Tuberculosis disease burden and attributable risk factors in Nigeria, 1990–2016

Abstract

BackgroundAccording to the World Health Organization, Nigeria is one of the countries with a high burden of tuberculosis (TB) worldwide. Improving the burden of TB among HIV-negative people would require comprehensive and up-to-date data to inform targeted policy actions in Nigeria. The study aimed to describe the incidence, prevalence, mortality, disability-adjusted life years (DALYs) and risk factors of tuberculosis in Nigeria between 1990 and 2016.MethodsThis study used the most recent data from the global burden of disease study 2016. TB deaths were estimated using the Cause of Death Ensemble model, while TB incidence, prevalence and DALYs, as well as years of life lost and years of life lived with disability were calculated in the DisMod-MR 2.1, a Bayesian meta-regression tool. Using a comparative risk assessment approach, TB burden attributable to risk factors was estimated in a spatial-temporal Gaussian Process Regression tool.ResultsIn 2016, the prevalence of TB among HIV-negative people was 27% (95% uncertainty interval [95% UI] 23–31%) in Nigeria. TB incidence rate (new and relapse cases) was 158 per 100,000 people (95% UI; 128-193), while the total number of TB mortality was 39,933 deaths (95% UI; 30,488-55,039) in 2016. Between 2000 and 2016, the age-standardised prevalence and incidence rates of TB-HIV negative decreased by 20.0 and 87.6%, respectively. The age-standardised mortality rate also dropped by 191.6% over the same period. DALYs due to TB among HIV-negative Nigerians was high but varied across the age groups. Of the risk factors studied, alcohol use accounted for the highest number of TB deaths and DALYs, followed by diabetes and smoking in 2016.ConclusionThe study shows an improving trend in TB disease burden among HIV-negative individuals in Nigeria from 1990 to 2016. Despite this progress, this study suggests that additional efforts are still needed to ensure that Nigeria is not left behind in the current global strategy to end TB disease. Reducing TB disease burden in the country will require a multipronged approach that includes increased funding, health system strengthening and improved TB surveillance, as well as preventive efforts for alcohol use, smoking and diabetes.Electronic supplementary materialThe online version of this article (10.1186/s41182-018-0114-9) contains supplementary material, which is available to authorized users.

Estimating Disability-Adjusted Life Years due to Tuberculosis in Korea through to the Year 2040

“…Similarities in Chinese and Korean trends in TB burden might be due to the relatively low incidence of HIV-positive TB in both countries compared with many countries with a high HIV prevalence, with 1.2 cases per 100,000 in China and 0.63 per 100,000 population in Korea [ 29 ]. In contrast to our findings, in Nigeria, the TB burden among HIV-negative individuals was the highest in those aged 15–49 years [ 32 ]. According to the GBD studies, DALYs due to the drug-susceptible TB among HIV/AIDS positives were the highest in males aged 30–39 globally [ 9 ].…”

<p>The Gap Between Global Tuberculosis Incidence and the First Milestone of the WHO End Tuberculosis Strategy: An Analysis Based on the Global Burden of Disease 2017 Database</p>

“…Previous studies have estimated the annual percentage change of the age-standardized incidence rate when investigating global trends in the incidence of TB. [19][20][21][22][23] While this metric is a good indicator, it was not applicable to the present study for several reasons: (1) the annual percentage change represents the degree of change compared with the previous year, while the incidence in the 2020 milestone of the WHO End Tuberculosis Strategy is compared with 2015; (2) an annual percentage change estimated using a long period of data (eg, 10+ years) does not represent the trend after 2015; and (3) the 2020 milestone of the WHO End Tuberculosis Strategy is to reduce the incidence rate of TB by 20%, and not the agestandardized incidence rate. We, therefore, chose the annual percentage change in the incidence rate of TB based on 2015 to evaluate the trend of TB incidence rate after 2015 in addressing the purpose of this study.…”

Environmental and Socio- Economic Factors as Drivers of Tuberculosis in Nigeria: Paradigm to Adopt Mathematical Approach for Research and Intervention

“…As a result, it replicates in the report of Cadmus et al, (2018) where Nigeria is rated fourth among the countries with the highest burden of TB. Similarly, Ogbo et al, (2018) reported prevalence trends of TB in Nigeria to be 158 in 100,000 people, and the total number of TB attributable deaths was 39,933 in 2016.…”

“…The prevalence of tuberculosis in Nigeria is shown in figure 2. The prevalence trends of TB in Nigeria were 158 in 100,000 people, and the total number of TB attributable deaths was 39,933 in 2016 (Ogbo et al, 2018). This study further shows decreases in prevalence and death cases from 2000 to 2016 in the country, but disease resurgence is also shown in figure 2.…”

“…and 3 shows the decrease in TB prevalence and mortality from 1990 to 2016 in Nigeria though, with fluctuations in years. The burden of tuberculosis in Nigeria is significant having 5% of overall global incidences(Ogbo et al 2018) …”