Global epidemic trend of tuberculosis during 1990-2010: using segmented regression model

Area of Science:

• Epidemiology
• Global Health
• Infectious Disease Control

Background:

• Tuberculosis (TB) remains a significant global pandemic, ranking as the second leading cause of death from infectious diseases worldwide.
• Understanding the epidemiological trends of TB incidence and its influencing factors is crucial for effective public health interventions.

Purpose of the Study:

• To determine and compare the epidemiology of TB incidence rate and its trend changes from 1990-2010 across six WHO regions.
• To analyze these trends concerning age, gender, and income levels.

Main Methods:

• Segmented regression analysis was employed to estimate the Average Annual Percent Change (AAPC) and Annual Percent Change (APC) of TB incidence, mortality, treatment success, and case detection rates.
• A permutation procedure based on the likelihood ratio test was used to identify trend change points.

Main Results:

• Globally, TB incidence and mortality rates showed a downward trend (AAPC of -1.4%), with the Americas region exhibiting the steepest decline (-3.5%).
• Significant upward trends were observed in TB treatment success rates globally (+1.1%) and in case detection rates in several regions, notably South East Asia (+7.5%).
• While most income categories showed decreasing TB incidence and mortality, upper-middle-income countries experienced an ascending incidence trend (+0.7%).

Conclusions:

• Globally, TB incidence and mortality are decreasing, and treatment success and detection rates are increasing, but the pace is insufficient to achieve the End TB Strategy goals.
• Economic levels influence TB trend patterns, indicating a need for country-specific evaluations of TB control programs to achieve eradication targets.