Updated: Oct 23, 2019
I chose to study the correlation of Tuberculosis with the HDI of six different countries, because I find the countries HDI interesting to study as well as something important for everyone to know and help to improve. Many believe that particular countries that are highly infected because of a disease is because the disease originates from there, whilst in reality most of the times it all goes down to hygiene and resources available. For example, Tuberculosis infections began to increase in 1985, mainly because of HIV that can cause AIDS, because it weakens the body's immune system and so the body couldn't fight back Mycobacterium tuberculosis bacterium. In USA, because of strict health controls, TB began to decrease in 1993, however still remains a concern. As awareness for the importance of hygiene and medical technology grew, The Centers for Disease Control and Prevention began highly recommending people such as those with HIV/AIDS, IV drug users and those in contact with infected individuals especially TB to get prescribed Latent TB infection.
Tuberculosis, also known as TB is a disease that mainly affects the lungs (can also affect other body parts) because of the bacteria Mycobacterium tuberculosis. One can get infected by this disease through inhalation of tiny particles emitted into the surrounding by coughs, sneezes or even talks by an already TB infected person. One can also get infected by drinking TB infected raw cattle milk. Symptoms you may encounter if you have TB can be a bad cough that lasts for several weeks, coughing blood or mucus, weakness, fever, night sweats, chills, cough blood, chest pain and weight loss because of loss of appetite. To find out if you do have this particular disease is by doing tests such as skin, blood, X-ray and other tests and if not treated properly, this disease can become deadly. As mentioned, TB can affect other body parts such as kidneys, spine or brain and depending on where your body is infected you may experience different symptoms. For example, if your spine is affected, then you may experience back pain and if your kidneys are affected, then you may experience blood in your urine.
To cure TB, you can take several types of medications to for a long period of time to eradicate the infection and prevent the development of antibiotic resistance, considering many strains of TB resist the drugs used to treat TB. Unfortunately, if cured, their is a risk of TB to re-infect the body again future in life. However, usually your immune system can prevent the bacteria from causing the disease and for this reason a patient gets usually prescribed with two different Tuberculosis :
Latent/ dormant TB: If a patient is prescribed of having Latent TB, the bacteria is then remained in the body in a inactive form and thus does not cause any symptoms. This particular condition is not contagious, but can turn into active TB and so it is necessary to treat this condition to avoid it from spreading, considering there is an estimated 2 billion people having Latent TB.
Active TB: If a patient is prescribed with Active TB, then it can spread to others and thus is known for being more dangerous. A condition such as this is difficult to estimate considering after infection, the symptoms may appear weeks or even years later.
Thus, more specifically, depending on if the Mycobacterium tuberculosis is latent or active, the body will get affected differently. But, once the body undergoes malnutrition or gets infected by HIV, the bacteria becomes active and cause enlarged lymph nodes. Tuberculosis can cause enlarged swollen lymph nodes either in the respiratory system or any other body part depending on the infected area. The swelled enlarged lymph nodes can cause severe neck pain with fever and weight loss accompanying such consequences. It is important to be careful with the swollen lymph nodes, considering they might be pus formation within and so might rupture and release the pus. Human Development Index, also known as HDI, is a summary measure of average achievement in key dimensions of human developments such as:
Long and healthy life
This dimension is assessed by life expectancy at birth.
This dimension is measured by mean of years of schooling for adults aged +25 and expected years of schooling for children of school entering age.
Having a decent standard of living
This dimension is measured by GNI (Gross national income) per capita
All of these dimensions are then aggregated into a complex index using geometric mean.
As a conclusion, it emphasizes that people and their capabilities and resources should be the ultimate criteria for measuring the development of a country and not just the economic growth alone. It is also a great comparison data between two countries with the same GNI per capita with the same HDI, which can also lead to debate about countries policy priorities.
The hypothesis of this investigation is to see a positive correlation between TB and HDI and so it is expected to see that as a countries HDI is low to see a growth in more people infected by the TB and vice versa.
Three different databases were used, being “Who Health Mortality” and “Worldbank.org”, “Hdr.undp” as well as an equation to calculate “Death rate per million” for Tuberculosis in the different countries chosen.
“Who Health Mortality Statistics”
This database was used to collect the numbers of deaths caused by Tuberculosis in the chosen countries, being Chile, Ecuador, Spain, Brazil, Mexico and Colombia between 1990-2010. Data in question was collected in the following way, starting with the page “Health mortality database” > Select parameter > Search “ Number of deaths caused by TB” > Total reporting countries 1990-2010 > Total reporting countries as mentioned above.
(2) “World bank.org for population by million”
This following database was used collect the population numbers by million of the following countries between 1990-2010. Data in question was collected in the following way, starting with the page Population, total > Searching all countries in question > collecting data between 1990-2010 from the graph.
(3) “HDR.UNDP for HDI values”
This last database was used to collect data on the “Human Development Index” of the chosen countries between 1990-2010. Data in question was collected in the following way, starting with the page Human development index > data > Dimension HDI.
(4) Death rate per million
The death rate per million by Tuberculosis is calculated using the following equation to process the data collected from the databases above;
In the equation presented above, n represents the year in which the values are being calculate individually between 1990-2010. The complete ratio will then be multiplied by 10^6, considering the actual ratio of death to population is significantly small. In conclusion, by multiplying the ratio by a million,the ratio will be converted into death rate per million in each country. As a total, this will make it easier to compare each country with its own HDI value as well as population over chosen years as well as show a proper visual increase and decrease in the numbers of deaths caused by Tuberculosis between 1990-2010.
The results and the analysis investigated agree with my hypothesis for the most part, that I should get a positive correlation between TB and HDI and as expected, I saw countries with low HDI having more TB infected population and death rate per million between 1990-2010. Also vice versa, that the higher the HDI value gets, the less will the death rate per million be during that time duration. Graph 1&6 however, do not show a positive correlation and they are Chile and Brazil. Chile has a significant decrease and increase in death rate per million, but the more shocking one is Brazil that Shows a complete negative correlation between HDI and death rate per million of TB.
Chile, in graph 1. Showed a bit of a difficult slope on the Death rate per million in order to be able to analyze whether or not it is a positive or negative correlation with it and the Human Development Index. When taking an overall line of best fit, we can see to an extent that there is a positive correlation between Death rate per million and HDI. However, why the line goes up and down in a Ziczac manner is the interesting part. Reasons for that, might be because the country went through tough times during certain years and had it easier with diseases and infections in others.
Ecuador, in Graph 2. Shows a much better positive correlation between Tuberculosis and HDI. As HDI increases, the Death rate per million decreases, however in years 1994-1997 their were certain ups and downs just like for Chile.
Spain & Colombia & Mexico
Spain, Colombia and Mexico in Graphs 3.4.5 Shows a clear positive correlation between Tuberculosis and HDI. As HDI increases, Tuberculosis decreases, which is what was expected according to my hypothesis.
Brazil in Graph 6. Presents the most shocking graph, with HDI and Death rate per million following each other. As HDI increases, so does Death rate per million between 1990-2010 giving no positive correlation between TB and HDI.
Their could be a few reasons behind it, one being that their might have been an epidemic spread of infection across the country for a while. Or the fact that maybe too high of HDI value might make the immune system very weak towards outside diseases and thus make death rate higher when a slight change occurs. Another reason is that HDI is a general sum of everything that is included in a “Standard Life” and thus, health and Tuberculosis is one of the many factors for death rate, meaning maybe Brazil might have a high HDI because of other factors, but when it comes to health it is low.
The most probable reason however, is likely to be the fact that Brazil is an enormous country and many might be distances away from Hospitals and thus might not make it their. Also, Hospitals are expensive in comparison to the income of many in the country and thus many might not be able to afford a proper treatment. As mentioned earlier, why Brazil has such a high HDI might most likely be because Brazil has great living standards when it comes to e.g. education but low value for specifically health resources.
Evaluation and further investigation
Considering each data such as population, numbers of deaths caused by Tuberculosis and HDI were each collected from only one database, the accuracy might be slightly off. The databases reliability could be checked by collected e.g. HDI from multiple databases and compare the values to see how accurate each are and if it is reliable. It is very difficult to just simply trust data taken straight from the internet, and thus some sort of analysis and comparison between multiple ones, would make the data I collected more trustworthy.
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