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. 2020 Jun 9:13:1663-1672.
doi: 10.2147/IDR.S249698. eCollection 2020.

Epidemic Trends of Tuberculosis in China from 1990 to 2017: Evidence from the Global Burden of Disease Study

Cheng Ding  1 , Shuting Wang  1 , Yanwan Shangguan  1 , Xuewen Feng  1 , Wanru Guo  1 , Pei Shi  1 , Zhongkang Ji  1 , Kaijin Xu  1
Affiliations

Epidemic Trends of Tuberculosis in China from 1990 to 2017: Evidence from the Global Burden of Disease Study

Cheng Ding et al. Infect Drug Resist. .

Abstract

Purpose: Tuberculosis remains a major public health problem globally, especially in undeveloped countries. This study aimed to evaluate and review the long-term epidemic trends of tuberculosis in China.

Methods: Data were extracted from the Global Health Data Exchange. Metrics (prevalence, incidence and mortality) and Joinpoint regression were used to identify the epidemic trends.

Results: From 1990 to 2017, decreasing trends in prevalence (average annual percent change, AAPC: -0.5%, 95% CI: -0.6% to -0.5%), incidence (-3.2%, 95% CI: -3.5% to -2.9%), and mortality (-5.7%, 95% CI: -6.2% to -5.3%) of tuberculosis were observed. The incidence and mortality of multidrug-resistant tuberculosis (MDR-TB) decreased with AAPC of -2.3% (-3.1% to -1.4%) and -4.9% (-5.4% to -4.5%), respectively, while the prevalence increased with an AAPC of 1.2% (0.3% to 2.0%). The burden of extensively drug-resistant tuberculosis (XDR-TB) increased with an AAPC of 12.5% (11.9% to 13.2%) in prevalence, 7.6% (6.5% to 8.7%) in incidence, and 4.5% (3.6% to 5.4%) in mortality. The disease burden of tuberculosis increased with age and peaked among those aged over 70.

Conclusion: The epidemic of tuberculosis decreased in China, while the disease burden was still challenging to control. MDR-TB and XDR-TB should be emphasized along with the epidemic. It will certainly be a difficult task to achieve the post-2015 global targets by 2025 and 2035.

Keywords: China; drug-resistant; epidemic; tuberculosis.

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Conflict of interest statement

The authors report no conflicts of interest in this work.

Figures

Figure 1
Figure 1
Trends of prevalence, incidence, and mortality by different types of tuberculosis in China, 1990–2017. (A) Tuberculosis; (B) drug-susceptible tuberculosis; (C) extensively drug-resistant; (D) multidrug-resistant tuberculosis.
Figure 2
Figure 2
Average annual percent changes of prevalence, incidence, and mortality among different age groups by different types of tuberculosis in China. (A) Tuberculosis; (B) drug-susceptible tuberculosis; (C) extensively drug-resistant; (D) multidrug-resistant tuberculosis.
Figure 3
Figure 3
Heat maps of prevalence, incidence, and mortality among different age groups by different types of tuberculosis in China, 1990–2017. (A) Tuberculosis; (B) drug-susceptible tuberculosis; (C) extensively drug-resistant; (D) multidrug-resistant tuberculosis.
Figure 4
Figure 4
Trends of mortality to incidence ratios by different types of tuberculosis in China, 1990–2017.
See this image and copyright information in PMC

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