Social factors associated with increases in tuberculosis notifications

Abstract

This study assessed the contribution of immigration and deprivation to the changes in tuberculosis notifications in Liverpool over the last 20 yrs. Ethnic origin was retrospectively assigned to all named cases from 1974 to 1995. Average tuberculosis rates were calculated for the 33 council wards in Liverpool for 1981-1985 and 1991-1995. Multiple regression was used to determine the independent effects of socioeconomic and population measures from the 1981 and 1991 censuses in explaining these ward-based rates. Since 1974, there has been a steady increase in the percentage of non-Caucasian cases of tuberculosis, from 8.7% in 1975-1977, 15.1% in 1981-1983, 17.5% in 1987-1989 to 28.0% in 1993-1995. Multiple regression analysis showed that in 1981 only unemployment had a significant independent relationship with tuberculosis rates, but in 1991 two indices of deprivation and ethnicity had a significant influence. The increasing proportion of non-Caucasian tuberculosis cases, both while the number of notifications was declining before 1987 and increasing afterwards, is not necessarily consistent with the concept that immigration has influenced the recent increase. However, the fact that ethnicity now independently explains some of the council ward variations but did not in the early 1980s suggests that immigration does influence the distribution of disease within the city.

Sugar cane manufacturing is associated with tuberculosis in an indigenous population in Brazil

“…Prior studies have shown that the distribution of TB is heterogeneous in developed and developing countries and that this distribution is usually influenced by demographic, socio-cultural and geographic characteristics. 4,16 Tuberculosis constitutes a major health problem among indigenous populations in Brazil. The incidence of disease in these populations is high, and the rates of infection are up to ten times greater than those found in the general Brazilian population.…”

Influencia de las desigualdades sociales, la conflictividad social y la pobreza extrema sobre la morbilidad por tuberculosis en la ciudad de Barcelona

“…La relación entre la TB y la privación social, la pobreza extrema, el hacinamiento y la indigencia ha sido descrita en otros estudios. En el Reino Unido se ha enfatizado la importancia de tener en cuenta tanto la privación como la inmigración de países en que la TB es una enfermedad común; aunque la privación y la inmigración están relacionadas, ambos tienen efectos sobre la distribución geográfica de la TB, sobre todo en los años más recientes 14,16,35,36 . En Estados Unidos el resurgimiento de la TB se ha relacionado con la infección por VIH, las toxicomanías, el hacinamiento, la inmigración y la indigencia 2 .…”

Predictors of Re-Emerging Tuberculosis: A Review

“…This is the reason BCG vaccinations were instituted at birth in many countries including Malaysia. However, statistics show that the majority of TB infections do not occur in children less than 16 years of age as the median age of infection in TB patients in the 1990s were at 49 -60 years in Caucasian patients and 31 -43 years in non-Caucasian patients [42]. Women, on the other hand, suffer severely with TB as TB is the third most common cause for mortality and morbidity in women aged 15 -44 from developing countries (higher than Malaria and AIDS) despite tuberculosis occurring less frequently amongst females [7] [43].…”