End TB strategy: the need to reduce risk inequalities.


Gomes, MG; Barreto, ML; Glaziou, P; Medley, GF; Rodrigues, LC; Wallinga, J; Squire, SB; (2016) End TB strategy: the need to reduce risk inequalities. BMC Infect Dis, 16 (1). p. 132. ISSN 1471-2334 DOI: 10.1186/s12879-016-1464-8

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Abstract

Diseases occur in populations whose individuals differ in essential characteristics, such as exposure to the causative agent, susceptibility given exposure, and infectiousness upon infection in the case of infectious diseases. Concepts developed in demography more than 30 years ago assert that variability between individuals affects substantially the estimation of overall population risk from disease incidence data. Methods that ignore individual heterogeneity tend to underestimate overall risk and lead to overoptimistic expectations for control. Concerned that this phenomenon is frequently overlooked in epidemiology, here we feature its significance for interpreting global data on human tuberculosis and predicting the impact of control measures. We show that population-wide interventions have the greatest impact in populations where all individuals face an equal risk. Lowering variability in risk has great potential to increase the impact of interventions. Reducing inequality, therefore, empowers health interventions, which in turn improves health, further reducing inequality, in a virtuous circle.

Item Type: Article
Faculty and Department: Faculty of Epidemiology and Population Health > Dept of Infectious Disease Epidemiology
Faculty of Public Health and Policy > Dept of Global Health and Development
Research Centre: TB Centre
Social and Mathematical Epidemiology (SaME)
SaME Modelling & Economics
PubMed ID: 27001766
Web of Science ID: 372704000001
URI: http://researchonline.lshtm.ac.uk/id/eprint/2536016

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