test respectively, by chemiluminescence immunoassay, 8 PTB and 4 EPTB and 47 non-TB patients were positive in C-reactive protein, 46 TB and 94 non-TB patients detected abnormal values out of these 160 patients in ESR test. ConclusionThe Prevalence of tuberculosis is significantly rising, especially in the middle-aged population. The rapid molecular diagnostics to detect TB are highly sensitive and specific. Serological markers are essential for the analysis of disease prognosis and need to focus on the guidance of DOTS and RNTCP to End TB.

EFEKTIFITAS POSISI ORTHOPNEA TERHADAP PENURUNAN SESAK NAFAS PADA PASIEN TB PARU

The incidence of tuberculosis according to the WHO Global Tuberculosis report 2016, tuberculosis occupies the second position with the highest TB burden in the world. Pulmonary TB is an inflammatory disease of the lung parenchyma caused by the bacterium Mycobacterium tuberculosis. Pulmonary TB can cause respiratory system disorders. Breathing is a condition in which air containing O2 enters the body and removes CO2 from the body as a residue of oxidation. The purpose of the study was to determine the effectiveness of the orthopnea position on the reduction of shortness of breath in pulmonary TB patients in RSUP H. Adam Malik Medan. Research design. Quasi-experimental with a two-group pretest-posttest design approach. To determine the effectiveness before and after the orthopnea position to decrease shortness of breath in pulmonary TB patients. The sample was 50 respondents, 25 for the intervention group, and 25 for the control group, using the purposive sampling technique. The study found that the mean value in the intervention group was 26,64 decreased to 21,36 and the control group was 24,80 to 24,88. Dependent test results in the intervention group obtained a value of p = 0.000 or p < 0.05 and the control group obtained a value of p = 0.161 or p> 0.05 so the intervention group had an effect and the control group had no effect. Suggestions are the effectiveness of respiratory frequency in pulmonary TB patients while the control group only measures the respiratory frequency, there is no effectiveness in pulmonary TB patients.

A systematic review and meta-analysis of active case finding for tuberculosis in India.

Active case finding (ACF) for tuberculosis (TB) is the cornerstone case-finding strategy in India's national TB policy. However, ACF strategies are highly diverse and pose implementation challenges in routine programming. We reviewed the literature to characterise ACF in India; assess the yield of ACF for different risk groups, screening locations, and screening criteria; and estimate losses to follow-up (LTFU) in screening and diagnosis. We searched PubMed, EMBASE, Scopus, and the Cochrane library to identify studies with ACF for TB in India from November 2010 to December 2020. We calculated 1) weighted mean number needed to screen (NNS) stratified by risk group, screening location, and screening strategy; and 2) the proportion of screening and pre-diagnostic LTFU. We assessed risk of bias using the AXIS tool for cross-sectional studies. Of 27,416 abstracts screened, we included 45 studies conducted in India. Most studies were from southern and western India and aimed to diagnose pulmonary TB at the primary health level in the public sector after screening. There was considerable heterogeneity in risk groups screened and ACF methodology across studies. Of the 17 risk groups identified, the lowest weighted mean NNS was seen in people with HIV (21, range 3-89, n=5), tribal populations (50, range 40-286, n=3), household contacts of people with TB (50, range 3-undefined, n=12), people with diabetes (65, range 21-undefined, n=3), and rural populations (131, range 23-737, n=5). ACF at facility-based screening (60, range 3-undefined, n=19) had lower weighted mean NNS than at other screening locations. Using the WHO symptom screen (135, 3-undefined, n=20) had lower weighted mean NNS than using criteria of abnormal chest x-ray or any symptom. Median screening and pre-diagnosis loss-to-follow-up was 6% (IQR 4.1%, 11.3%, range 0-32.5%, n=12) and 9.5% (IQR 2.4%, 34.4%, range 0-86.9%, n=27), respectively. For ACF to be impactful in India, its design must be based on contextual understanding. The narrow evidence base available currently is insufficient for effectively targeting ACF programming in a large and diverse country. Achieving case-finding targets in India requires evidence-based ACF implementation. WHO Global TB Programme.

Characteristics of Drug-sensitive and Drug-resistant Tuberculosis Cases among Adults at Tuberculosis Referral Hospitals in Indonesia.

As Indonesia's rifampin resistance testing rates are lower than global testing rates per the 2020 WHO global tuberculosis (TB) report, prevalence of multidrug-resistant TB may be underestimated. Our study aimed to evaluate prevalence and patterns of TB drug resistance (DR) within Indonesia. We conducted a cross-sectional analysis of baseline data collected from 2017-2018 as part of a cohort study of adults with presumed pulmonary TB at 7 DR-TB referral hospitals in Indonesia. Bacteriological examinations (acid-fast bacilli, GeneXpert, sputum culture) and drug-susceptibility testing were performed following the guidelines of the National TB Program. Of 447 participants with complete bacteriological examinations, 312 (69.8%) had positive sputum cultures for Mycobacterium tuberculosis. The proportion of MDR and pre-extensively drug-resistant was higher in previously treated compared with newly diagnosed participants (52.5% [73/139] versus 15% [26/173]). Compared with drug-sensitive case, drug-resistant TB was associated with cavities. Given the difference between rates of DR in TB referral hospitals from our study compared with the WHO survey in 2019 that showed 17.7% and 3.3% DR among previously treated and newly diagnosed participants globally, further characterization of Indonesia's TB epidemiology in the general population is needed. Strategies, including public policies to optimize case finding, strengthen capacity for resistance testing, and prevent loss to follow-up will be critical to reduce the burden of TB in Indonesia.

Pengaruh sanitasi lingkungan fisik rumah, sosial budaya dan kontak serumah terhadap kejadian Tuberkulosis Paru di Pulau Bengkalis Kabupaten Bengkalis

The degree of public health is influenced by four factors, namely environment, behavior, health services, and heredity. Data from 2019 WHO Global Tuberculosis Report, Indonesia ranks third with the highest tuberculosis cases in the world. The purpose of this study was to analyze the sanitary conditions of the house environment (temperature, humidity, type of floor, ventilation, lighting), socio-culture (trust), and household contact against the incidence of pulmonary tuberculosis on Bengkalis Island. This research is an analytical study with a case-control design. This research was conducted on Bengkalis Island, namely in two sub-districts (Bengkalis District and Bantan District) and in the working area of Puskesmas Bengkalis, Puskesmas Pematang Duku, Puskesmas Selatbaru and Puskesmas Teluk Pambang. The data used are quantitative data sourced from observations, interviews, and questionnaires. The research sample was 80 people consisting of 40 cases and 40 controls. Data analysis was performed by multiple logistic regression tests. The results of the study concluded that the most dominant variable affecting the incidence of pulmonary tuberculosis was temperature with a p-value of 0.008. Confounding variables for tuberculosis incidence were ventilation, floor type, lighting, and confidence. The multivariate model formed is fit/fit for use. Based on the results of the calculation of the equation, it can be concluded that if a person has temperature risk factors, humidity risk factors, ventilation risk factors, floor type risk factors, lighting risk factors, trust risk factors, and household contact risk factors, then he will have a chance of suffering from pulmonary tuberculosis by 94 percent (with a probability value of 0.94).

Multidrug-resistant tuberculosis in Sierra Leone

Tuberculosis has persisted as a human challenge since antiquity. The WHO's Global Tuberculosis Report of 2021 indicated that there were 9·5 million cases and 1·5 million deaths due to tuberculosis in 2021, surpassing deaths attributable to HIV and ranking as the second leading infectious cause of death after COVID-19.1 The impact of the tuberculosis pandemic has been felt most profoundly in Sierra Leone and 30 other countries with a high tuberculosis burden, mostly countries of lower wealth index, which collectively account for almost 90% of the global burden of the disease.

Predoperačná optimalizácia pacienta s multirezistentnou formou tuberkulózy pri kombinovanej farmakologickej a nefarmakologickej liečbe

Tuberculosis is a communicable infectious disease in majority caused by bacillus Mycobacterium tuberculosis. Lungs are the most often targeted body tissue where infection can spread. Although lung tuberculosis is well curable by combinations of antituberculotic drugs, more serious drug-resistant forms occur. WHO Global Tuberculosis Report provides information about almost half million of new resistant cases and rising multidrug resistant tuberculosis (MDR-TB) together with serious extensively drug resistant tuberculosis (XDR-TB). Resistant species increase cost of hospitalization and prolong length of stay in hospital. Combination of pharmacological and surgical (non-pharmacological) treatment strategy brings successful tuberculosis cure to certain group of patients. Adequate preoperative optimalization and interdisciplinary approach are essential points of effectual surgical care in combination with pharmacological treatment.

Assessment of Knowledge, Attitude and Practice (KAP) in Tuberculosis patients

Tuberculosis (TB) is a highly contagious airborne disease caused by Mycobacterium tuberculosis that primarily affects the lungs. TB is a significant and major public health emergency globally. According to the WHO Global Tuberculosis Report 2020, 10 million people developed TB disease in the year 2019. The main objective of the study was to assess the level of knowledge, attitude and practice in TB patients. The study also reveals the association between KAP and the demographics of the subjects. An observational study was employed to collect data from a total of 71 subjects. Both quantitative and qualitative statistical analysis were adopted. From the findings, the mean age of the study population was 45.5 ± 13.96 years. Over 15.50% of subjects appeared to have adequate knowledge, 87.33% of subjects had a fair attitude, and around 58% of subjects were reported to have good practices towards TB. A weak positive correlation between knowledge and attitude (p = 0.051), weak positive correlation between knowledge and practice (p = 0.138) whereas, a significant and moderately positive correlation between attitude and practice (p = 0.002) was observed. The mean knowledge scores of graduates and post-graduates were higher in comparison with other study subjects. The study findings showed that the majority of subjects had several misconceptions about TB and hence prioritized interventions and more awareness programs at the root levels are needed to aid TB control and eradication.

Wisata Kampung Lukis Berbasis Masyarakat dalam Meningkatkan Pola Hidup Bersih dan Kreatif (Studi Kasus Desa Panderejo Kabupaten Banyuwangi)

Reporting from WHO Global TB (Tuberculosis) in 2020, more than ten million people in this world suffer from TB. In Indonesia alone, 845,000 people are infected with TB disease. In Banyuwangi, TB sufferers reached 2,169 people. Panderejo Village, is one of the villages that can be considered as slums for many years in Banyuwangi. Besides caused by piles of garbage, 70 percent of the majority of its citizens are active smokers. After the change of management in Gagak Rimang Youth Association, at last the local youth who were assisted by the local community began to move to clean the village once a week and carry out activities to beautify Panderejo Village. The current study employs qualitative research method. The data collection techniques employed interviews, observation, and documentation. The objectives of this study are namely: 1) to determine the types and components of Kampung Lukis tourist attraction, 2) to determine the community development in Kampung Lukis tourist attraction, 3) to determine the supporting and inhibiting factors of Kampung Lukis tourist attraction. The results of this study are namely: 1) Kampung Lukis tourist attraction is a cultural tourism that fulfils 6 tourism components, 2) the community development carried out in Kampung Lukis tourist attraction is to have a free English language learning. Then there are also village women who are more active in exploring their talents in the culinary field whose food will then be sold on Saturdays or Sundays during the culinary bazaar. 3) The supporting factor are the awareness and willingness of the local community to develop Kampung Lukis and the present of governmental support. While the inhibiting factor is the Covid-19 pandemic which weakens the joints of the activities and the economy.

Hubungan faktor lingkungan fisik, sosial dan ekonomi dengan kejadian Tuberkulosis Paru di Kecamatan Tambang Kabupaten Kampar

Pulmonary tuberculosis is an infectious disease caused by Mycobacterium tuberculosis which mostly attacks the lungs and can also attack other organs. Tuberculosis is transmitted by smear positive tuberculosis patients, Tuberculosis germs are transmitted through the air when the patient coughs and sneezes so that the germs spread in the air in the form of droplets (sputum sparks), so people can become infected if they inhale the droplet into the respiratory tract (Ministry of Health Republic of Indonesia, 2014 ). According to Achmadi (2010) risk factors for tuberculosis transmission are environmental and behavioral factors. Environmental factors include ventilation, occupancy density, temperature, lighting and humidity. Whereas behavioral factors include smoking, spitting or sputum in any place, coughing or sneezing not closing the mouth and habit of not opening the window. Based on the results of a survey in Indonesia by the Directorate General of Communicable Disease Eradication and Environmental Health (2011), the high incidence of pulmonary TB is caused by a lack of knowledge. Knowledge of tuberculosis sufferers will affect the attitude and behavior such as throwing up spit or sputum that can be carelessly a source of transmission for people around him. Prabu in Fitriani (2013) explained that family heads who have an income below the regional minimum wage (UMR) will consume foods with nutrient levels that are not in accordance with the needs of each family member so that they have an nutritional status that is lacking and will make it easier to contract infectious diseases including Lung TB. According to WHO the number of cases of tuberculosis is ranked above HIV / AIDS. In 2016 there were an estimated 10.4 million new cases of tuberculosis or 142 cases / 100,000 population, 60% of new cases occurred in 6 (six) countries namely India, Indonesia, China, Nigeria, Pakistan and South Africa, and Indonesia ranked second (WHO Global Tuberculosis Report, 2017). Based on data on Indonesia's health profile in 2018 the number of tuberculosis cases in Indonesia in 2017 was 420,994 cases and increased in 2018 to reach 511,873 cases (Ministry of Health Republic of Indonesia, 2018). The number of pulmonary tuberculosis in Riau Province in 2018 is 11,135 cases (Ministry of Health of the Republic of Indonesia, 2018). Based on data on the health profile of Kampar Regency in 2017, tuberculosis is an environmentally-based direct infectious disease that ranks second with a total of 1,071 cases after diarrheal disease with a total of 1,076 cases. The number of positive AFB cases in 2017 in Kampar District reached 1071 cases, with the highest number of sufferers found in Tambang District, 78 cases. In 2018 the number of TB cases was 1079 cases, with the highest cases also occurring at the Tambang Health Center with a total of 67 cases and 43 new cases, followed by the Siak Hulu I Health Center with a total of 57 cases (Dinkes District Health Office, 2018). Based on this, this study aims to analyze and the risk of the relationship between the physical, social and economic environment with the incidence of pulmonary tuberculosis in Tambang District, Kampar Regency.

In the Shadows of the COVID-19 Pandemic

In the Shadows of the COVID-19 Pandemic

Pulmonary tuberculosis masquerading as coronavirus disease 2019 in an HIV-infected individual with advanced immune suppression

Pulmonary tuberculosis masquerading as coronavirus disease 2019 in an HIV-infected individual with advanced immune suppression

Tracking total spending on tuberculosis by source and function in 135 low-income and middle-income countries, 2000–17: a financial modelling study

SummaryBackgroundEstimates of government spending and development assistance for tuberculosis exist, but less is known about out-of-pocket and prepaid private spending. We aimed to provide comprehensive estimates of total spending on tuberculosis in low-income and middle-income countries for 2000–17.MethodsWe extracted data on tuberculosis spending, unit costs, and health-care use from the WHO global tuberculosis database, Global Fund proposals and reports, National Health Accounts, the WHO-Choosing Interventions that are Cost-Effective project database, and the Institute for Health Metrics and Evaluation Development Assistance for Health Database. We extracted data from at least one of these sources for all 135 low-income and middle-income countries using the World Bank 2019 definitions. We estimated tuberculosis spending by source and function for notified (officially reported) and non-notified tuberculosis cases separately and combined, using spatiotemporal Gaussian process regression to fill in for missing data and estimate uncertainty. We aggregated estimates of government, out-of-pocket, prepaid private, and development assistance spending on tuberculosis to estimate total spending in 2019 US$.FindingsTotal spending on tuberculosis in 135 low-income and middle-income countries increased annually by 3·9% (95% CI 3·0 to 4·6), from $5·7 billion (5·2 to 6·5) in 2000 to $10·9 billion (10·3 to 11·8) in 2017. Government spending increased annually by 5·1% (4·4 to 5·7) between 2000 and 2017, and reached $6·9 billion (6·5 to 7·5) or 63·5% (59·2 to 66·8) of all tuberculosis spending in 2017. Of government spending, $5·8 billion (5·6 to 6·1) was spent on notified cases. Out-of-pocket spending decreased annually by 0·8% (−2·9 to 1·3), from $2·4 billion (1·9 to 3·1) in 2000 to $2·1 billion (1·6 to 2·7) in 2017. Development assistance for country-specific spending on tuberculosis increased from $54·6 million in 2000 to $1·1 billion in 2017. Administrative costs and development assistance for global projects related to tuberculosis care increased from $85·3 million in 2000 to $576·2 million in 2017. 30 high tuberculosis burden countries of low and middle income accounted for 73·7% (71·8–75·8) of tuberculosis spending in 2017.InterpretationDespite substantial increases since 2000, funding for tuberculosis is still far short of global financing targets and out-of-pocket spending remains high in resource-constrained countries, posing a barrier to patient's access to care and treatment adherence. Of the 30 countries with a high-burden of tuberculosis, just over half were primarily funded by government, while others, especially lower-middle-income and low-income countries, were still primarily dependent on development assistance for tuberculosis or out-of-pocket health spending.FundingBill & Melinda Gates Foundation.

Tackling two pandemics: a plea on World Tuberculosis Day

Tackling two pandemics: a plea on World Tuberculosis Day

Drug-resistant tuberculosis in eastern Europe and central Asia: a time-series analysis of routine surveillance data

Among all WHO regions, the WHO European Region has the highest proportion of drug-resistant tuberculosis among new and retreated cases. The 18 high-priority countries in eastern Europe and central Asia account for 85% of the tuberculosis incidence and more than 90% of drug-resistant tuberculosis cases emerging in the region. We aimed to analyse time-series trends in notification rates of drug-resistant tuberculosis among new tuberculosis cases in the 18 high-priority countries in the WHO European Region. We used country data stored in WHO's global tuberculosis database. For each country, we calculated annual notification rates per 100 000 population of new tuberculosis cases and of drug-resistant tuberculosis among new cases reported from Jan 1, 2000, to Dec 31, 2017. We computed annual percentage changes of notification rates and identified time-points of significant change in trends using the joinpoint regression method. All 17 countries with data (no data available from Turkmenistan) showed a significant decline in new tuberculosis notification rates in the most recent years since the last joinpoint if one was identified. Notification rates of drug-resistant tuberculosis showed diverse trends, with substantial year-to-year variation. In the most recent years, notification rates of drug-resistant tuberculosis among new tuberculosis cases were decreasing in two countries (Estonia and Latvia), increasing in eight countries (Azerbaijan, Kyrgyzstan, Moldova [Republic of Moldova], Romania, Russia [Russian Federation], Tajikistan, Ukraine, and Uzbekistan), and stable in seven countries (Armenia, Belarus, Bulgaria, Georgia, Kazakhstan, Lithuania, and Turkey). Our findings suggest that countries in the WHO European Region are more successful in controlling drug-susceptible tuberculosis than drug-resistant forms, and as a result, the proportion of drug-resistant strains among newly notified patients with tuberculosis is increasing in many settings. Two countries showed that it is possible to decrease incidence of both drug-susceptible and drug-resistant tuberculosis. If no additional efforts are made in prevention and care of patients with drug-resistant tuberculosis, further decline of the tuberculosis burden will be halted. Further studies are needed to investigate the success stories and document the most effective interventions to reach the target to end tuberculosis by 2030. United States Agency for International Development.