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Global burden of disease due to rifampicin-resistant tuberculosis: a mathematical modeling analysis

Author

Listed:
  • Nicolas A. Menzies

    (Harvard T. H. Chan School of Public Health
    Harvard T. H. Chan School of Public Health)

  • Brian W. Allwood

    (Stellenbosch University & Tygerberg Hospital)

  • Anna S. Dean

    (World Health Organization)

  • Pete J. Dodd

    (University of Sheffield)

  • Rein M. G. J. Houben

    (London School of Hygiene and Tropical Medicine
    London School of Hygiene and Tropical Medicine)

  • Lyndon P. James

    (Harvard T. H. Chan School of Public Health
    Harvard University)

  • Gwenan M. Knight

    (EPH, London School of Hygiene and Tropical Medicine)

  • Jamilah Meghji

    (Imperial College London)

  • Linh N. Nguyen

    (World Health Organization)

  • Andrea Rachow

    (Medical Centre of the University of Munich (LMU)
    Partner Site Munich
    German Research Center for Environmental Health (HMGU))

  • Samuel G. Schumacher

    (World Health Organization)

  • Fuad Mirzayev

    (World Health Organization)

  • Ted Cohen

    (Yale School of Public Health)

Abstract

In 2020, almost half a million individuals developed rifampicin-resistant tuberculosis (RR-TB). We estimated the global burden of RR-TB over the lifetime of affected individuals. We synthesized data on incidence, case detection, and treatment outcomes in 192 countries (99.99% of global tuberculosis). Using a mathematical model, we projected disability-adjusted life years (DALYs) over the lifetime for individuals developing tuberculosis in 2020 stratified by country, age, sex, HIV, and rifampicin resistance. Here we show that incident RR-TB in 2020 was responsible for an estimated 6.9 (95% uncertainty interval: 5.5, 8.5) million DALYs, 44% (31, 54) of which accrued among TB survivors. We estimated an average of 17 (14, 21) DALYs per person developing RR-TB, 34% (12, 56) greater than for rifampicin-susceptible tuberculosis. RR-TB burden per 100,000 was highest in former Soviet Union countries and southern African countries. While RR-TB causes substantial short-term morbidity and mortality, nearly half of the overall disease burden of RR-TB accrues among tuberculosis survivors. The substantial long-term health impacts among those surviving RR-TB disease suggest the need for improved post-treatment care and further justify increased health expenditures to prevent RR-TB transmission.

Suggested Citation

  • Nicolas A. Menzies & Brian W. Allwood & Anna S. Dean & Pete J. Dodd & Rein M. G. J. Houben & Lyndon P. James & Gwenan M. Knight & Jamilah Meghji & Linh N. Nguyen & Andrea Rachow & Samuel G. Schumacher, 2023. "Global burden of disease due to rifampicin-resistant tuberculosis: a mathematical modeling analysis," Nature Communications, Nature, vol. 14(1), pages 1-9, December.
    • Handle: RePEc:nat:natcom:v:14:y:2023:i:1:d:10.1038_s41467-023-41937-9
    DOI: 10.1038/s41467-023-41937-9
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    References listed on IDEAS

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    1. Ronald L. Iman & Jon C. Helton, 1988. "An Investigation of Uncertainty and Sensitivity Analysis Techniques for Computer Models," Risk Analysis, John Wiley & Sons, vol. 8(1), pages 71-90, March.
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