RT Journal Article SR Electronic T1 Social determinants of tuberculosis in Europe: a prospective ecological study JF European Respiratory Journal JO Eur Respir J FD European Respiratory Society SP 925 OP 930 DO 10.1183/09031936.00184011 VO 40 IS 4 A1 George B. Ploubidis A1 Melissa J. Palmer A1 Charlotte Blackmore A1 Tek-Ang Lim A1 Davide Manissero A1 Andreas Sandgren A1 Jan C. Semenza YR 2012 UL http://erj.ersjournals.com/content/40/4/925.abstract AB Tuberculosis (TB) is considered to be a disease of poverty, since its incidence is exacerbated by socioeconomic factors, inconsistent or partial treatment practices, and immigration from endemic countries. A prospective country level study, using a comprehensive dataset of TB incidence and prevalence taken from countries within the World Health Organization (WHO) European region, was conducted. We employed quintile regression to investigate the prospective association between baseline (measured in 2000) and a nation’s wealth, level of egalitarianism, migration rate, health-related lifestyle and social capital with TB incidence and prevalence over a 10-yr period (2000–2009). We found that ∼50% of TB variation is accounted for by a nation's wealth and level of egalitarianism. We observed a negative prospective association between logged gross domestic product and TB rates, and a positive prospective association between income inequality and TB. National income levels per capita and income inequality are important predictors for TB incidence and prevalence in the WHO European region. They account for 50% of country-level variation, indicating the importance of a combined absolute and relative socioeconomic disadvantage in the development of TB. These findings also provide a tool for forecasting potential fluctuations in the level of TB epidemics in the WHO European region, with respect to socioeconomic changes.