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Article: The transmission dynamics of tuberculosis in a recently developed Chinese city.

TitleThe transmission dynamics of tuberculosis in a recently developed Chinese city.
Authors
Issue Date2010
PublisherPublic Library of Science. The Journal's web site is located at http://www.plosone.org/home.action
Citation
Plos One, 2010, v. 5 n. 5, p. e10468 How to Cite?
AbstractBACKGROUND: Hong Kong is an affluent subtropical city with a well-developed healthcare infrastructure but an intermediate TB burden. Declines in notification rates through the 1960s and 1970s have slowed since the 1980s to the current level of around 82 cases per 100 000 population. We studied the transmission dynamics of TB in Hong Kong to explore the factors underlying recent trends in incidence. METHODOLOGY/PRINCIPAL FINDINGS: We fitted an age-structured compartmental model to TB notifications in Hong Kong between 1968 and 2008. We used the model to quantify the proportion of annual cases due to recent transmission versus endogenous reactivation of latent infection, and to project trends in incidence rates to 2018. The proportion of annual TB notifications attributed to endogenous reactivation increased from 46% to 70% between 1968 and 2008. Age-standardized notification rates were projected to decline to approximately 56 per 100 000 in 2018. CONCLUSIONS/SIGNIFICANCE: Continued intermediate incidence of TB in Hong Kong is driven primarily by endogenous reactivation of latent infections. Public health interventions which focus on reducing transmission may not lead to substantial reductions in disease burden associated with endogenous reactivation of latent infections in the short- to medium-term. While reductions in transmission with socio-economic development and public health interventions will lead to declines in TB incidence in these regions, a high prevalence of latent infections may hinder substantial declines in burden in the longer term. These findings may therefore have important implications for the burden of TB in developing regions with higher levels of transmission currently.
Persistent Identifierhttp://hdl.handle.net/10722/92543
ISSN
2014 Impact Factor: 3.234
2014 SCImago Journal Rankings: 1.300
PubMed Central ID
ISI Accession Number ID
Funding AgencyGrant Number
Research Fund for the Control of Infectious Disease, Food and Health Bureau, Government of the Hong Kong SAR09080802
US National Institute of General Medical Sciences1 U54 GM088558
Funding Information:

This work was supported by the Research Fund for the Control of Infectious Disease, Food and Health Bureau, Government of the Hong Kong SAR (ref: 09080802) and the US National Institute of General Medical Sciences (grant no. 1 U54 GM088558, MIDAS Harvard Center for Communicable Disease Dynamics). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

References
Grants

 

DC FieldValueLanguage
dc.contributor.authorWu, Pen_HK
dc.contributor.authorLau, EHen_HK
dc.contributor.authorCowling, BJen_HK
dc.contributor.authorLeung, CCen_HK
dc.contributor.authorTam, CMen_HK
dc.contributor.authorLeung, GMen_HK
dc.date.accessioned2010-09-17T10:49:34Z-
dc.date.available2010-09-17T10:49:34Z-
dc.date.issued2010en_HK
dc.identifier.citationPlos One, 2010, v. 5 n. 5, p. e10468en_HK
dc.identifier.issn1932-6203en_HK
dc.identifier.urihttp://hdl.handle.net/10722/92543-
dc.description.abstractBACKGROUND: Hong Kong is an affluent subtropical city with a well-developed healthcare infrastructure but an intermediate TB burden. Declines in notification rates through the 1960s and 1970s have slowed since the 1980s to the current level of around 82 cases per 100 000 population. We studied the transmission dynamics of TB in Hong Kong to explore the factors underlying recent trends in incidence. METHODOLOGY/PRINCIPAL FINDINGS: We fitted an age-structured compartmental model to TB notifications in Hong Kong between 1968 and 2008. We used the model to quantify the proportion of annual cases due to recent transmission versus endogenous reactivation of latent infection, and to project trends in incidence rates to 2018. The proportion of annual TB notifications attributed to endogenous reactivation increased from 46% to 70% between 1968 and 2008. Age-standardized notification rates were projected to decline to approximately 56 per 100 000 in 2018. CONCLUSIONS/SIGNIFICANCE: Continued intermediate incidence of TB in Hong Kong is driven primarily by endogenous reactivation of latent infections. Public health interventions which focus on reducing transmission may not lead to substantial reductions in disease burden associated with endogenous reactivation of latent infections in the short- to medium-term. While reductions in transmission with socio-economic development and public health interventions will lead to declines in TB incidence in these regions, a high prevalence of latent infections may hinder substantial declines in burden in the longer term. These findings may therefore have important implications for the burden of TB in developing regions with higher levels of transmission currently.en_HK
dc.languageengen_HK
dc.publisherPublic Library of Science. The Journal's web site is located at http://www.plosone.org/home.actionen_HK
dc.relation.ispartofPloS oneen_HK
dc.rightsCreative Commons: Attribution 3.0 Hong Kong License-
dc.subject.meshAge Distribution-
dc.subject.meshCities - epidemiology-
dc.subject.meshHong Kong - epidemiology-
dc.subject.meshIncidence-
dc.subject.meshTuberculosis - epidemiology - transmission-
dc.titleThe transmission dynamics of tuberculosis in a recently developed Chinese city.en_HK
dc.typeArticleen_HK
dc.identifier.openurlhttp://library.hku.hk:4550/resserv?sid=HKU:IR&issn=1932-6203&volume=5&issue=5, article no. e10468&spage=&epage=&date=2010&atitle=The+transmission+dynamics+of+tuberculosis+in+a+recently+developed+Chinese+city-
dc.identifier.emailLau, EH:ehylau@hku.hken_HK
dc.identifier.emailCowling, BJ:bcowling@hku.hken_HK
dc.identifier.emailLeung, GM:gmleung@hku.hken_HK
dc.identifier.authorityLau, EH=rp01349en_HK
dc.identifier.authorityCowling, BJ=rp01326en_HK
dc.identifier.authorityLeung, GM=rp00460en_HK
dc.description.naturepublished_or_final_versionen_US
dc.identifier.doi10.1371/journal.pone.0010468en_HK
dc.identifier.pmid20454620en_HK
dc.identifier.pmcidPMC2862741-
dc.identifier.scopuseid_2-s2.0-77956418287-
dc.identifier.hkuros170719-
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-77956418287&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume5en_HK
dc.identifier.issue5en_HK
dc.identifier.spagee10468en_HK
dc.identifier.epagee10468en_HK
dc.identifier.isiWOS:000277240300029-
dc.publisher.placeUnited Statesen_HK
dc.relation.projectThe transmission of tuberculosis in Hong Kong: role of demographic factors and relative contribution of primary infection, exogenous reinfection and endogenous reactivation-
dc.identifier.scopusauthoridWu, P=7403119736en_HK
dc.identifier.scopusauthoridLau, EH=7103086074en_HK
dc.identifier.scopusauthoridCowling, BJ=8644765500en_HK
dc.identifier.scopusauthoridLeung, CC=7402612644en_HK
dc.identifier.scopusauthoridTam, CM=7201442997en_HK
dc.identifier.scopusauthoridLeung, GM=7007159841en_HK

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