Epidemiology of Tuberculosis in the World

Drobniewski, Francis; Pablos-Méndez, Ariel; Raviglione, Mario

doi:10.1055/s-2007-1009357

Cited by 28 publications

(28 citation statements)

References 50 publications

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“…Infection with Mycobacterium tuberculosis causes nearly 8 million new cases of tuberculosis and 3 million deaths annually [1]. The worldwide extent of drug resistance is not clear, but resistance to at least one drug has been reported in nearly 10% of patients with no prior treatment; the prevalence of cases of primary isoniazid resistance, rifampicin resistance and multiple drug-resistant tuberculosis (MDRTB, i.e., cases due to strains resistant to at least isoniazid and rifampicin) was 7.3%, 1.8% and 1.4%, respectively, in one study [2].…”

Section: Introductionmentioning

confidence: 99%

A clinical, microbiological and economic analysis of a national service for the rapid molecular diagnosis of tuberculosis and rifampicin resistance in Mycobacterium tuberculosis

Drobniewski

Watterson

Wilson

et al. 2000

Journal of Medical Microbiology

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A clinical, microbiological and economic study of a national rapid molecular service for the identification of Mycobacterium tuberculosis and the determination of rifampicin resistance in smear-positive sputum samples (and other primary specimens) was performed. Ninety-one primary specimens, of which 55 were smear-positive sputum, were examined by molecular and conventional assays. Concordance of molecular results from smear-positive sputum specimens with tuberculosis diagnosis and rifampicin resistance by conventional analysis was 52 (94.5%) of 55 and 44 (91.7%) of 48, respectively. Concordance of molecular analysis on all primary specimens was 81 (89.0%) of 91 (diagnosis) and 55 (90.2%) of 61 (rifampicin resistance). Approximately 28 days were saved in the time to diagnosis by using the molecular assay. Hospitals can reduce the cost of inappropriate isolation of patients with risk factors for multiple drugresistant tuberculosis (MDRTB) who subsequently are shown to have drug-sensitive tuberculosis. At one hospital potential annual savings were between £50 000 and £150 000. Of the nine MDRTB cases identified, all had a previous diagnosis of tuberculosis, 78% were born overseas, 44% were known to be non-compliant with therapy, but only one case (12.5%) was HIV positive. HIV status was not significantly different between MDRTB and drug-sensitive tuberculosis cases. Over 75% of specimens were taken while the patient was on therapy. Isolates from >50% of the MDRTB cases were resistant to three or more drugs and one was resistant to seven drugs. All patients were placed on additional therapy once the molecular result was known; this was subsequently modified based on the results of in-vitro drug susceptibility testing. All survived at least 6 months of follow-up. There was no difference in the proportion of successful cultures from smear-positive samples from patients with drug-sensitive tuberculosis or MDRTB who were on therapy. Molecular rifampicin resistance assays are reliable for diagnosis in cases with smear-positive disease.

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Section: Introductionmentioning

confidence: 99%

A clinical, microbiological and economic analysis of a national service for the rapid molecular diagnosis of tuberculosis and rifampicin resistance in Mycobacterium tuberculosis

Drobniewski

Watterson

Wilson

et al. 2000

Journal of Medical Microbiology

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“…However, most TB cases occur in the developing world, where there continues to be a significant increase in incidence. In 1993-1995, the bulk of cases were found in the South-East Asian (42%), Western Pacific (23.5%) and African (14.5%) regions, compared to Europe (8.l%), the Americans (6.9%) and the Eastern Mediterranean (5.0%) [4]. Factors such as poverty, homelessness, civil disturbance, poorly functioning National TB Programmes (NTP) and the dismantling of public health infrastructure have contributed significantly to the worsening situation .…”

Section: Introductionmentioning

confidence: 99%

The rapid diagnosis of isoniazid and rifampicin resistance in Mycobacterium tuberculosis -- a molecular story

Drobniewski

Wilson

1998

Journal of Medical Microbiology

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Isoniazid and rifampicin resistance are assayed phenotypically by the resistance ratio, absolute concentration or proportion methods. Assay methods are often difficult to standardise and the World Health Organization (WHO) Global Programme on Drug Resistance is attempting to produce standardised drug resistance data worldwide. Brothbased methods are faster than solid media systems, and a commercial radiometric system, the Bactec 460, is arguably the fastest method and permits testing to be completed within 7-14 days; however, this method is expensive and requires disposal of radioactive material. Novel phenotypic methods that utilise mycobacteriophages have shown promise. Other molecular detection systems require knowledge of the genes encoding the drug target (the inhA/mabA, katG, oxyR and ahpC genes for isoniazid; rpuB for rifampicin) and the mutations producing resistance. These genotypic methods are limited in that not all resistance mechanisms are known, but advanced assays for rifampicin resistance that use gene sequencing, heteroduplex analysis, solid-phase hybridisation or single-strand conformation polymorphism analysis are becoming available.

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“…In 2009 TB was responsible for an estimated 1.9 million deaths worldwide with a further 9.4 million reported new cases of TB [8]. TB is considered to be a disease of the socially and economically disadvantaged, since its incidence is exacerbated by socioeconomic factors, inconsistent or partial treatment practices and immigration from countries in which the disease is endemic [6,9,10]. Reducing inequalities in TB incidence in Europe is, therefore, a goal that needs to be addressed, especially since the recent global financial crisis is expected to exacerbate health inequalities [11,12].…”

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confidence: 99%

Social determinants of tuberculosis in Europe: a prospective ecological study

et al. 2012

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Tuberculosis (TB) is considered to be a disease of poverty, since its incidence is exacerbated by socioeconomic factors, inconsistent or partial treatment practices, and immigration from endemic countries.A prospective country level study, using a comprehensive dataset of TB incidence and prevalence taken from countries within the World Health Organization (WHO) European region, was conducted. We employed quintile regression to investigate the prospective association between baseline (measured in 2000) and a nation's wealth, level of egalitarianism, migration rate, health-related lifestyle and social capital with TB incidence and prevalence over a 10-yr period (2000)(2001)(2002)(2003)(2004)(2005)(2006)(2007)(2008)(2009).We found that ,50% of TB variation is accounted for by a nation's wealth and level of egalitarianism. We observed a negative prospective association between logged gross domestic product and TB rates, and a positive prospective association between income inequality and TB.National income levels per capita and income inequality are important predictors for TB incidence and prevalence in the WHO European region. They account for 50% of country-level variation, indicating the importance of a combined absolute and relative socioeconomic disadvantage in the development of TB. These findings also provide a tool for forecasting potential fluctuations in the level of TB epidemics in the WHO European region, with respect to socioeconomic changes.

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Epidemiology of Tuberculosis in the World

Cited by 28 publications

References 50 publications

A clinical, microbiological and economic analysis of a national service for the rapid molecular diagnosis of tuberculosis and rifampicin resistance in Mycobacterium tuberculosis

A clinical, microbiological and economic analysis of a national service for the rapid molecular diagnosis of tuberculosis and rifampicin resistance in Mycobacterium tuberculosis

The rapid diagnosis of isoniazid and rifampicin resistance in Mycobacterium tuberculosis -- a molecular story

Social determinants of tuberculosis in Europe: a prospective ecological study

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