Epidemiological measurement methodologies

To design appropriate prevention and care strategies, it is important to understand and map the burden of the disease in different countries and regions. The burden of tuberculosis (TB) in a country or a region is expressed in terms of illnesses and deaths per population. Because many people with TB have no clear symptoms of the disease, while they can transmit the disease to others (just like with many other infectious diseases!), it is difficult to get a good idea of the burden of the disease. Therefore, although TB is a notifiable disease, one cannot simply rely on the number of TB patients reported by clinicians to the authorities.

Measure the burden of disease

Studies are needed to measure the burden of disease. This is done through TB prevalence surveys. In such surveys, a sample of the population in a country is systematically investigated for the disease, and using statistical methods, inferences are made on the burden in the whole population. KNCV has been involved in the development of standard methodology for TB prevalence surveys since the 1990s, and has since then supervised many TB prevalence surveys in Africa and Asia. KNCV is still in the frontline of developing new methodologies to make the conduct of TB prevalence surveys easier. For example, we are currently involved in studies that investigate whether the methods for finding TB in the surveys can be simplified using newer diagnostic technologies.

To measure the burden of drug-resistant forms of TB, other types of studies known as TB drug resistance surveys (DRS) are needed, as drug resistance does occur in only a small proportion of the TB patients. KNCV has also contributed to the development of these DRS and has helped conducting surveys in Asia and Africa.

Epidemiological assessments

Countries can make better use of the data that they already collect. We help countries in doing so by contributing to epidemiological assessments, in which data from different sources is analyzed, combined and put into perspective, in order to help the National Tuberculosis Programs to better understand where the gaps are in the program that they can and need to address.

We also support countries who want to conduct modeling to assess the potential effect of proposed interventions to reduce the burden of TB. We provide the modelling support to countries in collaboration with other well-known TB modeling groups to estimate the burden of TB in countries and regions.

It is in KNCV’s immediate future plans to support countries in conducting inventory studies which are important to assess the extent of under-reporting; economic modelling; direct mortality measurements; and development of novel designs and methodologies.

KNCV has been fighting TB since its establishment in 1903. Over the past 120 years, the organization has acquired indispensable knowledge and experience in the field of effective TB prevention and care, resulting in pre-elimination in the Netherlands and significant contributions to global evidence generation, policy development and TB program implementation worldwide.

Our experts
KNCV governance framework and integrity
Our patroness
Partner with us

Tuberculosis is still one of the major causes of preventable death in the world and claims over 4000 lives a day, leading to over 1,5 million deaths a year.

Patient stories

The story of Abdurahim
The story of Fikeraddis
The story of Issayas
The story of Zarina
The story of Maxine
The story of Saanvi