scholarly journals Forecasting the impact of population ageing on tuberculosis incidence

2019 ◽  
Author(s):  
Chu-Chang Ku ◽  
Peter J Dodd

AbstractBackgroundTuberculosis (TB) disease reactivates from distant latent infection or recent (re)infection. Progression risks increase with age. Across the World Health Organisation Western Pacific region, many populations are ageing and have the highest per capita TB incidence rates in older age groups. However, methods for analysing age-specific TB incidence and forecasting epidemic trends while accounting for demographic change remain limited.MethodsWe applied the Lee-Carter models, which were originally developed for mortality modelling, to model the temporal trends in age-specific TB incidence data from 2005 to 2018 in Taiwan. Females and males were modelled separately. We combined our demographic forecasts, and age-specific TB incidence forecasts to project TB incidence until 2035. We compared TB incidence projections with demography fixed in 2018 to projections accounting for demographic change.ResultsOur models quantified increasing incidence rates with age and declining temporal trends. By 2035, the forecast suggests that the TB incidence rate in Taiwan will decrease by 54% (95% Prediction Interval (PI): 45%-59%) compared to 2015, while most age-specific incidence rates will reduce by more than 60%. In 2035, adults aged 65 and above will make up 78% of incident TB cases. Forecast TB incidence in 2035 accounting for demographic change will be 39% (95% PI: 36%-42%) higher than without population ageing.ConclusionsAge-specific incidence forecasts coupled with demographic forecasts can inform the impact of population ageing on TB epidemics. The TB control programme in Taiwan should develop plans specific to older age groups and their care needs.

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 641.1-641
Author(s):  
Y. B. Joo ◽  
Y. J. Park

Background:Infections have been associated with a higher risk of systemic lupus erythematosus (SLE) flares, but the impact of influenza infection on SLE flares has not been evaluated.Objectives:We evaluated the association between influenza infection and SLE flares resulting in hospitalization.Methods:SLE flares resulting in hospitalization and influenza cases were ascertained from the Korean national healthcare insurance database (2014-2018). We used a self-controlled case series design. We defined the risk interval as the first 7 days after the influenza index date and the control interval was defined as all other times during the observation period of each year. We estimated the incidence rates of SLE flares resulting in hospitalization during the risk interval and control interval and compared them using a Poisson regression model.Results:We identified 1,624 influenza infections among the 1,455 patients with SLE. Among those, there were 98 flares in 79 patients with SLE. The incidence ratio (IR) for flares during the risk interval as compared with the control interval was 25.75 (95% confidence interval 17.63 – 37.59). This significantly increased the IRs for flares during the risk interval in both women (IR 27.65) and men (IR 15.30), all age groups (IR 17.00 – 37.84), with and without immunosuppressive agent (IR 24.29 and 28.45, respectively), and with and without prior respiratory diseases (IR 21.86 and 26.82, respectively).Conclusion:We found significant association between influenza infection and SLE flares resulting in hospitalization. Influenza infection has to be considered as a risk factor for flares in all SLE patients regardless of age, sex, medications, and comorbidities.References:[1]Kwong, J. C. et al. Acute Myocardial Infarction after Laboratory-Confirmed Influenza Infection. N Engl J Med 2018:378;345-353.Table 1.Incidence ratios for SLE flares resulting in hospitalization after influenza infectionRisk intervalIncidence ratio95% CIDuring risk interval for 7 days / control interval25.7517.63 – 37.59Days 1-3 / control interval21.8114.71 – 32.35Days 4-7 / control interval7.563.69 – 15.47SLE, systemic lupus erythematosus; CI, confidence intervalDisclosure of Interests:None declared


2006 ◽  
pp. 249-258
Author(s):  
Vladimir Nikitovic

After five decades of insufficient reproduction of Vojvodina?s and Central Serbia?s population, the process of demographic ageing, came into the focus of the broadest public at last. Current Serbia?s population (without Kosovo and Metohija?s population) belongs to the group of the oldest populations in the world according to a number of indicators of demographic change. Considering population ageing as a planetary process without precedent in the human history, we tried to point out the main features of its evolution regarding spatial implications on population living in this part of Europe. The evolution of the process of population ageing during the 1981-2002 period was considered through functional relations between specific age groups. It was ascertained that the process started its spreading over Vojvodina at first, but continued to spread over Central Serbia afterwards moving the pole of demographic ageing to that part of the country. Some specific centres of demographic ageing as well as the regions which are still demographically more vital than the others were located by the analysis at the municipality level.


Author(s):  
Milou Ohm ◽  
Susan J M Hahné ◽  
Arie van der Ende ◽  
Elizabeth A M Sanders ◽  
Guy A M Berbers ◽  
...  

Abstract Background In response to the recent serogroup W invasive meningococcal disease (IMD-W) epidemic in the Netherlands, meningococcal serogroup C (MenC) conjugate vaccination for 14-month-olds was replaced with a MenACWY conjugate vaccination, and a mass campaign targeting 14-18 year-olds was executed. We investigated the impact of MenACWY vaccination implementation in 2018-2020 on incidence rates and estimated vaccine effectiveness (VE). Methods We extracted all IMD cases diagnosed between July 2014 and December 2020 from the national surveillance system. We calculated age group-specific incidence rate ratios by comparing incidence rates before (July 2017-March 2018) and after (July 2019-March 2020) MenACWY vaccination implementation. We estimated VE in vaccine-eligible cases using the screening method. Results Overall, IMD-W incidence rate lowered by 61% (95%CI 40-74). It declined by 82% (95%CI 18-96) in vaccine-eligible age group (15-36 month-olds and 14-18 year-olds) and by 57% (95%CI 34-72) in vaccine non-eligible age groups. VE was 92% (95%CI -20-99.5) against IMD-W vaccine-eligible toddlers. No IMD-W cases were reported in vaccine-eligible teenagers after the campaign. Conclusions The MenACWY vaccination programme was effective in preventing IMD-W in the target population. The IMD-W incidence reduction in vaccine non-eligible age groups may be caused by indirect effects of the vaccination programme. However, disentangling natural fluctuation from vaccine-effect was not possible. Our findings encourage the use of toddler- and teenager MenACWY vaccination in national immunization programmes especially when implemented together with a teenager mass campaign during an epidemic.


2019 ◽  
Vol 4 (6) ◽  

The Kingdom of Saudi Arabia is one of the largest Arab countries with a moderate annual problem of tuberculosis that is either pulmonary or extra-pulmonary. TB is still one of the most significant health troubles in the KSA, affecting different nationalities (Saudis, non-Saudis), ages, provinces, and genders. The control of TB still faces some challenges in different provinces of the KSA. Data were collected, arranged, analyzed and presented in tables and figures. In this retrospective study, we appraised TB surveillance data for the period between 2013 (1434H) and 2018 (1439H). Data were handled using Microsoft Excel and SPSS version 23. Data were checked for normality using Shapiro-Wilk normality test at 0.05 levels to determine whether they are parametric or nonparametric. Chi-squared, Kruskal Wallis, and analysis of variance tests were used to evaluate trends at a significance level of p< 0.05. Statistical analyses were performed using IBM-SPSS version 23 for Mac OS. We appraised TB surveillance data for the period between 2013 (1434H) and 2018 (1439H). The data included the region of the country (province), age, sex, and nationality (Saudis, non-Saudis). The study evaluated the impact of TB on various nationalities (Saudis and non-Saudis), age groups (0-14, 15-34, 35-55, more than 55 years old), and genders (males and females). Non-Saudis had a higher incidence rate than Saudis in 2013-2018. The number of cases and incidence rates of TB recorded in males between 2013 to 2018 were about two to three times greater than estimates for females. The Makkah, Riyadh, and Jeddah regions attract enormous numbers of non-Saudi migrant workers, who account for ~60% of all TB cases in the KSA. Assessing the main TB risk factors contributing to high TB rates in non-Saudi workers is essential. Furthermore, periodical accurate studies, including evidence-based studies for optimum surveillance, avoidance, spread risk, inspection, control procedures and treatment of TB, should be conducted. These assessments would lead to evaluating the strengths and weaknesses of KSA-NTP’s TB action plan.


2017 ◽  
Vol 4 (suppl_1) ◽  
pp. S734-S735 ◽  
Author(s):  
Jean Longtin ◽  
Rejean Dion ◽  
Marc Simard ◽  
Jean-Francois Betala Belinga ◽  
Yves Longtin ◽  
...  

Abstract Background Owing to a persistent increase of serogroup B Neisseria meningitidis (Nm) invasive infections in the Saguenay-Lac-Saint-Jean (SLSJ) region of the province of Quebec (Canada) since 2006, a wide-scale vaccination campaign of individuals aged 6 months to 20 years was conducted between May and December 2014 using the 4-component protein-based meningococcus serogroup B vaccine (4CMenB). Components of this vaccine have shown to potentially cross-react with Neisseria gonorrhoeae (Ng). The study objective was to assess the impact of the vaccination campaign on Ng incidence rate (IR). Methods Ng cases notified to public health authorities during prevaccination period (January 2006 to June 2014) and postvaccination period (July 2014 to June 2017) were analyzed. The impact of this mass campaign was estimated by a Poisson regression model, including the year (11 July–June categories), age (14–20 vs. 21 years and older), and the intervention (0 by default and 1 in those 14–20 years in the period of July 2014 to June 2017). Results Overall vaccine coverage was 82% in the target group. A total of 231 Ng cases were reported among persons 14 years and older (IR: 8.4/100,000 person-years) of the SLSJ region from January 2006 to June 2017. A decrease in the Ng number of cases and IR among individuals 14–20 years was observed during the post-vaccination period whereas it increased in those 21 years and older (figure). Estimate of vaccination impact was an Ng risk reduction of 59% (95% CI: −22% to 84%; P = 0.1). During the same period, Chlamydia trachomatis (Ct) infections increased among persons of both age groups in the SLSJ region. Conclusion Although the estimate of the impact of the campaign was not statistically significant, possibly due to limited size of the study population and the low incidence of the disease, it is congruent with results of a case–control study in New Zealand showing an OMV-MeNZB vaccine effectiveness of 31%. A higher effectiveness of 4CMenB is a plausible hypothesis as three additional proteins also found in Ng are included in the vaccine used in the SLSJ region. The results of this ecologic study suggest cross-protection of 4CMenB vaccine against Ng infections. Further studies on this topic are warranted. Disclosures P. De Wals, GlaxoSmithKline: Grant Investigator and Scientific Advisor, Grant recipient and travel expenses. Pfizer: Grant Investigator and Scientific Advisor, Grant recipient and travel expenses. Sanofi-Pasteur: Grant Investigator and Scientific Advisor, Grant recipient and travel expenses. Novartis: Grant Investigator and Scientific Advisor, Grant recipient and travel expenses.


2020 ◽  
pp. 1-10
Author(s):  
Fatheya Al Awadi ◽  
Mohamed Hassanein ◽  
Hamid Y. Hussain ◽  
Heba Mohammed ◽  
Gamal Ibrahim ◽  
...  

<b><i>Background:</i></b> The health and social burdens of diabetes mellitus (DM) are steadily increasing worldwide, reflecting the impact of urbanization, industrial transitions, and shifting to nonhealthy, sedentary life patterns’, as well as the high sugar, low-fiber food consumptions. All these factors have contributed to the global increase in the prevalence of DM and metabolic disorders. <b><i>Objectives:</i></b> The objective is to study the prevalence of DM among adult cohorts in Dubai and the extent of behavioral health risk factors associations. <b><i>Methodology:</i></b> A cross-sectional household health survey with multistage, stratified cluster random sample of 9,630 participants including 2,496 households was carried out in Dubai 2019. About 5,371 non-United Arab Emirates (UAE) national, 2,245 UAE-nationals, of different age-groups, gender, education, nationality, smoking, and marital status were included in the survey. The survey questionnaire was adapted from the one used in the World Bank’s Living Standards Measurement Surveys (LSMSs) and the WHO’s World Health Surveys (WHSs). Self-reported diabetes was considered as well as newly diagnosed diabetes based on HbA1C results. About 75 well-trained surveyors, 25 well-trained nurses, and other laboratory technicians conducted the survey. SPSS 21 and Stata 12 software was used for data management. <b><i>Results:</i></b> The data indicate that the prevalence of diabetes among Dubai Emiratis is much higher than Dubai expats (19.3 vs. 12.4% <i>p</i> = 0.000). The association between diabetes and age was evident regardless of nationality. Rates of diabetes were higher in males (15.4%) compared to females (11.8%) (<i>p</i> &#x3c; 0.001). About 11.2% of those considered overweight have DM, while the prevalence is 21.5% in obese people (<i>p</i> = 0.000). Physical inactivity, smoking, and hypertension (HTN) were strongly associated with higher rates of DM. Regardless of nationality, lower levels of education were statistically significantly associated with the prevalence of DM (<i>p</i> = 0.000), while single marital status was associated with the lowest rate of DM. <b><i>Conclusions:</i></b> Dubai household health survey 2019 indicated that the prevalence of DM among Dubai adults was still high as an overall estimation. Higher rates of diabetes were significantly associated with Emirati nationality, older age-groups, male gender, physical inactivity, high BMI, HTN, smoking<b>,</b> marital status of divorced, separated or divorced as well as low educational level groups.


2018 ◽  
Vol 14 (1) ◽  
pp. 61-68 ◽  
Author(s):  
Maria Carlsson ◽  
Tom Wilsgaard ◽  
Stein Harald Johnsen ◽  
Liv-Hege Johnsen ◽  
Maja-Lisa Løchen ◽  
...  

Background Studies on the relationship between temporal trends in risk factors and incidence rates of intracerebral hemorrhage are scarce. Aims To analyze temporal trends in risk factors and incidence rates of intracerebral hemorrhage using individual data from a population-based study. Methods We included 28,167 participants of the Tromsø Study enrolled between 1994 and 2008. First-ever intracerebral hemorrhages were registered through 31 December 2013. Hazard ratios (HRs) for intracerebral hemorrhage were analyzed by Cox proportional hazards models, risk factor levels over time by generalized estimating equations, and incidence rate ratios (IRR) by Poisson regression. Results We registered 219 intracerebral hemorrhages. Age, male sex, systolic blood pressure (BP), diastolic BP, and hypertension were associated with intracerebral hemorrhage. Hypertension was more strongly associated with non-lobar intracerebral hemorrhage (HR 5.08, 95% CI 2.86–9.01) than lobar intracerebral hemorrhage (HR 1.91, 95% CI 1.12–3.25). In women, incidence decreased significantly (IRR 0.46, 95% CI 0.23–0.90), driven by a decrease in non-lobar intracerebral hemorrhage. Incidence rates in men remained stable (IRR 1.27, 95% CI 0.69–2.31). BP levels were lower and decreased more steeply in women than in men. The majority with hypertension were untreated, and a high proportion of those treated did not reach treatment goals. Conclusions We observed a significant decrease in intracerebral hemorrhage incidence in women, but not in men. A steeper BP decrease in women may have contributed to the diverging trends. The high proportion of untreated and sub-optimally treated hypertension calls for improved strategies for prevention of intracerebral hemorrhage.


Author(s):  
Anastasia S. Kozhokar ◽  
Sergey V. Kuznetsov ◽  
Arina S. Podkhvatilina ◽  
Andrey E. Bratus ◽  
Yuriy O. Paramonov ◽  
...  

BACKGROUND: The study of dental problems characteristic of geriatric patients is becoming increasingly relevant. As a person ages, the entire dental system undergoes physiological and functional changes. To eliminate the adverse effects of oral diseases, prolong the period of remission, preventive measures, constant monitoring of the level of hygiene, dispensary supervision of elderly and senile persons are necessary. AIM: This study aimed to determine the prevalence and intensity of dental diseases in the following older age groups: young elderly (6574 years old), old elderly (7584 years old), and very old elderly (85 years old and older). MATERIALS AND METHODS: A dental examination of 183 patients was carried out using a modified card for assessing the state of the dental status, according to guidelines of the World Health Organization. RESULTS: Analysis of dental morbidity in the older age group showed that the most common dental diseases in this group were extractions of lossened teeth caused by caries and periodontal diseases. Following a comprehensive dental examination of elderly patients and people with senility, the intensity of KPU and OHI-S was 19.760.52 and 2.710.12, respec-tively, and this indicates the poor hygienic state of the oral cavity of this population. CONCLUSION: Data support the untimeliness and inadequacy of dental care in elderly patients and people with senility. This necessitates the development of special treatment and prophylactic programs for this population, aimed at reducing dental morbidity.


Author(s):  
Ian Sammy ◽  
Joanne Paul

Background & Objectives Over the past 50 years, epidemiological data from the World Health Organisation has demonstrated a trend towards population ageing throughout the world. While this is widely recognised in the developed world, the phenomenon has been largely overlooked in the developing world, despite the fact that the rate of ageing in developing countries far outstrips that of developed countries. This global trend towards an increasingly older society has significant implications for healthcare. This article aims to review the definitions of ageing, its epidemiological characteristics and physiological changes associated with ageing. Methods A narrative review of the literature was undertaken using Medline, CINAHL and the Cochrane Database, supplemented by manual searches of the literature, and guided by the reference lists of relevant papers identified in the electronic search. No restriction was placed on the type of paper to be included in the study. Results The initial electronic search of the three databases included 239 papers, of which 60 were found to be relevant and included in this review. These articles discussed the epidemiology and definition of ageing, the physiology of ageing and its impact on health and illness, and the implications for health services. The overall findings of the studies implicate the clear differences in the physiology of older people, which do create specific challenges for health service provision. Conclusion Population ageing is a significant global phenomenon, affecting both developed and developing regions of the world. More work is needed, particularly in the developing world, to better understand the impact of ageing on our population.


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