Michael Boah1,2, Timothy Adampah1,3, Baiming Jin1,4,5, Wenji Wang1,5, Kewei Wang1,5. 1. Center for Endemic Disease Control, Chinese Center for Disease Control and Prevention, Harbin Medical University, Harbin, China. 2. Ghana Health Service, Upper East Region, Bolgatanga, Ghana. 3. Education, Culture and Health Opportunities (ECHO) Research Group International, Aflao, Ghana. 4. Department of Preventive Medicine, Qiqihar Medical University, Qiqihar, China. 5. Institute of Cell Biotechnology, China and Russia Medical Research Center, Harbin Medical University, Harbin, China.
Abstract
Background: The World Health Organization (WHO) regions of Africa and South-East Asia are the epicentres of the global tuberculosis (TB) epidemic. This study aimed at examining the trend and determinants of TB case notifications in the two regions during 2000-2018. Methods: This was a retrospective analysis of yearly, new TB cases notified to the WHO. We obtained data on potential determinants for the 58 countries in the two regions during 2000-2018. Multivariable longitudinal fixed-effects regression analysis was used to quantify the association between the determinants and TB notifications. Results: During 2000-2018, TB notifications and incidence declined in Africa. In South-East Asia, case notifications increased while the incidence declined, on average, by 2% per year during the same period. After controlling for health, socioeconomic indicators, country and year fixed-effects, each 1% increase in the antiretroviral therapy (ART) coverage and the TB treatment success was associated with a decrease per 100,000 population in the TB case notification rate of -1.62 (95% CI: -4.93, -1.90; p = .037) and -0.91(95% CI: -1.54, -0.28; p = .005) respectively. Similarly, each 1-year increase in the life expectancy at birth resulted in a decrease in TB case notification rates of -6.64 (95% CI: -12.32, -0.95; p = .037). By contrast, a 1% increase in the unemployment rate resulted in an increase in TB notification rate of 3.49 cases (95% CI: 0.19, 6.79; p = .039). Conclusion: Improving population health and the broad scale-up of ART coverage could complement existing TB treatment coverage and cure programmes to drive down new cases in Africa and South-East Asia.
Background: The World Health Organization (WHO) regions of Africa and South-East Asia are the epicentres of the global tuberculosis (TB) epidemic. This study aimed at examining the trend and determinants of TB case notifications in the two regions during 2000-2018. Methods: This was a retrospective analysis of yearly, new TB cases notified to the WHO. We obtained data on potential determinants for the 58 countries in the two regions during 2000-2018. Multivariable longitudinal fixed-effects regression analysis was used to quantify the association between the determinants and TB notifications. Results: During 2000-2018, TB notifications and incidence declined in Africa. In South-East Asia, case notifications increased while the incidence declined, on average, by 2% per year during the same period. After controlling for health, socioeconomic indicators, country and year fixed-effects, each 1% increase in the antiretroviral therapy (ART) coverage and the TB treatment success was associated with a decrease per 100,000 population in the TB case notification rate of -1.62 (95% CI: -4.93, -1.90; p = .037) and -0.91(95% CI: -1.54, -0.28; p = .005) respectively. Similarly, each 1-year increase in the life expectancy at birth resulted in a decrease in TB case notification rates of -6.64 (95% CI: -12.32, -0.95; p = .037). By contrast, a 1% increase in the unemployment rate resulted in an increase in TB notification rate of 3.49 cases (95% CI: 0.19, 6.79; p = .039). Conclusion: Improving population health and the broad scale-up of ART coverage could complement existing TB treatment coverage and cure programmes to drive down new cases in Africa and South-East Asia.
Entities:
Keywords:
Morbidity; case notifications; determinants; infectious diseases; tuberculosis
Authors: Joseph Baruch Baluku; Resty Nanyonjo; Jolly Ayo; Jehu Eleazer Obwalatum; Jane Nakaweesi; Catherine Senyimba; Deus Lukoye; Joseph Lubwama; Jennifer Ward; Barbara Mukasa Journal: BMC Public Health Date: 2022-04-05 Impact factor: 3.295