If we can't contain TB, nothing is off the table for a comeback.
Tuberculosis remains a major health problem worldwide, with at least three million deaths annually (1). Each year there are nearly 10 million new cases, of which four to five million are smear positive and, thus, highly contagious. The problem is smallest in the developed countries of Europe, North America, Australia and New Zealand. The largest problem exists in southeast Asia and subSaharan Africa. In Latin America, where the incidence is generally lower than in Africa, it is still five to 30 times higher than in Canada. Tuberculosis is primarily a socioeconomic problem associated with overcrowding, poor hygiene, lack of fresh water and limited access to health care. The lack of a well organized health care infrastructure for case finding and treatment of tuberculosis complicates disease control in these countries. In the developing countries, many cases are unrecognized, incorrectly diagnosed or unreported, and the available statistical data significantly underestimate the problem of tuberculosis in the world. In these countries only cases that are sputum smear positive are diagnosed, as facilities for culture are almost nonexistent. Tuberculosis in children is rarely diagnosed unless a complication occurs. Extrapulmonary tuberculosis is not often recognized.
