Age-period-cohort analysis of tuberculosis notifications in Hong Kong from 1961 to 2005

Wu, P; Cowling, B J; Schooling, C M; Wong, I O L; Johnston, J M; Leung, C-C; Tam, C-M; Leung, G M
April 2008
Thorax;Apr2008, Vol. 63 Issue 4, p312
Academic Journal
Background: Despite its wealth, excellent vital indices and robust health care infrastructure, Hong Kong has a relatively high incidence of tuberculosis (TB) (85.4 per 100 000). Hong Kong residents have also experienced a very rapid and recent epidemiological transition; the population largely originated from migration by southern Chinese in the mid 20th century. Given the potentially long latency period of TB infection, an investigation was undertaken to determine the extent to which TB incidence rates reflect the population history and the impact of public health interventions. Methods: An age-period-cohort model was used to break down the Hong Kong TB notification rates from 1961 to 2005 into the effects of age, calendar period and birth cohort. Results: Analysis by age showed a consistent pattern across all the cohorts by year of birth, with a peak in the relative risk of TB at 20-24 years of age. Analysis by year of birth showed an increase in the relative risk of TB from 1880 to 1900, stable risk until 1910, then a linear rate of decline from 1910 with an inflection point at 1990 for a steeper rate of decline. Period effects yielded only one inflection during the calendar years 1971-5. Conclusions: Economic development, social change and the World Health Organisation's short-course directly observed therapy (DOTS) strategy have contributed to TB control in Hong Kong. The linear cohort effect until 1990 suggests that a relatively high, but slowly falling, incidence of TB in Hong Kong will continue into the next few decades.


Related Articles

  • Cost Resulting from Anti-Tuberculosis Drug Shortages in the United States: A Hypothetical Cohort Study. Scott, James C.; Shah, Neha; Porco, Travis; Flood, Jennifer // PLoS ONE;8/18/2015, Vol. 10 Issue 8, p1 

    Background: From 2012 through 2014, the United States experienced acute shortages and price escalations of several first-line anti-tuberculosis (TB) medications. Because secondary TB drug regimens are longer and adverse events occur more frequently with them, we sought to conservatively...

  • Tuberculosis recurrence in smear-positive patients cured under DOTS in southern Ethiopia: retrospective cohort study. Datiko, Daniel G.; Lindtjørn, Bernt // BMC Public Health;2009, Vol. 9 Issue 1, p348 

    Background: Decentralization of DOTS has increased the number of cured smear-positive tuberculosis (TB) patients. However, the rate of recurrence has increased mainly due to HIV infection. Recurrence rate could be taken as an important measure of long-term success of TB treatment. We aimed to...

  • The role of entry screening in case finding of tuberculosis among asylum seekers in Norway. Harstad, Ingunn; Jacobsen, Geir W.; Heldal, Einar; Winje, Brita A.; Vahedi, Saeed; Helvik, Anne-Sofie; Steinshamn, Sigurd L.; Garåsen, Helge // BMC Public Health;2010, Vol. 10 Issue 1, p670 

    Background: Most new cases of active tuberculosis in Norway are presently caused by imported strains and not transmission within the country. Screening for tuberculosis with a Mantoux test of everybody and a chest X-ray of those above 15 years of age is compulsory on arrival for asylum seekers....

  • Tuberculosis in Healthcare Workers: A Matched Cohort Study in Taiwan. Pan, Sung-Ching; Chen, Yee-Chun; Wang, Jann-Yuan; Sheng, Wang-Huei; Lin, Hsien-Ho; Fang, Chi-Tai; Chang, Shan-Chwen // PLoS ONE;12/17/2015, Vol. 10 Issue 12, p1 

    Background: Proportional mortality ratio data indicate that healthcare workers (HCWs) have an elevated tuberculosis (TB) mortality. Whether this is caused by an increased TB incidence, a worse TB treatment outcome, or a combination of effects, remains unclear. To elucidate the hazard components...

  • Variations in Anticoagulation Practices Following the Maze Procedure. Chung, Jennifer; Sami, Magdi; Albert, Carole; De Varennes, Benoit // JAFIB: Journal of Atrial Fibrillation;Oct/Nov2015, Vol. 8 Issue 3, p12 

    The current real-world anticoagulation practices following left atrial appendectomy in the context of the Maze procedure are unknown. This is a cohort study of all patients who underwent the Maze procedure with amputation of the left atrial appendage from June 2005 to November 2012. Data was...

  • Impacts of the “transport subsidy initiative on poor TB patients” in Rural China: A Patient-Cohort Based Longitudinal Study in Rural China. Zhao, Qi; Wang, Lixia; Tao, Tao; Xu, Biao // PLoS ONE;Nov2013, Vol. 8 Issue 11, p1 

    Objective:To describe the financial burden on TB patients for transportation during treatment, and to evaluate the impacts of the “transportation subsidy initiative on poor TB patients” in rural China for improving poor patients’ access to TB treatment. Methods:A...

  • Risk Factors Associated with Default from Multi- and Extensively Drug-Resistant Tuberculosis Treatment, Uzbekistan: A Retrospective Cohort Analysis. Lalor, Maeve K.; Greig, Jane; Allamuratova, Sholpan; Althomsons, Sandy; Tigay, Zinaida; Khaemraev, Atadjan; Braker, Kai; Telnov, Oleksander; du Cros, Philipp // PLoS ONE;Nov2013, Vol. 8 Issue 11, p1 

    Background: The Médecins Sans Frontières project of Uzbekistan has provided multidrug-resistant tuberculosis treatment in the Karakalpakstan region since 2003. Rates of default from treatment have been high, despite psychosocial support, increasing particularly since programme scale-up in...

  • Rezultati tretmana tuberkuloznih pacijenata u FBIH u periodu od 1998. do 2003. godine. Ustamujić, Aida; Dizdarević, Zehra; Žutić, Hasan // Medicinski Arhiv;2007, Vol. 61 Issue 4, p240 

    The aim: To evaluate treatment outcome data for all new pulmonary sputum smear positive cases and treatment outcome data for all new pulmonary culture positive cases. To evaluate re-treatment outcome data for all retreated pulmonary sputum smear positive Tb cases and re-treatment outcome data...

  • Risk factors for unfavorable outcome of pulmonary tuberculosis in adults in Taipei, Taiwan. Yen, Yung-Feng; Yen, Muh-Yong; Shih, Hsiu-Chen; Deng, Chung-Yeh // Transactions of the Royal Society of Tropical Medicine & Hygiene;May2012, Vol. 106 Issue 5, p303 

    Summary: This study was undertaken to identify factors associated with unfavorable outcomes in patients with pulmonary tuberculosis (PTB) in Taipei, Taiwan in 2007–2008. Taiwanese adults with culture-positive PTB diagnosed in Taipei during the study period were included in this...


Read the Article


Sign out of this library

Other Topics