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End TB strategy: the need to reduce risk inequalities

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Gomes, Gabriela ORCID: https://orcid.org/0000-0002-1454-4979, Barreto, Maurício L., Glaziou, Philippe, Medley, Graham F., Rodrigues, Laura C., Wallinga, Jacco and Squire, Bertie ORCID: https://orcid.org/0000-0001-7173-9038 (2016) 'End TB strategy: the need to reduce risk inequalities'. BMC Infectious Diseases, Vol 16, Issue 132.

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Abstract

Background
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.

Discussion
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.

Summary
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
Subjects: WA Public Health > WA 30 Socioeconomic factors in public health (General)
WA Public Health > Health Administration and Organization > WA 530 International health administration
WF Respiratory System > Tuberculosis > WF 200 Tuberculosis (General)
Faculty: Department: Clinical Sciences & International Health > Clinical Sciences Department
Digital Object Identifer (DOI): https://doi.org/10.1186/s12879-016-1464-8
Depositing User: Jessica Jones
Date Deposited: 29 Mar 2016 14:47
Last Modified: 13 Nov 2019 11:22
URI: https://archive.lstmed.ac.uk/id/eprint/5817

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