Projection of the number of patients with tuberculosis in the Netherlands in 2030.
BACKGROUND
The incidence of tuberculosis (TB) in The Netherlands has been declining for many years. For the purpose of planning future TB-control activities we estimated the number of TB patients in The Netherlands up to 2030.


METHODS
Statistical modelling for 5-year age groups up to 2030 distinguishing among Dutch TB patients infected by a Dutch source (survival model), non-Dutch patients (projection of the proportion of culture-positive patients among first generation immigrants) and Dutch patients infected by a non-Dutch source (fixed relation with the number of non-Dutch patients).


RESULTS
The number of TB patients is expected to decline to 877 in 2030. After 2010 declines may slow due to an increase in non-Dutch TB patients. This increase cancels out the decrease of Dutch TB patients infected by a Dutch source. In 2030, 85% of all TB patients are expected to be non-Dutch. In the four largest counties and the rest of The Netherlands, this will be 89 and 76%, respectively.


CONCLUSIONS
The decrease in TB incidence observed over many years may stall from 2010 onwards because of an estimated increase in non-Dutch TB patients. Given their disproportionate burden, future TB-control activities should prioritize the health of first-generation immigrants. Enhanced TB control in the countries of origin and new diagnostic tests to identify those at high risk of developing active TB could help in reducing further the TB incidence in the Netherlands. Future TB-control efforts must be organized in a flexible way to be able to incorporate changing epidemiological situations.
van Leth
Frank
F
KNCV Tuberculosis Foundation, 2514 JD Den Haag, The Hague, The Netherlands. vanlethf@kncvtbc.nl
Kalisvaart
Nico A
NA
Erkens
Connie G M
CG
Borgdoff
Martien W
MW
D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D005544:Forecasting; D006801:Humans; D015993:Life Tables; D008297:Male; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D014376:Tuberculosis / Q000453:epidemiology* / Q000208:ethnology; D055815:Young Adult