ArticleBulletin of the World Health Organization2015
Tuberculosis control and economic recession: longitudinal study of data from 21 European countries, 1991-2012.
Article in Bulletin of the World Health Organization, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 2 of them syntheses that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
9 citing papers in PubMed, 2 syntheses or guidelines pooled it, 32 citations in OpenAlex.
- Drug-Resistant Tuberculosis Among Children: A Systematic Review and Meta-Analysis.Frontiers in public health · 2021Pooled it
- Effectiveness of interventions for reducing TB incidence in countries with low TB incidence: a systematic review of reviews.European respiratory review : an official journal of the European Respiratory Society · 2019Pooled it
- The burden of tuberculosis among adolescents and young adults in five Asian countries from 1990 to 2019.Archives of public health = Archives belges de sante publique · 2023Article
- Pediatric Tuberculosis Management: A Global Challenge or Breakthrough?Children (Basel, Switzerland) · 2022Review
- Social determinants of the changing tuberculosis prevalence in Việt Nam: Analysis of population-level cross-sectional studies.PLoS medicine · 2022Article
- How investment in public health has impacted the prevalence of tuberculosis in China: A study of provincial variations between 2005 and 2015.The International journal of health planning and management · 2020Article
- Slowdown in the Decline of Tuberculosis Rates in California, 2000-2016.American journal of public health · 2019Article
- Modelling the social and structural determinants of tuberculosis: opportunities and challenges.The international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease · 2017Review
- Cost-effectiveness of screening for active cases of tuberculosis in Flanders, Belgium.Bulletin of the World Health Organization · 2017Article
Corrections and comments
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Authors and funding
6 authors at 1 institution in 1 country.
Funding
Abstract
objectiveTo investigate whether the economic recession affected the control of tuberculosis in the European Union.
methodsMultivariate regression models were used to quantify the association between gross domestic product, public health expenditure and tuberculosis case detection rates, using data from 21 European Union member states (1991-2012). The estimated changes in case detection attributable to the recession were combined with mathematical models of tuberculosis transmission, to project the potential influence of the recession on tuberculosis epidemiology until 2030.
findingsBetween 1991 and 2007, detection rates for sputum-smear-positive tuberculosis in the European Union were stable at approximately 85%. During the economic recession (2008-2011) detection rates declined by a mean of 5.22% (95% confidence interval, CI: 2.54-7.90) but treatment success rates showed no significant change (P = 0.62). A fall in economic output of 100 United States dollars per capita was associated with a 0.22% (95% CI: 0.05-0.39) mean reduction in the tuberculosis case detection rate. An equivalent fall in spending on public health services was associated with a 2.74% (95% CI: 0.31-5.16) mean reduction in the detection rate. Mathematical models suggest that the recession and consequent austerity policies will lead to increases in tuberculosis prevalence and tuberculosis-attributable mortality that are projected to persist for over a decade.
conclusionAcross the European Union, reductions in spending on public health services appear to have reduced tuberculosis case detection and to have increased the long-term risk of a resurgence in the disease.
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