Global, regional, and national burden of HIV-negative tuberculosis, 1990-2021: findings from the Global Burden of Disease Study 2021.

IF 8.1 1区 医学 Infectious Diseases of Poverty Pub Date : 2024-08-19 DOI:10.1186/s40249-024-01227-y
Shun-Xian Zhang, Feng-Yu Miao, Jian Yang, Wen-Ting Zhou, Shan Lv, Fan-Na Wei, Yu Wang, Xiao-Jie Hu, Ping Yin, Pei-Yong Zheng, Ming Yang, Mei-Ti Wang, Xin-Yu Feng, Lei Duan, Guo-Bing Yang, Ji-Chun Wang, Zhen-Hui Lu
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Abstract

Background: Tuberculosis (TB) is a major infectious disease with significant public health implications. Its widespread transmission, prolonged treatment duration, notable side effects, and high mortality rate pose severe challenges. This study examines the epidemiological characteristics of TB globally and across major regions, providing a scientific basis for enhancing TB prevention and control measures worldwide.

Methods: The ecological study used data from the Global Burden of Disease (GBD) Study 2021. It assessed new incidence cases, deaths, disability-adjusted life years (DALYs), and trends in age-standardized incidence rates (ASIRs), mortality rates (ASMRs), and DALY rates for drug-susceptible tuberculosis (DS-TB), multidrug-resistant tuberculosis (MDR-TB), and extensively drug-resistant tuberculosis (XDR-TB) from 1990 to 2021. A Bayesian age-period-cohort model was applied to project ASIR and ASMR.

Results: In 2021, the global ASIR for all HIV-negative TB was 103.00 per 100,000 population [95% uncertainty interval (UI): 92.21, 114.91 per 100,000 population], declining by 0.40% (95% UI: - 0.43, - 0.38%) compared to 1990. The global ASMR was 13.96 per 100,000 population (95% UI: 12.61, 15.72 per 100,000 population), with a decline of 0.44% (95% UI: - 0.61, - 0.23%) since 1990. The global age-standardized DALY rate for HIV-negative TB was 580.26 per 100,000 population (95% UI: 522.37, 649.82 per 100,000 population), showing a decrease of 0.65% (95% UI: - 0.69, - 0.57 per 100,000 population) from 1990. The global ASIR of MDR-TB has not decreased since 2015, instead, it has shown a slow upward trend in recent years. The ASIR of XDR-TB has exhibited significant increase in the past 30 years. The projections indicate MDR-TB and XDR-TB are expected to see significant increases in both ASIR and ASMR from 2022 to 2035, highlighting the growing challenge of drug-resistant TB.

Conclusions: This study found that the ASIR of MDR-TB and XDR-TB has shown an upward trend in recent years. To reduce the TB burden, it is essential to enhance health infrastructure and increase funding in low-SDI regions. Developing highly efficient, accurate, and convenient diagnostic reagents, along with more effective therapeutic drugs, and improving public health education and community engagement, are crucial for curbing TB transmission.

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1990-2021 年全球、地区和国家艾滋病毒阴性结核病负担:2021 年全球疾病负担研究的发现。
背景:结核病(TB)是一种对公共卫生有重大影响的主要传染病。其传播范围广、治疗时间长、副作用大、死亡率高,给人们带来了严峻的挑战。本研究探讨了结核病在全球和主要地区的流行病学特征,为加强全球结核病预防和控制措施提供了科学依据:这项生态研究使用了 2021 年全球疾病负担(GBD)研究的数据。该研究评估了 1990 年至 2021 年期间新发病例、死亡病例、残疾调整生命年(DALYs),以及年龄标准化发病率(ASIRs)、死亡率(ASMRs)和残疾调整生命年(DALYs)的趋势,涉及药物易感性结核病(DS-TB)、耐多药结核病(MDR-TB)和广泛耐药结核病(XDR-TB)。应用贝叶斯年龄-时期-队列模型预测 ASIR 和 ASMR:结果:2021 年,全球所有 HIV 阴性肺结核的 ASIR 为每 10 万人 103.00 例[95% 不确定区间(UI):每 10 万人 92.21 例,114.91 例],与 1990 年相比下降了 0.40%(95% UI:- 0.43,- 0.38%)。全球年龄标准化死亡率为每 10 万人 13.96 例(95% UI:每 10 万人 12.61 例,15.72 例),与 1990 年相比下降了 0.44%(95% UI:- 0.61,- 0.23%)。全球艾滋病毒阴性肺结核的年龄标准化 DALY 率为每 10 万人 580.26(95% UI:每 10 万人 522.37,649.82),与 1990 年相比下降了 0.65%(95% UI:每 10 万人-0.69,-0.57)。自 2015 年以来,全球 MDR-TB 的 ASIR 没有下降,近年来反而呈缓慢上升趋势。在过去 30 年中,XDR-TB 的 ASIR 呈显著上升趋势。预测结果表明,从 2022 年到 2035 年,MDR-TB 和 XDR-TB 的 ASIR 和 ASMR 预计都将大幅上升,这凸显了耐药结核病日益严峻的挑战:本研究发现,近年来 MDR-TB 和 XDR-TB 的 ASIR 呈上升趋势。为减轻结核病负担,必须加强卫生基础设施建设,增加低 SDI 地区的资金投入。开发高效、准确、便捷的诊断试剂和更有效的治疗药物,以及加强公共卫生教育和社区参与,对于遏制结核病传播至关重要。
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来源期刊
Infectious Diseases of Poverty
Infectious Diseases of Poverty INFECTIOUS DISEASES-
自引率
1.20%
发文量
368
期刊介绍: Infectious Diseases of Poverty is an open access, peer-reviewed journal that focuses on addressing essential public health questions related to infectious diseases of poverty. The journal covers a wide range of topics including the biology of pathogens and vectors, diagnosis and detection, treatment and case management, epidemiology and modeling, zoonotic hosts and animal reservoirs, control strategies and implementation, new technologies and application. It also considers the transdisciplinary or multisectoral effects on health systems, ecohealth, environmental management, and innovative technology. The journal aims to identify and assess research and information gaps that hinder progress towards new interventions for public health problems in the developing world. Additionally, it provides a platform for discussing these issues to advance research and evidence building for improved public health interventions in poor settings.
期刊最新文献
Global burden of zoonotic infectious diseases of poverty, 1990-2021. Out-of-pocket payment and catastrophic health expenditure of tuberculosis patients in accessing care at public-private mix clinics in Myanmar, 2022. Point-of-care test of blood Plasmodium RNA within a Pasteur pipette using a novel isothermal amplification without nucleic acid purification. Molecular characterisation of human rabies in Tanzania and Kenya: a case series report and phylogenetic investigation. Spatial and temporal characterization of Aedes albopictus oviposition activity in candidate urban settings for sterile insect technique testing in La Reunion Island.
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