A Long-Term Trend Study of Tuberculosis Incidence in China, India and United States 1992-2017: A Joinpoint and Age-Period-Cohort Analysis.

Yiran Cui,Zixin Zeng,Hui Shen,Yafeng Wang,Fang Wang,Chuanhua Yu,Haoyu Wen

doi:10.3390/ijerph17093334

Yiran Cui, Zixin Zeng + Show 5 more

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https://doi.org/10.3390/ijerph17093334

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Abstract

Tuberculosis (TB) is one of the major infectious diseases with the largest number of morbidity and mortality. Based on the comparison of high and low burden countries of tuberculosis in China, India and the United States, the influence of age-period-cohort on the incidence of tuberculosis in three countries from 1992 to 2017 was studied based on the Global burden of Disease Study 2017. We studied the trends using Joinpoint regression in the age-standardized incidence rate (ASIR). The regression model showed a significant decreasing behavior in China, India and the United States between 1992 and 2017. Here, we analyzed the tuberculosis incidence trends in China, India, as well as the United States and distinguished age, period and cohort effects by using age-period-cohort (APC) model. We found that the relative risks (RRs) of tuberculosis in China and India have similar trends, but the United States was found different. The period effect showed that the incidence of the three countries as a whole declines with time. The incidence of tuberculosis had increased in most age group. The older the age, the higher the risk of TB incidence. The net age effect in China and India showed a negative trend, while the cohort effect decreased from the earlier birth cohort to the recent birth cohort. Aging may lead to a continuous increase in the incidence of tuberculosis. It is related to the aging of the population and the relative decline of the immune function in the elderly. This should be timely population intervention or vaccine measures, especially for the elderly. The net cohort effect in the United States showed an unfavorable trend, mainly due to rising smoking rates and the emergence of an economic crisis. Reducing tobacco consumption can effectively reduce the incidence.

Highlights

Tuberculosis (TB) is a chronic infectious disease caused by Mycobacterium tuberculosis infection and the main cause of a single infectious disease
crude incidence rates (CIR) of TB in China is observed to Figures 1 and 2 provide the characteristics curves that representing the temporal evolution of have a significant decrement from 1992 to 2017 as compared to the United States
The results of the annual percentage change (APC) model show that the incidence in China and India decreases with age and cohort, but increases with age, while the incidence in the United States rises first and decreases with age and period, but declines and rises with the cohort

Summary

Introduction

Tuberculosis (TB) is a chronic infectious disease caused by Mycobacterium tuberculosis infection and the main cause of a single infectious disease. It is listed as one of the ten most important causes of death from infectious diseases in the world [1]. It has become a death-related infectious disease at a higher level than human immunodeficiency virus (HIV). China has the world’s second-largest TB epidemic, behind India, with more than 1.3 million new cases of TB every year. 2 million new cases every year, accounting for 18% of the estimated burden of TB in the world [2].

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