Tuberculosis Risk Index (TBRI) Released

Maplecroft, a UK based organization has released a new study ranking 196 countries on their vulnerability to Tuberculosis (TB).

The Tuberculosis Risk Index (TBRI) developed by Maplecroft, uses 10 separate indicators to measure the impacts of TB in each country, including: incidence, prevalence, mortality, treatment success and the capacity of a country to contain infectious diseases.
Africa is by far the region most at risk with 23 out of the 25 most vulnerable countries. The top ten countries most at risk are:
Rank
Country
Risk
Hardship Differential as of 2/14/2010) 
1
Chad
Extreme
30%
2
Côte d’Ivoire
Extreme
25%
3
Nigeria
Extreme
25%
4
Angola
Extreme
30%
5
Uganda
Extreme
25%
6
Burundi
Extreme
25%
7
Sierra Leone
Extreme
30%
8
Mali
Extreme
25%
9
Tanzania
Extreme
25%
10
Mozambique
Extreme
25%
All the above listed countries have hardship differentials between 25-30%. The State Department’s hardship differential is established for any place when, and only when, the place involves extraordinarily difficult living conditions, excessive physical hardship, or notably unhealthful conditions affecting the majority of employees officially stationed or detailed at that place.  Living costs are not considered in differential determination.
The Maplecroft report adds that TB is curable, but underfunded health services in Less Economically Developed Countries (LEDCs) means that the inter-relationships with poverty and the disease are inescapable. The World Health Organisation estimates that 92% of TB cases and deaths occur in low income and lower-income nations and according to Maplecroft’s Poverty Index, more than half of the 30 countries most severely affected by poverty are also severely affected by TB.
The CDC recommends that travelers who anticipate possible prolonged exposure to persons with TB (for example, those who expect to come in contact routinely with clinic, hospital, prison, or homeless shelter populations) should have a tuberculin skin test (TST) before leaving the United States. If the test reaction is negative, they should have a repeat test 8 to 10 weeks after returning to the United States. Additionally, annual testing may be recommended for those who anticipate repeated or prolonged exposure or an extended stay over a period of years.
If you are assigned overseas and plan on hiring household help, do check with the embassy’s health unit for health screening requirements of prospective employees before they start working for you. 
Additional Information below that you may also find useful:
CDC. BCG Vaccine (2006).

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