Quantifying the global number of tuberculosis survivors: a modelling study

Abstract

BackgroundPeople who survive tuberculosis continue to experience clinical and societal consequences after recovery, including increased risks of recurrent tuberculosis, premature death, reduced lung function, and ongoing stigma. We aimed to describe the magnitude of this issue by estimating the number of tuberculosis survivors, who could be amenable to intervention. MethodsWe estimated the number of people who developed tuberculosis during 1980-2019 and survived until 2020. Numbers surviving treatment were based on country-level data on tuberculosis case notifications reported to the World Health Organization (WHO), excluding people who died during treatment. Numbers surviving untreated tuberculosis were based on the difference between WHO country-level incidence estimates and notifications, with published age-and HIV-stratified case fatality ratios applied. Post-tuberculosis life tables were developed for each country-year, using United Nations World Population Prospects 2019 mortality rates and published post-tuberculosis mortality hazard ratios. FindingsBetween 1980 and 2019 we estimate that 363 (95% uncertainty interval [UI] 287 -438) million people developed tuberculosis, of whom 172 (95%UI 169 -174) million were treated. Individuals who developed tuberculosis since 1980 experienced a total of 3.5 (95%UI 3.0 -3.9) billion life-years post-tuberculosis, with survivors of paediatric tuberculosis contributing 12% (95%UI 7 -17%) of these life-years. We estimate that 155 (95%UI 138 -171) million tuberculosis survivors were alive in 2020. The South-East Asia region had the largest proportion of tuberculosis survivors (47%). We estimate that 27 (95%UI 26 -29) million tuberculosis survivors alive in 2020 were treated within the past 5 years. InterpretationThe number of tuberculosis survivors alive today is over ten times the estimated annual tuberculosis incidence. Interventions to alleviate respiratory morbidity, screen for and prevent recurrent tuberculosis, and reduce stigma should be immediately prioritised for recently treated tuberculosis survivors.

Psychometric Properties of a Vaccine Hesitancy Scale Adapted for COVID-19 Vaccination Among People with HIV

“…Vaccination is an effective method to achieve herd immunity and thereby curb the catastrophic effects of the COVID-19 pandemic worldwide. In line with previous literature, in this sample, vaccine hesitancy was influenced by referent health authority of physicians and by contemporary health issues, COVID-19 beliefs, and the perception that the COVID health risk had been exaggerated [ 7 , 21 ]. The complexity of attitudes underlying vaccine hesitancy and the potential for a vaccine to mitigate the COVID-19 pandemic underscore the urgent need to accurately measure and address the issues influencing vaccination uptake in populations at highest risk of severe COVID-19, such as PWH with comorbid conditions.…”

Association of protein consumption and energy intake on sarcopenia in tuberculosis survivors

“…One study reported that 363 million people in 190 countries developed TB between 1980 and 2019, of whom 155 million were alive in 2020. 4 This indicates that the number of TB survivors alive in 2020 is more than 10 times the estimated annual TB incidence. Three definitions of sarcopenia: Sarcopenia_BMI = ASM (kg) / BMI (kg/m 2 ) was defined as < 0.789 in men or < 0.512 in women, according to the FNIH recommendation using ASM/BMI ratio; Sarcopenia_weight = ASM (kg) / weight (%) was defined as < 29.0 in men or < 22.9 in women, according to the 2008-2011 KNHANES data; Sarcopenia_height = ASM (kg) / height 2 was defined as 7.0 kg/m 2 in men or < 5.4 mg/m 2 in women, according to the AWGS recommendation using height-adjusted skeletal muscle mass.…”

Patients with presumed tuberculosis in sub-Saharan Africa that are not diagnosed with tuberculosis: a systematic review and meta-analysis

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