Social protection and tuberculosis control in 21 European countries, 1995–2012: a cross-national statistical modelling analysis

摘要: Summary Background WHO stresses the need to act on social determinants of tuberculosis. We tested whether alternative protection programmes have affected tuberculosis case notifications, prevalence, and mortality, detection treatment success rates in 21 European countries from 1995 2012. Methods obtained notification data Centre for Disease Prevention Control's 2014 Surveillance System database. also detection, success, mortality WHO's extracted between Jan 1, 1995, Dec 31, Social were EuroStat, edition. used multivariate cross-national statistical models quantify association differing types with outcomes. All analyses prespecified. Findings After we controlled economic output, public health spending, country fixed effects, each US$100 increase spending was associated a decrease per 100 000 population number notifications −1·53% (95% CI −0·28 −2·79; p=0·0191), estimated incidence −1·70% (−0·30 −3·11; p=0·0201), non-HIV-related rate −2·74% (−0·66 −4·82; p=0·0125), all-cause −3·08% (−0·73 −5·43; p=0·0127). noted no relation increased prevalence (−1·50% [–3·10 0·10] $100; p=0·0639) or smear-positive (−0·079% [–0·18 0·34] p=0·5235) (−0·59% [–1·31 0·14] p=0·1066). Old age pension expenditure seemed strongest reductions those aged 65 years older (−3·87% [–0·95 −6·78]; p=0·0137). Interpretation Investment are likely provide an effective complement prevention programmes, especially vulnerable groups. Funding Control.