 Tuberculosis control and mortality rates 222. Tuberculosis is a public health concern in Chad with an estimated prevalence of 221 cases per 100,000 inhabitants and an estimated incidence of 151 new cases per 100,000 inhabitants (Health Statistical Yearbook, 2013). 223. A Strategic Plan to combat Tuberculosis (PSN-TB) was implemented from 2009 to 2013 and enabled the National TB Control Programme (PNT) to improve its performance. 224. The number of tuberculosis cases reported by the PNT has almost doubled in the last seven (7) years according to its annual reports. The number of cases (all forms of TB included) increased from 6,200 to 11,505 between 2007 and 2013. The same applies to new cases of PTB+, which increased from 2,806 to 4,758 during the same period. 225. The number of cases of smear-positive pulmonary tuberculosis (PTB+) and clinically diagnosed tuberculosis (PTB-, EPTB) increased between 2007 and 2013. Considering that the disease transmission rate is stable, significant screening activities were carried out to obtain these figures. There is an uneven distribution of TB cases among the three (3) main cities (N'Djaména, Moundou and Sarh), which account for 60% (6,517/11,505) of cases. The disaggregation of data per gender shows that 33.4% of cases are female and 66.6% male (male/female ratio = 1.9). The distribution per age shows a higher prevalence among 25-34 year olds, indicating a higher transmission rate among young people. Children aged 0-14 years account for 6.4% of the total number of cases. The proportion of cases diagnosed in the 0-14 age group also indicates a significant transmission rate among children. 226. The incidence of the disease is very unevenly distributed across the territory. The distribution of cases per gender and age is similar to that of several other developing countries or African countries. The disease is predominantly contracted by men and the 24-45 year old age group. Page 53 sur 87