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Lifetime burden of disease due to incident tuberculosis

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New study finds the consequences of post-tuberculosis adds substantially to the disease burden caused by tuberculosis.

The Centre for Operational Research at The Union was part of the research collaboration looking into the lifetime burden of disease due to incident tuberculosis. The study team, led by Nick Menzies from the Harvard T.H. Chan School of Public Health, was made up of colleagues from the USA, UK, South Africa, Australia and the Netherlands. The findings have been published in the Lancet Global Health.

In policy analyses and disease burden estimates the impact of post-tuberculosis sequelae is generally omitted, despite the fact that many individuals who survive tuberculosis face ongoing disability and elevated mortality risks. The current study constructed a hypothetical cohort of individuals developing both pulmonary and extrapulmonary tuberculosis in 2019, and used disability-adjusted life-years (DALYs) to summarise fatal and non-fatal health losses attributable to tuberculosis, during the disease episode and afterwards.

Globally, the study authors estimated 122 million DALYs due to incident tuberculosis disease in 2019, with 58 million DALYs attributed to post-tuberculosis sequelae, representing 47% of the total burden estimate. The burden of post-tuberculosis was spread over the remaining lifetime of tuberculosis survivors, with almost a third of total DALYs accruing 15 or more years after incident tuberculosis.

This is an important study showing that post-tuberculosis sequelae add substantially to the overall disease burden caused by tuberculosis. Future policy analyses and burden estimates need to take better account of post-tuberculosis, to avoid the potential misallocation of funding, political attention, and research effort resulting from continued neglect of this issue.

This open access paper in Lancet Global Health can be read from the following link: https://authors.elsevier.com/sd/article/S2214-109X(21)00367-3