LOGIN

International Epidemiology Databases to Evaluate AIDS

Home >> Publications >> Burden of new and recurrent tuberculosis in a major South African city stratified by age and HIV-status.

Publication

Author(s):

Wood R, Lawn SD, Caldwell J, Kaplan R, Middelkoop K, Bekker LG.

Pub Title:

Burden of new and recurrent tuberculosis in a major South African city stratified by age and HIV-status.

Pub Date:

Oct 31 2011

Pub Region(s):

Southern Africa

Journal Issue:

10

Page Number:
e25098

Journal:

Title: 
PLoS One
Link: 
http://www.plosone.org/article/info%3Adoi%2F10.1371%2Fjournal.pone.0025098

PubMed: 22016763
Pub PDF: PDF icon 22016763.pdf

Abstract
AIM
: To describe the burden of tuberculosis (TB) in Cape Town by calculating TB incidence rates stratified by age and HIV-status, assessing the contribution of retreatment disease and estimating the cumulative lifetime TB risk in HIV-negative individuals.

METHODS: Details of TB cases were abstracted from the 2009 electronic TB register. Population denominators were estimated from census data and actuarial estimates of HIV prevalence, allowing calculation of age-specific and HIV-stratified TB notification rates.

RESULTS: The 2009 mid-year population was 3,443,010 (3,241,508 HIV-negative and 201,502 HIV-positive individuals). There were 29,478 newly notified TB cases of which 56% were laboratory confirmed. HIV status was recorded for 87% of cases and of those with known HIV-status 49% were HIV-negative and 51% were positive. Discrete peaks in the incidence of non-HIV-associated TB occurred at three ages: 511/100,000 at 0-4 years of age, 553/100,000 at 20-24 years and 628/100,000 at 45-49 years with 1.5%, 19% and 45% being due to retreatment TB, respectively. Only 15.5% of recurrent cases had a history of TB treatment failure or default. The cumulative lifetime risks in the HIV-negative population of all new TB episodes and new smear-positive TB episodes were 24% and 12%, respectively; the lifetime risk of retreatment disease was 9%. The HIV-positive notification rate was 6,567/100,000 (HIV-associated TB rate ratio = 17). Although retreatment cases comprised 30% of the HIV-associated TB burden, 88% of these patients had no history of prior treatment failure or default.

CONCLUSIONS: The annual burden of TB in this city is huge. TB in the HIV-negative population contributed almost half of the overall disease burden and cumulative lifetime risks were similar to those reported in the pre-chemotherapy era. Retreatment TB contributed significantly to both HIV-associated and non-HIV-associated TB but infrequently followed prior inadequate treatment. This likely reflects ongoing TB transmission to both HIV-negative and positive individuals.

PMID: 22016763 [PubMed - indexed for MEDLINE]

PMCID: PMC3189963

 

The following websites provide guidelines and policies when citing from PubMed®: http://www.ncbi.nlm.nih.gov/books/NBK7243/
http://www.nlm.nih.gov/bsd/policy/cit_format.html

Citation:

Wood R, Lawn SD, Caldwell J, Kaplan R, Middelkoop K, Bekker LG. Burden of new and recurrent tuberculosis in a major South African city stratified by age and HIV-status. PLoS One. 2011;6(10):e25098. doi: 10.1371/journal.pone.0025098. Epub 2011 Oct 10. PubMed PMID: 22016763; PubMed Central PMCID: PMC3189963.