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Differences in solar ultraviolet B (UV-B) exposure, the major source of vitamin D, might therefore partially explain global variation in tuberculosis incidence.<\/jats:p><jats:p>In a global country-based ecological study, we explored the correlation between vitamin D-proxies, such as solar UV-B exposure, and other relevant variables with tuberculosis incidence, averaged over the period 2004\u20132013.<\/jats:p><jats:p>Across 154 countries, annual solar UV-B exposure was associated with tuberculosis incidence. Tuberculosis incidence in countries in the highest quartile of UV-B exposure was 78% (95% CI 57\u201388%, p&lt;0.001) lower than that in countries in the lowest quartile, taking into account other vitamin D-proxies and covariates. Of the explained global variation in tuberculosis incidence, 6.3% could be attributed to variations in annual UV-B exposure. Exposure to UV-B had a similar, but weaker association with tuberculosis notification rates in the multilevel analysis with sub-national level data for large countries (highest<jats:italic>versus<\/jats:italic>lowest quartile 29% lower incidence; p=0.057).<\/jats:p><jats:p>The potential preventive applications of vitamin D supplementation in high-risk groups for tuberculosis merits further investigation.<\/jats:p>","DOI":"10.1183\/13993003.01979-2016","type":"journal-article","created":{"date-parts":[[2017,7,6]],"date-time":"2017-07-06T16:32:08Z","timestamp":1499358728000},"page":"1601979","update-policy":"https:\/\/doi.org\/10.1183\/ers-crossmark-policy","source":"Crossref","is-referenced-by-count":16,"title":["Solar ultraviolet B exposure and global variation in tuberculosis incidence: an ecological analysis"],"prefix":"10.1183","volume":"49","author":[{"given":"Tjarda M.","family":"Boere","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Douwe H.","family":"Visser","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A. 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