Global, regional and national trends in tuberculosis incidence and main risk factors: a study using data from 2000 to 2021

Abstract

Background: Despite the significant progress over the years, Tuberculosis remains a major public health concern and a danger to global health. This study aimed to analyze the spatial and temporal characteristics of the incidence of tuberculosis and its risk factors and to predict future trends in the incidence of Tuberculosis.

Methods: This study used secondary data on tuberculosis incidence and tuberculosis risk factor data from 209 countries and regions worldwide between 2000 and 2021 for analysis. Specifically, this study analyses the spatial autocorrelation of Tuberculosis incidence from 2000 to 2021 by calculating Moran's I and identified risk factors for Tuberculosis incidence by multiple stepwise linear regression analysis. We also used the Autoregressive Integrated Moving Average model to predict the trend of Tuberculosis incidence to 2030. This study used ArcGIS Pro, Geoda and R studio 4.2.2 for analysis.

Results: The study found the global incidence of Tuberculosis and its spatial autocorrelation trends from 2000 to 2021 showed a general downward trend, but its spatial autocorrelation trends remained significant (Moran's I = 0.465, P < 0.001). The risk factors for Tuberculosis incidence are also geographically specific. Low literacy rate was identified as the most pervasive and profound risk factor for Tuberculosis.

Conclusions: This study shows the global spatial and temporal status of Tuberculosis incidence and risk factors. Although the incidence of Tuberculosis and Moran's Index of Tuberculosis are both declining, there are still differences in Tuberculosis risk factors across countries and regions. Even though literacy rate is the leading risk factor affecting the largest number of countries and regions, there are still many countries and regions where gender (male) is the leading risk factor. In addition, at the current rate of decline in Tuberculosis incidence, the World Health Organization's goal of ending the Tuberculosis pandemic by 2030 will be difficult to achieve. Targeted preventive interventions, such as health education and regular screening of Tuberculosis-prone populations are needed if we are to achieve the goal. The results of this study will help policymakers to identify high-risk groups based on differences in TB risk factors in different areas, rationalize the allocation of healthcare resources, and provide timely health education, so as to formulate more effective Tuberculosis prevention and control policies.

Keywords: Autoregressive integrated moving average; Global; Multiple stepwise regression analysis; Risk factors; Spatial autocorrelation; Tuberculosis.

Fig. 1

Global distribution of TB incidence in 2021

Fig. 2

Global and region category trends in incidence of TB (2000–2021)

Fig. 3

Global and income category trends in incidence of TB (2000–2021)

Fig. 4

Global Moran’s I of TB incidence in 2021

Fig. 5

Global Moran’s I of TB incidence from 2000 to 2021

Fig. 6

Significance map of local Moran’s I of TB incidence in 2021

Fig. 7

Cluster map of local Moran’s I of TB incidence in 2021

Fig. 8

Analysis of the leading risk factors for TB

Fig. 9

Analysis of the second leading risk factors for TB

Fig. 10

Analysis of the third leading risk factors for TB

Fig. 11

Analysis of the main risk factors for TB

Fig. 12

Projections of global and region category in TB incidence to 2030

Fig. 13

Projections of Gl obal and income category in TB incidence to 2030