Article: The transmission dynamics of tuberculosis in a recently developed Chinese city.
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- Publisher Website: 10.1371/journal.pone.0010468
- Scopus: eid_2-s2.0-77956418287
- PMID: 20454620
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| Title | The transmission dynamics of tuberculosis in a recently developed Chinese city. | ||||||
|---|---|---|---|---|---|---|---|
| Authors | Wu, P1 Lau, EH1 Cowling, BJ1 Leung, CC2 Tam, CM2 Leung, GM1 | ||||||
| Issue Date | 2010 | ||||||
| Publisher | Public 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?] DOI: http://dx.doi.org/10.1371/journal.pone.0010468 | ||||||
| Abstract | BACKGROUND: 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. | ||||||
| ISSN | 1932-6203 2011 Impact Factor: 4.092 2011 SCImago Journal Rankings: 0.519 | ||||||
| DOI | http://dx.doi.org/10.1371/journal.pone.0010468 | ||||||
| ISI Accession Number ID | WOS:000277240300029
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. | ||||||
| PubMed Central ID | PMC2862741 | ||||||
| References | References in Scopus | ||||||
| Grants | The transmission of tuberculosis in Hong Kong: role of demographic factors and relative contribution of primary infection, exogenous reinfection and endogenous reactivation |
| dc.contributor.author | Wu, P | ||||||
|---|---|---|---|---|---|---|---|
| dc.contributor.author | Lau, EH | ||||||
| dc.contributor.author | Cowling, BJ | ||||||
| dc.contributor.author | Leung, CC | ||||||
| dc.contributor.author | Tam, CM | ||||||
| dc.contributor.author | Leung, GM | ||||||
| dc.date.accessioned | 2010-09-17T10:49:34Z | ||||||
| dc.date.available | 2010-09-17T10:49:34Z | ||||||
| dc.date.issued | 2010 | ||||||
| dc.description.abstract | BACKGROUND: 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. | ||||||
| dc.description.grant | The transmission of tuberculosis in Hong Kong: role of demographic factors and relative contribution of primary infection, exogenous reinfection and endogenous reactivation | ||||||
| dc.description.grantcode | 100884 | ||||||
| dc.description.nature | published_or_final_version | ||||||
| dc.identifier.citation | Plos One, 2010, v. 5 n. 5, p. e10468 [How to Cite?] DOI: http://dx.doi.org/10.1371/journal.pone.0010468 | ||||||
| dc.identifier.doi | http://dx.doi.org/10.1371/journal.pone.0010468 | ||||||
| dc.identifier.epage | e10468 | ||||||
| dc.identifier.hkuros | 170719 | ||||||
| dc.identifier.isi | WOS:000277240300029
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. | ||||||
| dc.identifier.issn | 1932-6203 2011 Impact Factor: 4.092 2011 SCImago Journal Rankings: 0.519 | ||||||
| dc.identifier.issue | 5 | ||||||
| dc.identifier.openurl | | ||||||
| dc.identifier.pmcid | PMC2862741 | ||||||
| dc.identifier.pmid | 20454620 | ||||||
| dc.identifier.scopus | eid_2-s2.0-77956418287 | ||||||
| dc.identifier.spage | e10468 | ||||||
| dc.identifier.uri | http://hdl.handle.net/10722/92543 | ||||||
| dc.identifier.volume | 5 | ||||||
| dc.language | eng | ||||||
| dc.publisher | Public Library of Science. The Journal's web site is located at http://www.plosone.org/home.action | ||||||
| dc.publisher.place | United States | ||||||
| dc.relation.ispartof | PloS one | ||||||
| dc.relation.references | References in Scopus | ||||||
| dc.rights | Creative Commons: Attribution 3.0 Hong Kong License | ||||||
| dc.subject.mesh | Age Distribution | ||||||
| dc.subject.mesh | Cities - epidemiology | ||||||
| dc.subject.mesh | Hong Kong - epidemiology | ||||||
| dc.subject.mesh | Incidence | ||||||
| dc.subject.mesh | Tuberculosis - epidemiology - transmission | ||||||
| dc.title | The transmission dynamics of tuberculosis in a recently developed Chinese city. | ||||||
| dc.type | Article |
Author Affiliations
- The University of Hong Kong Li Ka Shing Faculty of Medicine
- Tuberculosis and Chest Service