Social determinants of tuberculosis in Europe: A prospective ecological study.

: Tuberculosis (TB) is considered to be a disease of poverty since its incidence is exacerbated by socio-economic 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 in countries within the WHO European region was conducted. We employed quintile regression to investigate the prospective association between baseline (measured in 2000) nations wealth, level of egalitarianism, migration rate, health related lifestyle and social capital with TB incidence and prevalence over 10 years (2000-2009).We found that around 50% of TB variation is accounted for by a nation's wealth and level of egalitarianism. We observed a negative prospective association between logged GDP and TB rates and a positive prospective association between income inequality and TB.National income levels per capita and income inequality are important predictors of TB incidence and prevalence in the WHO European region, accounting for 50% of country level variation, indicating the importance of combination of absolute and relative socio-economic disadvantage in the development of TB. The findings also provide a tool for forecasting potential fluctuations of the level of the TB epidemic in the EU with respect to socio economic changes