Trends in pulmonary tuberculosis mortality between 1985 and 2018: an observational analysis

Area of Science:

• Epidemiology
• Public Health
• Infectious Diseases

Background:

• Pulmonary tuberculosis (TB) remains a significant global health challenge, causing widespread morbidity and mortality.
• A resurgence in TB cases occurred in the late 1980s and early 1990s, linked to the HIV epidemic and the rise of multidrug-resistant TB.
• Limited research exists on pulmonary TB mortality trends, necessitating further investigation.

Purpose of the Study:

• To analyze and compare pulmonary TB mortality trends across various countries from 1985 to 2018.
• To identify regional and demographic variations in TB mortality rates.

Main Methods:

• Utilized the World Health Organization (WHO) mortality database (1985-2018).
• Analyzed TB mortality using International Classification of Diseases-10 codes across 33 countries.
• Employed joinpoint regression analysis to investigate time trends in age-standardized death rates, dichotomized by sex.

Main Results:

• A general decrease in pulmonary TB mortality was observed across most countries.
• The Republic of Moldova showed an increase in female mortality, while Croatia exhibited a rapid increase in both male and female mortality in recent years.
• Lithuania and Hungary demonstrated the greatest reductions in male and female mortality, respectively. Slovenia and New Zealand had the most rapid declining trends for males and females, respectively.

Conclusions:

• Pulmonary TB mortality rates are disproportionately high in Central and Eastern European countries.
• A global approach is essential for TB elimination, focusing on early diagnosis and treatment for vulnerable groups.
• Improved epidemiological data reporting to the WHO is crucial for accurate trend analysis and evaluating interventions.