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

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:

• tuberculosis
• drug-resistant
• epidemic
• China

Acknowledgments

This work was supported by the Mega-Project of National Science and Technology of China (2017ZX10105001, 2018ZX10715014, 2014ZX10004008, 2013ZX10004904, 2013ZX10004901), the key joint project for data center of the National Natural Science Foundation of China and Guangdong Provincial Government (U1611264), and the National Natural Science Foundation of China (81672005, 81001271). The funders had no role in study design, data collection, data analysis, or writing of the paper.

Disclosure

The authors report no conflicts of interest in this work.