Increased Incidence of Tuberculosis in Zimbabwe, in Association with Food Insecurity, and Economic Collapse: An Ecological Analysis
Identifieur interne : 002A81 ( Pmc/Curation ); précédent : 002A80; suivant : 002A82Increased 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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D." last="Barker">R. D. 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></affiliation><affiliation wicri:level="1"><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></affiliation></author><author><name sortKey="Simor, Andrew" sort="Simor, Andrew" uniqKey="Simor A" first="Andrew" last="Simor">Andrew Simor</name><affiliation wicri:level="1"><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></affiliation></author><author><name sortKey="Silverman, Michael" sort="Silverman, Michael" uniqKey="Silverman M" first="Michael" last="Silverman">Michael Silverman</name><affiliation wicri:level="1"><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></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></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></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. 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<front><journal-meta><journal-id journal-id-type="nlm-ta">PLoS One</journal-id><journal-id journal-id-type="iso-abbrev">PLoS ONE</journal-id><journal-id journal-id-type="publisher-id">plos</journal-id><journal-id journal-id-type="pmc">plosone</journal-id><journal-title-group><journal-title>PLoS ONE</journal-title></journal-title-group><issn pub-type="epub">1932-6203</issn><publisher><publisher-name>Public Library of Science</publisher-name><publisher-loc>San Francisco, USA</publisher-loc></publisher></journal-meta><article-meta><article-id pub-id-type="pmid">24505245</article-id><article-id pub-id-type="pmc">3914787</article-id><article-id pub-id-type="publisher-id">PONE-D-13-24926</article-id><article-id pub-id-type="doi">10.1371/journal.pone.0083387</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group><subj-group subj-group-type="Discipline-v2"><subject>Medicine</subject><subj-group><subject>Epidemiology</subject><subj-group><subject>Conflict Epidemiology</subject><subject>Economic Epidemiology</subject><subject>Environmental Epidemiology</subject><subject>Infectious Disease Epidemiology</subject><subject>Social Epidemiology</subject></subj-group></subj-group><subj-group><subject>Global Health</subject></subj-group><subj-group><subject>Infectious Diseases</subject><subj-group><subject>Tropical Diseases (Non-Neglected)</subject><subj-group><subject>Tuberculosis</subject></subj-group></subj-group><subj-group><subject>Infectious Disease Control</subject><subject>Sexually Transmitted Diseases</subject></subj-group></subj-group><subj-group><subject>Nutrition</subject><subj-group><subject>Malnutrition</subject></subj-group></subj-group><subj-group><subject>Public Health</subject><subj-group><subject>Socioeconomic Aspects of Health</subject></subj-group></subj-group><subj-group><subject>Pulmonology</subject><subj-group><subject>Respiratory Infections</subject></subj-group></subj-group></subj-group></article-categories><title-group><article-title>Increased Incidence of Tuberculosis in Zimbabwe, in Association with Food Insecurity, and Economic Collapse: An Ecological Analysis</article-title><alt-title alt-title-type="running-head">Impact of Malnutrition on Tuberculosis in Zimbabwe</alt-title></title-group><contrib-group><contrib contrib-type="author" equal-contrib="yes"><name><surname>Burke</surname><given-names>Stephen J.</given-names></name><xref ref-type="aff" rid="aff1"><sup>1</sup></xref></contrib><contrib contrib-type="author" equal-contrib="yes"><name><surname>Lass</surname><given-names>Elliot</given-names></name><xref ref-type="aff" rid="aff2"><sup>2</sup></xref></contrib><contrib contrib-type="author"><name><surname>Thistle</surname><given-names>Paul</given-names></name><xref ref-type="aff" rid="aff2"><sup>2</sup></xref><xref ref-type="aff" rid="aff3"><sup>3</sup></xref><xref ref-type="aff" rid="aff4"><sup>4</sup></xref></contrib><contrib contrib-type="author"><name><surname>Katumbe</surname><given-names>Lovemore</given-names></name><xref ref-type="aff" rid="aff5"><sup>5</sup></xref></contrib><contrib contrib-type="author"><name><surname>Jetha</surname><given-names>Arif</given-names></name><xref ref-type="aff" rid="aff2"><sup>2</sup></xref><xref ref-type="aff" rid="aff6"><sup>6</sup></xref></contrib><contrib contrib-type="author"><name><surname>Schwarz</surname><given-names>Dan</given-names></name><xref ref-type="aff" rid="aff7"><sup>7</sup></xref></contrib><contrib contrib-type="author"><name><surname>Bolotin</surname><given-names>Shelly</given-names></name><xref ref-type="aff" rid="aff6"><sup>6</sup></xref></contrib><contrib contrib-type="author"><name><surname>Barker</surname><given-names>R. D.</given-names></name><xref ref-type="aff" rid="aff8"><sup>8</sup></xref><xref ref-type="aff" rid="aff9"><sup>9</sup></xref></contrib><contrib contrib-type="author"><name><surname>Simor</surname><given-names>Andrew</given-names></name><xref ref-type="aff" rid="aff2"><sup>2</sup></xref></contrib><contrib contrib-type="author"><name><surname>Silverman</surname><given-names>Michael</given-names></name><xref ref-type="aff" rid="aff2"><sup>2</sup></xref><xref ref-type="aff" rid="aff6"><sup>6</sup></xref><xref ref-type="aff" rid="aff10"><sup>10</sup></xref><xref ref-type="corresp" rid="cor1"><sup>*</sup></xref></contrib></contrib-group><aff id="aff1"><label>1</label><addr-line>University of Ottawa, Ottawa, Canada</addr-line></aff><aff id="aff2"><label>2</label><addr-line>University of Toronto, Toronto, Canada</addr-line></aff><aff id="aff3"><label>3</label><addr-line>Karanda Hospital, Mount Darwin, Zimbabwe</addr-line></aff><aff id="aff4"><label>4</label><addr-line>The University of Zimbabwe, Harare, Zimbabwe</addr-line></aff><aff id="aff5"><label>5</label><addr-line>The Howard Hospital, Glendale, Zimbabwe</addr-line></aff><aff id="aff6"><label>6</label><addr-line>The Dalla Lana School of Public Health, Toronto, Canada</addr-line></aff><aff id="aff7"><label>7</label><addr-line>Brigham and Women's Hospital and Children's Hospital of Boston, Boston, Massachusetts, United States of America</addr-line></aff><aff id="aff8"><label>8</label><addr-line>Murambinda Mission Hospital, Murambinda, Zimbabwe</addr-line></aff><aff id="aff9"><label>9</label><addr-line>Kings College Hospital, NHS Foundation Trust, London, United Kingdom</addr-line></aff><aff id="aff10"><label>10</label><addr-line>Lakeridge Health Corp, Oshawa, Canada</addr-line></aff><contrib-group><contrib contrib-type="editor"><name><surname>Dowdy</surname><given-names>David W.</given-names></name><role>Editor</role><xref ref-type="aff" rid="edit1"></xref></contrib></contrib-group><aff id="edit1"><addr-line>Johns Hopkins Bloomberg School of Public Health, United States of America</addr-line></aff><author-notes><corresp id="cor1">* E-mail: <email>Michael.Silverman@utoronto.ca</email></corresp><fn fn-type="conflict"><p><bold>Competing Interests: </bold>No authors have any potential personal, professional, or commercial conflicts of interest in the material presented in this manuscript.</p></fn><fn fn-type="con"><p>Conceived and designed the experiments: MSS PT. Performed the experiments: EL SJB PT MSS DS RDB LK SB AS AJ. Analyzed the data: AJ RDB. Contributed reagents/materials/analysis tools: AJ. Wrote the paper: EL SJB PT MSS.</p></fn></author-notes><pub-date pub-type="collection"><year>2014</year></pub-date><pub-date pub-type="epub"><day>5</day><month>2</month><year>2014</year></pub-date><volume>9</volume><issue>2</issue><elocation-id>e83387</elocation-id><history><date date-type="received"><day>14</day><month>6</month><year>2013</year></date><date date-type="accepted"><day>3</day><month>11</month><year>2013</year></date></history><permissions><copyright-year>2014</copyright-year><copyright-holder>Burke et al</copyright-holder><license xlink:href="http://creativecommons.org/licenses/by/4.0/"><license-p>This is an open-access article distributed under the terms of the <ext-link ext-link-type="uri" xlink:href="http://creativecommons.org/licenses/by/4.0/">Creative Commons Attribution License</ext-link>, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.</license-p></license></permissions><abstract><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></abstract><funding-group><funding-statement>The authors have no support or funding to report.</funding-statement></funding-group><counts><page-count count="9"></page-count></counts></article-meta></front></pmc></record>Pour manipuler ce document sous Unix (Dilib)
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