The following was originally posted by PW blogger Kelly Cawcutt, MD, to the University of Nebraska Medical Center Division of Infectious Diseases blog.
Global Burden of Tuberculosis: Are We Making Any Improvements?
UNMC is proud to play a critical role in biopreparedness and global health, which also means we have to stay up-to-date on global health, including tuberculosis.
In a recent Infectious Diseases journal club, Dr. Lawler presented the following 2018 Lancet article on the global burden of TB.
Global, regional, and national burden of tuberculosis, 1990 -2016: results from the Global burden of disease, injury and risk
We still see over 10.4 incident cases of TB globally (HIV and non-HIV patients) with over 1.4 million deaths in 2016. TB remains a critical need and epidemic globally that demands attention.
The vast majority of non-HIV related TB deaths are in those < 65. This relates to significant socioeconomic burdens of disease.
The incidence is decreasing by 1.3% among HIV negative individuals and 4% among HIV positive patients, far below the the goal of 10% decrease by 2030 in the Sustainable Development Goal.
Much of this data is done via modeling, but truth be told, many of model are based on assumptions in areas of the world with high burden of disease and very poor diagnostics for confirming TB. Per Dr. Lawler’s assessment, only approximately 400,000 data points are hard data vs theoretical data with the subsequent modeling. Yet, this is the data driving our guideline development. Thus raising critical, ethical questions of: What if we used the millions of dollars funding this study to provide those diagnostics? Where is the greatest impact for generating support for improving care and reduction of TB?
The study is perhaps a cautionary tale of the dangers of taking modeling data as a hard, cold truth. The highlight – the reminder that TB is still a major player in global disease and death.