SETTING: Although a preventable and treatable disease, tuberculosis (TB) is among the top 10 causes of death worldwide. A consequence of inadequately treated drug-susceptible TB (DS-TB) is multidrug-resistant TB (MDR-TB). OBJECTIVES: To improve our understanding of the primary drivers of incidence and prevalence of DS- and MDR-TB in China. METHODS: The Tuberculosis Disease Transmission Model (TBDTM) uses historical and current disease epidemiology and transmission trends and treatment effectiveness, and accounts for annual changes to these to estimate future DS-TB and MDR-TB burden. RESULTS: The model shows that in China, by 2050, incidence, prevalence and mortality of DS-TB will decrease by 32%, 50% and 41%, respectively, whereas MDR-TB will increase by respectively 60%, 48% and 35%. Reduction in DS-TB is a result of high treatment and cure rates leading to a decrease in the prevalence of latent tuberculous infection (LTBI), while the increase in MDR-TB is attributed to inappropriate treatment, leading to high transmission of infection and increased LTBI prevalence. CONCLUSIONS: These results demonstrate a reduction in DS-TB in China over the next 40 years, while MDR-TB will increase. Improvements in the diagnosis and treatment of MDR-TB are needed to counter this threat. The TBDTM tool has potential value in public health practice by demonstrating the impact of interventions and estimating their cost-effectiveness.
SETTING: Although a preventable and treatable disease, tuberculosis (TB) is among the top 10 causes of death worldwide. A consequence of inadequately treated drug-susceptible TB (DS-TB) is multidrug-resistant TB (MDR-TB). OBJECTIVES: To improve our understanding of the primary drivers of incidence and prevalence of DS- and MDR-TB in China. METHODS: The Tuberculosis Disease Transmission Model (TBDTM) uses historical and current disease epidemiology and transmission trends and treatment effectiveness, and accounts for annual changes to these to estimate future DS-TB and MDR-TB burden. RESULTS: The model shows that in China, by 2050, incidence, prevalence and mortality of DS-TB will decrease by 32%, 50% and 41%, respectively, whereas MDR-TB will increase by respectively 60%, 48% and 35%. Reduction in DS-TB is a result of high treatment and cure rates leading to a decrease in the prevalence of latent tuberculous infection (LTBI), while the increase in MDR-TB is attributed to inappropriate treatment, leading to high transmission of infection and increased LTBI prevalence. CONCLUSIONS: These results demonstrate a reduction in DS-TB in China over the next 40 years, while MDR-TB will increase. Improvements in the diagnosis and treatment of MDR-TB are needed to counter this threat. The TBDTM tool has potential value in public health practice by demonstrating the impact of interventions and estimating their cost-effectiveness.
Authors: Grace H Huynh; Daniel J Klein; Daniel P Chin; Bradley G Wagner; Philip A Eckhoff; Renzhong Liu; Lixia Wang Journal: BMC Med Date: 2015-04-21 Impact factor: 8.775
Authors: Christopher J L Murray; Katrina F Ortblad; Caterina Guinovart; Stephen S Lim; Timothy M Wolock; D Allen Roberts; Emily A Dansereau; Nicholas Graetz; Ryan M Barber; Jonathan C Brown; Haidong Wang; Herbert C Duber; Mohsen Naghavi; Daniel Dicker; Lalit Dandona; Joshua A Salomon; Kyle R Heuton; Kyle Foreman; David E Phillips; Thomas D Fleming; Abraham D Flaxman; Bryan K Phillips; Elizabeth K Johnson; Megan S Coggeshall; Foad Abd-Allah; Semaw Ferede Abera; Jerry P Abraham; Ibrahim Abubakar; Laith J Abu-Raddad; Niveen Me Abu-Rmeileh; Tom Achoki; Austine Olufemi Adeyemo; Arsène Kouablan Adou; José C Adsuar; Emilie Elisabet Agardh; Dickens Akena; Mazin J Al Kahbouri; Deena Alasfoor; Mohammed I Albittar; Gabriel Alcalá-Cerra; Miguel Angel Alegretti; Zewdie Aderaw Alemu; Rafael Alfonso-Cristancho; Samia Alhabib; Raghib Ali; Francois Alla; Peter J Allen; Ubai Alsharif; Elena Alvarez; Nelson Alvis-Guzman; Adansi A Amankwaa; Azmeraw T Amare; Hassan Amini; Walid Ammar; Benjamin O Anderson; Carl Abelardo T Antonio; Palwasha Anwari; Johan Arnlöv; Valentina S Arsic Arsenijevic; Ali Artaman; Rana J Asghar; Reza Assadi; Lydia S Atkins; Alaa Badawi; Kalpana Balakrishnan; Amitava Banerjee; Sanjay Basu; Justin Beardsley; Tolesa Bekele; Michelle L Bell; Eduardo Bernabe; Tariku Jibat Beyene; Neeraj Bhala; Ashish Bhalla; Zulfiqar A Bhutta; Aref Bin Abdulhak; Agnes Binagwaho; Jed D Blore; Berrak Bora Basara; Dipan Bose; Michael Brainin; Nicholas Breitborde; Carlos A Castañeda-Orjuela; Ferrán Catalá-López; Vineet K Chadha; Jung-Chen Chang; Peggy Pei-Chia Chiang; Ting-Wu Chuang; Mercedes Colomar; Leslie Trumbull Cooper; Cyrus Cooper; Karen J Courville; Benjamin C Cowie; Michael H Criqui; Rakhi Dandona; Anand Dayama; Diego De Leo; Louisa Degenhardt; Borja Del Pozo-Cruz; Kebede Deribe; Don C Des Jarlais; Muluken Dessalegn; Samath D Dharmaratne; Uğur Dilmen; Eric L Ding; Tim R Driscoll; Adnan M Durrani; Richard G Ellenbogen; Sergey Petrovich Ermakov; Alireza Esteghamati; Emerito Jose A Faraon; Farshad Farzadfar; Seyed-Mohammad Fereshtehnejad; Daniel Obadare Fijabi; Mohammad H Forouzanfar; Urbano Fra Paleo; Lynne Gaffikin; Amiran Gamkrelidze; Fortuné Gbètoho Gankpé; Johanna M Geleijnse; Bradford D Gessner; Katherine B Gibney; Ibrahim Abdelmageem Mohamed Ginawi; Elizabeth L Glaser; Philimon Gona; Atsushi Goto; Hebe N Gouda; Harish Chander Gugnani; Rajeev Gupta; Rahul Gupta; Nima Hafezi-Nejad; Randah Ribhi Hamadeh; Mouhanad Hammami; Graeme J Hankey; Hilda L Harb; Josep Maria Haro; Rasmus Havmoeller; Simon I Hay; Mohammad T Hedayati; Ileana B Heredia Pi; Hans W Hoek; John C Hornberger; H Dean Hosgood; Peter J Hotez; Damian G Hoy; John J Huang; Kim M Iburg; Bulat T Idrisov; Kaire Innos; Kathryn H Jacobsen; Panniyammakal Jeemon; Paul N Jensen; Vivekanand Jha; Guohong Jiang; Jost B Jonas; Knud Juel; Haidong Kan; Ida Kankindi; Nadim E Karam; André Karch; Corine Kakizi Karema; Anil Kaul; Norito Kawakami; Dhruv S Kazi; Andrew H Kemp; Andre Pascal Kengne; Andre Keren; Maia Kereselidze; Yousef Saleh Khader; Shams Eldin Ali Hassan Khalifa; Ejaz Ahmed Khan; Young-Ho Khang; Irma Khonelidze; Yohannes Kinfu; Jonas M Kinge; Luke Knibbs; Yoshihiro Kokubo; S Kosen; Barthelemy Kuate Defo; Veena S Kulkarni; Chanda Kulkarni; Kaushalendra Kumar; Ravi B Kumar; G Anil Kumar; Gene F Kwan; Taavi Lai; Arjun Lakshmana Balaji; Hilton Lam; Qing Lan; Van C Lansingh; Heidi J Larson; Anders Larsson; Jong-Tae Lee; James Leigh; Mall Leinsalu; Ricky Leung; Yichong Li; Yongmei Li; Graça Maria Ferreira De Lima; Hsien-Ho Lin; Steven E Lipshultz; Shiwei Liu; Yang Liu; Belinda K Lloyd; Paulo A Lotufo; Vasco Manuel Pedro Machado; Jennifer H Maclachlan; Carlos Magis-Rodriguez; Marek Majdan; Christopher Chabila Mapoma; Wagner Marcenes; Melvin Barrientos Marzan; Joseph R Masci; Mohammad Taufiq Mashal; Amanda J Mason-Jones; Bongani M Mayosi; Tasara T Mazorodze; Abigail Cecilia Mckay; Peter A Meaney; Man Mohan Mehndiratta; Fabiola Mejia-Rodriguez; Yohannes Adama Melaku; Ziad A Memish; Walter Mendoza; Ted R Miller; Edward J Mills; Karzan Abdulmuhsin Mohammad; Ali H Mokdad; Glen Liddell Mola; Lorenzo Monasta; Marcella Montico; Ami R Moore; Rintaro Mori; Wilkister Nyaora Moturi; Mitsuru Mukaigawara; Kinnari S Murthy; Aliya Naheed; Kovin S Naidoo; Luigi Naldi; Vinay Nangia; K M Venkat Narayan; Denis Nash; Chakib Nejjari; Robert G Nelson; Sudan Prasad Neupane; Charles R Newton; Marie Ng; Muhammad Imran Nisar; Sandra Nolte; Ole F Norheim; Vincent Nowaseb; Luke Nyakarahuka; In-Hwan Oh; Takayoshi Ohkubo; Bolajoko O Olusanya; Saad B Omer; John Nelson Opio; Orish Ebere Orisakwe; Jeyaraj D Pandian; Christina Papachristou; Angel J Paternina Caicedo; Scott B Patten; Vinod K Paul; Boris Igor Pavlin; Neil Pearce; David M Pereira; Aslam Pervaiz; Konrad Pesudovs; Max Petzold; Farshad Pourmalek; Dima Qato; Amado D Quezada; D Alex Quistberg; Anwar Rafay; Kazem Rahimi; Vafa Rahimi-Movaghar; Sajjad Ur Rahman; Murugesan Raju; Saleem M Rana; Homie Razavi; Robert Quentin Reilly; Giuseppe Remuzzi; Jan Hendrik Richardus; Luca Ronfani; Nobhojit Roy; Nsanzimana Sabin; Mohammad Yahya Saeedi; Mohammad Ali Sahraian; Genesis May J Samonte; Monika Sawhney; Ione J C Schneider; David C Schwebel; Soraya Seedat; Sadaf G Sepanlou; Edson E Servan-Mori; Sara Sheikhbahaei; Kenji Shibuya; Hwashin Hyun Shin; Ivy Shiue; Rupak Shivakoti; Inga Dora Sigfusdottir; Donald H Silberberg; Andrea P Silva; Edgar P Simard; Jasvinder A Singh; Vegard Skirbekk; Karen Sliwa; Samir Soneji; Sergey S Soshnikov; Chandrashekhar T Sreeramareddy; Vasiliki Kalliopi Stathopoulou; Konstantinos Stroumpoulis; Soumya Swaminathan; Bryan L Sykes; Karen M Tabb; Roberto Tchio Talongwa; Eric Yeboah Tenkorang; Abdullah Sulieman Terkawi; Alan J Thomson; Andrew L Thorne-Lyman; Jeffrey A Towbin; Jefferson Traebert; Bach X Tran; Zacharie Tsala Dimbuene; Miltiadis Tsilimbaris; Uche S Uchendu; Kingsley N Ukwaja; Selen Begüm Uzun; Andrew J Vallely; Tommi J Vasankari; N Venketasubramanian; Francesco S Violante; Vasiliy Victorovich Vlassov; Stein Emil Vollset; Stephen Waller; Mitchell T Wallin; Linhong Wang; XiaoRong Wang; Yanping Wang; Scott Weichenthal; Elisabete Weiderpass; Robert G Weintraub; Ronny Westerman; Richard A White; James D Wilkinson; Thomas Neil Williams; Solomon Meseret Woldeyohannes; John Q Wong; Gelin Xu; Yang C Yang; Yuichiro Yano; Gokalp Kadri Yentur; Paul Yip; Naohiro Yonemoto; Seok-Jun Yoon; Mustafa Younis; Chuanhua Yu; Kim Yun Jin; Maysaa El Sayed Zaki; Yong Zhao; Yingfeng Zheng; Maigeng Zhou; Jun Zhu; Xiao Nong Zou; Alan D Lopez; Theo Vos Journal: Lancet Date: 2014-07-22 Impact factor: 79.321