Percentage of incident TB cases with isoniazid resistance.

<p>World map showing the percentage of incident TB cases with isoniazid resistance (INH-R) from the most recent survey in each setting in three time periods: (a) 1994-1999, (b) 2000-2004, (c) 2005-2009. Grey areas indicate those that did not report national data in the time period in question.</p

Linear trends in isoniazid resistance (INH-R) among new TB cases.

<p>We estimated trends in the percentage of new TB cases with INH-R and the estimated number of new TB cases with INH-R per 100,000 population. Settings are grouped by any linear trend (p<0.1) found (“down” or “up”) or “no consistent linear trend” if no linear trend was found. RF = Russian Federation.</p

Trends in the number of new TB cases per 100,000 population with INH-R.

<p>Settings were included that provided at least 3 data points from 1994 to 2009. Trends were estimated for two types of INH-R: INH-R with rifampin resistance (multi-drug resistance (MDR)) and INH-R without rifampin resistance. Settings are grouped by any linear trend (p<0.1) found (“down” or “up”) or “no consistent linear trend” if no linear trend was found. RF = Russian Federation.</p

Estimated effects of proactive culling on the incidence of confirmed cattle TB breakdowns on lands ≤2 km outside trial areas.

<p>Analyses adjust for triplet, baseline herds, and historic cattle TB incidence (over three years) and include the entire during- and post-trial periods.</p><p>*The analysis dividing both during- and post-trial periods into shorter intervals has overdispersion factor 1.14, p = 0.030; †Insufficient breakdowns to calculate estimates.</p

Estimated effects of proactive culling on the incidence of confirmed cattle TB breakdowns inside trial areas.

<p>Analyses adjust for triplet, baseline herds, and historic cattle TB incidence (over three years) and include the entire during- and post-trial periods.</p><p>*The analysis dividing both during- and post-trial periods into shorter intervals has overdispersion factor 1.21,p = 0.003; †Insufficient breakdowns to calculate estimates.</p

Estimated effects of proactive culling on the incidence of confirmed cattle TB breakdowns.

<p>Estimates are presented for herds inside trial areas as well as those on adjoining lands ≤2 km outside trial area boundaries. The estimated effects of proactive culling are stratified by time periods defined by the cull dates in the during-trial period, and by 6-month intervals from 1 year after the last proactive cull (the post-trial period).</p

Estimated effects of proactive culling on the incidence of confirmed cattle TB breakdowns at varying distances inside and outside trial area boundaries, over the period from the initial culls to the end of first 30 months of the post-trial period.

<p>Analyses adjust for triplet, baseline herds, and historic cattle TB incidence (over three years).</p

Odds for death, by risk group (with bootstrap in estimating coefficient standard errors).

<p>Odds for death, by risk group (with bootstrap in estimating coefficient standard errors).</p

Flowchart of the study population.

<p>Footnote: TBGIMS, TB Genotyping Information Management System.</p

Extrapolation of overall effects to culling areas of different sizes.

<p>The blue area shows the 95% confidence interval for the overall impact (combining the impact inside the targeted area with that seen ≤2 km² outside) of different sized circular culling areas. The red area shows the impact inside the targeted area only. The estimated overall effect is of increased incidence for areas smaller than 17 km², moving to a decreased incidence when areas larger than 17 km² are targeted. The effect of decreased overall incidence is statistically significant for areas larger than 141 km².</p