title: The effect of diabetes and undernutrition trends on reaching 2035 global tuberculosis targets.
abstract: To achieve the post-2015 global tuberculosis target of 90% reduction in tuberculosis incidence by 2035, the present rate of decline must accelerate. Among factors that hinder tuberculosis control, malnutrition and diabetes are key challenges. We review available data to describe the complex relationship between tuberculosis, diabetes, and nutritional status. Additionally, we review past trends, present burden, and available future global projections for diabetes, overweight and obesity, as well as undernutrition and food insecurity. Using a mathematical model, we estimate the potential effect of these factors on tuberculosis burden up to 2035. Great potential exists for reduction of worldwide tuberculosis burden by combination of improved prevention and care of diabetes with reduction of undernutrition. To achieve this combination will require joint efforts and strong cross-programme links, enabling synergistic effects of public health policies that promote good nutrition and optimum clinical care for tuberculosis and diabetes.
authors.affiliation: Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA. Electronic address: anna.odone@mail.harvard.edu.
authors.forename: Anna
authors.initials: A
authors.lastname: Odone
authors.affiliation: Tuberculosis Modelling Group, Tuberculosis Centre and Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK.
authors.forename: Rein M G J
authors.initials: RM
authors.lastname: Houben
authors.affiliation: Tuberculosis Modelling Group, Tuberculosis Centre and Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK.
authors.forename: Richard G
authors.initials: RG
authors.lastname: White
authors.affiliation: Global Tuberculosis Programme, World Health Organization, Geneva, Switzerland.
authors.forename: Knut
authors.initials: K
authors.lastname: Lönnroth
mesh_terms: D017281:Cost of Illness; D003920:Diabetes Mellitus / Q000453:epidemiology* / Q000517:prevention & control*; D005523:Food Supply; D014943:Global Health; D006293:Health Promotion / Q000458:organization & administration*; D006801:Humans; D015994:Incidence; D044342:Malnutrition / Q000150:complications / Q000453:epidemiology*; D008962:Models, Theoretical; D018673:Nutrition Policy; D009752:Nutritional Status; D010353:Patient Education as Topic; D014376:Tuberculosis / Q000453:epidemiology* / Q000209:etiology / Q000517:prevention & control*