In:
PLOS Medicine, Public Library of Science (PLoS), Vol. 19, No. 3 ( 2022-3-18), p. e1003935-
Abstract:
An ecological relationship between economic development and reduction in tuberculosis prevalence has been observed. Between 2007 and 2017, Việt Nam experienced rapid economic development with equitable distribution of resources and a 37% reduction in tuberculosis prevalence. Analysing consecutive prevalence surveys, we examined how the reduction in tuberculosis (and subclinical tuberculosis) prevalence was concentrated between socioeconomic groups. Methods and findings We combined data from 2 nationally representative Việt Nam tuberculosis prevalence surveys with provincial-level measures of poverty. Data from 94,156 (2007) and 61,763 (2017) individuals were included. Of people with microbiologically confirmed tuberculosis, 21.6% (47/218) in 2007 and 29.0% (36/124) in 2017 had subclinical disease. We constructed an asset index using principal component analysis of consumption data. An illness concentration index was estimated to measure socioeconomic position inequality in tuberculosis prevalence. The illness concentration index changed from −0.10 (95% CI −0.08, −0.16; p = 0.003) in 2007 to 0.07 (95% CI 0.06, 0.18; p = 0.158) in 2017, indicating that tuberculosis was concentrated among the poorest households in 2007, with a shift towards more equal distribution between rich and poor households in 2017. This finding was similar for subclinical tuberculosis. We fitted multilevel models to investigate relationships between change in tuberculosis prevalence, individual risks, household socioeconomic position, and neighbourhood poverty. Controlling for provincial poverty level reduced the difference in prevalence, suggesting that changes in neighbourhood poverty contribute to the explanation of change in tuberculosis prevalence. A limitation of our study is that while tuberculosis prevalence surveys are valuable for understanding socioeconomic differences in tuberculosis prevalence in countries, given that tuberculosis is a relatively rare disease in the population studied, there is limited power to explore socioeconomic drivers. However, combining repeated cross-sectional surveys with provincial deprivation estimates during a period of remarkable economic growth provides valuable insights into the dynamics of the relationship between tuberculosis and economic development in Việt Nam. Conclusions We found that with equitable economic growth and a reduction in tuberculosis burden, tuberculosis became less concentrated among the poor in Việt Nam.
Type of Medium:
Online Resource
ISSN:
1549-1676
DOI:
10.1371/journal.pmed.1003935
DOI:
10.1371/journal.pmed.1003935.g001
DOI:
10.1371/journal.pmed.1003935.g002
DOI:
10.1371/journal.pmed.1003935.g003
DOI:
10.1371/journal.pmed.1003935.g004
DOI:
10.1371/journal.pmed.1003935.g005
DOI:
10.1371/journal.pmed.1003935.t001
DOI:
10.1371/journal.pmed.1003935.t002
DOI:
10.1371/journal.pmed.1003935.t003
DOI:
10.1371/journal.pmed.1003935.s001
DOI:
10.1371/journal.pmed.1003935.s002
DOI:
10.1371/journal.pmed.1003935.s003
DOI:
10.1371/journal.pmed.1003935.s004
DOI:
10.1371/journal.pmed.1003935.s005
DOI:
10.1371/journal.pmed.1003935.r001
DOI:
10.1371/journal.pmed.1003935.r002
DOI:
10.1371/journal.pmed.1003935.r003
DOI:
10.1371/journal.pmed.1003935.r004
DOI:
10.1371/journal.pmed.1003935.r005
DOI:
10.1371/journal.pmed.1003935.r006
Language:
English
Publisher:
Public Library of Science (PLoS)
Publication Date:
2022
detail.hit.zdb_id:
2164823-2
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