Increased Incidence of Tuberculosis in Zimbabwe, in Association with Food Insecurity, and Economic Collapse: An Ecological Analysis
Identifieur interne : 002728 ( Ncbi/Curation ); précédent : 002727; suivant : 002729Increased Incidence of Tuberculosis in Zimbabwe, in Association with Food Insecurity, and Economic Collapse: An Ecological Analysis
Auteurs : Stephen J. Burke [Canada] ; Elliot Lass [Canada] ; Paul Thistle [Canada, Zimbabwe] ; Lovemore Katumbe [Zimbabwe] ; Arif Jetha [Canada] ; Dan Schwarz [États-Unis] ; Shelly Bolotin [Canada] ; R. D. Barker [Zimbabwe, Royaume-Uni] ; Andrew Simor [Canada] ; Michael Silverman [Canada]Source :
- PLoS ONE [ 1932-6203 ] ; 2014.
Abstract
Zimbabwe underwent a socioeconomic crisis and resultant increase in food insecurity in 2008–9. The impact of the crisis on Tuberculosis (TB) incidence is unknown.
Prospective databases from two mission hospitals, which were geographically widely separated, and remained open during the crisis, were reviewed.
At the Howard Hospital (HH) in northern Zimbabwe, TB incidence increased 35% in 2008 from baseline rates in 2003–2007 (p<0.01) and remained at that level in 2009. Murambinda Hospital (MH) in Eastern Zimbabwe also demonstrated a 29% rise in TB incidence from 2007 to 2008 (p<0.01) and remained at that level in 2009. Data collected post-crisis at HH showed a decrease of 33% in TB incidence between 2009 to 2010 (p<0.001) and 2010/2011 TB incidence remained below that of the crisis years of 2008/2009 (p<0.01). Antenatal clinic HIV seroprevalence at HH decreased between 2001(23%) to 2011(11%) (p<0.001). Seasonality of TB incidence was analyzed at both MH and HH. There was a higher TB incidence in the dry season when food is least available (September-November) compared to post harvest (April-June) (p<0.001).
This study suggests that an epidemic of TB mirrored socioeconomic collapse and recovery in Zimbabwe. The seasonal data suggests that food security may have been associated with TB incidence both annually and during the crisis in this high HIV prevalence country.
Url:
DOI: 10.1371/journal.pone.0083387
PubMed: 24505245
PubMed Central: 3914787
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Burke</name><affiliation wicri:level="1"><nlm:aff id="aff1"><addr-line>University of Ottawa, Ottawa, Canada</addr-line></nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>University of Ottawa, Ottawa</wicri:regionArea><wicri:noRegion>Ottawa</wicri:noRegion></affiliation></author><author><name sortKey="Lass, Elliot" sort="Lass, Elliot" uniqKey="Lass E" first="Elliot" last="Lass">Elliot Lass</name><affiliation wicri:level="4"><nlm:aff id="aff2"><addr-line>University of Toronto, Toronto, Canada</addr-line></nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>University of Toronto, Toronto</wicri:regionArea><orgName type="university">Université de Toronto</orgName><placeName><settlement type="city">Toronto</settlement><region type="state">Ontario</region></placeName></affiliation></author><author><name sortKey="Thistle, Paul" sort="Thistle, Paul" uniqKey="Thistle P" first="Paul" last="Thistle">Paul Thistle</name><affiliation wicri:level="4"><nlm:aff id="aff2"><addr-line>University of Toronto, Toronto, Canada</addr-line></nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>University of Toronto, Toronto</wicri:regionArea><orgName type="university">Université de Toronto</orgName><placeName><settlement type="city">Toronto</settlement><region type="state">Ontario</region></placeName></affiliation><affiliation wicri:level="1"><nlm:aff id="aff3"><addr-line>Karanda Hospital, Mount Darwin, Zimbabwe</addr-line></nlm:aff><country xml:lang="fr">Zimbabwe</country><wicri:regionArea>Karanda Hospital, Mount Darwin</wicri:regionArea><wicri:noRegion>Mount Darwin</wicri:noRegion></affiliation><affiliation wicri:level="1"><nlm:aff id="aff4"><addr-line>The University of Zimbabwe, Harare, Zimbabwe</addr-line></nlm:aff><country xml:lang="fr">Zimbabwe</country><wicri:regionArea>The University of Zimbabwe, Harare</wicri:regionArea><wicri:noRegion>Harare</wicri:noRegion></affiliation></author><author><name sortKey="Katumbe, Lovemore" sort="Katumbe, Lovemore" uniqKey="Katumbe L" first="Lovemore" last="Katumbe">Lovemore Katumbe</name><affiliation wicri:level="1"><nlm:aff id="aff5"><addr-line>The Howard Hospital, Glendale, Zimbabwe</addr-line></nlm:aff><country xml:lang="fr">Zimbabwe</country><wicri:regionArea>The Howard Hospital, Glendale</wicri:regionArea><wicri:noRegion>Glendale</wicri:noRegion></affiliation></author><author><name sortKey="Jetha, Arif" sort="Jetha, Arif" uniqKey="Jetha A" first="Arif" last="Jetha">Arif Jetha</name><affiliation wicri:level="4"><nlm:aff id="aff2"><addr-line>University of Toronto, Toronto, Canada</addr-line></nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>University of Toronto, Toronto</wicri:regionArea><orgName type="university">Université de Toronto</orgName><placeName><settlement type="city">Toronto</settlement><region type="state">Ontario</region></placeName></affiliation><affiliation wicri:level="1"><nlm:aff id="aff6"><addr-line>The Dalla Lana School of Public Health, Toronto, Canada</addr-line></nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>The Dalla Lana School of Public Health, Toronto</wicri:regionArea><wicri:noRegion>Toronto</wicri:noRegion></affiliation></author><author><name sortKey="Schwarz, Dan" sort="Schwarz, Dan" uniqKey="Schwarz D" first="Dan" last="Schwarz">Dan Schwarz</name><affiliation wicri:level="2"><nlm:aff id="aff7"><addr-line>Brigham and Women's Hospital and Children's Hospital of Boston, Boston, Massachusetts, United States of America</addr-line></nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Brigham and Women's Hospital and Children's Hospital of Boston, Boston, Massachusetts</wicri:regionArea><placeName><region type="state">Massachusetts</region></placeName></affiliation></author><author><name sortKey="Bolotin, Shelly" sort="Bolotin, Shelly" uniqKey="Bolotin S" first="Shelly" last="Bolotin">Shelly Bolotin</name><affiliation wicri:level="1"><nlm:aff id="aff6"><addr-line>The Dalla Lana School of Public Health, Toronto, Canada</addr-line></nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>The Dalla Lana School of Public Health, Toronto</wicri:regionArea><wicri:noRegion>Toronto</wicri:noRegion></affiliation></author><author><name sortKey="Barker, R D" sort="Barker, R D" uniqKey="Barker R" first="R. 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Barker</name><affiliation wicri:level="1"><nlm:aff id="aff8"><addr-line>Murambinda Mission Hospital, Murambinda, Zimbabwe</addr-line></nlm:aff><country xml:lang="fr">Zimbabwe</country><wicri:regionArea>Murambinda Mission Hospital, Murambinda</wicri:regionArea><wicri:noRegion>Murambinda</wicri:noRegion></affiliation><affiliation wicri:level="3"><nlm:aff id="aff9"><addr-line>Kings College Hospital, NHS Foundation Trust, London, United Kingdom</addr-line></nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Kings College Hospital, NHS Foundation Trust, London</wicri:regionArea><placeName><settlement type="city">Londres</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Grand Londres</region></placeName></affiliation></author><author><name sortKey="Simor, Andrew" sort="Simor, Andrew" uniqKey="Simor A" first="Andrew" last="Simor">Andrew Simor</name><affiliation wicri:level="4"><nlm:aff id="aff2"><addr-line>University of Toronto, Toronto, Canada</addr-line></nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>University of Toronto, Toronto</wicri:regionArea><orgName type="university">Université de Toronto</orgName><placeName><settlement type="city">Toronto</settlement><region type="state">Ontario</region></placeName></affiliation></author><author><name sortKey="Silverman, Michael" sort="Silverman, Michael" uniqKey="Silverman M" first="Michael" last="Silverman">Michael Silverman</name><affiliation wicri:level="4"><nlm:aff id="aff2"><addr-line>University of Toronto, Toronto, Canada</addr-line></nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>University of Toronto, Toronto</wicri:regionArea><orgName type="university">Université de Toronto</orgName><placeName><settlement type="city">Toronto</settlement><region type="state">Ontario</region></placeName></affiliation><affiliation wicri:level="1"><nlm:aff id="aff6"><addr-line>The Dalla Lana School of Public Health, Toronto, Canada</addr-line></nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>The Dalla Lana School of Public Health, Toronto</wicri:regionArea><wicri:noRegion>Toronto</wicri:noRegion></affiliation><affiliation wicri:level="1"><nlm:aff id="aff10"><addr-line>Lakeridge Health Corp, Oshawa, Canada</addr-line></nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>Lakeridge Health Corp, Oshawa</wicri:regionArea><wicri:noRegion>Oshawa</wicri:noRegion></affiliation></author></analytic><series><title level="j">PLoS ONE</title><idno type="eISSN">1932-6203</idno><imprint><date when="2014">2014</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec><title>Background</title><p>Zimbabwe underwent a socioeconomic crisis and resultant increase in food insecurity in 2008–9. The impact of the crisis on Tuberculosis (TB) incidence is unknown.</p></sec><sec><title>Methods</title><p>Prospective databases from two mission hospitals, which were geographically widely separated, and remained open during the crisis, were reviewed.</p></sec><sec><title>Results</title><p>At the Howard Hospital (HH) in northern Zimbabwe, TB incidence increased 35% in 2008 from baseline rates in 2003–2007 (p<0.01) and remained at that level in 2009. Murambinda Hospital (MH) in Eastern Zimbabwe also demonstrated a 29% rise in TB incidence from 2007 to 2008 (p<0.01) and remained at that level in 2009. Data collected post-crisis at HH showed a decrease of 33% in TB incidence between 2009 to 2010 (p<0.001) and 2010/2011 TB incidence remained below that of the crisis years of 2008/2009 (p<0.01). Antenatal clinic HIV seroprevalence at HH decreased between 2001(23%) to 2011(11%) (p<0.001). Seasonality of TB incidence was analyzed at both MH and HH. There was a higher TB incidence in the dry season when food is least available (September-November) compared to post harvest (April-June) (p<0.001).</p></sec><sec><title>Conclusion</title><p>This study suggests that an epidemic of TB mirrored socioeconomic collapse and recovery in Zimbabwe. The seasonal data suggests that food security may have been associated with TB incidence both annually and during the crisis in this high HIV prevalence country.</p></sec></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Ploch, L" uniqKey="Ploch L">L Ploch</name></author></analytic></biblStruct><biblStruct></biblStruct><biblStruct><analytic><author><name sortKey="Sollom, R" uniqKey="Sollom R">R Sollom</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Mintz, Ed" uniqKey="Mintz E">ED Mintz</name></author><author><name sortKey="Guerrant, Rl" uniqKey="Guerrant R">RL Guerrant</name></author></analytic></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct><analytic><author><name sortKey="Wilkinson, D" uniqKey="Wilkinson D">D Wilkinson</name></author><author><name sortKey="Davies, Gr" uniqKey="Davies G">GR Davies</name></author></analytic></biblStruct><biblStruct><analytic><author><name 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Halperin</name></author><author><name sortKey="Mugurungi, O" uniqKey="Mugurungi O">O Mugurungi</name></author><author><name sortKey="Hallett, Tb" uniqKey="Hallett T">TB Hallett</name></author><author><name sortKey="Muchini, B" uniqKey="Muchini B">B Muchini</name></author><author><name sortKey="Campbell, B" uniqKey="Campbell B">B Campbell</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Gregson, S" uniqKey="Gregson S">S Gregson</name></author><author><name sortKey="Garnett, Gp" uniqKey="Garnett G">GP Garnett</name></author><author><name sortKey="Nyamukapa, Ca" uniqKey="Nyamukapa C">CA Nyamukapa</name></author><author><name sortKey="Hallett, Tb" uniqKey="Hallett T">TB Hallett</name></author><author><name sortKey="Lewis, Jjc" uniqKey="Lewis J">JJC Lewis</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Mahomva, A" uniqKey="Mahomva A">A Mahomva</name></author><author><name sortKey="Greby, S" uniqKey="Greby S">S Greby</name></author><author><name sortKey="Dube, S" uniqKey="Dube S">S Dube</name></author><author><name sortKey="Mugurungi, O" uniqKey="Mugurungi O">O Mugurungi</name></author><author><name sortKey="Hargrove, J" uniqKey="Hargrove J">J Hargrove</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Wojcicki, Jm" uniqKey="Wojcicki J">JM Wojcicki</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Williams, Bg" uniqKey="Williams B">BG Williams</name></author><author><name sortKey="Dye, C" uniqKey="Dye C">C Dye</name></author></analytic></biblStruct><biblStruct></biblStruct></listBibl></div1></back></TEI></record>Pour manipuler ce document sous Unix (Dilib)
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