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Global burden of disease due to rifampicin-resistant tuberculosis: a mathematical modeling analysis.
Menzies, Nicolas A; Allwood, Brian W; Dean, Anna S; Dodd, Pete J; Houben, Rein M G J; James, Lyndon P; Knight, Gwenan M; Meghji, Jamilah; Nguyen, Linh N; Rachow, Andrea; Schumacher, Samuel G; Mirzayev, Fuad; Cohen, Ted.
Affiliation
  • Menzies NA; Department of Global Health and Population, Harvard T. H. Chan School of Public Health, Boston, USA. nmenzies@hsph.harvard.edu.
  • Allwood BW; Center for Health Decision Science, Harvard T. H. Chan School of Public Health, Boston, USA. nmenzies@hsph.harvard.edu.
  • Dean AS; Division of Pulmonology, Department of Medicine, Stellenbosch University & Tygerberg Hospital, Cape Town, South Africa.
  • Dodd PJ; Global Tuberculosis Programme, World Health Organization, Geneva, Switzerland.
  • Houben RMGJ; School of Health and Related Research, University of Sheffield, Sheffield, United Kingdom.
  • James LP; TB Modelling Group, TB Centre, London School of Hygiene and Tropical Medicine, London, United Kingdom.
  • Knight GM; Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, United Kingdom.
  • Meghji J; Center for Health Decision Science, Harvard T. H. Chan School of Public Health, Boston, USA.
  • Nguyen LN; Harvard Interfaculty Initiative in Health Policy, Harvard University, Cambridge, USA.
  • Rachow A; AMR Centre, Department of Infectious Disease Epidemiology, EPH, London School of Hygiene and Tropical Medicine, London, United Kingdom.
  • Schumacher SG; National Heart & Lung Institute, Imperial College London, London, United Kingdom.
  • Mirzayev F; Global Tuberculosis Programme, World Health Organization, Geneva, Switzerland.
  • Cohen T; Division of Infectious Diseases and Tropical Medicine, Medical Centre of the University of Munich (LMU), Munich, Germany.
Nat Commun ; 14(1): 6182, 2023 10 04.
Article in En | MEDLINE | ID: mdl-37794037
In 2020, almost half a million individuals developed rifampicin-resistant tuberculosis (RR-TB). We estimated the global burden of RR-TB over the lifetime of affected individuals. We synthesized data on incidence, case detection, and treatment outcomes in 192 countries (99.99% of global tuberculosis). Using a mathematical model, we projected disability-adjusted life years (DALYs) over the lifetime for individuals developing tuberculosis in 2020 stratified by country, age, sex, HIV, and rifampicin resistance. Here we show that incident RR-TB in 2020 was responsible for an estimated 6.9 (95% uncertainty interval: 5.5, 8.5) million DALYs, 44% (31, 54) of which accrued among TB survivors. We estimated an average of 17 (14, 21) DALYs per person developing RR-TB, 34% (12, 56) greater than for rifampicin-susceptible tuberculosis. RR-TB burden per 100,000 was highest in former Soviet Union countries and southern African countries. While RR-TB causes substantial short-term morbidity and mortality, nearly half of the overall disease burden of RR-TB accrues among tuberculosis survivors. The substantial long-term health impacts among those surviving RR-TB disease suggest the need for improved post-treatment care and further justify increased health expenditures to prevent RR-TB transmission.
Subject(s)

Full text: 1 Collection: 01-internacional Health context: 1_ASSA2030 / 2_ODS3 / 3_ND / 4_TD Database: MEDLINE Main subject: Tuberculosis / Tuberculosis, Multidrug-Resistant Type of study: Diagnostic_studies Aspects: Patient_preference Limits: Humans Language: En Journal: Nat Commun Year: 2023 Document type: Article

Full text: 1 Collection: 01-internacional Health context: 1_ASSA2030 / 2_ODS3 / 3_ND / 4_TD Database: MEDLINE Main subject: Tuberculosis / Tuberculosis, Multidrug-Resistant Type of study: Diagnostic_studies Aspects: Patient_preference Limits: Humans Language: En Journal: Nat Commun Year: 2023 Document type: Article