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SDG 3: Tuberculosis

Abstract

Background

Denmark possesses an exceptional historical data collection on tuberculosis (TB) from 1876 to the present, providing a unique opportunity to assess TB epidemiology over 147 years in Denmark.

Aim

Our aim was to describe the TB disease burden in Denmark in relation to historical events, living conditions and health interventions during the past 147 years.

Methods

We performed a nationwide register-based ecological study including all persons with TB in Denmark from 1876 through 2022, correlating the TB incidence to social, economic and health indicators.

Results

In Denmark, the overall TB incidence and mortality declined markedly over the past 147 years, only marginally influenced by specific TB interventions such as sanatoria, Bacillus Calmette-Guèrin (BCG) vaccination, mass screenings and antibiotics. Parallel to this decline, the country experienced improved living conditions, as illustrated by decreased infant mortality and increased life expectancy and wealth. In 1978, Denmark became a low-incidence country for TB with risk groups predominantly affected, and with a continuous change in demographics towards fewer Danish-born cases and relatively more migrant cases.

Conclusions

The decline over time in TB incidence and mortality in Denmark preceded specific TB interventions and can, first of all, be attributed to improved living conditions. TB has now become a rare disease in Denmark, predominantly occurring in particular risk groups. Future elimination of TB will require a combination of specific health interventions in these risk groups combined with a continued focus on improving socioeconomic status and living conditions.

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2024-06-13
2024-12-12
http://instance.metastore.ingenta.com/content/10.2807/1560-7917.ES.2024.29.24.2300652
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References

  1. Groth-Petersen E, Knudsen J, Wilbek E. Epidemiological basis of tuberculosis eradication in an advanced country. Bull World Health Organ. 1959;21(1):5-49. PMID: 13829735 
  2. Langholz Kristensen K, Lillebaek T, Holm Petersen J, Hargreaves S, Nellums LB, Friedland JS, et al. Tuberculosis incidence among migrants according to migrant status: a cohort study, Denmark, 1993 to 2015. Euro Surveill. 2019;24(44):1900238.  https://doi.org/10.2807/1560-7917.ES.2019.24.44.1900238  PMID: 31690363 
  3. Nordholm AC, Andersen AB, Wejse C, Norman A, Ekstrøm CT, Andersen PH, et al. Social determinants of tuberculosis: a nationwide case-control study, Denmark, 1990-2018. Int J Epidemiol. 2022;51(5):1446-56.  https://doi.org/10.1093/ije/dyac109  PMID: 35595514 
  4. Nordholm AC, Andersen AB, Wejse C, Norman A, Ekstrøm CT, Andersen PH, et al. Mental illness, substance abuse, and tuberculosis risk. J Infect. 2023;86(5):e135-7.  https://doi.org/10.1016/j.jinf.2023.01.035  PMID: 36716977 
  5. Nordholm AC, Andersen AB, Wejse C, Norman A, Ekstrøm CT, Andersen PH, et al. Mortality, risk factors, and causes of death among people with tuberculosis in Denmark, 1990-2018. Int J Infect Dis. 2023;130:76-82.  https://doi.org/10.1016/j.ijid.2023.02.024  PMID: 36907546 
  6. The National Association for the Fight against Tuberculosis. The fight against tuberculosis in Denmark. Copenhagen: Nyt Nordisk Forlag Arnold Busck; 1950.
  7. Poulsen S, Rønne T, Kok-Jensen A, Bauer JO, Miörner H. Tuberkuloseudviklingen i Danmark 1972-1996. [Tuberculosis in Denmark 1972-1996]. Ugeskr Laeger. 1999;161(23):3452-7. Danish. PMID:10388353 PMID: 10388353 
  8. Holm J. Tuberculosis Control in Denmark. Public Health Rep. 1946;41(40):1426-43.  https://doi.org/10.2307/4585854 
  9. Møller ES. Nationalforeningen til Tuberkulosens bekæmpelse 1901 - 16. Januar - 1951. [The National Association for the Control of Tuberculosis 1901 - 16 January - 1951]. Copenhagen: Egmont H. Petersens Kgl. Hof-Bogtrykkeri; 1950. Danish.
  10. Horwitz O, Iversen E. Tuberkulosen i Danmark: Status og projection. [Tuberculosis in Denmark: Status and perspectives]. Copenhagen: Sundhedsstyrelsen. 1979. Danish.
  11. Härö AS. Cohort approach in tuberculosis surveillance: comparison of the situation in Sweden and Finland. Tuber Lung Dis. 1994;75(4):271-82.  https://doi.org/10.1016/0962-8479(94)90132-5  PMID: 7949073 
  12. Holloway-Kew KL, Henneberg M. Dynamics of tuberculosis infection in various populations during the 19th and 20th century: The impact of conservative and pharmaceutical treatments. Tuberculosis (Edinb). 2023;143S:102389.  https://doi.org/10.1016/j.tube.2023.102389  PMID: 38012934 
  13. Murray JF. Tuberculosis and World War I. Am J Respir Crit Care Med. 2015;192(4):411-4.  https://doi.org/10.1164/rccm.201501-0135OE  PMID: 26278794 
  14. Dragsted UB, Bauer J, Poulsen S, Askgaard D, Andersen ÅB, Lundgren JD, et al. Epidemiology of tuberculosis in HIV-infected patients in Denmark. Scand J Infect Dis. 1999;31(1):57-61.  https://doi.org/10.1080/00365549950161899  PMID: 10381219 
  15. Kristensen H. Kristensens bolighistorie, fire generationers boliger 1910-2010. [Kristensen's housing history, housings in four generations 1910-2010]. 1st ed. Copenhagen: Bolius; 2012. Danish.
  16. Statistics Denmark. Boliger med CPR-tilmeldte personer (gennemsnit) efter område, enhed og anvendelse. [Housings with persons with CPR number (average) by area, unit and application]. Copenhagen: Statistics Denmark. [Accessed: 20 Jul 2023]. Danish. Available from: https://www.statistikbanken.dk/bol106
  17. NCD Risk Factor Collaboration (NCD-RisC). A century of trends in adult human height. eLife. 2016;5:e13410.  https://doi.org/10.7554/eLife.13410  PMID: 27458798 
  18. Folkvardsen DB, Norman A, Andersen ÅB, Michael Rasmussen E, Jelsbak L, Lillebaek T. Genomic epidemiology of a major Mycobacterium tuberculosis outbreak: Retrospective cohort study in a low-incidence setting using sparse time-series sampling. J Infect Dis. 2017;216(3):366-74.  https://doi.org/10.1093/infdis/jix298  PMID: 28666374 
  19. Skaksen JR, Jensen B. Hvad ved vi om indvandring og integration? Indvandringen til Danmark og forløbet af integrationen fra 1960’erne til i dag. [What do we know about immigration and integration? Immigration to Denmark and the course of integration from the 1960s to the present]. Gyldendal: Rockwool Fondens Forskningsenhed; 2016. Danish.
  20. Lillebaek T, Andersen ÅB, Dirksen A, Smith E, Skovgaard LT, Kok-Jensen A. Persistent high incidence of tuberculosis in immigrants in a low-incidence country. Emerg Infect Dis. 2002;8(7):679-84.  https://doi.org/10.3201/eid0807.010482  PMID: 12095434 
  21. Lillebaek T, Andersen AB, Bauer J, Dirksen A, Glismann S, de Haas P, et al. Risk of Mycobacterium tuberculosis transmission in a low-incidence country due to immigration from high-incidence areas. J Clin Microbiol. 2001;39(3):855-61.  https://doi.org/10.1128/JCM.39.3.855-861.2001  PMID: 11230395 
  22. Lillebæk T, Andersen AB, Seersholm NJ, Thomsen VO. Fortsat tuberkuloseproblemer blandt danskere og grønlændere i Danmark og behov for styrket kontrol. [Continuing tuberculosis problems among Danes and Greenlanders in Denmark and the need for strengthened control]. Ugeskr Laeger. 2012;174(44):2696-701. Danish. PMID:23121905 PMID: 23121905 
  23. Rådet for Socialt Udsatte. I Grønland er jeg for dansk, og i Danmark er jeg “bare” grønlænder. [In Greenland I am too Danish, and in Denmark I am “just” a Greenlander]. Rønne: Rådet for Socialt Udsatte; 2014. ISBN: 978-87-7546-466-1. Danish. Available from: https://udsatte.dk/udgivelser/groenland-er-jeg-dansk-danmark-er-jeg-bare-groenlaender
  24. Seung KJ, Keshavjee S, Rich ML. Multidrug-resistant tuberculosis and extensively drug-resistant tuberculosis. Cold Spring Harb Perspect Med. 2015;5(9):a017863.  https://doi.org/10.1101/cshperspect.a017863  PMID: 25918181 
  25. Bang D, Lillebaek T, Thomsen VØ, Andersen ÅB. Multidrug-resistant tuberculosis: treatment outcome in Denmark, 1992-2007. Scand J Infect Dis. 2010;42(4):288-93.  https://doi.org/10.3109/00365540903456282  PMID: 20082573 
  26. Statens Serum Institut. Tuberkulose. [Tuberculosis]. Copenhagen: Statens Serum Institut. [Accessed: 20.07.2023]. Danish. Available from: https://www.ssi.dk/sygdomme-beredskab-og-forskning/sygdomsleksikon/t/tuberkulose
  27. Kristensen KL, Ravn P, Petersen JH, Hargreaves S, Nellums LB, Friedland JS, et al. Long-term risk of tuberculosis among migrants according to migrant status: a cohort study. Int J Epidemiol. 2020;49(3):776-85.  https://doi.org/10.1093/ije/dyaa063  PMID: 32380550 
  28. Stærke NB, Hilberg O, Wejse C, Hoffmann HJ, Fløe A. Latent tuberculosis infection is prevalent among socially marginalised citizens in Aarhus, Denmark. Dan Med J. 2016;63(7):4-8. PMID: 27399979 
The impact of living conditions and health interventions on tuberculosis, Denmark, 1876 to 2022
<p class="citation"> <span>Citation style for this article:</span> <span class="meta-value authors"> <a href="/search?value1=Anne+Christine+Nordholm&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Nordholm Anne Christine</a>, <a href="/search?value1=Anja+Joergensen&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Joergensen Anja</a>, <a href="/search?value1=Louise+Hedevang+Holm&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Holm Louise Hedevang</a>, <a href="/search?value1=Aase+Bengaard+Andersen&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Andersen Aase Bengaard</a>, <a href="/search?value1=Anders+Koch&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Koch Anders</a>, <a href="/search?value1=Peter+Henrik+Andersen&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Andersen Peter Henrik</a>, <a href="/search?value1=Troels+Lillebaek&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Lillebaek Troels</a></span>. The impact of living conditions and health interventions on tuberculosis, Denmark, 1876 to 2022. <a href="/content/ecdc">Euro Surveill.</a> 2024;29(24):pii=2300652. <a href="https://doi.org/10.2807/1560-7917.ES.2024.29.24.2300652" title="doi link" target="_blank">https://doi.org/10.2807/1560-7917.ES.2024.29.24.2300652</a> <span class="ES_Article_citation"> <span class="generated">Received</span>: 20 Nov 2023;&nbsp;&nbsp; <span class="generated">Accepted</span>: 18 Apr 2024 </span> </p>
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