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

 

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dc.contributor.author Wood, Robin en_ZA
dc.contributor.author Lawn, Stephen D en_ZA
dc.contributor.author Caldwell, Judy en_ZA
dc.contributor.author Kaplan, Richard en_ZA
dc.contributor.author Middelkoop, Keren en_ZA
dc.contributor.author Bekker, Linda-Gail en_ZA
dc.date.accessioned 2015-11-23T12:25:36Z
dc.date.available 2015-11-23T12:25:36Z
dc.date.issued 2011 en_ZA
dc.identifier.citation Wood, R., Lawn, S. D., Caldwell, J., Kaplan, R., Middelkoop, K., & Bekker, L. G. (2011). Burden of new and recurrent tuberculosis in a major South African city stratified by age and HIV-status. PLoS One, 6(10), e25098. doi:10.1371/journal.pone.0025098 en_ZA
dc.identifier.uri http://hdl.handle.net/11427/15272
dc.identifier.uri http://dx.doi.org/10.1371/journal.pone.0025098
dc.description.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. en_ZA
dc.language.iso eng en_ZA
dc.publisher Public Library of Science en_ZA
dc.rights This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. en_ZA
dc.rights.uri http://creativecommons.org/licenses/by/4.0 en_ZA
dc.source PLoS One en_ZA
dc.source.uri http://journals.plos.org/plosone en_ZA
dc.subject.other Tuberculosis en_ZA
dc.subject.other HIV en_ZA
dc.subject.other HIV epidemiology en_ZA
dc.subject.other Mycobacterium tuberculosis en_ZA
dc.subject.other History of tuberculosis en_ZA
dc.subject.other Recurrent diseases en_ZA
dc.subject.other Public and occupational health en_ZA
dc.subject.other South Africa en_ZA
dc.title Burden of new and recurrent tuberculosis in a major South African city stratified by age and HIV-status en_ZA
dc.type Journal Article en_ZA
dc.rights.holder © 2011 Wood et al en_ZA
uct.type.publication Research en_ZA
uct.type.resource Article en_ZA
dc.publisher.institution University of Cape Town
dc.publisher.faculty Faculty of Health Sciences en_ZA
dc.publisher.department Desmond Tutu HIV Centre en_ZA
uct.type.filetype Text
uct.type.filetype Image
dc.identifier.apacitation Wood, R., Lawn, S. D., Caldwell, J., Kaplan, R., Middelkoop, K., & Bekker, L. (2011). Burden of new and recurrent tuberculosis in a major South African city stratified by age and HIV-status. <i>PLoS One</i>, http://hdl.handle.net/11427/15272 en_ZA
dc.identifier.chicagocitation Wood, Robin, Stephen D Lawn, Judy Caldwell, Richard Kaplan, Keren Middelkoop, and Linda-Gail Bekker "Burden of new and recurrent tuberculosis in a major South African city stratified by age and HIV-status." <i>PLoS One</i> (2011) http://hdl.handle.net/11427/15272 en_ZA
dc.identifier.vancouvercitation Wood R, Lawn SD, Caldwell J, Kaplan R, Middelkoop K, Bekker L. Burden of new and recurrent tuberculosis in a major South African city stratified by age and HIV-status. PLoS One. 2011; http://hdl.handle.net/11427/15272. en_ZA
dc.identifier.ris TY - Journal Article AU - Wood, Robin AU - Lawn, Stephen D AU - Caldwell, Judy AU - Kaplan, Richard AU - Middelkoop, Keren AU - Bekker, Linda-Gail AB - 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. DA - 2011 DB - OpenUCT DO - 10.1371/journal.pone.0025098 DP - University of Cape Town J1 - PLoS One LK - https://open.uct.ac.za PB - University of Cape Town PY - 2011 T1 - Burden of new and recurrent tuberculosis in a major South African city stratified by age and HIV-status TI - Burden of new and recurrent tuberculosis in a major South African city stratified by age and HIV-status UR - http://hdl.handle.net/11427/15272 ER - en_ZA


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This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Except where otherwise noted, this item's license is described as This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.