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Lv H, Zhang X, Zhang X, Bai J, You S, Li X, Li S, Wang Y, Zhang W, Xu Y. Global prevalence and burden of multidrug-resistant tuberculosis from 1990 to 2019. BMC Infect Dis 2024; 24:243. [PMID: 38388352 PMCID: PMC10885623 DOI: 10.1186/s12879-024-09079-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Accepted: 01/31/2024] [Indexed: 02/24/2024] Open
Abstract
BACKGROUND Tuberculosis(TB) remains a pressing public health challenge, with multidrug-resistant tuberculosis (MDR-TB) emerging as a major threat. And healthcare authorities require reliable epidemiological evidence as a crucial reference to address this issue effectively. The aim was to offer a comprehensive epidemiological assessment of the global prevalence and burden of MDR-TB from 1990 to 2019. METHODS Estimates and 95% uncertainty intervals (UIs) for the age-standardized prevalence rate (ASPR), age-standardized incidence rate (ASIR), age-standardized disability-adjusted life years rate (ASR of DALYs), and age-standardized death rate (ASDR) of MDR-TB were obtained from the Global Burden of Disease (GBD) 2019 database. The prevalence and burden of MDR-TB in 2019 were illustrated in the population and regional distribution. Temporal trends were analyzed by using Joinpoint regression analysis to calculate the annual percentage change (APC), average annual percentage change (AAPC) and its 95% confidence interval(CI). RESULTS The estimates of the number of cases were 687,839(95% UIs: 365,512 to 1223,262), the ASPR were 8.26 per 100,000 (95%UIs: 4.61 to 15.20), the ASR of DALYs were 52.38 per 100,000 (95%UIs: 22.64 to 97.60) and the ASDR were 1.36 per 100,000 (95%UIs: 0.54 to 2.59) of MDR-TB at global in 2019. Substantial burden was observed in Africa and Southeast Asia. Males exhibited higher ASPR, ASR of DALYs, and ASDR than females across most age groups, with the burden of MDR-TB increasing with age. Additionally, significant increases were observed globally in the ASIR (AAPC = 5.8; 95%CI: 5.4 to 6.1; P < 0.001), ASPR (AAPC = 5.9; 95%CI: 5.4 to 6.4; P < 0.001), ASR of DALYs (AAPC = 4.6; 95%CI: 4.2 to 5.0; P < 0.001) and ASDR (AAPC = 4.4; 95%CI: 4.0 to 4.8; P < 0.001) of MDR-TB from 1990 to 2019. CONCLUSIONS This study underscored the persistent threat of drug-resistant tuberculosis to public health. It is imperative that countries and organizations worldwide take immediate and concerted action to implement measures aimed at significantly reducing the burden of TB.
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Affiliation(s)
- Hengliang Lv
- Department of Epidemiology, School of Public Health, China Medical University, Shenyang, China
- Chinese PLA Center for Disease Control and Prevention, Beijing, China
| | - Xin Zhang
- Department of Epidemiology, School of Public Health, China Medical University, Shenyang, China
- Chinese PLA Center for Disease Control and Prevention, Beijing, China
| | - Xueli Zhang
- Changchun University of Chinese Medicine, Changchun, China
| | - Junzhu Bai
- Department of Epidemiology, School of Public Health, China Medical University, Shenyang, China
- Chinese PLA Center for Disease Control and Prevention, Beijing, China
| | - Shumeng You
- Department of Epidemiology, School of Public Health, China Medical University, Shenyang, China
- Chinese PLA Center for Disease Control and Prevention, Beijing, China
| | - Xuan Li
- Department of Epidemiology, School of Public Health, China Medical University, Shenyang, China
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, China
| | - Shenlong Li
- Chinese PLA Center for Disease Control and Prevention, Beijing, China
| | - Yong Wang
- Department of Epidemiology, School of Public Health, China Medical University, Shenyang, China
- Chinese PLA Center for Disease Control and Prevention, Beijing, China
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, China
| | - Wenyi Zhang
- Department of Epidemiology, School of Public Health, China Medical University, Shenyang, China.
- Chinese PLA Center for Disease Control and Prevention, Beijing, China.
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, China.
| | - Yuanyong Xu
- Department of Epidemiology, School of Public Health, China Medical University, Shenyang, China.
- Chinese PLA Center for Disease Control and Prevention, Beijing, China.
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Bruce ATI, Berra TZ, Dos Santos FL, Alves YM, Souza LLL, Ramos ACV, Arroyo LH, de Almeida Crispim J, Pinto IC, Palha PF, Monroe AA, Yamamura M, Fiorati RC, Moncaio ACS, de Oliveira Gomes DM, Arcêncio RA. Temporal trends in areas at risk for concomitant tuberculosis in a hyperendemic municipality in the Amazon region of Brazil. Infect Dis Poverty 2020; 9:111. [PMID: 32778170 PMCID: PMC7418188 DOI: 10.1186/s40249-020-00732-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Accepted: 07/29/2020] [Indexed: 01/19/2023] Open
Abstract
Background Although preventable and curable, tuberculosis (TB) still occurs in poor or developing countries, mainly in metropolitan regions of larger cities. The disease is a serious public health problem, and is directly linked to social issues. We analyzed temporal trend variations in areas at risk for concomitant TB, and characterized the clinical and epidemiological profiles of cases in a hyperendemic municipality in the Amazon region of Brazil. Methods This ecological study was performed in the municipality of Manaus, in northern Brazil. The population comprised cases with concomitant pulmonary and extrapulmonary TB, registered on the Notifiable Diseases Information System (SINAN), between January 1, 2009 and December 31, 2018. For risk cluster detection, spatial and spatiotemporal scanning statistical techniques were used. The Spatial Variation in Temporal Trends (SVTT) approach was used to detect and infer clusters for significantly different time trends. Results Between 2009 and 2018, 873 concomitant TB cases were registered in Manaus. By using purely spatial scanning statistics, we identified two risk clusters. The relative risk (RR) of the clusters was 2.21 (95% confidence interval [CI]: 1.57–2.88; P = 0.0031) and 2.03 (95% CI: 1.58–2.58; P = 0.0029). Using space-time scanning, we identified a risk cluster with an RR of 3.57 (95% CI: 2.84–4.41; P = 0.014), between 2017 and 2018. For SVTT analyses, three clusters with spatial variations were detected in the significant temporal trends: SVTT 1 (P = 0.042), SVTT 2 (P = 0.046) and SVTT 3 (P = 0.036). Conclusions In Brazil, several TB-determining factors such as race/color, gender, low educational level and low income overlap in needy urban areas and communities, demonstrating that it is unlikely to reach the goals, agreed and launched with the END TB Strategy within the deadlines of international agreements, if there is no reduction in existing inequities determinants and risk of illness in the country.
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Affiliation(s)
- Alexandre Tadashi Inomata Bruce
- Department of Maternal-Infant and Public Health Nursing, University of São Paulo at Ribeirão Preto College of Nursing, Ribeirão Preto, São Paulo, Brazil.
| | - Thais Zamboni Berra
- Department of Maternal-Infant and Public Health Nursing, University of São Paulo at Ribeirão Preto College of Nursing, Ribeirão Preto, São Paulo, Brazil
| | - Felipe Lima Dos Santos
- Department of Maternal-Infant and Public Health Nursing, University of São Paulo at Ribeirão Preto College of Nursing, Ribeirão Preto, São Paulo, Brazil
| | - Yan Mathias Alves
- Department of Maternal-Infant and Public Health Nursing, University of São Paulo at Ribeirão Preto College of Nursing, Ribeirão Preto, São Paulo, Brazil
| | - Ludmilla Leidianne Limirio Souza
- Department of Maternal-Infant and Public Health Nursing, University of São Paulo at Ribeirão Preto College of Nursing, Ribeirão Preto, São Paulo, Brazil
| | - Antônio Carlos Vieira Ramos
- Department of Maternal-Infant and Public Health Nursing, University of São Paulo at Ribeirão Preto College of Nursing, Ribeirão Preto, São Paulo, Brazil
| | - Luiz Henrique Arroyo
- Department of Maternal-Infant and Public Health Nursing, University of São Paulo at Ribeirão Preto College of Nursing, Ribeirão Preto, São Paulo, Brazil
| | - Juliane de Almeida Crispim
- Department of Maternal-Infant and Public Health Nursing, University of São Paulo at Ribeirão Preto College of Nursing, Ribeirão Preto, São Paulo, Brazil
| | - Ione Carvalho Pinto
- Department of Maternal-Infant and Public Health Nursing, University of São Paulo at Ribeirão Preto College of Nursing, Ribeirão Preto, São Paulo, Brazil
| | - Pedro Fredemir Palha
- Department of Maternal-Infant and Public Health Nursing, University of São Paulo at Ribeirão Preto College of Nursing, Ribeirão Preto, São Paulo, Brazil
| | - Aline Aparecida Monroe
- Department of Maternal-Infant and Public Health Nursing, University of São Paulo at Ribeirão Preto College of Nursing, Ribeirão Preto, São Paulo, Brazil
| | - Mellina Yamamura
- Department of Nursing, Federal University of São Carlos, São Carlos, São Paulo, Brazil
| | - Regina Célia Fiorati
- Department of Neurosciences and Behavioral Sciences, Ribeirão Preto Medical School of the University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | | | | | - Ricardo Alexandre Arcêncio
- Department of Maternal-Infant and Public Health Nursing, University of São Paulo at Ribeirão Preto College of Nursing, Ribeirão Preto, São Paulo, Brazil
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3
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Leal DFDVB, Santana da Silva MN, Fernandes DCRDO, Rodrigues JCG, Barros MCDC, Pinto PDDC, Pastana LF, da Silva CA, Fernandes MR, de Assumpção PP, dos Santos SEB, dos Santos NPC. Amerindian genetic ancestry as a risk factor for tuberculosis in an amazonian population. PLoS One 2020; 15:e0236033. [PMID: 32673332 PMCID: PMC7365596 DOI: 10.1371/journal.pone.0236033] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2020] [Accepted: 06/27/2020] [Indexed: 02/07/2023] Open
Abstract
In recent years, the incidence of tuberculosis (TB) has declined worldwide, although this disease still occurs at relatively high rates in Amerindian populations. This suggests that the genetic ancestry of Amerindians may be an important factor in the development of infections, and may account for at least some of the variation in infection rates in the different populations. The present study investigated the potential influence of Amerindian genetic ancestry on susceptibility to tuberculosis in an Amazon population. The study included 280 patients diagnosed with tuberculosis and 138 asymptomatic hospital employees with no history of TB, but who were in contact with bacterially active TB patients. Ancestry analysis was run on a set of 61 Ancestry-Informative Markers to estimate European, African, and Amerindian genetic ancestry using STRUCTURE v2.2. The TB group had significantly higher Amerindian ancestry in comparison with the control group, and significantly lower European ancestry. Amerindian ancestry in the 20–60% range was found to be the principal risk factor for increased susceptibility to TB. The results of the study indicate that Amerindian ancestry is an important risk factor for susceptibility to TB in the admixed population of the Brazilian Amazon region.
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Affiliation(s)
| | | | | | | | | | - Pablo Diego do Carmo Pinto
- Núcleo de Pesquisas em Oncologia, Universidade Federal do Pará, Belém, Pará, Brazil
- Laboratório de Genética Humana e Médica, Universidade Federal do Pará, Belém, Pará, Brazil
| | | | | | | | | | - Sidney Emanuel Batista dos Santos
- Núcleo de Pesquisas em Oncologia, Universidade Federal do Pará, Belém, Pará, Brazil
- Laboratório de Genética Humana e Médica, Universidade Federal do Pará, Belém, Pará, Brazil
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Safe IP, Lacerda MVG, Printes VS, Praia Marins AF, Rebelo Rabelo AL, Costa AA, Tavares MA, Jesus JS, Souza AB, Beraldi-Magalhães F, Neves CP, Monteiro WM, Sampaio VS, Amaral EP, Gomes RS, Andrade BB, Cordeiro-Santos M. Safety and efficacy of N-acetylcysteine in hospitalized patients with HIV-associated tuberculosis: An open-label, randomized, phase II trial (RIPENACTB Study). PLoS One 2020; 15:e0235381. [PMID: 32589648 PMCID: PMC7319340 DOI: 10.1371/journal.pone.0235381] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2019] [Accepted: 06/12/2020] [Indexed: 12/13/2022] Open
Abstract
Despite the availability of effective antimicrobials, tuberculosis (TB) is still a serious health threat. Mortality is even higher in people living with HIV who are diagnosed with TB. New therapies are needed to shorten the time required to cure TB and decrease fatality rates in this population. N-acetylcysteine (NAC) is a glutathione precursor and has shown recently in experimental setting to present in vitro and in vivo anti-mycobacterial activity. We test the hypothesis that NAC is safe, well tolerated and secondarily efficacious as adjunctive anti-TB therapy in hospitalized individuals with HIV-associated TB. Patients were enrolled sequentially in a tertiary care center, in the Brazilian Amazon. We performed a randomized, parallel group, single-center, open study trial of two arms, in hospitalized patients over 18 years of age, with microbiologically confirmed pulmonary TB in HIV: one with rifampicin, isoniazid, pyrazinamide and ethambutol at standard doses (Control Group), and a second in which NAC 600 mg bid for eight weeks was added (NAC Group). A total of 21 and 18 patients were enrolled to the Control Group and NAC Group, respectively. Adverse event rates were similar in the two arms. Our findings suggest that in the more critical population of hospitalized patients with HIV-associated TB, the use of NAC was not unsafe, despite the low sample size, and a potential impact on faster negative cultures needs to be further explored in larger studies.
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Affiliation(s)
- Izabella Picinin Safe
- Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Manaus, Brazil.,Programa de Pós-Graduação em Medicina Tropical, Universidade do Estado do Amazonas, Manaus, Brazil
| | - Marcus Vinícius Guimarães Lacerda
- Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Manaus, Brazil.,Programa de Pós-Graduação em Medicina Tropical, Universidade do Estado do Amazonas, Manaus, Brazil.,Instituto Leônidas & Maria Deane, Fiocruz, Manaus, Brazil
| | | | | | - Amanda Lia Rebelo Rabelo
- Programa de Pós-Graduação em Medicina Tropical, Universidade do Estado do Amazonas, Manaus, Brazil
| | | | | | | | - Alexandra Brito Souza
- Programa de Pós-Graduação em Medicina Tropical, Universidade do Estado do Amazonas, Manaus, Brazil
| | | | - Cynthia Pessoa Neves
- Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Manaus, Brazil.,Programa de Pós-Graduação em Medicina Tropical, Universidade do Estado do Amazonas, Manaus, Brazil
| | - Wuelton Marcelo Monteiro
- Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Manaus, Brazil.,Programa de Pós-Graduação em Medicina Tropical, Universidade do Estado do Amazonas, Manaus, Brazil
| | - Vanderson Souza Sampaio
- Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Manaus, Brazil.,Programa de Pós-Graduação em Medicina Tropical, Universidade do Estado do Amazonas, Manaus, Brazil
| | - Eduardo P Amaral
- Immunobiology Section, National Institutes of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, United States of America
| | - Renata Spener Gomes
- Programa de Pós-Graduação em Medicina Tropical, Universidade do Estado do Amazonas, Manaus, Brazil
| | - Bruno B Andrade
- Laboratório de Inflamação e Biomarcadores, Instituto Gonçalo Moniz, Fundação Oswaldo Cruz (FIOCRUZ), Salvador, Brazil.,Multinational Organization Network Sponsoring Translational and Epidemiological Research, (MONSTER) Initiative, Salvador, Brazil.,Universidade Salvador (UNIFACS), Laureate Universities, Salvador, Brazil.,Curso de Medicina, Faculdade de Tecnologia e Ciências, Salvador, Brazil.,Escola Bahiana de Medicina e Saúde Pública (EBMSP), Salvador, Brazil.,Wellcome Centre for Infectious Diseases Research in Africa (CIDRI-Africa), Institute of Infectious Disease and Molecular Medicine, University of Cape Town (UCT), Cape Town, South Africa.,Division of Infectious Diseases, Department of Medicine, Vanderbilt University School of Medicine, Nashville, TN, United States of America
| | - Marcelo Cordeiro-Santos
- Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Manaus, Brazil.,Programa de Pós-Graduação em Medicina Tropical, Universidade do Estado do Amazonas, Manaus, Brazil
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Gaspar RS, Nunes N, Nunes M, Rodrigues VP. Temporal analysis of reported cases of tuberculosis and of tuberculosis-HIV co-infection in Brazil between 2002 and 2012. J Bras Pneumol 2017; 42:416-422. [PMID: 28117471 PMCID: PMC5344089 DOI: 10.1590/s1806-37562016000000054] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2016] [Accepted: 07/07/2016] [Indexed: 11/30/2022] Open
Abstract
Objective: To investigate the reported cases of tuberculosis and of tuberculosis-HIV co-infection in Brazil between 2002 and 2012. Methods: This was an observational study based on secondary time series data collected from the Brazilian Case Registry Database for the 2002-2012 period. The incidence of tuberculosis was stratified by gender, age group, geographical region, and outcome, as was that of tuberculosis-HIV co-infection. Results: Nationally, the incidence of tuberculosis declined by 18%, whereas that of tuberculosis-HIV co-infection increased by 3.8%. There was an overall decrease in the incidence of tuberculosis, despite a significant increase in that of tuberculosis-HIV co-infection in women. The incidence of tuberculosis decreased only in the 0- to 9-year age bracket, remaining stable or increasing in the other age groups. The incidence of tuberculosis-HIV co-infection increased by 209% in the ≥ 60-year age bracket. The incidence of tuberculosis decreased in all geographical regions except the south, whereas that of tuberculosis-HIV co-infection increased by over 150% in the north and northeast. Regarding the outcomes, patients with tuberculosis-HIV co-infection, in comparison with patients infected with tuberculosis only, had a 48% lower chance of cure, a 50% greater risk of treatment nonadherence, and a 94% greater risk of death from tuberculosis. Conclusions: Our study shows that tuberculosis continues to be a relevant public health issue in Brazil, because the goals for the control and cure of the disease have yet to be achieved. In addition, the sharp increase in the incidence of tuberculosis-HIV co-infection in women, in the elderly, and in the northern/northeastern region reveals that the population of HIV-infected individuals is rapidly becoming more female, older, and more impoverished.
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Affiliation(s)
| | - Natália Nunes
- . Curso de Medicina, Universidade Federal do Maranhão, São Luís (MA) Brasil
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da Silveira EO, da Costa Salina TD, Aguiar RDAL, Schriefer A, Fraiji NA. Severe and late complication of central venous catheters in a patient with haemophilia A. Haemophilia 2017; 23:e135-e137. [PMID: 28181339 DOI: 10.1111/hae.13087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/02/2016] [Indexed: 06/06/2023]
Affiliation(s)
- E O da Silveira
- Fundação Hospitalar de Hematologia e Hemoterapia do Amazonas (FHEMOAM), Manaus, AM, Brazil
| | - T D da Costa Salina
- Fundação Hospitalar de Hematologia e Hemoterapia do Amazonas (FHEMOAM), Manaus, AM, Brazil
- Universidade Federal do Amazonas, Manaus, AM, Brazil
| | - R D A L Aguiar
- Fundação Hospitalar de Hematologia e Hemoterapia do Amazonas (FHEMOAM), Manaus, AM, Brazil
- Universidade Estadual do Amazonas, Manaus, AM
| | - A Schriefer
- Fundação Hospitalar de Hematologia e Hemoterapia do Amazonas (FHEMOAM), Manaus, AM, Brazil
- Serviço de Imunologia, Hospital Universitário Prof. Edgard Santos, Salvador, BA, Brazil
- Departamento de Ciências da Biointeração, Instituto de Ciências da Saúde, Universidade Federal da Bahia, Salvador, BA, Brazil
| | - N A Fraiji
- Fundação Hospitalar de Hematologia e Hemoterapia do Amazonas (FHEMOAM), Manaus, AM, Brazil
- Universidade Federal do Amazonas, Manaus, AM, Brazil
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Lacerda MVG, Romero GAS. Epidemiological transition of tropical diseases in the Brazilian Amazon. Rev Soc Bras Med Trop 2015; 48 Suppl 1:1-3. [PMID: 26061364 DOI: 10.1590/0037-8682-0155-2015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2015] [Accepted: 05/12/2015] [Indexed: 11/22/2022] Open
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