BACKGROUND: Many international organizations are advocating for new funds for tuberculosis (TB) specific interventions. Although this approach should help reduce TB incidence, improvements in population health may also be important. We have analyzed the association between changes in population health and health service indicators, and concomitant changes in TB incidence between 1990 and 2005. METHODS: Country level data on population health and health services, economic and epidemiologic indicators were obtained for 165 countries. Regression methods were used to estimate the association of changes in potential predictors with changes in TB incidence. RESULTS: Improvements in population health and health services are associated with improvements in TB outcomes. In adjusted analyses, each 1 year increase in life expectancy was associated with a 7.8/100,000 decline in TB incidence. A 1/1000 decrease in mortality rate in children aged <5 years and a 1% increase in measles vaccination coverage (serving as a general health services indicator) was associated with approximately a 1/100,000 decrease in TB incidence. In countries with a lower prevalence of human immunodeficiency virus (HIV) infection, a 1% increase in TB treatment success rate was also associated with a 1/100,000 decrease in incidence. CONCLUSION: Investment in improving population health and health services may be as important as targeted strategies for controlling TB.
BACKGROUND: Many international organizations are advocating for new funds for tuberculosis (TB) specific interventions. Although this approach should help reduce TB incidence, improvements in population health may also be important. We have analyzed the association between changes in population health and health service indicators, and concomitant changes in TB incidence between 1990 and 2005. METHODS: Country level data on population health and health services, economic and epidemiologic indicators were obtained for 165 countries. Regression methods were used to estimate the association of changes in potential predictors with changes in TB incidence. RESULTS: Improvements in population health and health services are associated with improvements in TB outcomes. In adjusted analyses, each 1 year increase in life expectancy was associated with a 7.8/100,000 decline in TB incidence. A 1/1000 decrease in mortality rate in children aged <5 years and a 1% increase in measles vaccination coverage (serving as a general health services indicator) was associated with approximately a 1/100,000 decrease in TB incidence. In countries with a lower prevalence of human immunodeficiency virus (HIV) infection, a 1% increase in TB treatment success rate was also associated with a 1/100,000 decrease in incidence. CONCLUSION: Investment in improving population health and health services may be as important as targeted strategies for controlling TB.
Authors: Emily Bloss; Timothy H Holtz; John Jereb; John T Redd; Laura Jean Podewils; James E Cheek; Eugene McCray Journal: Public Health Rep Date: 2011 Sep-Oct Impact factor: 2.792
Authors: Eyal Oren; Carla A Winston; Robert Pratt; Valerie A Robison; Masahiro Narita Journal: Am J Public Health Date: 2011-05-12 Impact factor: 9.308
Authors: C Rocha; R Montoya; K Zevallos; A Curatola; W Ynga; J Franco; F Fernandez; N Becerra; M Sabaduche; M A Tovar; E Ramos; A Tapley; N R Allen; D A Onifade; C D Acosta; M Maritz; D F Concha; S G Schumacher; C A Evans Journal: Int J Tuberc Lung Dis Date: 2011-06 Impact factor: 2.373