Trends and determinants of tuberculosis incidence in Turkey: A secondary data analysis

Tuberculosis remains a major public health concern, with incidence rates influenced by social determinants of health. Although tuberculosis incidence in Turkey has declined markedly in recent decades, the factors associated with this decline have not been comprehensively evaluated at the country-level. This study aimed to examine trends in tuberculosis incidence in Turkey from 1982 to 2021 and to identify determinants of tuberculosis incidence rates between 2000 and 2021, considering variables categorized under composite development, economic indicators, population, and health services. A longitudinal ecological study was conducted using secondary data to examine trends and determinants of tuberculosis incidence in Turkey. Univariate and multivariable linear regression were employed to evaluate the associations between tuberculosis incidence rates and 10 selected variables. Tuberculosis incidence in Turkey declined substantially over the 40-year period analyzed, with an overall decrease of 86.6% and sharper reductions observed in certain intervals. In multivariable linear regression, only the Human Development Index remained independently associated with tuberculosis incidence (β = -1.041, P < .001), indicating that higher Human Development Index values were associated with lower tuberculosis incidence rates in Turkey. These findings indicate that tuberculosis incidence in Turkey has declined alongside changes in human development, as reflected by the composite Human Development Index.