Was the rise of TB contemporaneous with the industrial revolution? Epidemiological evolution of TB in France (17th-20th centuries) inferred from osteoarchaeological and historical archives

Abstract

Objective: The development of tuberculosis is classically associated with the rise of the Industrial Revolution. Our objective is to test this epidemiological hypothesis for populations in France between the 18th and 20th centuries using osteoarchaeological and historical sources.Materials: Osteoarchaeological sources include two skeletal collections from plague epidemics in Provence (1590 and 1722) representing a total of 349 individuals and medical archives dating 1750 to 1930 from Paris, Lyon, Marseille, Montpellier.Methods: Paleoepidemiological analysis (crude prevalence rate) of the archeological data, and epidemiological analysis of historical data included the proportional mortality rate of tuberculosis (PMR-TB) and the mortality rate by tuberculosis (MR-TB).Results: Mean prevalence of TB before the 19 th century was approximately 30%, according to osteoarchaeological data. Historical sources showed that pulmonary TB was responsible for 33% of total deaths in the city of Marseille during the second half of the 18 th century and represented about 20% of deaths in the four French cities during the 19 th century. The mortality rate was 6.5 per thousand inhabitants in the 18 th century (Marseille) and stable at 4 to 5 ‰ during the 19 th century before, during, and after the Industrial Revolution period, with the exception of years 1870-1871 (French-Prussian war), when it increased.Conclusions: Population increase contemporary to the industrialization process did not increase the mortality rate by tuberculosis in France. Significance:The epidemiological assertion that tuberculosis increased with the Industrial Revolution in cities must be reevaluated. In France, and perhaps in other cities, it was an endemic disease at least a century before, and associated with a higher mortality rate.Limitations: Reliability and biases inherent to archaeological and historical data prior and during the Industrial Revolution must be taken into account.

Tackling Drug-Resistant Tuberculosis: New Challenges from the Old Pathogen Mycobacterium tuberculosis

“…In 1890, Kock announced the discovery of tuberculin, which was the basis for Mantoux’s tuberculin skin test in 1907 ( Figure 1 ) [ 28 , 29 ]. TB peaked with the onset of the Industrial Revolution, a time of increasing population density, with people living in crowded conditions, often without running water, ventilation, or sanitation [ 30 ]. During the 20th century, there was a gradual decline in the incidence of tuberculosis, particularly in developed countries [ 31 ].…”