Modeling tuberculosis incidence in Nepal

Background: Tuberculosis (TB) constitutes a large burden of infectious disease in Nepal. Objective: Model incidence of TB between 2003 and 2008 in Nepal. Methods: A retrospective study was conducted in Nepal of tuberculosis incidence by gender and location over the six years period. Data were obtained for 198,719 tuberculosis cases from the Nepal Tuberculosis Center (NTC). A negative binomial model with two multiplicative components as predictors was used and provided a good fit. Results: The model extracted a decreasing trend during the first five years followed by a drop in 2008.The overall incidence of TB was 1.31 cases per 1,000 population with a male to female incidence rate ratio of 1.86. There were pronounced spatial variations with higher rates occurring in the Terai region, followed by the Hill, and Mountain regions. Conclusion: Tuberculosis incidence showed a steady decreasing trend, but the number of cases was still very high. Gender differences existed in TB incidence in Nepal. Higher rates were observed in the Terai Region and urban areas. These findings highlight the need for the tuberculosis control measures to remain on a sustained and long-term basis for the high TB burden rate of Nepal.