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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

Crude incidence rates by resident status, age groups and ethnicity and age-standardized incidence rates; (a) Comparative risk plot of Tuberculosis among non-resident and resident communities in Singapore (b) Age-specific incidence rates of Tuberculosis (Residents) (c) Ethnicity-specific incidence rates of Tuberculosis (Residents) (d) Age-standardized incidence rates (Residents); dashed lines are 95% confidence intervals.
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Fig2: Crude incidence rates by resident status, age groups and ethnicity and age-standardized incidence rates; (a) Comparative risk plot of Tuberculosis among non-resident and resident communities in Singapore (b) Age-specific incidence rates of Tuberculosis (Residents) (c) Ethnicity-specific incidence rates of Tuberculosis (Residents) (d) Age-standardized incidence rates (Residents); dashed lines are 95% confidence intervals.

Mentions: TB incidence rates were consistently higher among non-residents than residents over the period studied (Figure 2a). Among residents, the TB incidence rate was higher among those aged ≥65 years and who belong to Malay and Other ethnic groups (Figure 2b,c). Age-standardized incidence rates (ASIR) among residents were significantly lower in 2011 (ASIR: 36.5 per 100,000 population, 95% CI = 34.8-38.3 per 100,000 population) by 24% compared with 1995 (ASIR: 48.5 per 100,000 population, 95% CI = 46-50.9 per 100,000 population) (Figure 2d). Despite a drop between 2004 and 2007, the ASIR has been increasing since 2008. Compared with the 2007 ASIR (29.9 per 100,000 population, 95% CI = 28.3-31.6 per 100,000 population), there was a 22% increase by 2011 (36.5 per 100,000 population, 95% CI = 34.8-38.3 per 100,000 population). When stratified by ethnic groups among residents, Malay and Other ethnicities had significantly higher ASIR over years (Additional file 1: Figure S1).Figure 2


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)

Crude incidence rates by resident status, age groups and ethnicity and age-standardized incidence rates; (a) Comparative risk plot of Tuberculosis among non-resident and resident communities in Singapore (b) Age-specific incidence rates of Tuberculosis (Residents) (c) Ethnicity-specific incidence rates of Tuberculosis (Residents) (d) Age-standardized incidence rates (Residents); dashed lines are 95% confidence intervals.
© Copyright Policy - open-access
Related In: Results  -  Collection

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

Fig2: Crude incidence rates by resident status, age groups and ethnicity and age-standardized incidence rates; (a) Comparative risk plot of Tuberculosis among non-resident and resident communities in Singapore (b) Age-specific incidence rates of Tuberculosis (Residents) (c) Ethnicity-specific incidence rates of Tuberculosis (Residents) (d) Age-standardized incidence rates (Residents); dashed lines are 95% confidence intervals.
Mentions: TB incidence rates were consistently higher among non-residents than residents over the period studied (Figure 2a). Among residents, the TB incidence rate was higher among those aged ≥65 years and who belong to Malay and Other ethnic groups (Figure 2b,c). Age-standardized incidence rates (ASIR) among residents were significantly lower in 2011 (ASIR: 36.5 per 100,000 population, 95% CI = 34.8-38.3 per 100,000 population) by 24% compared with 1995 (ASIR: 48.5 per 100,000 population, 95% CI = 46-50.9 per 100,000 population) (Figure 2d). Despite a drop between 2004 and 2007, the ASIR has been increasing since 2008. Compared with the 2007 ASIR (29.9 per 100,000 population, 95% CI = 28.3-31.6 per 100,000 population), there was a 22% increase by 2011 (36.5 per 100,000 population, 95% CI = 34.8-38.3 per 100,000 population). When stratified by ethnic groups among residents, Malay and Other ethnicities had significantly higher ASIR over years (Additional file 1: Figure S1).Figure 2

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