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Free Content Long-term course of Mycobacterium tuberculosis infection in Swedish birth cohorts during the twentieth century

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SETTING: Sweden under transition from high to low tuberculosis (TB) incidence from 1920 to 2009.

OBJECTIVE: To correlate estimates of TB infection in birth cohorts with the longitudinal incidence of active TB to assess the long-term risk and time pattern of reactivated TB.

DESIGN: Time trend analysis on TB incidence using age-cohort modelling.

RESULTS: The overall TB incidence decreased from 700 per 100 000 population in 1920 to 1.4 in 2009 in the Sweden-born population. The estimated disease rate (number of cases divided by the estimated number of infected in 1967), for each birth cohort between 1920 and 1940, was stable on a level between 9.8% and 10.7%. The reactivation rate of latent TB infection (LTBI) was 2% after 1967, when indigenous transmission had disappeared.

CONCLUSION: Although approximately 10% of persons with LTBI developed active TB, the majority of cases occurred shortly after infection, and the rates of reactivation declined over time. This indicates extensive spontaneous clearance of LTBI.
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Keywords: Sweden; age-cohort modelling; epidemic; latent tuberculosis; tuberculosis

Document Type: Regular Paper

Affiliations: 1: Infectious Disease Research Unit, Department of Clinical Sciences, Lund University, Malmö University Hospital, Malmö, Sweden; and Regional Department of Infectious Disease Control and Prevention, Malmö, Sweden 2: Competence Centre for Clinical Research, Lund University Hospital, Lund, Sweden 3: Department of Laboratory Medicine, Lund University, Lund, Sweden 4: Infectious Disease Research Unit, Department of Clinical Sciences, Lund University, Malmö University Hospital, Malmö, Sweden

Publication date: 2011-06-01

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  • The International Journal of Tuberculosis and Lung Disease publishes articles on all aspects of lung health, including public health-related issues such as training programmes, cost-benefit analysis, legislation, epidemiology, intervention studies and health systems research. The IJTLD is dedicated to the continuing education of physicians and health personnel and the dissemination of information on tuberculosis and lung health world-wide.

    Certain IJTLD articles are selected for translation into French, Spanish, Chinese or Russian. They are available on the Union website

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