Burden of tuberculosis in indigenous peoples globally: a systematic review [Review article]

Abstract

SUMMARY BACKGROUND The burden of tuberculosis (TB) in the estimated 370 million indigenous peoples worldwide is unknown. OBJECTIVE To conduct a literature review to summarize the TB burden in indigenous peoples, identify gaps in current knowledge, and provide the foundation for a research agenda prioritizing indigenous health within TB control. METHODS A systematic literature review identified articles published between January 1990 and November 2011 quantifying TB disease burden in indigenous populations worldwide. RESULTS Among the 91 articles from 19 countries included in the review, only 56 were from outside Australia, Canada, New Zealand and the United States. The majority of the studies showed higher TB rates among indigenous groups than non-indigenous groups. Studies from the Amazon generally reported the highest TB prevalence and incidence, but select populations from South-East Asia and Africa were found to have similarly high rates of TB. In North America, the Inuit had the highest reported TB incidence (156/100 000), whereas the Metis of Canada and American Indians/Alaska Natives experienced rates of <10/100 000. New Zealand’s Maori and Pacific Islanders had higher TB incidence rates than Australian Aborigines, but all were at greater risk of developing TB than non-indigenous groups. CONCLUSION Where data exist, indigenous peoples were generally found to have higher rates of TB disease than non-indigenous peoples; however, this burden varied greatly. The paucity of published information on TB burden among indigenous peoples highlights the need to implement and improve TB surveillance to better measure and understand global disparities in TB rates.

High Tuberculosis Disease Burden among Indigenous People of the Paraguayan Chaco and Associated Community Characteristics, 2002–2004: An Ecological Study

“…A review of published data on TB disease burden in indigenous populations worldwide found that, in most cases, indigenous populations have higher rates of active TB disease than nonindigenous populations [1,2]. These findings are consistent with growing evidence on health disparities between indigenous and nonindigenous people worldwide; across regions, macrolinguistic families, and countries, disease burden and disability rates are higher among the former when compared to their most underprivileged neighbors [2][3][4].…”

“…The TB burden in indigenous communities of the Chaco region fits well within the range of variation in indigenous TB burden worldwide and further supports evidence that indigenous people generally suffer greater disease burden than nonindigenous people [1]. When compared with other South American indigenous groups (Figure 1), the burden of disease in Chacoan indigenous groups is lower than that experienced by their indigenous neighbors.…”

“…The period prevalence of tuberculosis cases from 2002 to 2004 and demographic characteristics of the three departments and five linguistic families in the Chaco are presented in Table 1 [1]). When restricting the comparison to Latin America, the prevalence of TB for indigenous groups in the Chaco is on the lower end, but two of the high prevalence studies (among the Panara [23] and Yanomami [24]) were conducted several years earlier (Figure 1).…”

Magnitude da tuberculose pulmonar na população fronteiriça de Mato Grosso do Sul (Brasil), Paraguai e Bolívia

“…Tal estudo revelou que a carga da tuberculose é elevada e desproporcional, com grande variação entre grupos e regiões. Os grupos indígenas com maior carga da doença estão localizados em pequenas regiões da América Latina 28 .…”

Inadequate Diet is Associated with AcquiringMycobacterium tuberculosisInfection in an Inuit Community: A Case-Control Study

“…Indigenous communities in many high-income countries have substantially higher rates of tuberculosis than the non-indigenous population (9) and rates of tuberculosis are particularly high amongst the Inuit in the Canadian Arctic regions (10). Although socioeconomic factors are thought to be important contributors, the reasons for this remain unclear, making it difficult to target interventions to reduce this disease burden.…”