An ecological analysis of incidence of tuberculosis and per capita gross domestic product

To the Editor: In 2006, an estimated 9 million new cases of tuberculosis (TB) emerged worldwide 1. Of these, only 1% occurred in the European Union and North America combined, while Africa and South-East Asia contributed >65%. Among the 22 high-burden countries, 17 were in Africa, 16 of which were in the lowest quartile in terms of per capita gross domestic product (GDP). Since 2001, the fight against poverty has been a major theme in the World Health Organization’s (WHO) “Stop TB” strategy. Indeed, poverty “fuels” TB by facilitating transmission through crowded working and living conditions, it may increase the risk of progression to disease through malnutrition, and imposes barriers to accessing health services. The aim of the present analysis …