Global, regional, and national burden of tuberculosis, 1990–2016: results from the Global Burden of Diseases, Injuries, and Risk Factors 2016 Study

Hmwe Hmwe Kyu(University of Washington), Emilie R Maddison(University of Washington), Nathaniel J Henry(University of Washington), Jorge R Ledesma(University of Washington), Kirsten E. Wiens(University of Washington), Robert C. Reiner(University of Washington), Molly H Biehl(University of Washington), Chloe Shields(University of Washington), Aaron Osgood‐Zimmerman(University of Washington), Jennifer M. Ross(University of Washington), Austin Carter(University of Washington), Tahvi Frank(University of Washington), Haidong Wang(University of Washington), Vinay Srinivasan(University of Washington), Sanjay Agarwal(University of Washington), Fares Alahdab(University of Washington), Kefyalew Addis Alene(University of Washington), Beriwan Abdulqadir Ali(University of Washington), Nelson Alvis‐Guzmán(University of Washington), Jason R. Andrews(University of Washington), Carl Abelardo T. Antonio(University of Washington), Suleman Atique(University of Washington), Sachin Atre(University of Washington), Ashish Awasthi(University of Washington), Henok Tadesse Ayele(University of Washington), Hamid Badali(University of Washington), Alaa Badawi(University of Washington), Aleksandra Barać(University of Washington), Neeraj Bedi(University of Washington), Masoud Behzadifar(University of Washington), Meysam Behzadifar(University of Washington), Bayu Begashaw Bekele(University of Washington), Saba Abraham Belay(University of Washington), Isabela M. Benseñor(University of Washington), Zahid A Butt(University of Washington), Félix Carvalho(University of Washington), Kelly Cercy(University of Washington), Devasahayam Jesudas Christopher(University of Washington), Alemneh Kabeta Daba(University of Washington), Lalit Dandona(University of Washington), Rakhi Dandona(University of Washington), Ahmad Daryani(University of Washington), Feleke Mekonnen Demeke(University of Washington), Kebede Deribe(University of Washington), Samath Dhamminda Dharmaratne(University of Washington), David Teye Doku(University of Washington), Manisha Dubey(University of Washington), Dumessa Edessa(University of Washington), Ziad El‐Khatib(University of Washington), Shymaa Enany(University of Washington), Eduarda Fernandes(University of Washington), Florian Fischer(University of Washington), Alberto L. García‐Basteiro(University of Washington), Abadi Kahsu Gebre(University of Washington), Gebremedhin Berhe Gebregergs, Teklu Gebrehiwo Gebremichael(University of Washington), Tilayie Feto Gelano(University of Washington), Demeke Geremew(University of Washington), Philimon Gona(University of Washington), Amador Goodridge(University of Washington), Rahul Gupta(University of Washington), Hassan Haghparast‐Bidgoli(University of Washington), Gessessew Bugssa Hailu(University of Washington), Hamid Yimam Hassen(University of Washington), Mohammad Taghi Hedayati(University of Washington), Andualem Henok(University of Washington), Sorin Hostiuc(University of Washington), Mamusha Aman Hussen(University of Washington), Olayinka Stephen Ilesanmi(University of Washington), Seyed Sina Naghibi Irvani(University of Washington), Kathryn H. Jacobsen(University of Washington), Sarah Charlotte Johnson(University of Washington), Jost B Jonas(University of Washington), Amaha Kahsay(University of Washington), Surya Kant(University of Washington), Amir Kasaeian(University of Washington), Tesfaye Kassa(University of Washington), Yousef Khader(University of Washington), Morteza Abdullatif Khafaie(University of Washington), Ibrahim Khalil(University of Washington), Ejaz Ahmad Khan(University of Washington), Young‐Ho Khang(University of Washington), Yun Jin Kim(University of Washington), Sonali Kochhar(University of Washington), Ai Koyanagi(University of Washington), Kristopher J Krohn(University of Washington), G Anil Kumar(University of Washington), Ayenew Molla Lakew(University of Washington), Cheru Tesema Leshargie(University of Washington), Rakesh Lodha(University of Washington), Erlyn Rachelle King Macarayan(University of Washington), Reza Majdzadeh(University of Washington), Francisco Rogerlândio Martins‐Melo(University of Washington), Addisu Melese(University of Washington), Ziad A. Memish(University of Washington), Walter Mendoza(University of Washington), Desalegn Tadese Mengistu(University of Washington), Getnet Mengistu(University of Washington), Tomislav Meštrović(University of Washington), Babak Moazen(University of Washington), Karzan Abdulmuhsin Mohammad(University of Washington), Shafiu Mohammed(University of Washington), Ali H. Mokdad(University of Washington), Mahmood Moosazadeh(University of Washington), Seyyed Meysam Mousavi(University of Washington), Ghulam Mustafa(University of Washington), Jean B. Nachega(University of Washington), Long Hoang Nguyen(University of Washington), Son Hoang Nguyen(University of Washington), Trang Huyen Nguyen(University of Washington), Dina Nur Anggraini Ningrum(University of Washington), Yirga Legesse Nirayo, Vuong Minh Nong(University of Washington), Richard Ofori‐Asenso(University of Washington), Felix Akpojene Ogbo(University of Washington), In‐Hwan Oh(University of Washington), Olanrewaju Oladimeji(University of Washington), Andrew T Olagunju(University of Washington), Eyal Oren(University of Washington), David M. Pereira(University of Washington), Swayam Prakash(University of Washington), Mostafa Qorbani(University of Washington), Anwar Rafay(University of Washington), Rajesh Kumar(University of Washington), Usha Ram(University of Washington), Salvatore Rubino(University of Washington), Saeid Safiri(University of Washington), Joshua A. Salomon(University of Washington), Abdallah M Samy(University of Washington), Benn Sartorius(University of Washington), Maheswar Satpathy(University of Washington), Seyedmojtaba Seyedmousavi(University of Washington), Mehdi Sharif(University of Washington), João Pedro Silva(University of Washington), Dayane Gabriele Alves Silveira(University of Washington), Jasvinder A. Singh(University of Washington), Chandrashekhar T Sreeramareddy, Bach Xuan Tran(University of Washington), Afewerki Gebremeskel Tsadik(University of Washington), Kingsley Nnanna Ukwaja(University of Washington), Irfan Ullah(University of Washington), Olalekan A. Uthman(University of Washington), Vasily Vlassov(University of Washington), Stein Emil Vollset(University of Washington), Giang Thu Vu(University of Washington), Fitsum Weldegebreal(University of Washington), Andrea Werdecker(University of Washington), Ebrahim M Yimer(University of Washington), Naohiro Yonemoto(University of Washington), Marcel Yotebieng(University of Washington), Mohsen Naghavi(University of Washington), Theo Vos(University of Washington), Simon I Hay(University of Washington), Christopher J L Murray(University of Washington)
The Lancet Infectious Diseases
November 21, 2018
10.1016/s1473-3099(18)30625-x
Cited by 449Open Access
Full Text

Abstract

BACKGROUND: Although a preventable and treatable disease, tuberculosis causes more than a million deaths each year. As countries work towards achieving the Sustainable Development Goal (SDG) target to end the tuberculosis epidemic by 2030, robust assessments of the levels and trends of the burden of tuberculosis are crucial to inform policy and programme decision making. We assessed the levels and trends in the fatal and non-fatal burden of tuberculosis by drug resistance and HIV status for 195 countries and territories from 1990 to 2016. METHODS: We analysed 15 943 site-years of vital registration data, 1710 site-years of verbal autopsy data, 764 site-years of sample-based vital registration data, and 361 site-years of mortality surveillance data to estimate mortality due to tuberculosis using the Cause of Death Ensemble model. We analysed all available data sources, including annual case notifications, prevalence surveys, population-based tuberculin surveys, and estimated tuberculosis cause-specific mortality to generate internally consistent estimates of incidence, prevalence, and mortality using DisMod-MR 2.1, a Bayesian meta-regression tool. We assessed how the burden of tuberculosis differed from the burden predicted by the Socio-demographic Index (SDI), a composite indicator of income per capita, average years of schooling, and total fertility rate. FINDINGS: Globally in 2016, among HIV-negative individuals, the number of incident cases of tuberculosis was 9·02 million (95% uncertainty interval [UI] 8·05-10·16) and the number of tuberculosis deaths was 1·21 million (1·16-1·27). Among HIV-positive individuals, the number of incident cases was 1·40 million (1·01-1·89) and the number of tuberculosis deaths was 0·24 million (0·16-0·31). Globally, among HIV-negative individuals the age-standardised incidence of tuberculosis decreased annually at a slower rate (-1·3% [-1·5 to -1·2]) than mortality did (-4·5% [-5·0 to -4·1]) from 2006 to 2016. Among HIV-positive individuals during the same period, the rate of change in annualised age-standardised incidence was -4·0% (-4·5 to -3·7) and mortality was -8·9% (-9·5 to -8·4). Several regions had higher rates of age-standardised incidence and mortality than expected on the basis of their SDI levels in 2016. For drug-susceptible tuberculosis, the highest observed-to-expected ratios were in southern sub-Saharan Africa (13·7 for incidence and 14·9 for mortality), and the lowest ratios were in high-income North America (0·4 for incidence) and Oceania (0·3 for mortality). For multidrug-resistant tuberculosis, eastern Europe had the highest observed-to-expected ratios (67·3 for incidence and 73·0 for mortality), and high-income North America had the lowest ratios (0·4 for incidence and 0·5 for mortality). INTERPRETATION: If current trends in tuberculosis incidence continue, few countries are likely to meet the SDG target to end the tuberculosis epidemic by 2030. Progress needs to be accelerated by improving the quality of and access to tuberculosis diagnosis and care, by developing new tools, scaling up interventions to prevent risk factors for tuberculosis, and integrating control programmes for tuberculosis and HIV. FUNDING: Bill & Melinda Gates Foundation.

Related Papers

No related papers found

Powered by citation graph analysis