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Time series analysis of demographic and temporal trends of tuberculosis in Singapore.

Wah W, Das S, Earnest A, Lim LK, Chee CB, Cook AR, Wang YT, Win KM, Ong ME, Hsu LY - BMC Public Health (2014)

Bottom Line: We found no significant association between demographic and macro-economic factors and annual incidence of TB with or without adjusting for the population-at-risk.Despite growing non-resident population, there was a significant decrease in the non-resident TB risk (p < 0.0001).The study found that despite an increasing size of non-resident population, TB risk among non-residents was decreasing at a rate of about 3% per year.

View Article: PubMed Central - PubMed

Affiliation: Centre for Infectious Disease Epidemiology & Research, Saw Swee Hock School of Public Health, National University of Singapore and NUHS, Singapore, Singapore. Liyang_hsu@yahoo.com.

ABSTRACT

Background: Singapore is an intermediate tuberculosis (TB) incidence country, with a recent rise in TB incidence from 2008, after a fall in incidence since 1998. This study identified population characteristics that were associated with the recent increase in TB cases, and built a predictive model of TB risk in Singapore.

Methods: Retrospective time series analysis was used to study TB notification data collected from 1995 to 2011 from the Singapore Tuberculosis Elimination Program (STEP) registry. A predictive model was developed based on the data collected from 1995 to 2010 and validated using the data collected in 2011.

Results: There was a significant difference in demographic characteristics between resident and non-resident TB cases. TB risk was higher in non-residents than in residents throughout the period. We found no significant association between demographic and macro-economic factors and annual incidence of TB with or without adjusting for the population-at-risk. Despite growing non-resident population, there was a significant decrease in the non-resident TB risk (p < 0.0001). However, there was no evidence of trend in the resident TB risk over this time period, though differences between different demographic groups were apparent with ethnic minorities experiencing higher incidence rates.

Conclusion: The study found that despite an increasing size of non-resident population, TB risk among non-residents was decreasing at a rate of about 3% per year. There was an apparent seasonality in the TB reporting.

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Related in: MedlinePlus

Non-resident and resident TB cases with population characteristics; (a) Non-resident TB cases (b) Resident TB cases (c) GDP (in 10000$) (d) Population density (per sqkm) (e) Resident population (in 100,000) (f) Non-resident population (in 100,000) (g) Elderly population (Age over 65) (in 100,000) (h) HIV incidence rate (Per 100,000 population).
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Fig1: Non-resident and resident TB cases with population characteristics; (a) Non-resident TB cases (b) Resident TB cases (c) GDP (in 10000$) (d) Population density (per sqkm) (e) Resident population (in 100,000) (f) Non-resident population (in 100,000) (g) Elderly population (Age over 65) (in 100,000) (h) HIV incidence rate (Per 100,000 population).

Mentions: There were 40,046 laboratory-confirmed TB cases reported to the STEP registry between 1995 and 2011. Table 3 shows the demographic characteristics of TB cases by residential status. Among both residents and non-residents, most TB cases were aged 15–64 years old. Compared to resident TB cases, non-resident cases were more likely to be younger, belong to other (i.e. not belonging to any of the three main ethnic groups in Singapore, Chinese, Indian and Malay) ethnic groups and to be in prison. As residents and non-residents have substantially different demographic features and health issues, we did separate time series analyses for the two groups. Figure 1 shows the increasing trend of resident and non-resident TB cases corresponding to increasing population size and density. The proportion of non-resident TB cases contributing to the total case burden increased from 25.5% in 1995 and 28.9% in 2004 to 47.7% in 2011.Table 3


Time series analysis of demographic and temporal trends of tuberculosis in Singapore.

Wah W, Das S, Earnest A, Lim LK, Chee CB, Cook AR, Wang YT, Win KM, Ong ME, Hsu LY - BMC Public Health (2014)

Non-resident and resident TB cases with population characteristics; (a) Non-resident TB cases (b) Resident TB cases (c) GDP (in 10000$) (d) Population density (per sqkm) (e) Resident population (in 100,000) (f) Non-resident population (in 100,000) (g) Elderly population (Age over 65) (in 100,000) (h) HIV incidence rate (Per 100,000 population).
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4230736&req=5

Fig1: Non-resident and resident TB cases with population characteristics; (a) Non-resident TB cases (b) Resident TB cases (c) GDP (in 10000$) (d) Population density (per sqkm) (e) Resident population (in 100,000) (f) Non-resident population (in 100,000) (g) Elderly population (Age over 65) (in 100,000) (h) HIV incidence rate (Per 100,000 population).
Mentions: There were 40,046 laboratory-confirmed TB cases reported to the STEP registry between 1995 and 2011. Table 3 shows the demographic characteristics of TB cases by residential status. Among both residents and non-residents, most TB cases were aged 15–64 years old. Compared to resident TB cases, non-resident cases were more likely to be younger, belong to other (i.e. not belonging to any of the three main ethnic groups in Singapore, Chinese, Indian and Malay) ethnic groups and to be in prison. As residents and non-residents have substantially different demographic features and health issues, we did separate time series analyses for the two groups. Figure 1 shows the increasing trend of resident and non-resident TB cases corresponding to increasing population size and density. The proportion of non-resident TB cases contributing to the total case burden increased from 25.5% in 1995 and 28.9% in 2004 to 47.7% in 2011.Table 3

Bottom Line: We found no significant association between demographic and macro-economic factors and annual incidence of TB with or without adjusting for the population-at-risk.Despite growing non-resident population, there was a significant decrease in the non-resident TB risk (p < 0.0001).The study found that despite an increasing size of non-resident population, TB risk among non-residents was decreasing at a rate of about 3% per year.

View Article: PubMed Central - PubMed

Affiliation: Centre for Infectious Disease Epidemiology & Research, Saw Swee Hock School of Public Health, National University of Singapore and NUHS, Singapore, Singapore. Liyang_hsu@yahoo.com.

ABSTRACT

Background: Singapore is an intermediate tuberculosis (TB) incidence country, with a recent rise in TB incidence from 2008, after a fall in incidence since 1998. This study identified population characteristics that were associated with the recent increase in TB cases, and built a predictive model of TB risk in Singapore.

Methods: Retrospective time series analysis was used to study TB notification data collected from 1995 to 2011 from the Singapore Tuberculosis Elimination Program (STEP) registry. A predictive model was developed based on the data collected from 1995 to 2010 and validated using the data collected in 2011.

Results: There was a significant difference in demographic characteristics between resident and non-resident TB cases. TB risk was higher in non-residents than in residents throughout the period. We found no significant association between demographic and macro-economic factors and annual incidence of TB with or without adjusting for the population-at-risk. Despite growing non-resident population, there was a significant decrease in the non-resident TB risk (p < 0.0001). However, there was no evidence of trend in the resident TB risk over this time period, though differences between different demographic groups were apparent with ethnic minorities experiencing higher incidence rates.

Conclusion: The study found that despite an increasing size of non-resident population, TB risk among non-residents was decreasing at a rate of about 3% per year. There was an apparent seasonality in the TB reporting.

Show MeSH
Related in: MedlinePlus