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Global tuberculosis incidence and mortality during 1990-2000
P J Dolin1, M C Raviglione, A Kochi
1Imperial Cancer Research Fund, Radcliffe Infirmary, University of Oxford, England.
Bulletin of the World Health Organization
|January 1, 1994
Summary
Global tuberculosis (TB) cases and deaths are projected to rise significantly between 1990 and 1999, with the human immunodeficiency virus (HIV) epidemic exacerbating the TB burden. Demographic shifts and HIV are key drivers of this increasing global TB epidemic.
Area of Science:
- Epidemiology
- Public Health
- Infectious Diseases
Background:
- Tuberculosis (TB) remains a major global health challenge.
- The co-epidemic of TB and human immunodeficiency virus (HIV) infection presents a complex public health crisis.
- Accurate forecasting of TB morbidity and mortality is crucial for resource allocation and intervention planning.
Purpose of the Study:
- To forecast tuberculosis morbidity and mortality for the decade 1990-1999.
- To estimate the impact of HIV infection on TB incidence and mortality.
- To identify demographic factors contributing to the projected increase in TB cases.
Main Methods:
- Utilized epidemiological modeling to project TB cases and deaths.
- Incorporated demographic data, including population growth and age structure changes.
- Accounted for the influence of HIV seroprevalence on TB incidence rates, particularly in specific regions.
Main Results:
- An estimated 88 million new TB cases and 30 million TB deaths are predicted for 1990-1999.
- HIV infection is expected to contribute to 8 million new TB cases and 2.9 million TB deaths during this period.
- Annual TB cases are projected to increase from 7.5 million in 1990 to 10.2 million by 2000.
- Annual TB deaths are predicted to rise from 2.5 million in 1990 to 3.5 million by 2000.
- Demographic factors will drive 79.5% of the increase in new cases, while HIV will account for the remaining 20.5%.
Conclusions:
- The TB epidemic is projected to worsen globally through 1999, significantly driven by demographic changes and the HIV epidemic.
- Sub-Saharan Africa faces increasing age-specific TB incidence rates due to HIV.
- While TB incidence rates may fall in some regions, the pace is expected to slow due to rising HIV prevalence.