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An alternative estimation of tuberculosis incidence from 1980 to 2010: methods from the Global Burden of Disease 2010

Background Estimating tuberculosis (TB) incidence is difficult; it cannot be measured directly because surveillance systems are incomplete and conducting nationwide surveys of TB incidence would be too expensive. We sought a strictly empirical approach to estimating TB incidence that eliminates reli... Full description

Journal Title: The Lancet 17 June 2013, Vol.381, pp.S104-S104
Main Author: Ortblad, Katrina F
Other Authors: Lozano, Rafael , Murray, Christopher Jl
Format: Electronic Article Electronic Article
Language: English
Subjects:
ID: ISSN: 0140-6736 ; E-ISSN: 1474-547X ; DOI: 10.1016/S0140-6736(13)61358-6
Link: https://www.sciencedirect.com/science/article/pii/S0140673613613586
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recordid: elsevier_sdoi_10_1016_S0140_6736_13_61358_6
title: An alternative estimation of tuberculosis incidence from 1980 to 2010: methods from the Global Burden of Disease 2010
format: Article
creator:
  • Ortblad, Katrina F
  • Lozano, Rafael
  • Murray, Christopher Jl
subjects:
  • Medicine
ispartof: The Lancet, 17 June 2013, Vol.381, pp.S104-S104
description: Background Estimating tuberculosis (TB) incidence is difficult; it cannot be measured directly because surveillance systems are incomplete and conducting nationwide surveys of TB incidence would be too expensive. We sought a strictly empirical approach to estimating TB incidence that eliminates reliance upon expert opinion. Methods Our TB incidence model was multistep: (1) model TB incidence with antiretroviral (ARV)-adjusted HIV prevalence and other covariates as independent variables; (2) run a Gaussian process regression on "high income" countries using step 1 estimates as a prior; (3) model the fraction of TB-HIV in TB incidence with ARV-adjusted HIV prevalence as an independent variable; and (4) apply these fractions to our TB incidence predictions to parse out TB-HIV. Findings Since its peak in 2003, the global TB incidence rate has been declining by 1 times 65% annually. At the 187 country level, annual rates of change vary significantly; from 2000 to 2010, the median annual change was -1 times 24%, while the bottom and top 5% were 1 times 53% and -4 times 56%, respectively. During the past decade, some high-burden countries have made impressive progress; China and Nigeria both saw annual declines in TB incidence rates around 2 times 8%. Unlike other diseases, TB affects countries across the globe. In 2010, 55 countries in six of seven Global Burden of Disease (GBD) 2010 super regions had TB incidence rates greater than 150 per 100000 people. In 2010, TB-HIV still accounted for 31 times 6% (95% CI 31 times 3-32 times 0) of all TB cases in sub-Saharan Africa; however, since its 2002 peak, the global TB-HIV incidence rate here has been decreasing by 5 times 11% annually. Interpretation Measurement is a powerful motivator for action. Case notifications provide the principle input to both the WHO and GBD 2010 analyses but both approaches are less than ideal. Efforts must be made to improve country-level case detection rates so case notifications can become a close proxy for future TB incidence estimations. Funding Bill & Melinda Gates Foundation.
language: eng
source:
identifier: ISSN: 0140-6736 ; E-ISSN: 1474-547X ; DOI: 10.1016/S0140-6736(13)61358-6
fulltext: fulltext
issn:
  • 0140-6736
  • 01406736
  • 1474-547X
  • 1474547X
url: Link


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titleAn alternative estimation of tuberculosis incidence from 1980 to 2010: methods from the Global Burden of Disease 2010
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descriptionBackground Estimating tuberculosis (TB) incidence is difficult; it cannot be measured directly because surveillance systems are incomplete and conducting nationwide surveys of TB incidence would be too expensive. We sought a strictly empirical approach to estimating TB incidence that eliminates reliance upon expert opinion. Methods Our TB incidence model was multistep: (1) model TB incidence with antiretroviral (ARV)-adjusted HIV prevalence and other covariates as independent variables; (2) run a Gaussian process regression on "high income" countries using step 1 estimates as a prior; (3) model the fraction of TB-HIV in TB incidence with ARV-adjusted HIV prevalence as an independent variable; and (4) apply these fractions to our TB incidence predictions to parse out TB-HIV. Findings Since its peak in 2003, the global TB incidence rate has been declining by 1 times 65% annually. At the 187 country level, annual rates of change vary significantly; from 2000 to 2010, the median annual change was -1 times 24%, while the bottom and top 5% were 1 times 53% and -4 times 56%, respectively. During the past decade, some high-burden countries have made impressive progress; China and Nigeria both saw annual declines in TB incidence rates around 2 times 8%. Unlike other diseases, TB affects countries across the globe. In 2010, 55 countries in six of seven Global Burden of Disease (GBD) 2010 super regions had TB incidence rates greater than 150 per 100000 people. In 2010, TB-HIV still accounted for 31 times 6% (95% CI 31 times 3-32 times 0) of all TB cases in sub-Saharan Africa; however, since its 2002 peak, the global TB-HIV incidence rate here has been decreasing by 5 times 11% annually. Interpretation Measurement is a powerful motivator for action. Case notifications provide the principle input to both the WHO and GBD 2010 analyses but both approaches are less than ideal. Efforts must be made to improve country-level case detection rates so case notifications can become a close proxy for future TB incidence estimations. Funding Bill & Melinda Gates Foundation.
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