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2025, Social Science History
https://doi.org/10.1017/SSH.2025.23…
29 pages
1 file
This article investigates tuberculosis mortality in Hermoupolis, the capital of the Greek island of Syros, during the period of continuous cause-of-death reporting from 1916 to 1940. Contemporary reports identified Greece as having one of the highest levels of tuberculosis mortality in Europe, with Hermoupolis ranking at the top within the country. In the early twentieth century, Greece launched an anti-tuberculosis campaign, primarily supported by philanthropists due to limited state intervention. The study examines the actions, if any, taken by the local authorities in Hermoupolis and analyzes mortality attributed to tuberculosis by age group and sex. The results reveal that tuberculosis mortality declined across all age groups in the 1930s, particularly among females. Deaths were concentrated in infancy, early adulthood (20-39 years), and the elderly. Clear differences in tuberculosis fatality rates among occupational classes were found, although they did not markedly differ from all-cause mortality patterns. Factors such as the lack of sanitary reforms, poor living standards, inadequate nutrition, and overcrowding could have potentially played key roles in the high tuberculosis mortality in the city. Considering the inefficacy of sanatorium treatment before the mid-1940s, it is plausible that improvements in factory working conditions and the decrease in industrial activity in the city may have contributed to the reduction in tuberculosis mortality in Hermoupolis during the 1930s.
Cureus
Tuberculosis is an infectious disease that mainly affects the lungs (known as pulmonary tuberculosis). Mycobacterium tuberculosis is a species of pathogenic bacteria in the family of Mycobacteriaceae and the causative agent of tuberculosis; it was discovered by Robert Koch in 1882. From about 1918 to 1939, tuberculosis in Greece was characterized as a social disease because it seemed to spread among the lower social classes, including displaced people living in refugee camps. The battle against tuberculosis involved private initiatives aimed at educating people on hygiene and establishing anti-tuberculosis institutions, such as sanatoria and preventoria.
Cadernos De Saude Publica, 1999
The objective of this study was to characterize tuberculosis mortality trends in the Municipality of São Paulo, Brazil, from 1900. Standardized tuberculosis mortality rates and proportional mortality ratios were calculated and stratified by gender and age group based on data provided by government agencies. These measures were submitted to time-series analysis. We verified distinct trends: high mortality and a stationary trend from 1900 to 1945, a heavy reduction in mortality (7.41% per year) from 1945 to 1985, and a resumption of increased mortality (4.08% per year) from 1985 to 1995. In 1996 and 1997 we observed a drop in tuberculosis mortality rates, which may be indicating a new downward trend for the disease. The period from 1945 to 1985 witnessed a real reduction in tuberculosis, brought about by social improvements, the introduction of therapeutic resources, and expansion of health services. Recrudescence of tuberculosis mortality from 1985 to 1995 may reflect the increasing prevalence of Mycobacterium and HIV co-infection, besides loss of quality in specific health programs.
Cad Saude Publica, 1999
The objective of this study was to characterize tuberculosis mortality trends in the Municipality of São Paulo, Brazil, from 1900. Standardized tuberculosis mortality rates and proportional mortality ratios were calculated and stratified by gender and age group based on data provided by government agencies. These measures were submitted to time-series analysis. We verified distinct trends: high mortality and a stationary trend from 1900 to 1945, a heavy reduction in mortality (7.41% per year) from 1945 to 1985, and a resumption of increased mortality (4.08% per year) from 1985 to 1995. In 1996 and 1997 we observed a drop in tuberculosis mortality rates, which may be indicating a new downward trend for the disease. The period from 1945 to 1985 witnessed a real reduction in tuberculosis, brought about by social improvements, the introduction of therapeutic resources, and expansion of health services. Recrudescence of tuberculosis mortality from 1985 to 1995 may reflect the increasing prevalence of Mycobacterium and HIV co-infection, besides loss of quality in specific health programs.
The Economic History Review, 2022
The paper examines mortality patterns in the city of Hermoupolis, on the Greek island of Syros, from 1859 to 1940. It produces important new insights into Mediterranean urban historical demography and is the first comprehensive study of urban mortality in Greece, utilising the largest and one of the longest time series at the individual level yet calculated from civil registration and census data. Abridged life tables were constructed for the first time for a Greek urban settlement, enabling the calculation of age-specific mortality rates and life expectancies. Hermoupolis experienced much higher mortality levels than the national average. The findings suggest that early childhood mortality started to decline rapidly from the late nineteenth century onwards, with declines in early adulthood and infancy following. The paper reinforces and confirms our limited knowledge about the timing of the mortality transition in Greece. It proposes that an urban penalty was clearly operating in the country even during the early twentieth century. Finally, this paper suggests that a combination of factors was responsible for the mortality decline in Hermoupolis, including wider access to water, which even when it was not clean enough to drink, nevertheless enabled improvements in personal hygiene among the residents of the city. This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
Over half a century ago, McKeown and colleagues proposed that economics was a major contributor to the decline of infectious diseases, including respiratory tuberculosis, during the 19 th and 20 th centuries. Since then, there is no consensus among researchers as to the factors responsible for the mortality decline. Using the case study of the islands of Malta and Gozo, we examine the relationship of economics, in particular, the cost of living (Fisher index) and its relationship to the secular trends of tuberculosis mortality. Notwithstanding the criticism that has been directed at McKeown, we present results that improvement in economics is the most parsimonious explanation for the decline of tuberculosis mortality. We reaffirmed that the reproductively aged individuals were most at risk of dying of tuberculosis , seeing that 70 to 90% of all deaths due to tuberculosis occurred between the ages of 15 and 45. There was a clear sex differential in deaths in that, prior to 1930, rates in females were generally higher than males. During times of extreme hardship, the sex differential was exacerbated. Over the course of World War I, the sex gap in tuberculosis rates increased until peaking in 1918 when there was also the influenza pandemic. The heightened differential was most likely a result of gendered roles as opposed to biological differences since female tuberculosis rates again surpassed male rates in 1945 during World War II. Respiratory tuberculosis in both urban and rural settlements (in Malta proper) was significantly influenced by the Fisher index, which explains approximately 61% of the variation in TB death rates (R = 0.78; p<0.0001). In Gozo, there was no significant impact on respiratory tuberculosis (R = 0.23; p = 0.25), most likely a consequence of the island's isolation, a self-sufficient economy and limited exposure to tuberculosis.
Social Science & Medicine, 2002
The resurgence of tuberculosis is one of the most serious global public health challenges of the twenty-first century. This paper argues that the decline of tuberculosis since the nineteenth century is far better understood than its resurgence over the last twenty years. It is suggested that insights gained from the historical study of disease may provide a better analytical framework for understanding the contemporary dynamics of disease epidemiology than the current emphasis on the bio-medical and behavioural characteristics of individual patients. It is concluded that tuberculosis research requires a combination of advances in bio-medical knowledge with a broader understanding of the evolving relationship between disease and modern societies. r
PloS one, 2016
Tuberculosis (TB) is a poverty-related disease that is associated with poor living conditions. We studied TB mortality and living conditions in Bern between 1856 and 1950. We analysed cause-specific mortality based on mortality registers certified by autopsies, and public health reports 1856 to 1950 from the city council of Bern. TB mortality was higher in the Black Quarter (550 per 100,000) and in the city centre (327 per 100,000), compared to the outskirts (209 per 100,000 in 1911-1915). TB mortality correlated positively with the number of persons per room (r = 0.69, p = 0.026), the percentage of rooms without sunlight (r = 0.72, p = 0.020), and negatively with the number of windows per apartment (r = -0.79, p = 0.007). TB mortality decreased 10-fold from 330 per 100,000 in 1856 to 33 per 100,000 in 1950, as housing conditions improved, indoor crowding decreased, and open-air schools, sanatoria, systematic tuberculin skin testing of school children and chest radiography screening...
Journal of Preventive Medicine and Hygiene, 2020
Summary Between the end of the nineteenth century and the first half of the twentieth century, the city of Siena experienced elevated tuberculosis-related morbidity and mortality, to the point that on January 1, 1929 the newspaper La Nazione wrote that “Siena ranks second in the official Tuberculosis (TB) incidence rate”. The author presents statistical data relating to a time span ranging from 1898 to 1935, interpreting them in light of social and sanitary conditions found in the city. The result is an exhaustive picture of the most important actions implemented at city level to prevent tuberculosis and to assist and treat the sick, such as: the creation of seaside hospices conceived by Carlo Livi for children suffering from scrofula, as well as centers committed to the prevention of childhood poverty and malnutrition; the realization of activities in the green areas of the ramparts of the Fortress, upon recommendation by the great hygienist Achille Sclavo; the establishment of a P...
Eurosurveillance: bulletin europeen sur les maladies transmissibles = European communicable disease bulletin
The Greek National Reference Laboratory for Mycobacteria is a major source of tuberculosis (TB)-related data for Greece, where the TB burden and epidemiology still need to be better defined. We present data regarding newly diagnosed TB cases and resistance to anti-TB drugs during the last 15 years in Greece. Although the total number of newly detected TB cases has declined, cases among immigrants are increasing. Resistance to first-line anti-TB drugs is widely prevalent, although stable or declining. The implementation of an efficient and effective countrywide TB surveillance system in Greece is urgently needed.
Images of Disease. Science, Public policy and health in Post-war Europe, 2001
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Eurosurveillance: bulletin europeen sur les maladies transmissibles = European communicable disease bulletin
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