Tuberculosis incidence and its socioeconomic determinants

Dye, C., Garnett, G.P., Sleeman, K. and Williams, B.G., 1998. Prospects for worldwide tuberculosis control under the WHO DOTS strategy. The Lancet, 352(9144), pp.1886-1891.

  • The fall in tuberculosis incidence under DOTS is greater in younger populations than in older ones.
  • Non-curative treatment can prevent death without eliminating infectiousness.
  • In countries where tuberculosis incidence is stable and HIV-1 is absent:
    • A control program reaching WHO targets (70% case detection, 85% cure) would reduce the incidence rate by 11% per year (range 8–12%).
    • It would reduce the death rate by 12% per year (range 9–13%).
  • If tuberculosis has been in decline for several years, the same case detection and cure rates would have a smaller effect on incidence.
  • DOTS saves a greater proportion of deaths than cases, with a larger difference in the presence of HIV-1.
  • HIV-1 epidemics increase tuberculosis incidence but do not significantly reduce the preventable proportion of cases and deaths.
    • == == ==

    Sorokina, M., Ukubayev, T. and Koichubekov, B., 2023. Tuberculosis incidence and its socioeconomic determinants: developing a parsimonious model. Annali di Igiene, Medicina Preventiva e di Comunita, 35(4): 468-479.

    · There is a strong relationship between economic indicators and health expenditure.

    · In bivariate analysis, per-capita GDP, per-capita income, proportion of the poor, unemployment rate, CHE per capita, number of GPs, and number of TB hospital beds were significant predictors of TB incidence rate.

    · Two key components, economic development and healthcare capacity, were identified.

    · Both economic development and healthcare capacity have a significant negative effect on TB incidence.

    · The findings are based on population-level data and indicate that stronger economies and better healthcare systems reduce TB incidence, though the results cannot be applied to individuals directly.

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