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Epidemic Trends of Tuberculosis in China from 1990 to 2017: Evidence from the Global Burden of Disease Study

Authors Ding C, Wang S, Shangguan Y, Feng X, Guo W, Shi P, Ji Z, Xu K

Received 13 February 2020

Accepted for publication 15 May 2020

Published 9 June 2020 Volume 2020:13 Pages 1663—1672


Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 2

Editor who approved publication: Dr Joachim Wink

Cheng Ding, Shuting Wang, Yanwan Shangguan, Xuewen Feng, Wanru Guo, Pei Shi, Zhongkang Ji, Kaijin Xu

State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310003, Zhejiang, People’s Republic of China

Correspondence: Kaijin Xu Email

Purpose: Tuberculosis remains a major public health problem globally, especially in undeveloped countries. This study aimed to evaluate and review the long-term epidemic trends of tuberculosis in China.
Methods: Data were extracted from the Global Health Data Exchange. Metrics (prevalence, incidence and mortality) and Joinpoint regression were used to identify the epidemic trends.
Results: From 1990 to 2017, decreasing trends in prevalence (average annual percent change, AAPC: − 0.5%, 95% CI: − 0.6% to − 0.5%), incidence (− 3.2%, 95% CI: − 3.5% to − 2.9%), and mortality (− 5.7%, 95% CI: − 6.2% to − 5.3%) of tuberculosis were observed. The incidence and mortality of multidrug-resistant tuberculosis (MDR-TB) decreased with AAPC of − 2.3% (− 3.1% to − 1.4%) and − 4.9% (− 5.4% to − 4.5%), respectively, while the prevalence increased with an AAPC of 1.2% (0.3% to 2.0%). The burden of extensively drug-resistant tuberculosis (XDR-TB) increased with an AAPC of 12.5% (11.9% to 13.2%) in prevalence, 7.6% (6.5% to 8.7%) in incidence, and 4.5% (3.6% to 5.4%) in mortality. The disease burden of tuberculosis increased with age and peaked among those aged over 70.
Conclusion: The epidemic of tuberculosis decreased in China, while the disease burden was still challenging to control. MDR-TB and XDR-TB should be emphasized along with the epidemic. It will certainly be a difficult task to achieve the post-2015 global targets by 2025 and 2035.

Keywords: tuberculosis, drug-resistant, epidemic, China

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