The global burden of tuberculosis : results from the Global Burden of Disease Study 2015

Christopher J. L. Murray; Hmwe H. Kyu; Emilie R. Maddison; Nathaniel J. Henry; John Everett Mumford; Ryan Barber; Chloe Shields; Jonathan C. Brown; Grant Nguyen; Austin Carter; Timothy M. Wolock; Haidong Wang; Patrick Y. Liu; Marissa Reitsma; Jennifer M. Ross; Amanuel Alemu Abajobir; Kalkidan Hassen Abate; Kaja Abbas; Mubarek Abera; Semaw Ferede Abera; Habtamu Abera Hareri; Muktar Ahmed; Kefyalew Addis Alene; Nelson Alvis-Guzman; Joshua Amo-Adjei; Jason Andrews; Hossein Ansari; Carl Abelardo Antonio; Palwasha Anwari; Hamid Asayesh; Tesfay Mehari Atey; Sachin Atre; Aleksandra Barac; Justin Beardsley; Neeraj Bedi; Isabela Bensenor; Addisu Shunu Beyene; Zahid Ahmad Butt; Pere-Joan Cardona; Devasahayam Christopher; Lalit Dandona; Rakhi Dandona; Kebede Deribe; Amare Deribew; Rebecca Ehrenkranz; Maysaa El Sayed Zaki; Aman Endries; Tesfaye R. Feyissa; Florian Fischer; Ruoyan Gai; Alberto L. Garcia-Basteiro; Tsegaye Tewelde Gebrehiwot; Hailay Gesesew; Belete Getahun; Philimon Gona; Amador Goodridge; Harish Gugnani; Hassan Haghparast-Bidgoli; Gessessew Bugssa Hailu; Hamid Yimam Hassen; Esayas Hilawe; Nobuyuki Horita; Kathryn H. Jacobsen; Jost B. Jonas; Amir Kasaeian; Muktar Sano Kedir; Laura Kemmer; Yousef Khader; Ejaz Khan; Young-Ho Khang; Abdullah T. Khoja; Yun Jin Kim; Parvaiz Koul; Ai Koyanagi; Kristopher J. Krohn; G. Anil Kumar; Michael Kutz; Rakesh Lodha; Hasan Magdy Abd El Razek; Reza Majdzadeh; Tsegahun Manyazewal; Ziad Memish; Walter Mendoza; Haftay Berhane Mezgebe; Shafiu Mohammed; Felix Akpojene Ogbo; In-Hwan Oh; Eyal Oren; Aaron Osgood-Zimmerman; David Pereira; Dietrich Plass; Farshad Pourmalek; Mostafa Qorbani; Anwar Rafay; Mahfuzar Rahman; Rajesh Kumar Rai; Puja C. Rao; Sarah E. Ray; Robert Reiner; Nickolas Reinig; Saeid Safiri; Joshua A. Salomon; Logan Sandar; Benn Sartorius; Morteza Shamsizadeh; Muki Shey; Desalegn Markos Shifti; Hirbo Shore; Jasvinder Singh; Chandrashekhar T. Sreeramareddy; Soumya Swaminathan; Scott J. Swartz; Fentaw Tadese; Bemnet Amare Tedla; Balewgizie Sileshi Tegegne; Belay Tessema; Roman Topor-Madry; Kingsley Nnanna Ukwaja; Olalekan A. Uthman; Vasiliy Vlassov; Stein Emil Vollset; Tolassa Wakayo; Solomon Weldegebreal; Ronny Westerman; Abdulhalik Workicho; Naohiro Yonemoto; Seok-Jun Yoon; Marcel Yotebieng; Mohsen Naghavi; Simon I. Hay; Theo Vos

doi:10.1016/S1473-3099(17)30703-X

The global burden of tuberculosis : results from the Global Burden of Disease Study 2015

Christopher J. L. Murray, Hmwe H. Kyu, Emilie R. Maddison, Nathaniel J. Henry, John Everett Mumford, Ryan Barber, Chloe Shields, Jonathan C. Brown, Grant Nguyen, Austin Carter, Timothy M. Wolock, Haidong Wang, Patrick Y. Liu, Marissa Reitsma, Jennifer M. Ross, Amanuel Alemu Abajobir, Kalkidan Hassen Abate, Kaja Abbas, Mubarek Abera, Semaw Ferede AberaHabtamu Abera Hareri, Muktar Ahmed, Kefyalew Addis Alene, Nelson Alvis-Guzman, Joshua Amo-Adjei, Jason Andrews, Hossein Ansari, Carl Abelardo Antonio, Palwasha Anwari, Hamid Asayesh, Tesfay Mehari Atey, Sachin Atre, Aleksandra Barac, Justin Beardsley, Neeraj Bedi, Isabela Bensenor, Addisu Shunu Beyene, Zahid Ahmad Butt, Pere-Joan Cardona, Devasahayam Christopher, Lalit Dandona, Rakhi Dandona, Kebede Deribe, Amare Deribew, Rebecca Ehrenkranz, Maysaa El Sayed Zaki, Aman Endries, Tesfaye R. Feyissa, Florian Fischer, Ruoyan Gai, Alberto L. Garcia-Basteiro, Tsegaye Tewelde Gebrehiwot, Hailay Gesesew, Belete Getahun, Philimon Gona, Amador Goodridge, Harish Gugnani, Hassan Haghparast-Bidgoli, Gessessew Bugssa Hailu, Hamid Yimam Hassen, Esayas Hilawe, Nobuyuki Horita, Kathryn H. Jacobsen, Jost B. Jonas, Amir Kasaeian, Muktar Sano Kedir, Laura Kemmer, Yousef Khader, Ejaz Khan, Young-Ho Khang, Abdullah T. Khoja, Yun Jin Kim, Parvaiz Koul, Ai Koyanagi, Kristopher J. Krohn, G. Anil Kumar, Michael Kutz, Rakesh Lodha, Hasan Magdy Abd El Razek, Reza Majdzadeh, Tsegahun Manyazewal, Ziad Memish, Walter Mendoza, Haftay Berhane Mezgebe, Shafiu Mohammed, Felix Akpojene Ogbo, In-Hwan Oh, Eyal Oren, Aaron Osgood-Zimmerman, David Pereira, Dietrich Plass, Farshad Pourmalek, Mostafa Qorbani, Anwar Rafay, Mahfuzar Rahman, Rajesh Kumar Rai, Puja C. Rao, Sarah E. Ray, Robert Reiner, Nickolas Reinig, Saeid Safiri, Joshua A. Salomon, Logan Sandar, Benn Sartorius, Morteza Shamsizadeh, Muki Shey, Desalegn Markos Shifti, Hirbo Shore, Jasvinder Singh, Chandrashekhar T. Sreeramareddy, Soumya Swaminathan, Scott J. Swartz, Fentaw Tadese, Bemnet Amare Tedla, Balewgizie Sileshi Tegegne, Belay Tessema, Roman Topor-Madry, Kingsley Nnanna Ukwaja, Olalekan A. Uthman, Vasiliy Vlassov, Stein Emil Vollset, Tolassa Wakayo, Solomon Weldegebreal, Ronny Westerman, Abdulhalik Workicho, Naohiro Yonemoto, Seok-Jun Yoon, Marcel Yotebieng, Mohsen Naghavi, Simon I. Hay, Theo Vos

Western Sydney University

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

276 Citations (Scopus)

Abstract

Background: An understanding of the trends in tuberculosis incidence, prevalence, and mortality is crucial to tracking of the success of tuberculosis control programmes and identification of remaining challenges. We assessed trends in the fatal and non-fatal burden of tuberculosis over the past 25 years for 195 countries and territories. Methods: We analysed 10 691 site-years of vital registration data, 768 site-years of verbal autopsy data, and 361 site-years of mortality surveillance data using the Cause of Death Ensemble model to estimate tuberculosis mortality rates. We analysed all available age-specific and sex-specific data sources, including annual case notifications, prevalence surveys, and estimated 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 observed tuberculosis incidence, prevalence, and mortality differed from expected trends as predicted by the Socio-demographic Index (SDI), a composite indicator based on income per capita, average years of schooling, and total fertility rate. We also estimated tuberculosis mortality and disability-adjusted life-years attributable to the independent effects of risk factors including smoking, alcohol use, and diabetes. Findings: Globally, in 2015, the number of tuberculosis incident cases (including new and relapse cases) was 10.2 million (95% uncertainty interval 9.2 million to 11.5 million), the number of prevalent cases was 10.1 million (9.2 million to 11.1 million), and the number of deaths was 1.3 million (1.1 million to 1.6 million). Among individuals who were HIV negative, the number of incident cases was 8.8 million (8.0 million to 9.9 million), the number of prevalent cases was 8.9 million (8.1 million to 9.7 million), and the number of deaths was 1.1 million (0.9 million to 1.4 million). Annualised rates of change from 2005 to 2015 showed a faster decline in mortality (-4.1% [-5.0 to -3.4]) than in incidence (-1.6% [-1.9 to -1.2]) and prevalence (-0.7% [-1.0 to -0.5]) among HIV-negative individuals. The SDI was inversely associated with HIV-negative mortality rates but did not show a clear gradient for incidence and prevalence. Most of Asia, eastern Europe, and sub-Saharan Africa had higher rates of HIV-negative tuberculosis burden than expected given their SDI. Alcohol use accounted for 11.4% (9.3-13.0) of global tuberculosis deaths among HIV-negative individuals in 2015, diabetes accounted for 10.6% (6.8-14.8), and smoking accounted for 7.8% (3.8-12.0). Interpretation: Despite a concerted global effort to reduce the burden of tuberculosis, it still causes a large disease burden globally. Strengthening of health systems for early detection of tuberculosis and improvement of the quality of tuberculosis care, including prompt and accurate diagnosis, early initiation of treatment, and regular follow-up, are priorities. Countries with higher than expected tuberculosis rates for their level of sociodemographic development should investigate the reasons for lagging behind and take remedial action. Efforts to prevent smoking, alcohol use, and diabetes could also substantially reduce the burden of tuberculosis.

Original language	English
Pages (from-to)	261-284
Number of pages	24
Journal	The Lancet Infectious Diseases
Volume	18
Issue number	3
DOIs	https://doi.org/10.1016/S1473-3099(17)30703-X
Publication status	Published - 2018

Keywords

public health
tuberculosis

UN SDGs

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

Access to Document

10.1016/S1473-3099(17)30703-X

Cite this

Murray, C. J. L., Kyu, H. H., Maddison, E. R., Henry, N. J., Mumford, J. E., Barber, R., Shields, C., Brown, J. C., Nguyen, G., Carter, A., Wolock, T. M., Wang, H., Liu, P. Y., Reitsma, M., Ross, J. M., Abajobir, A. A., Abate, K. H., Abbas, K., Abera, M., ... Vos, T. (2018). The global burden of tuberculosis : results from the Global Burden of Disease Study 2015. The Lancet Infectious Diseases, 18(3), 261-284. https://doi.org/10.1016/S1473-3099(17)30703-X

@article{7b3e4bac936444cf9c030615eb909fa4,

title = "The global burden of tuberculosis : results from the Global Burden of Disease Study 2015",

abstract = "Background: An understanding of the trends in tuberculosis incidence, prevalence, and mortality is crucial to tracking of the success of tuberculosis control programmes and identification of remaining challenges. We assessed trends in the fatal and non-fatal burden of tuberculosis over the past 25 years for 195 countries and territories. Methods: We analysed 10 691 site-years of vital registration data, 768 site-years of verbal autopsy data, and 361 site-years of mortality surveillance data using the Cause of Death Ensemble model to estimate tuberculosis mortality rates. We analysed all available age-specific and sex-specific data sources, including annual case notifications, prevalence surveys, and estimated 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 observed tuberculosis incidence, prevalence, and mortality differed from expected trends as predicted by the Socio-demographic Index (SDI), a composite indicator based on income per capita, average years of schooling, and total fertility rate. We also estimated tuberculosis mortality and disability-adjusted life-years attributable to the independent effects of risk factors including smoking, alcohol use, and diabetes. Findings: Globally, in 2015, the number of tuberculosis incident cases (including new and relapse cases) was 10.2 million (95% uncertainty interval 9.2 million to 11.5 million), the number of prevalent cases was 10.1 million (9.2 million to 11.1 million), and the number of deaths was 1.3 million (1.1 million to 1.6 million). Among individuals who were HIV negative, the number of incident cases was 8.8 million (8.0 million to 9.9 million), the number of prevalent cases was 8.9 million (8.1 million to 9.7 million), and the number of deaths was 1.1 million (0.9 million to 1.4 million). Annualised rates of change from 2005 to 2015 showed a faster decline in mortality (-4.1% [-5.0 to -3.4]) than in incidence (-1.6% [-1.9 to -1.2]) and prevalence (-0.7% [-1.0 to -0.5]) among HIV-negative individuals. The SDI was inversely associated with HIV-negative mortality rates but did not show a clear gradient for incidence and prevalence. Most of Asia, eastern Europe, and sub-Saharan Africa had higher rates of HIV-negative tuberculosis burden than expected given their SDI. Alcohol use accounted for 11.4% (9.3-13.0) of global tuberculosis deaths among HIV-negative individuals in 2015, diabetes accounted for 10.6% (6.8-14.8), and smoking accounted for 7.8% (3.8-12.0). Interpretation: Despite a concerted global effort to reduce the burden of tuberculosis, it still causes a large disease burden globally. Strengthening of health systems for early detection of tuberculosis and improvement of the quality of tuberculosis care, including prompt and accurate diagnosis, early initiation of treatment, and regular follow-up, are priorities. Countries with higher than expected tuberculosis rates for their level of sociodemographic development should investigate the reasons for lagging behind and take remedial action. Efforts to prevent smoking, alcohol use, and diabetes could also substantially reduce the burden of tuberculosis.",

keywords = "public health, tuberculosis",

author = "Murray, {Christopher J. L.} and Kyu, {Hmwe H.} and Maddison, {Emilie R.} and Henry, {Nathaniel J.} and Mumford, {John Everett} and Ryan Barber and Chloe Shields and Brown, {Jonathan C.} and Grant Nguyen and Austin Carter and Wolock, {Timothy M.} and Haidong Wang and Liu, {Patrick Y.} and Marissa Reitsma and Ross, {Jennifer M.} and Abajobir, {Amanuel Alemu} and Abate, {Kalkidan Hassen} and Kaja Abbas and Mubarek Abera and Abera, {Semaw Ferede} and Hareri, {Habtamu Abera} and Muktar Ahmed and Alene, {Kefyalew Addis} and Nelson Alvis-Guzman and Joshua Amo-Adjei and Jason Andrews and Hossein Ansari and Antonio, {Carl Abelardo} and Palwasha Anwari and Hamid Asayesh and Atey, {Tesfay Mehari} and Sachin Atre and Aleksandra Barac and Justin Beardsley and Neeraj Bedi and Isabela Bensenor and Beyene, {Addisu Shunu} and Butt, {Zahid Ahmad} and Pere-Joan Cardona and Devasahayam Christopher and Lalit Dandona and Rakhi Dandona and Kebede Deribe and Amare Deribew and Rebecca Ehrenkranz and {El Sayed Zaki}, Maysaa and Aman Endries and Feyissa, {Tesfaye R.} and Florian Fischer and Ruoyan Gai and Garcia-Basteiro, {Alberto L.} and Gebrehiwot, {Tsegaye Tewelde} and Hailay Gesesew and Belete Getahun and Philimon Gona and Amador Goodridge and Harish Gugnani and Hassan Haghparast-Bidgoli and Hailu, {Gessessew Bugssa} and Hassen, {Hamid Yimam} and Esayas Hilawe and Nobuyuki Horita and Jacobsen, {Kathryn H.} and Jonas, {Jost B.} and Amir Kasaeian and Kedir, {Muktar Sano} and Laura Kemmer and Yousef Khader and Ejaz Khan and Young-Ho Khang and Khoja, {Abdullah T.} and Kim, {Yun Jin} and Parvaiz Koul and Ai Koyanagi and Krohn, {Kristopher J.} and Kumar, {G. Anil} and Michael Kutz and Rakesh Lodha and {Abd El Razek}, {Hasan Magdy} and Reza Majdzadeh and Tsegahun Manyazewal and Ziad Memish and Walter Mendoza and Mezgebe, {Haftay Berhane} and Shafiu Mohammed and Ogbo, {Felix Akpojene} and In-Hwan Oh and Eyal Oren and Aaron Osgood-Zimmerman and David Pereira and Dietrich Plass and Farshad Pourmalek and Mostafa Qorbani and Anwar Rafay and Mahfuzar Rahman and Rai, {Rajesh Kumar} and Rao, {Puja C.} and Ray, {Sarah E.} and Robert Reiner and Nickolas Reinig and Saeid Safiri and Salomon, {Joshua A.} and Logan Sandar and Benn Sartorius and Morteza Shamsizadeh and Muki Shey and Shifti, {Desalegn Markos} and Hirbo Shore and Jasvinder Singh and Sreeramareddy, {Chandrashekhar T.} and Soumya Swaminathan and Swartz, {Scott J.} and Fentaw Tadese and Tedla, {Bemnet Amare} and Tegegne, {Balewgizie Sileshi} and Belay Tessema and Roman Topor-Madry and Ukwaja, {Kingsley Nnanna} and Uthman, {Olalekan A.} and Vasiliy Vlassov and Vollset, {Stein Emil} and Tolassa Wakayo and Solomon Weldegebreal and Ronny Westerman and Abdulhalik Workicho and Naohiro Yonemoto and Seok-Jun Yoon and Marcel Yotebieng and Mohsen Naghavi and Hay, {Simon I.} and Theo Vos",

year = "2018",

doi = "10.1016/S1473-3099(17)30703-X",

language = "English",

volume = "18",

pages = "261--284",

journal = "The Lancet Infectious Diseases",

issn = "1473-3099",

publisher = "Elsevier Ltd.",

number = "3",

}

Murray, CJL, Kyu, HH, Maddison, ER, Henry, NJ, Mumford, JE, Barber, R, Shields, C, Brown, JC, Nguyen, G, Carter, A, Wolock, TM, Wang, H, Liu, PY, Reitsma, M, Ross, JM, Abajobir, AA, Abate, KH, Abbas, K, Abera, M, Abera, SF, Hareri, HA, Ahmed, M, Alene, KA, Alvis-Guzman, N, Amo-Adjei, J, Andrews, J, Ansari, H, Antonio, CA, Anwari, P, Asayesh, H, Atey, TM, Atre, S, Barac, A, Beardsley, J, Bedi, N, Bensenor, I, Beyene, AS, Butt, ZA, Cardona, P-J, Christopher, D, Dandona, L, Dandona, R, Deribe, K, Deribew, A, Ehrenkranz, R, El Sayed Zaki, M, Endries, A, Feyissa, TR, Fischer, F, Gai, R, Garcia-Basteiro, AL, Gebrehiwot, TT, Gesesew, H, Getahun, B, Gona, P, Goodridge, A, Gugnani, H, Haghparast-Bidgoli, H, Hailu, GB, Hassen, HY, Hilawe, E, Horita, N, Jacobsen, KH, Jonas, JB, Kasaeian, A, Kedir, MS, Kemmer, L, Khader, Y, Khan, E, Khang, Y-H, Khoja, AT, Kim, YJ, Koul, P, Koyanagi, A, Krohn, KJ, Kumar, GA, Kutz, M, Lodha, R, Abd El Razek, HM, Majdzadeh, R, Manyazewal, T, Memish, Z, Mendoza, W, Mezgebe, HB, Mohammed, S, Ogbo, FA, Oh, I-H, Oren, E, Osgood-Zimmerman, A, Pereira, D, Plass, D, Pourmalek, F, Qorbani, M, Rafay, A, Rahman, M, Rai, RK, Rao, PC, Ray, SE, Reiner, R, Reinig, N, Safiri, S, Salomon, JA, Sandar, L, Sartorius, B, Shamsizadeh, M, Shey, M, Shifti, DM, Shore, H, Singh, J, Sreeramareddy, CT, Swaminathan, S, Swartz, SJ, Tadese, F, Tedla, BA, Tegegne, BS, Tessema, B, Topor-Madry, R, Ukwaja, KN, Uthman, OA, Vlassov, V, Vollset, SE, Wakayo, T, Weldegebreal, S, Westerman, R, Workicho, A, Yonemoto, N, Yoon, S-J, Yotebieng, M, Naghavi, M, Hay, SI & Vos, T 2018, 'The global burden of tuberculosis : results from the Global Burden of Disease Study 2015', The Lancet Infectious Diseases, vol. 18, no. 3, pp. 261-284. https://doi.org/10.1016/S1473-3099(17)30703-X

TY - JOUR

T1 - The global burden of tuberculosis : results from the Global Burden of Disease Study 2015

AU - Murray, Christopher J. L.

AU - Kyu, Hmwe H.

AU - Maddison, Emilie R.

AU - Henry, Nathaniel J.

AU - Mumford, John Everett

AU - Barber, Ryan

AU - Shields, Chloe

AU - Brown, Jonathan C.

AU - Nguyen, Grant

AU - Carter, Austin

AU - Wolock, Timothy M.

AU - Wang, Haidong

AU - Liu, Patrick Y.

AU - Reitsma, Marissa

AU - Ross, Jennifer M.

AU - Abajobir, Amanuel Alemu

AU - Abate, Kalkidan Hassen

AU - Abbas, Kaja

AU - Abera, Mubarek

AU - Abera, Semaw Ferede

AU - Hareri, Habtamu Abera

AU - Ahmed, Muktar

AU - Alene, Kefyalew Addis

AU - Alvis-Guzman, Nelson

AU - Amo-Adjei, Joshua

AU - Andrews, Jason

AU - Ansari, Hossein

AU - Antonio, Carl Abelardo

AU - Anwari, Palwasha

AU - Asayesh, Hamid

AU - Atey, Tesfay Mehari

AU - Atre, Sachin

AU - Barac, Aleksandra

AU - Beardsley, Justin

AU - Bedi, Neeraj

AU - Bensenor, Isabela

AU - Beyene, Addisu Shunu

AU - Butt, Zahid Ahmad

AU - Cardona, Pere-Joan

AU - Christopher, Devasahayam

AU - Dandona, Lalit

AU - Dandona, Rakhi

AU - Deribe, Kebede

AU - Deribew, Amare

AU - Ehrenkranz, Rebecca

AU - El Sayed Zaki, Maysaa

AU - Endries, Aman

AU - Feyissa, Tesfaye R.

AU - Fischer, Florian

AU - Gai, Ruoyan

AU - Garcia-Basteiro, Alberto L.

AU - Gebrehiwot, Tsegaye Tewelde

AU - Gesesew, Hailay

AU - Getahun, Belete

AU - Gona, Philimon

AU - Goodridge, Amador

AU - Gugnani, Harish

AU - Haghparast-Bidgoli, Hassan

AU - Hailu, Gessessew Bugssa

AU - Hassen, Hamid Yimam

AU - Hilawe, Esayas

AU - Horita, Nobuyuki

AU - Jacobsen, Kathryn H.

AU - Jonas, Jost B.

AU - Kasaeian, Amir

AU - Kedir, Muktar Sano

AU - Kemmer, Laura

AU - Khader, Yousef

AU - Khan, Ejaz

AU - Khang, Young-Ho

AU - Khoja, Abdullah T.

AU - Kim, Yun Jin

AU - Koul, Parvaiz

AU - Koyanagi, Ai

AU - Krohn, Kristopher J.

AU - Kumar, G. Anil

AU - Kutz, Michael

AU - Lodha, Rakesh

AU - Abd El Razek, Hasan Magdy

AU - Majdzadeh, Reza

AU - Manyazewal, Tsegahun

AU - Memish, Ziad

AU - Mendoza, Walter

AU - Mezgebe, Haftay Berhane

AU - Mohammed, Shafiu

AU - Ogbo, Felix Akpojene

AU - Oh, In-Hwan

AU - Oren, Eyal

AU - Osgood-Zimmerman, Aaron

AU - Pereira, David

AU - Plass, Dietrich

AU - Pourmalek, Farshad

AU - Qorbani, Mostafa

AU - Rafay, Anwar

AU - Rahman, Mahfuzar

AU - Rai, Rajesh Kumar

AU - Rao, Puja C.

AU - Ray, Sarah E.

AU - Reiner, Robert

AU - Reinig, Nickolas

AU - Safiri, Saeid

AU - Salomon, Joshua A.

AU - Sandar, Logan

AU - Sartorius, Benn

AU - Shamsizadeh, Morteza

AU - Shey, Muki

AU - Shifti, Desalegn Markos

AU - Shore, Hirbo

AU - Singh, Jasvinder

AU - Sreeramareddy, Chandrashekhar T.

AU - Swaminathan, Soumya

AU - Swartz, Scott J.

AU - Tadese, Fentaw

AU - Tedla, Bemnet Amare

AU - Tegegne, Balewgizie Sileshi

AU - Tessema, Belay

AU - Topor-Madry, Roman

AU - Ukwaja, Kingsley Nnanna

AU - Uthman, Olalekan A.

AU - Vlassov, Vasiliy

AU - Vollset, Stein Emil

AU - Wakayo, Tolassa

AU - Weldegebreal, Solomon

AU - Westerman, Ronny

AU - Workicho, Abdulhalik

AU - Yonemoto, Naohiro

AU - Yoon, Seok-Jun

AU - Yotebieng, Marcel

AU - Naghavi, Mohsen

AU - Hay, Simon I.

AU - Vos, Theo

PY - 2018

Y1 - 2018

N2 - Background: An understanding of the trends in tuberculosis incidence, prevalence, and mortality is crucial to tracking of the success of tuberculosis control programmes and identification of remaining challenges. We assessed trends in the fatal and non-fatal burden of tuberculosis over the past 25 years for 195 countries and territories. Methods: We analysed 10 691 site-years of vital registration data, 768 site-years of verbal autopsy data, and 361 site-years of mortality surveillance data using the Cause of Death Ensemble model to estimate tuberculosis mortality rates. We analysed all available age-specific and sex-specific data sources, including annual case notifications, prevalence surveys, and estimated 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 observed tuberculosis incidence, prevalence, and mortality differed from expected trends as predicted by the Socio-demographic Index (SDI), a composite indicator based on income per capita, average years of schooling, and total fertility rate. We also estimated tuberculosis mortality and disability-adjusted life-years attributable to the independent effects of risk factors including smoking, alcohol use, and diabetes. Findings: Globally, in 2015, the number of tuberculosis incident cases (including new and relapse cases) was 10.2 million (95% uncertainty interval 9.2 million to 11.5 million), the number of prevalent cases was 10.1 million (9.2 million to 11.1 million), and the number of deaths was 1.3 million (1.1 million to 1.6 million). Among individuals who were HIV negative, the number of incident cases was 8.8 million (8.0 million to 9.9 million), the number of prevalent cases was 8.9 million (8.1 million to 9.7 million), and the number of deaths was 1.1 million (0.9 million to 1.4 million). Annualised rates of change from 2005 to 2015 showed a faster decline in mortality (-4.1% [-5.0 to -3.4]) than in incidence (-1.6% [-1.9 to -1.2]) and prevalence (-0.7% [-1.0 to -0.5]) among HIV-negative individuals. The SDI was inversely associated with HIV-negative mortality rates but did not show a clear gradient for incidence and prevalence. Most of Asia, eastern Europe, and sub-Saharan Africa had higher rates of HIV-negative tuberculosis burden than expected given their SDI. Alcohol use accounted for 11.4% (9.3-13.0) of global tuberculosis deaths among HIV-negative individuals in 2015, diabetes accounted for 10.6% (6.8-14.8), and smoking accounted for 7.8% (3.8-12.0). Interpretation: Despite a concerted global effort to reduce the burden of tuberculosis, it still causes a large disease burden globally. Strengthening of health systems for early detection of tuberculosis and improvement of the quality of tuberculosis care, including prompt and accurate diagnosis, early initiation of treatment, and regular follow-up, are priorities. Countries with higher than expected tuberculosis rates for their level of sociodemographic development should investigate the reasons for lagging behind and take remedial action. Efforts to prevent smoking, alcohol use, and diabetes could also substantially reduce the burden of tuberculosis.

AB - Background: An understanding of the trends in tuberculosis incidence, prevalence, and mortality is crucial to tracking of the success of tuberculosis control programmes and identification of remaining challenges. We assessed trends in the fatal and non-fatal burden of tuberculosis over the past 25 years for 195 countries and territories. Methods: We analysed 10 691 site-years of vital registration data, 768 site-years of verbal autopsy data, and 361 site-years of mortality surveillance data using the Cause of Death Ensemble model to estimate tuberculosis mortality rates. We analysed all available age-specific and sex-specific data sources, including annual case notifications, prevalence surveys, and estimated 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 observed tuberculosis incidence, prevalence, and mortality differed from expected trends as predicted by the Socio-demographic Index (SDI), a composite indicator based on income per capita, average years of schooling, and total fertility rate. We also estimated tuberculosis mortality and disability-adjusted life-years attributable to the independent effects of risk factors including smoking, alcohol use, and diabetes. Findings: Globally, in 2015, the number of tuberculosis incident cases (including new and relapse cases) was 10.2 million (95% uncertainty interval 9.2 million to 11.5 million), the number of prevalent cases was 10.1 million (9.2 million to 11.1 million), and the number of deaths was 1.3 million (1.1 million to 1.6 million). Among individuals who were HIV negative, the number of incident cases was 8.8 million (8.0 million to 9.9 million), the number of prevalent cases was 8.9 million (8.1 million to 9.7 million), and the number of deaths was 1.1 million (0.9 million to 1.4 million). Annualised rates of change from 2005 to 2015 showed a faster decline in mortality (-4.1% [-5.0 to -3.4]) than in incidence (-1.6% [-1.9 to -1.2]) and prevalence (-0.7% [-1.0 to -0.5]) among HIV-negative individuals. The SDI was inversely associated with HIV-negative mortality rates but did not show a clear gradient for incidence and prevalence. Most of Asia, eastern Europe, and sub-Saharan Africa had higher rates of HIV-negative tuberculosis burden than expected given their SDI. Alcohol use accounted for 11.4% (9.3-13.0) of global tuberculosis deaths among HIV-negative individuals in 2015, diabetes accounted for 10.6% (6.8-14.8), and smoking accounted for 7.8% (3.8-12.0). Interpretation: Despite a concerted global effort to reduce the burden of tuberculosis, it still causes a large disease burden globally. Strengthening of health systems for early detection of tuberculosis and improvement of the quality of tuberculosis care, including prompt and accurate diagnosis, early initiation of treatment, and regular follow-up, are priorities. Countries with higher than expected tuberculosis rates for their level of sociodemographic development should investigate the reasons for lagging behind and take remedial action. Efforts to prevent smoking, alcohol use, and diabetes could also substantially reduce the burden of tuberculosis.

KW - public health

KW - tuberculosis

UR - http://hdl.handle.net/1959.7/uws:46370

U2 - 10.1016/S1473-3099(17)30703-X

DO - 10.1016/S1473-3099(17)30703-X

M3 - Article

SN - 1473-3099

VL - 18

SP - 261

EP - 284

JO - The Lancet Infectious Diseases

JF - The Lancet Infectious Diseases

IS - 3

ER -

The global burden of tuberculosis : results from the Global Burden of Disease Study 2015

Abstract

Keywords

UN SDGs

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