Tuberculosis (TB) remains the world’s leading cause of death from an infectious disease, with more than 80% of cases and deaths occurring in low- and middle-income countries.
However, many of the places most affected by TB also have limited local health data. Without that information, it can be difficult to identify who is most at risk and where to target testing and treatment resources to reduce local TB incidence.
To help address that gap, researchers at the University of Pittsburgh School of Public Health collaborated with colleagues at Hanoi Medical University to examine TB incidence and mortality in Lang Son Province, a rural border region in northern Vietnam.
“The only way to eliminate TB is to address it everywhere,” said Joshua Mattila, PhD, a co-author of the study and associate professor of infectious diseases and microbiology. “Rural communities are frequently left out of the equation, so these results could potentially lead to better-targeted treatment and reduced incidence.”
Published in April in Tropical Medicine and Infectious Disease, the study analyzed health data collected in Lang Son from 2005-2008 and 2011-2018. The group found that mortality rates were significantly higher among men than women, and that mortality increased with age, peaking among adults age 70 and older.
“Higher mortality among men may reflect greater occupational and community exposure, along with broader differences in risk behaviors and healthcare access,” said Toan Ha, MD, DrPH, assistant professor of infectious diseases and microbiology. “Among older adults, aging immune systems are often less able to fight infection, making disease more likely to be severe in older populations.” Future studies will examine the factors contributing to mortality differences among demographic groups in the province.
Ha said another challenge is that many residents and workers regularly cross the nearby Chinese border for trade, making it more difficult to identify and monitor people at risk.
“We want to highlight that border provinces require more attention and resources,” said Ha. “These areas often have significant ethnic minority populations, so health policies must account for disparities in healthcare access between ethnic minorities and the general population, as well as between urban and rural communities.”
Later this year, Pitt faculty will travel to Hanoi to participate in the Vietnam Annual Conference on Medical Innovation and Healthcare Models, where researchers will contribute to sessions on One Health and infectious diseases, including tuberculosis.
“This collaboration extends beyond a single study,” said Mattila.” “It reflects a broader effort to strengthen international partnerships and develop innovative, context-specific strategies to control TB.”
“TB and HIV are important focus areas for us in our department, and this study reflects both that commitment and the strength of our global partnerships. Recognizing regional differences in disease burden and disproportionate impact is critical to developing effective, context-specific public health responses,” said Suresh Kuchipudi, PhD, MVSc, MBA, professor and chair of the Department of Infectious Diseases and Microbiology at Pitt Public Health.
This research was partially funded by the Australian Government (2006–2012, grant number HSS100) to Le Tran Ngoan. Toan Ha, Joshua T. Mattila and Suresh V. Kuchipudi were supported in part by funding from the University of Pittsburgh School of Public Health.
Other authors include Ngan Dieu Ta of Nguyen Tat Thanh University and Hanoi Medical University; Thang Quyet Nguyen of CDC Lang Son; and Thanh C. Bui of the University of Oklahoma Health Sciences Center.
-Ava Dzurenda