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Decrease in risk of tuberculosis infection despite increase in tuberculosis among young adults in urban Vietnam

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OBJECTIVE: To assess whether the increase in tuberculosis (TB) notification rates among young adults in Vietnam reflects increased transmission in the population at large.

METHOD: Trends of case notification rates of new smear-positive TB were calculated from routinely reported data of district TB units over the period 1996–2005. Results from repeated tuberculin surveys among children aged 6–9 years were obtained to calculate the trend in annual risk of TB infection (ARTI).

FINDINGS: From 1996 to 2006, notification rates in the age group 15–24 years increased by 4.3% per year, and more so in highly urbanised (6.7%) than in rural districts (1.7%). The ARTI in urban districts declined from 2.4% in 1992 to 1.2% in 1998 and 0.9% in 2005. In rural districts, the ARTI increased from 0.7% in 1991 to 1.2% in 1997, and then declined to 0.9% in 2006.

CONCLUSION: The increase in TB notification rates among young adults in Ho Chi Minh Province is accompanied by a decrease in ARTI in children. This suggests that the trend in TB notification among young adults reflects increased rates of progression from infection to disease and/or increased transmission within this age group, rather than increased transmission in the population at large.

Keywords: case notification; risk of TB infection; urban Vietnam

Document Type: Regular Paper

Affiliations: 1: Pham Ngoc Thach Tuberculosis and Lung Disease Hospital, Ho Chi Minh City, Ho Chi Minh Province, Vietnam 2: National Tuberculosis Program and Central Tuberculosis and Lung Disease Hospital, Ha Noi City, Vietnam 3: KNCV Tuberculosis Foundation, The Hague, The Netherlands; and Centre for Poverty-related Communicable Diseases, Centre for Infection and Immunity Amsterdam, Academic Medical Centre, Amsterdam, The Netherlands

Publication date: 01 March 2010

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