Biological Anthropology and Comparative Anatomy Research Unit, University of Adelaide
Friday All day, Park Concourse
Tuberculosis (TB) was a major cause of mortality in Europe during the 16th century and is re-emerging again in developing countries at present. This re-emergence is associated with the HIV/AIDS epidemic as well as developing drug resistance of the Mycobacterium. The aim of this study was to determine the non-drug-therapy related factors in the initial decline of TB in Europe and the United States during the 19th and early 20th centuries prior to the introduction of chemical therapies including antibiotics. We examined unpublished records from archives in Zürich, Switzerland covering the period 1840 -1933 and compared the results with data from the literature for England and Wales, New York (United States), Japan, Brazil and Sierra Leone. Mathematical fitting showed the mortality rate followed a substantial logistic decline through time in Switzerland, England and Wales and the United States. The major decline of TB mortality occurred well before mid-20th century, from 370 per 100,000 in 1867 to 116 in 1931 for Switzerland. Analysis including historical dates corresponding to important events in the control of TB showed that milk quality was an important factor in the decline. Sanitation was also important while the introduction of chemical/antibiotic therapy was of minor relevance (mortality decline from 77 per 100,000 in 1946 to 35 in 1951 for Switzerland). Implementation of sanitation and milk control may aid in the treatment and control of TB in high-burden countries at present.