The Baltic States risk seeing an upsurge in tuberculosis (TB) cases because of the recession brought about by the financial crisis, scientists said on Wednesday, and Latvia is particularly vulnerable.
"Put simply, there's a lot less money around for spending on public health," said Nimalan Arinaminpathy of Britain's Oxford University, who led the study.
Tuberculosis, which is caused by the Mycobacterium tuberculosis bacteria, is one of three primary diseases linked to poverty, the other two being AIDS and malaria.
The scientists designed models based on economic figures and tuberculosis data and predicted that Latvia, Estonia and Lithuania could see TB increases in the coming years.
Their estimates were for 200 excess cases of tuberculosis per 100,000 people in the population in Latvia, 130 per 100,000 in Lithuania and 75 per 100,000 in Estonia compared with some 40 per 100,000 in Russia over the period of recession and recovery.
"An upturn of TB in any region becomes a concern for neighboring countries, and because people travel so much these days it also becomes a concern for countries further away," Arinaminpathy said in a telephone interview.
Tuberculosis killed 1.8 million people in 2008, or nearly 5,000 people a day. More than 2 billion people are infected, but most TB infections are latent with carriers showing no symptoms.
The disease can be cured with antibiotics, but they must be taken daily for months to be effective and public health funding cuts in some countries may mean fewer drugs are available.
Because people do not always take the drugs as directed, multiple drug-resistant strains called MDR-TB are also emerging and the World Health Organisation (WHO) has said there is an urgent need for countries to set up laboratories to fight it.
Arinaminpathy and Christopher Dye of the WHO's department for HIV/AIDS, tuberculosis, malaria and neglected tropical diseases, used WHO data on TB cases and deaths from 1980 to 2006, and World Bank data on Gross Domestic Product.
Analyzing 15 countries in central and eastern Europe, they found strong links between the lost economic productivity during recessions and excess numbers of TB cases and deaths, they wrote in the study in the Royal Society journal Interface.
"If TB epidemiology and control are linked to economies in 2009 as they were in 1991 then the Baltic states, particularly Latvia, are now vulnerable to another upturn in TB cases and deaths," they wrote.