School of Health and Related Research, University of Sheffield, Sheffield, England, United Kingdom.
PLoS One. 2019 Sep 24;14(9):e0222937. doi: 10.1371/journal.pone.0222937. eCollection 2019.
Tuberculosis (TB) disease reactivates from distant latent infection or recent (re)infection. Progression risks increase with age. Across the World Health Organisation Western Pacific region, many populations are ageing and have the highest per capita TB incidence rates in older age groups. However, methods for analysing age-specific TB incidence and forecasting epidemic trends while accounting for demographic change remain limited.
We applied the Lee-Carter models, which were originally developed for mortality modelling, to model the temporal trends in age-specific TB incidence data from 2005 to 2018 in Taiwan. Females and males were modelled separately. We combined our demographic forecasts, and age-specific TB incidence forecasts to project TB incidence until 2035. We compared TB incidence projections with demography fixed in 2018 to projections accounting for demographic change.
Our models quantified increasing incidence rates with age and declining temporal trends. By 2035, the forecast suggests that the TB incidence rate in Taiwan will decrease by 54% (95% Prediction Interval (PI): 45%-59%) compared to 2015, while most age-specific incidence rates will reduce by more than 60%. In 2035, adults aged 65 and above will make up 78% of incident TB cases. Forecast TB incidence in 2035 accounting for demographic change will be 39% (95% PI: 36%-42%) higher than without population ageing.
Age-specific incidence forecasts coupled with demographic forecasts can inform the impact of population ageing on TB epidemics. The TB control programme in Taiwan should develop plans specific to older age groups and their care needs.
结核病（TB）是由潜伏感染或近期（再）感染引起的。随着年龄的增长，进展风险会增加。在世卫组织西太平洋区域，许多人群正在老龄化，并且在老年人群中结核病发病率最高。然而，分析特定年龄组结核病发病率并预测流行趋势的方法，同时考虑人口变化，仍然有限。
我们应用了最初为死亡率建模而开发的 Lee-Carter 模型，对 2005 年至 2018 年台湾特定年龄组结核病发病率数据的时间趋势进行建模。分别对女性和男性进行建模。我们结合人口预测和特定年龄组结核病发病率预测，预测到 2035 年的结核病发病率。我们将结核病发病率预测与 2018 年人口固定的预测进行比较，并与考虑人口变化的预测进行比较。
我们的模型量化了随年龄增长而增加的发病率和下降的时间趋势。到 2035 年，预测表明，与 2015 年相比，台湾的结核病发病率将下降 54%（95%预测区间（PI）：45%-59%），而大多数特定年龄组的发病率将下降 60%以上。到 2035 年，65 岁及以上的成年人将占新发结核病病例的 78%。考虑人口老龄化的 2035 年预测结核病发病率将比不考虑人口老龄化高出 39%（95%PI：36%-42%）。
特定年龄组发病率预测与人口预测相结合，可以了解人口老龄化对结核病流行的影响。台湾的结核病控制计划应制定针对老年人群及其护理需求的具体计划。
