COVID-19 Mortality in the Continental United States
Choropleth map titled "COVID-19 Mortality in the Continental United States (2021, deaths per 100,000 population)." States are shaded light blue to dark purple indicating mortality ranges: 29–56, 57–88, 89–112, 113–127, and 128–159 deaths per 100,000. Five states are outlined in black as having the highest rates — Oklahoma (OK), Texas (TX), Alabama (AL), Mississippi (MS), and West Virginia (WV). A COVID-19 Mortality Comparison table shows 2021 and 2022 rates: Oklahoma 158.8 and 71.9; Alabama 152.8 and 54.6; Texas 151.4 and 49.0; West Virginia 146.8 and 71.5; Mississippi 146.3 and 63.8. Body text states: "COVID-19 briefly eclipsed tuberculosis as the world's deadliest infectious disease during the pandemic, but by 2023, tuberculosis retook its spot. The World Health Organization declared COVID-19 a pandemic in March 2020. With a global push towards finding a way to combat the disease, vaccine development began immediately, with widespread rollout within a year and a half. By 2022, COVID-19 mortality rates in the United States had plummeted, even in the states effected the most. The treatment for tuberculosis doesn't need to be developed — it has existed for years." Data from the CDC; created by Lauren Parkinson at the University of Colorado Denver.
Tuberculosis Mortality in 2023
World map titled "Tuberculosis Mortality in 2023" using a Robinson projection, with data from the World Health Organization, created by Lauren Parkinson at the University of Colorado Denver. Countries are shaded in five ranges from light peach to dark brown-orange representing deaths per 100,000: 0–10; 11–28; 29–55; 56–98; and 99–229. Gray indicates no data. The top 10 countries with the highest TB mortality rates are outlined in black. Sub-Saharan Africa and Myanmar show the darkest shading and are outlined in black. Most of the Americas, Europe, and East Asia show very low rates.
A continental average mortality rate table shows: Africa 38, Asia 12, Australia 15, Europe 2, N. America 2, S. America 7.
A table lists countries with the highest TB mortality rates in 2023: Lesotho 229, Central African Rep. 142, Gabon 139, Guinea-Bissau 122, Namibia 98, Myanmar 90, South Africa 88, Liberia 85, Congo 84, Eswatini 77.
Body text reads: "In 2023, tuberculosis (TB) overtook COVID-19 to once again become the deadliest infectious disease globally, killing more than 1.2 million people. 60.5% of these deaths occurred in Asia. However, adjusted for population, tuberculosis is much more deadly in Africa; the average mortality rate in African counties was more than 3x higher than the average mortality rate in Asian countries. The deadliest place to receive a TB diagnosis in 2023 was Lesotho, where 229 people per 100,000 people died."
Estimated HIV in incident TB in 2023 (%)
World map titled "Estimated HIV in incident TB in 2023 (%)" using a Robinson projection, with data from the World Health Organization, created by Lauren Parkinson at the University of Colorado Denver. Countries are shaded in four ranges from light to dark blue representing the percentage of new TB cases occurring in people already living with HIV: 0–4.6%; 4.61–11%; 11.1–25%; 25.1–49%; and 49.1–81%. Gray indicates no data. Countries where the largest percentage of new TB cases happen in the HIV community are outlined in black. Southern and eastern African nations show the darkest shading and are outlined in black, while most of Asia, Europe, and the Americas show low rates.
A table lists countries with the highest percentage of new TB cases happening in people with HIV: Zambia 81%, Botswana 79%, Malawi 79%, Namibia 78%, South Africa 75%, Eswatini 72%, Kenya 69%, Lesotho 69%, Cote d'Ivoire 66%, Mozambique 66%.
Body text reads: "People living with HIV have a higher risk of developing active tuberculosis compared to those without HIV because HIV weakens a person's immune system, thus also weakening the body's ability to combat TB bacteria effectively. This map shows the percentage of new TB cases that occur in people already living with HIV. 81% of new TB cases in Zambia occurred in people living with HIV in 2023."
Inadequate Nutrition (% of population)
World map titled "Inadequate Nutrition (% of population)" using a Robinson projection, with data from the Global Nutrition Report, created by Lauren Parkinson at the University of Colorado Denver. Countries are shaded in five ranges from light to dark pink/magenta representing the percentage of the population without adequate nutrition in 2018: 0–4.8%; 4.9–9.8%; 9.9–17.2%; 17.3–28%; and 29–48.2%. Gray indicates no data. Countries with the highest percentages are outlined in black. Sub-Saharan Africa and parts of South and Southeast Asia show the darkest shading. Haiti and Timor-Leste are labeled with arrows.
A footnote states: "Inadequate nutrition is defined as 'habitual food consumption insufficient to provide the dietary energy levels required to maintain a normal active and healthy life' by the Global Nutrition Report."
A table lists countries with the highest percentage of people without adequate nutrition: Haiti 48.2%, North Korea 47.6%, Madagascar 41.7%, Chad 39.6%, Liberia 37.5%, Rwanda 35.6%, Mozambique 32.6%, Lesotho 32.6%, Venezuela 31.4%, Timor-Leste 30.9%, Afghanistan 29.9%, Congo 28.0%, Sierra Leone 26.0%, Tanzania 25.0%, Botswana 24.1%.
Body text reads: "Chronic malnutrition compromises the body's immune defenses, making individuals more susceptible to infections and reducing their ability to combat illnesses naturally. Tuberculosis drugs are also notoriously nauseating, a situation which can be exacerbated if taken on an empty stomach. Since tuberculosis treatment often spans several months, these unpleasant effects — along with other challenges — may lead patients to discontinue their therapy."
Drug-Resistant Tuberculosis
World map titled "Drug-Resistant Tuberculosis" using a Robinson projection, with data from the World Health Organization, created by Lauren Parkinson at the University of Colorado Denver. Country shading (light to dark green) represents total new TB cases in 2023 across five ranges: 0–55,000; 55,001–188,000; 188,001–499,000; 499,000–1,090,000; and 1,090,000–2,800,000. Gray indicates no data. Proportional purple circles overlaid on countries represent new MDR-TB cases in four size ranges: 0–239; 240–966; 967–4,455; and 4,456–11,606. The largest circles appear over India, China, and Russia. Kazakhstan is labeled with an arrow. South and Southeast Asia and sub-Saharan Africa show the darkest green shading and largest circles.
Body text reads: "When someone receives a positive tuberculosis diagnosis, treatment typically consists of a course of various antibiotics for at least 3 or 4 months but can be 24 months or more. Patients usually begin with what are known as first-line drugs, which are older and less toxic medications. Second-line drugs are used when first-line treatments are not effective or when significant drug resistance is detected and are newer, more expensive, and often more toxic. In many places where tuberculosis is rampant, a system called DOTS (directly observed short-term treatment) is in place. In this system, a patient with TB has to visit a health clinic every day to be observed taking their cocktail of TB drugs. The social stigma of tuberculosis, the transportation cost to get to the clinic, and the distance of the clinic from a patient's home, can make adherence to DOTS can be difficult in many parts of the world. These difficulties, as well as horrendous side-effects and supply chain disruptions, all contribute to patients halting or pausing their treatment, which leads to increasingly more cases of drug resistant TB. When resistance to isoniazid and rifampicin (the most common and effective first-line drugs) is detected, tuberculosis is called multidrug-resistant tuberculosis or MDR-TB. When resistance to both of these drugs as well as resistance to several kinds of second-line drugs, tuberculosis is called extensively drug-resistant tuberculosis or XDR-TB. This variety of tuberculosis is extremely difficult to treat. Drug-resistance is not only a problem for countries with high levels of TB incidence. In 2023, Kazakhstan had 14,000 new cases of all TB in 2023 and 1,496 new cases of MDR-TB, which meant around 10% of the cases in that country were resistant to the most effective first-line treatment that year."