Prevalence of tuberculosis and multidrug resistant tuberculosis in the Middle East Region.

INTRODUCTION: Prevalence of TB and MDR-TB varies considerably among various regions of World Health Organization (WHO) and also among individual countries within each region. Many Middle Eastern countries have war/civil war-like situations, refugees from war-torn countries or dynamic expatriate population from TB endemic countries which will likely affect the END-TB strategy launched by the WHO in 2015. Areas covered: The data for each of 17 countries comprising the Middle East were analyzed for estimated incidence of TB, number of notified TB cases, mortality rate, and rate of MDR-TB in new and previously treated TB cases as reported by WHO. Data from national surveys or surveillance studies from individual countries were also analyzed for incidence of MDR-TB in new and previously treated TB patients and compared with the estimated data by WHO. Expert commentary: Several Middle Eastern countries have low/intermediate incidence rate and are striving for TB elimination. Reaching pre-elimination (< 1 TB case per 100 000 population) stage will require testing and treatment of latent TB infection in groups at high risk of reactivation and effective treatment of drug-susceptible and drug-resistant TB cases. Large numbers of refugees, expatriate workers, or confounding noncommunicable diseases in some countries pose major challenges in achieving progress toward TB elimination.