Global, regional, and national burden of tuberculosis, 1990–2016 : results from the Global Burden of Diseases, Injuries, and Risk Factors 2016 Study

Tuberculosis GBD Tuberculosis; Hmwe Hmwe Kyu; Emilie R. Maddison; Nathaniel J. Henry; Jorge R. Ledesma; Kirsten E. Wiens; Robert Jr. Reiner; Molly H. Biehl; Chloe Shields; Aaron Osgood-Zimmerman; Jennifer M. Ross; Austin Carter; Tahvi D. Frank; Haidong Wang; Vinay Srinivasan; Zegeye Abebe; Sanjay Kumar Agarwal; Fares Alahdab; Kefyalew Addis Alene; Beriwan Abdulqadir Ali; Nelson Alvis-Guzman; Jason R. Andrews; Carl Abelardo T. Antonio; Suleman Atique; Sachin R. Atre; Ashish Awasthi; Henok Tadesse Ayele; Hamid Badali; Alaa Badawi; Aleksandra Barac; Neeraj Bedi; Masoud Behzadifar; Meysam Behzadifar; Bayu Begashaw Bekele; Saba Abraham Belay; Isabela M. Bensenor; Zahid A. Butt; Felix Carvalho; Kelly Cercy; Devasahayam J. Christopher; Alemneh Kabeta Daba; Lalit Dandona; Rakhi Dandona; Ahmad Daryani; Feleke Mekonnen Demeke; Kebede Deribe; Samath Dhamminda Dharmaratne; David Teye Doku; Manisha Dubey; Dumessa Edessa; Ziad El-Khatib; Shymaa Enany; Eduarda Fernandes; Florian Fischer; Alberto L. Garcia-Basteiro; Abadi Kahsu Gebre; Gebremedhin Berhe Gebregergs; Teklu Gebrehiwo Gebremichael; Tilayie Feto Gelano; Demeke Geremew; Philimon N. Gona; Amador Goodridge; Rahul Gupta; Hassan Haghparast Bidgoli; Gessessew Bugssa Hailu; Hamid Yiman Hassen; Mohammad T. Tadesse Hedayati; Andualem Henok; Sorin Hostiuc; Mamusha Aman Hussen; Olayinka Stephen Ilesanmi; Seyed Sina Naghibi Irvani; Kathryn H. Jacobsen; Sarah C. Johnson; Jost B. Jonas; Amaha Kahsay; Surya Kant; Amir Kasaeian; Tesfaye Dessale Kassa; Yousef Saleh Khader; Morteza Abdullatif Khafaie; Ibrahim Khalil; Ejaz Ahmad Khan; Young-Ho Khang; Yun Jin Kim; Sonali Kochhar; Ai Koyanagi; Kristopher J. Krohn; G. Anil Kumar; Ayenew Molla Lakew; Cheru Tesema Leshargie; Rakesh Lodha; Erlyn Rachelle King Macarayan; Reza Majdzadeh; Francisco Rogerlandio Martins-Melo; Addisu Melese; Ziad A. Memish; Walter Mendoza; Desalegn Tadese Mengistu; Getnet Mengistu; Tomislav Mestrovic; Babak Moazen; Karzan Abdulmuhsin Mohammad; Shafiu Mohammed; Ali H. Mokdad; Mahmood Moosazadeh; Seyyed Meysam Mousavi; Ghulam Mustafa; Jean B. Nachega; Long Hoang Nguyen; Son Hoang Nguyen; Trang Huyen Nguyen; Dina Nur Anggraini Ningrum; Yirga Legesse Nirayo; Vuong Minh Nong; Richard Ofori-Asenso; Felix Akpojene Ogbo; null et al.

doi:10.1016/S1473-3099(18)30625-X

Global, regional, and national burden of tuberculosis, 1990–2016 : results from the Global Burden of Diseases, Injuries, and Risk Factors 2016 Study

Tuberculosis GBD Tuberculosis, Hmwe Hmwe Kyu, Emilie R. Maddison, Nathaniel J. Henry, Jorge R. Ledesma, Kirsten E. Wiens, Robert Jr. Reiner, Molly H. Biehl, Chloe Shields, Aaron Osgood-Zimmerman, Jennifer M. Ross, Austin Carter, Tahvi D. Frank, Haidong Wang, Vinay Srinivasan, Zegeye Abebe, Sanjay Kumar Agarwal, Fares Alahdab, Kefyalew Addis Alene, Beriwan Abdulqadir AliNelson Alvis-Guzman, Jason R. Andrews, Carl Abelardo T. Antonio, Suleman Atique, Sachin R. Atre, Ashish Awasthi, Henok Tadesse Ayele, Hamid Badali, Alaa Badawi, Aleksandra Barac, Neeraj Bedi, Masoud Behzadifar, Meysam Behzadifar, Bayu Begashaw Bekele, Saba Abraham Belay, Isabela M. Bensenor, Zahid A. Butt, Felix Carvalho, Kelly Cercy, Devasahayam J. Christopher, Alemneh Kabeta Daba, Lalit Dandona, Rakhi Dandona, Ahmad Daryani, Feleke Mekonnen Demeke, Kebede Deribe, Samath Dhamminda Dharmaratne, David Teye Doku, Manisha Dubey, Dumessa Edessa, Ziad El-Khatib, Shymaa Enany, Eduarda Fernandes, Florian Fischer, Alberto L. Garcia-Basteiro, Abadi Kahsu Gebre, Gebremedhin Berhe Gebregergs, Teklu Gebrehiwo Gebremichael, Tilayie Feto Gelano, Demeke Geremew, Philimon N. Gona, Amador Goodridge, Rahul Gupta, Hassan Haghparast Bidgoli, Gessessew Bugssa Hailu, Hamid Yiman Hassen, Mohammad T. Tadesse Hedayati, Andualem Henok, Sorin Hostiuc, Mamusha Aman Hussen, Olayinka Stephen Ilesanmi, Seyed Sina Naghibi Irvani, Kathryn H. Jacobsen, Sarah C. Johnson, Jost B. Jonas, Amaha Kahsay, Surya Kant, Amir Kasaeian, Tesfaye Dessale Kassa, Yousef Saleh Khader, Morteza Abdullatif Khafaie, Ibrahim Khalil, Ejaz Ahmad Khan, Young-Ho Khang, Yun Jin Kim, Sonali Kochhar, Ai Koyanagi, Kristopher J. Krohn, G. Anil Kumar, Ayenew Molla Lakew, Cheru Tesema Leshargie, Rakesh Lodha, Erlyn Rachelle King Macarayan, Reza Majdzadeh, Francisco Rogerlandio Martins-Melo, Addisu Melese, Ziad A. Memish, Walter Mendoza, Desalegn Tadese Mengistu, Getnet Mengistu, Tomislav Mestrovic, Babak Moazen, Karzan Abdulmuhsin Mohammad, Shafiu Mohammed, Ali H. Mokdad, Mahmood Moosazadeh, Seyyed Meysam Mousavi, Ghulam Mustafa, Jean B. Nachega, Long Hoang Nguyen, Son Hoang Nguyen, Trang Huyen Nguyen, Dina Nur Anggraini Ningrum, Yirga Legesse Nirayo, Vuong Minh Nong, Richard Ofori-Asenso, Felix Akpojene Ogbo, et al.

Western Sydney University

Research output: Contribution to journal › Article › peer-review

Abstract

Background: Although a preventable and treatable disease, tuberculosis causes more than a million deaths each year. As countries work towards achieving the Sustainable Development Goal (SDG) target to end the tuberculosis epidemic by 2030, robust assessments of the levels and trends of the burden of tuberculosis are crucial to inform policy and programme decision making. We assessed the levels and trends in the fatal and non-fatal burden of tuberculosis by drug resistance and HIV status for 195 countries and territories from 1990 to 2016. Methods: We analysed 15 943 site-years of vital registration data, 1710 site-years of verbal autopsy data, 764 site-years of sample-based vital registration data, and 361 site-years of mortality surveillance data to estimate mortality due to tuberculosis using the Cause of Death Ensemble model. We analysed all available data sources, including annual case notifications, prevalence surveys, population-based tuberculin surveys, and estimated tuberculosis cause-specific mortality to generate internally consistent estimates of incidence, prevalence, and mortality using DisMod-MR 2.1, a Bayesian meta-regression tool. We assessed how the burden of tuberculosis differed from the burden predicted by the Socio-demographic Index (SDI), a composite indicator of income per capita, average years of schooling, and total fertility rate. Findings: Globally in 2016, among HIV-negative individuals, the number of incident cases of tuberculosis was 9ÃÂ·02 million (95% uncertainty interval [UI] 8ÃÂ·05–10ÃÂ·16) and the number of tuberculosis deaths was 1ÃÂ·21 million (1ÃÂ·16–1ÃÂ·27). Among HIV-positive individuals, the number of incident cases was 1ÃÂ·40 million (1ÃÂ·01–1ÃÂ·89) and the number of tuberculosis deaths was 0ÃÂ·24 million (0ÃÂ·16–0ÃÂ·31). Globally, among HIV-negative individuals the age-standardised incidence of tuberculosis decreased annually at a slower rate (–1ÃÂ·3% [–1ÃÂ·5 to −1ÃÂ·2]) than mortality did (–4ÃÂ·5% [–5ÃÂ·0 to −4ÃÂ·1]) from 2006 to 2016. Among HIV-positive individuals during the same period, the rate of change in annualised age-standardised incidence was −4ÃÂ·0% (–4ÃÂ·5 to −3ÃÂ·7) and mortality was −8ÃÂ·9% (–9ÃÂ·5 to −8ÃÂ·4). Several regions had higher rates of age-standardised incidence and mortality than expected on the basis of their SDI levels in 2016. For drug-susceptible tuberculosis, the highest observed-to-expected ratios were in southern sub-Saharan Africa (13ÃÂ·7 for incidence and 14ÃÂ·9 for mortality), and the lowest ratios were in high-income North America (0ÃÂ·4 for incidence) and Oceania (0ÃÂ·3 for mortality). For multidrug-resistant tuberculosis, eastern Europe had the highest observed-to-expected ratios (67ÃÂ·3 for incidence and 73ÃÂ·0 for mortality), and high-income North America had the lowest ratios (0ÃÂ·4 for incidence and 0ÃÂ·5 for mortality). Interpretation: If current trends in tuberculosis incidence continue, few countries are likely to meet the SDG target to end the tuberculosis epidemic by 2030. Progress needs to be accelerated by improving the quality of and access to tuberculosis diagnosis and care, by developing new tools, scaling up interventions to prevent risk factors for tuberculosis, and integrating control programmes for tuberculosis and HIV. Funding: Bill & Melinda Gates Foundation.

Original language	English
Pages (from-to)	1329-1349
Number of pages	21
Journal	The Lancet Infectious Diseases
Volume	18
Issue number	12
DOIs	https://doi.org/10.1016/S1473-3099(18)30625-X
Publication status	Published - 2018

Open Access - Access Right Statement

Keywords

World health
epidemics
health surveys
risk factors
tuberculosis

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

Access to Document

10.1016/S1473-3099(18)30625-X

Cite this

GBD Tuberculosis, T., Kyu, H. H., Maddison, E. R., Henry, N. J., Ledesma, J. R., Wiens, K. E., Reiner, R. J., Biehl, M. H., Shields, C., Osgood-Zimmerman, A., Ross, J. M., Carter, A., Frank, T. D., Wang, H., Srinivasan, V., Abebe, Z., Agarwal, S. K., Alahdab, F., Alene, K. A., ... et al. (2018). Global, regional, and national burden of tuberculosis, 1990–2016 : results from the Global Burden of Diseases, Injuries, and Risk Factors 2016 Study. The Lancet Infectious Diseases, 18(12), 1329-1349. https://doi.org/10.1016/S1473-3099(18)30625-X

@article{c91bd0030bad4c93b30e672fd63991ef,

title = "Global, regional, and national burden of tuberculosis, 1990–2016 : results from the Global Burden of Diseases, Injuries, and Risk Factors 2016 Study",

abstract = "Background: Although a preventable and treatable disease, tuberculosis causes more than a million deaths each year. As countries work towards achieving the Sustainable Development Goal (SDG) target to end the tuberculosis epidemic by 2030, robust assessments of the levels and trends of the burden of tuberculosis are crucial to inform policy and programme decision making. We assessed the levels and trends in the fatal and non-fatal burden of tuberculosis by drug resistance and HIV status for 195 countries and territories from 1990 to 2016. Methods: We analysed 15 943 site-years of vital registration data, 1710 site-years of verbal autopsy data, 764 site-years of sample-based vital registration data, and 361 site-years of mortality surveillance data to estimate mortality due to tuberculosis using the Cause of Death Ensemble model. We analysed all available data sources, including annual case notifications, prevalence surveys, population-based tuberculin surveys, and estimated tuberculosis cause-specific mortality to generate internally consistent estimates of incidence, prevalence, and mortality using DisMod-MR 2.1, a Bayesian meta-regression tool. We assessed how the burden of tuberculosis differed from the burden predicted by the Socio-demographic Index (SDI), a composite indicator of income per capita, average years of schooling, and total fertility rate. Findings: Globally in 2016, among HIV-negative individuals, the number of incident cases of tuberculosis was 9{\~A}{\^A}·02 million (95% uncertainty interval [UI] 8{\~A}{\^A}·05–10{\~A}{\^A}·16) and the number of tuberculosis deaths was 1{\~A}{\^A}·21 million (1{\~A}{\^A}·16–1{\~A}{\^A}·27). Among HIV-positive individuals, the number of incident cases was 1{\~A}{\^A}·40 million (1{\~A}{\^A}·01–1{\~A}{\^A}·89) and the number of tuberculosis deaths was 0{\~A}{\^A}·24 million (0{\~A}{\^A}·16–0{\~A}{\^A}·31). Globally, among HIV-negative individuals the age-standardised incidence of tuberculosis decreased annually at a slower rate (–1{\~A}{\^A}·3% [–1{\~A}{\^A}·5 to −1{\~A}{\^A}·2]) than mortality did (–4{\~A}{\^A}·5% [–5{\~A}{\^A}·0 to −4{\~A}{\^A}·1]) from 2006 to 2016. Among HIV-positive individuals during the same period, the rate of change in annualised age-standardised incidence was −4{\~A}{\^A}·0% (–4{\~A}{\^A}·5 to −3{\~A}{\^A}·7) and mortality was −8{\~A}{\^A}·9% (–9{\~A}{\^A}·5 to −8{\~A}{\^A}·4). Several regions had higher rates of age-standardised incidence and mortality than expected on the basis of their SDI levels in 2016. For drug-susceptible tuberculosis, the highest observed-to-expected ratios were in southern sub-Saharan Africa (13{\~A}{\^A}·7 for incidence and 14{\~A}{\^A}·9 for mortality), and the lowest ratios were in high-income North America (0{\~A}{\^A}·4 for incidence) and Oceania (0{\~A}{\^A}·3 for mortality). For multidrug-resistant tuberculosis, eastern Europe had the highest observed-to-expected ratios (67{\~A}{\^A}·3 for incidence and 73{\~A}{\^A}·0 for mortality), and high-income North America had the lowest ratios (0{\~A}{\^A}·4 for incidence and 0{\~A}{\^A}·5 for mortality). Interpretation: If current trends in tuberculosis incidence continue, few countries are likely to meet the SDG target to end the tuberculosis epidemic by 2030. Progress needs to be accelerated by improving the quality of and access to tuberculosis diagnosis and care, by developing new tools, scaling up interventions to prevent risk factors for tuberculosis, and integrating control programmes for tuberculosis and HIV. Funding: Bill & Melinda Gates Foundation.",

keywords = "World health, epidemics, health surveys, risk factors, tuberculosis",

author = "{GBD Tuberculosis}, Tuberculosis and Kyu, {Hmwe Hmwe} and Maddison, {Emilie R.} and Henry, {Nathaniel J.} and Ledesma, {Jorge R.} and Wiens, {Kirsten E.} and Reiner, {Robert Jr.} and Biehl, {Molly H.} and Chloe Shields and Aaron Osgood-Zimmerman and Ross, {Jennifer M.} and Austin Carter and Frank, {Tahvi D.} and Haidong Wang and Vinay Srinivasan and Zegeye Abebe and Agarwal, {Sanjay Kumar} and Fares Alahdab and Alene, {Kefyalew Addis} and Ali, {Beriwan Abdulqadir} and Nelson Alvis-Guzman and Andrews, {Jason R.} and Antonio, {Carl Abelardo T.} and Suleman Atique and Atre, {Sachin R.} and Ashish Awasthi and Ayele, {Henok Tadesse} and Hamid Badali and Alaa Badawi and Aleksandra Barac and Neeraj Bedi and Masoud Behzadifar and Meysam Behzadifar and Bekele, {Bayu Begashaw} and Belay, {Saba Abraham} and Bensenor, {Isabela M.} and Butt, {Zahid A.} and Felix Carvalho and Kelly Cercy and Christopher, {Devasahayam J.} and Daba, {Alemneh Kabeta} and Lalit Dandona and Rakhi Dandona and Ahmad Daryani and Demeke, {Feleke Mekonnen} and Kebede Deribe and Dharmaratne, {Samath Dhamminda} and Doku, {David Teye} and Manisha Dubey and Dumessa Edessa and Ziad El-Khatib and Shymaa Enany and Eduarda Fernandes and Florian Fischer and Garcia-Basteiro, {Alberto L.} and Gebre, {Abadi Kahsu} and Gebregergs, {Gebremedhin Berhe} and Gebremichael, {Teklu Gebrehiwo} and Gelano, {Tilayie Feto} and Demeke Geremew and Gona, {Philimon N.} and Amador Goodridge and Rahul Gupta and Bidgoli, {Hassan Haghparast} and Hailu, {Gessessew Bugssa} and Hassen, {Hamid Yiman} and Hedayati, {Mohammad T. Tadesse} and Andualem Henok and Sorin Hostiuc and Hussen, {Mamusha Aman} and Ilesanmi, {Olayinka Stephen} and Irvani, {Seyed Sina Naghibi} and Jacobsen, {Kathryn H.} and Johnson, {Sarah C.} and Jonas, {Jost B.} and Amaha Kahsay and Surya Kant and Amir Kasaeian and Kassa, {Tesfaye Dessale} and Khader, {Yousef Saleh} and Khafaie, {Morteza Abdullatif} and Ibrahim Khalil and Khan, {Ejaz Ahmad} and Young-Ho Khang and Kim, {Yun Jin} and Sonali Kochhar and Ai Koyanagi and Krohn, {Kristopher J.} and Kumar, {G. Anil} and Lakew, {Ayenew Molla} and Leshargie, {Cheru Tesema} and Rakesh Lodha and Macarayan, {Erlyn Rachelle King} and Reza Majdzadeh and Martins-Melo, {Francisco Rogerlandio} and Addisu Melese and Memish, {Ziad A.} and Walter Mendoza and Mengistu, {Desalegn Tadese} and Getnet Mengistu and Tomislav Mestrovic and Babak Moazen and Mohammad, {Karzan Abdulmuhsin} and Shafiu Mohammed and Mokdad, {Ali H.} and Mahmood Moosazadeh and Mousavi, {Seyyed Meysam} and Ghulam Mustafa and Nachega, {Jean B.} and Nguyen, {Long Hoang} and Nguyen, {Son Hoang} and Nguyen, {Trang Huyen} and Ningrum, {Dina Nur Anggraini} and Nirayo, {Yirga Legesse} and Nong, {Vuong Minh} and Richard Ofori-Asenso and Ogbo, {Felix Akpojene} and {et al.}",

year = "2018",

doi = "10.1016/S1473-3099(18)30625-X",

language = "English",

volume = "18",

pages = "1329--1349",

journal = "The Lancet Infectious Diseases",

issn = "1474-4457",

publisher = "The Lancet Publishing Group",

number = "12",

}

GBD Tuberculosis, T, Kyu, HH, Maddison, ER, Henry, NJ, Ledesma, JR, Wiens, KE, Reiner, RJ, Biehl, MH, Shields, C, Osgood-Zimmerman, A, Ross, JM, Carter, A, Frank, TD, Wang, H, Srinivasan, V, Abebe, Z, Agarwal, SK, Alahdab, F, Alene, KA, Ali, BA, Alvis-Guzman, N, Andrews, JR, Antonio, CAT, Atique, S, Atre, SR, Awasthi, A, Ayele, HT, Badali, H, Badawi, A, Barac, A, Bedi, N, Behzadifar, M, Behzadifar, M, Bekele, BB, Belay, SA, Bensenor, IM, Butt, ZA, Carvalho, F, Cercy, K, Christopher, DJ, Daba, AK, Dandona, L, Dandona, R, Daryani, A, Demeke, FM, Deribe, K, Dharmaratne, SD, Doku, DT, Dubey, M, Edessa, D, El-Khatib, Z, Enany, S, Fernandes, E, Fischer, F, Garcia-Basteiro, AL, Gebre, AK, Gebregergs, GB, Gebremichael, TG, Gelano, TF, Geremew, D, Gona, PN, Goodridge, A, Gupta, R, Bidgoli, HH, Hailu, GB, Hassen, HY, Hedayati, MTT, Henok, A, Hostiuc, S, Hussen, MA, Ilesanmi, OS, Irvani, SSN, Jacobsen, KH, Johnson, SC, Jonas, JB, Kahsay, A, Kant, S, Kasaeian, A, Kassa, TD, Khader, YS, Khafaie, MA, Khalil, I, Khan, EA, Khang, Y-H, Kim, YJ, Kochhar, S, Koyanagi, A, Krohn, KJ, Kumar, GA, Lakew, AM, Leshargie, CT, Lodha, R, Macarayan, ERK, Majdzadeh, R, Martins-Melo, FR, Melese, A, Memish, ZA, Mendoza, W, Mengistu, DT, Mengistu, G, Mestrovic, T, Moazen, B, Mohammad, KA, Mohammed, S, Mokdad, AH, Moosazadeh, M, Mousavi, SM, Mustafa, G, Nachega, JB, Nguyen, LH, Nguyen, SH, Nguyen, TH, Ningrum, DNA, Nirayo, YL, Nong, VM, Ofori-Asenso, R, Ogbo, FA & et al. 2018, 'Global, regional, and national burden of tuberculosis, 1990–2016 : results from the Global Burden of Diseases, Injuries, and Risk Factors 2016 Study', The Lancet Infectious Diseases, vol. 18, no. 12, pp. 1329-1349. https://doi.org/10.1016/S1473-3099(18)30625-X

TY - JOUR

T1 - Global, regional, and national burden of tuberculosis, 1990–2016 : results from the Global Burden of Diseases, Injuries, and Risk Factors 2016 Study

AU - GBD Tuberculosis, Tuberculosis

AU - Kyu, Hmwe Hmwe

AU - Maddison, Emilie R.

AU - Henry, Nathaniel J.

AU - Ledesma, Jorge R.

AU - Wiens, Kirsten E.

AU - Reiner, Robert Jr.

AU - Biehl, Molly H.

AU - Shields, Chloe

AU - Osgood-Zimmerman, Aaron

AU - Ross, Jennifer M.

AU - Carter, Austin

AU - Frank, Tahvi D.

AU - Wang, Haidong

AU - Srinivasan, Vinay

AU - Abebe, Zegeye

AU - Agarwal, Sanjay Kumar

AU - Alahdab, Fares

AU - Alene, Kefyalew Addis

AU - Ali, Beriwan Abdulqadir

AU - Alvis-Guzman, Nelson

AU - Andrews, Jason R.

AU - Antonio, Carl Abelardo T.

AU - Atique, Suleman

AU - Atre, Sachin R.

AU - Awasthi, Ashish

AU - Ayele, Henok Tadesse

AU - Badali, Hamid

AU - Badawi, Alaa

AU - Barac, Aleksandra

AU - Bedi, Neeraj

AU - Behzadifar, Masoud

AU - Behzadifar, Meysam

AU - Bekele, Bayu Begashaw

AU - Belay, Saba Abraham

AU - Bensenor, Isabela M.

AU - Butt, Zahid A.

AU - Carvalho, Felix

AU - Cercy, Kelly

AU - Christopher, Devasahayam J.

AU - Daba, Alemneh Kabeta

AU - Dandona, Lalit

AU - Dandona, Rakhi

AU - Daryani, Ahmad

AU - Demeke, Feleke Mekonnen

AU - Deribe, Kebede

AU - Dharmaratne, Samath Dhamminda

AU - Doku, David Teye

AU - Dubey, Manisha

AU - Edessa, Dumessa

AU - El-Khatib, Ziad

AU - Enany, Shymaa

AU - Fernandes, Eduarda

AU - Fischer, Florian

AU - Garcia-Basteiro, Alberto L.

AU - Gebre, Abadi Kahsu

AU - Gebregergs, Gebremedhin Berhe

AU - Gebremichael, Teklu Gebrehiwo

AU - Gelano, Tilayie Feto

AU - Geremew, Demeke

AU - Gona, Philimon N.

AU - Goodridge, Amador

AU - Gupta, Rahul

AU - Bidgoli, Hassan Haghparast

AU - Hailu, Gessessew Bugssa

AU - Hassen, Hamid Yiman

AU - Hedayati, Mohammad T. Tadesse

AU - Henok, Andualem

AU - Hostiuc, Sorin

AU - Hussen, Mamusha Aman

AU - Ilesanmi, Olayinka Stephen

AU - Irvani, Seyed Sina Naghibi

AU - Jacobsen, Kathryn H.

AU - Johnson, Sarah C.

AU - Jonas, Jost B.

AU - Kahsay, Amaha

AU - Kant, Surya

AU - Kasaeian, Amir

AU - Kassa, Tesfaye Dessale

AU - Khader, Yousef Saleh

AU - Khafaie, Morteza Abdullatif

AU - Khalil, Ibrahim

AU - Khan, Ejaz Ahmad

AU - Khang, Young-Ho

AU - Kim, Yun Jin

AU - Kochhar, Sonali

AU - Koyanagi, Ai

AU - Krohn, Kristopher J.

AU - Kumar, G. Anil

AU - Lakew, Ayenew Molla

AU - Leshargie, Cheru Tesema

AU - Lodha, Rakesh

AU - Macarayan, Erlyn Rachelle King

AU - Majdzadeh, Reza

AU - Martins-Melo, Francisco Rogerlandio

AU - Melese, Addisu

AU - Memish, Ziad A.

AU - Mendoza, Walter

AU - Mengistu, Desalegn Tadese

AU - Mengistu, Getnet

AU - Mestrovic, Tomislav

AU - Moazen, Babak

AU - Mohammad, Karzan Abdulmuhsin

AU - Mohammed, Shafiu

AU - Mokdad, Ali H.

AU - Moosazadeh, Mahmood

AU - Mousavi, Seyyed Meysam

AU - Mustafa, Ghulam

AU - Nachega, Jean B.

AU - Nguyen, Long Hoang

AU - Nguyen, Son Hoang

AU - Nguyen, Trang Huyen

AU - Ningrum, Dina Nur Anggraini

AU - Nirayo, Yirga Legesse

AU - Nong, Vuong Minh

AU - Ofori-Asenso, Richard

AU - Ogbo, Felix Akpojene

AU - et al., null

PY - 2018

Y1 - 2018

N2 - Background: Although a preventable and treatable disease, tuberculosis causes more than a million deaths each year. As countries work towards achieving the Sustainable Development Goal (SDG) target to end the tuberculosis epidemic by 2030, robust assessments of the levels and trends of the burden of tuberculosis are crucial to inform policy and programme decision making. We assessed the levels and trends in the fatal and non-fatal burden of tuberculosis by drug resistance and HIV status for 195 countries and territories from 1990 to 2016. Methods: We analysed 15 943 site-years of vital registration data, 1710 site-years of verbal autopsy data, 764 site-years of sample-based vital registration data, and 361 site-years of mortality surveillance data to estimate mortality due to tuberculosis using the Cause of Death Ensemble model. We analysed all available data sources, including annual case notifications, prevalence surveys, population-based tuberculin surveys, and estimated tuberculosis cause-specific mortality to generate internally consistent estimates of incidence, prevalence, and mortality using DisMod-MR 2.1, a Bayesian meta-regression tool. We assessed how the burden of tuberculosis differed from the burden predicted by the Socio-demographic Index (SDI), a composite indicator of income per capita, average years of schooling, and total fertility rate. Findings: Globally in 2016, among HIV-negative individuals, the number of incident cases of tuberculosis was 9ÃÂ·02 million (95% uncertainty interval [UI] 8ÃÂ·05–10ÃÂ·16) and the number of tuberculosis deaths was 1ÃÂ·21 million (1ÃÂ·16–1ÃÂ·27). Among HIV-positive individuals, the number of incident cases was 1ÃÂ·40 million (1ÃÂ·01–1ÃÂ·89) and the number of tuberculosis deaths was 0ÃÂ·24 million (0ÃÂ·16–0ÃÂ·31). Globally, among HIV-negative individuals the age-standardised incidence of tuberculosis decreased annually at a slower rate (–1ÃÂ·3% [–1ÃÂ·5 to −1ÃÂ·2]) than mortality did (–4ÃÂ·5% [–5ÃÂ·0 to −4ÃÂ·1]) from 2006 to 2016. Among HIV-positive individuals during the same period, the rate of change in annualised age-standardised incidence was −4ÃÂ·0% (–4ÃÂ·5 to −3ÃÂ·7) and mortality was −8ÃÂ·9% (–9ÃÂ·5 to −8ÃÂ·4). Several regions had higher rates of age-standardised incidence and mortality than expected on the basis of their SDI levels in 2016. For drug-susceptible tuberculosis, the highest observed-to-expected ratios were in southern sub-Saharan Africa (13ÃÂ·7 for incidence and 14ÃÂ·9 for mortality), and the lowest ratios were in high-income North America (0ÃÂ·4 for incidence) and Oceania (0ÃÂ·3 for mortality). For multidrug-resistant tuberculosis, eastern Europe had the highest observed-to-expected ratios (67ÃÂ·3 for incidence and 73ÃÂ·0 for mortality), and high-income North America had the lowest ratios (0ÃÂ·4 for incidence and 0ÃÂ·5 for mortality). Interpretation: If current trends in tuberculosis incidence continue, few countries are likely to meet the SDG target to end the tuberculosis epidemic by 2030. Progress needs to be accelerated by improving the quality of and access to tuberculosis diagnosis and care, by developing new tools, scaling up interventions to prevent risk factors for tuberculosis, and integrating control programmes for tuberculosis and HIV. Funding: Bill & Melinda Gates Foundation.

AB - Background: Although a preventable and treatable disease, tuberculosis causes more than a million deaths each year. As countries work towards achieving the Sustainable Development Goal (SDG) target to end the tuberculosis epidemic by 2030, robust assessments of the levels and trends of the burden of tuberculosis are crucial to inform policy and programme decision making. We assessed the levels and trends in the fatal and non-fatal burden of tuberculosis by drug resistance and HIV status for 195 countries and territories from 1990 to 2016. Methods: We analysed 15 943 site-years of vital registration data, 1710 site-years of verbal autopsy data, 764 site-years of sample-based vital registration data, and 361 site-years of mortality surveillance data to estimate mortality due to tuberculosis using the Cause of Death Ensemble model. We analysed all available data sources, including annual case notifications, prevalence surveys, population-based tuberculin surveys, and estimated tuberculosis cause-specific mortality to generate internally consistent estimates of incidence, prevalence, and mortality using DisMod-MR 2.1, a Bayesian meta-regression tool. We assessed how the burden of tuberculosis differed from the burden predicted by the Socio-demographic Index (SDI), a composite indicator of income per capita, average years of schooling, and total fertility rate. Findings: Globally in 2016, among HIV-negative individuals, the number of incident cases of tuberculosis was 9ÃÂ·02 million (95% uncertainty interval [UI] 8ÃÂ·05–10ÃÂ·16) and the number of tuberculosis deaths was 1ÃÂ·21 million (1ÃÂ·16–1ÃÂ·27). Among HIV-positive individuals, the number of incident cases was 1ÃÂ·40 million (1ÃÂ·01–1ÃÂ·89) and the number of tuberculosis deaths was 0ÃÂ·24 million (0ÃÂ·16–0ÃÂ·31). Globally, among HIV-negative individuals the age-standardised incidence of tuberculosis decreased annually at a slower rate (–1ÃÂ·3% [–1ÃÂ·5 to −1ÃÂ·2]) than mortality did (–4ÃÂ·5% [–5ÃÂ·0 to −4ÃÂ·1]) from 2006 to 2016. Among HIV-positive individuals during the same period, the rate of change in annualised age-standardised incidence was −4ÃÂ·0% (–4ÃÂ·5 to −3ÃÂ·7) and mortality was −8ÃÂ·9% (–9ÃÂ·5 to −8ÃÂ·4). Several regions had higher rates of age-standardised incidence and mortality than expected on the basis of their SDI levels in 2016. For drug-susceptible tuberculosis, the highest observed-to-expected ratios were in southern sub-Saharan Africa (13ÃÂ·7 for incidence and 14ÃÂ·9 for mortality), and the lowest ratios were in high-income North America (0ÃÂ·4 for incidence) and Oceania (0ÃÂ·3 for mortality). For multidrug-resistant tuberculosis, eastern Europe had the highest observed-to-expected ratios (67ÃÂ·3 for incidence and 73ÃÂ·0 for mortality), and high-income North America had the lowest ratios (0ÃÂ·4 for incidence and 0ÃÂ·5 for mortality). Interpretation: If current trends in tuberculosis incidence continue, few countries are likely to meet the SDG target to end the tuberculosis epidemic by 2030. Progress needs to be accelerated by improving the quality of and access to tuberculosis diagnosis and care, by developing new tools, scaling up interventions to prevent risk factors for tuberculosis, and integrating control programmes for tuberculosis and HIV. Funding: Bill & Melinda Gates Foundation.

KW - World health

KW - epidemics

KW - health surveys

KW - risk factors

KW - tuberculosis

UR - http://handle.westernsydney.edu.au:8081/1959.7/uws:50530

U2 - 10.1016/S1473-3099(18)30625-X

DO - 10.1016/S1473-3099(18)30625-X

M3 - Article

SN - 1474-4457

SN - 1473-3099

VL - 18

SP - 1329

EP - 1349

JO - The Lancet Infectious Diseases

JF - The Lancet Infectious Diseases

IS - 12

ER -

Global, regional, and national burden of tuberculosis, 1990–2016 : results from the Global Burden of Diseases, Injuries, and Risk Factors 2016 Study

Abstract

Open Access - Access Right Statement

Keywords

UN SDGs

Access to Document

Other files and links

Fingerprint

Cite this