Department of Epidemiology, School of Public Health, China Medical University, Shenyang, China.
Chinese PLA Center for Disease Control and Prevention, Beijing, China.
BMC Infect Dis. 2024 Feb 22;24(1):243. doi: 10.1186/s12879-024-09079-5.
Tuberculosis(TB) remains a pressing public health challenge, with multidrug-resistant tuberculosis (MDR-TB) emerging as a major threat. And healthcare authorities require reliable epidemiological evidence as a crucial reference to address this issue effectively. The aim was to offer a comprehensive epidemiological assessment of the global prevalence and burden of MDR-TB from 1990 to 2019.
Estimates and 95% uncertainty intervals (UIs) for the age-standardized prevalence rate (ASPR), age-standardized incidence rate (ASIR), age-standardized disability-adjusted life years rate (ASR of DALYs), and age-standardized death rate (ASDR) of MDR-TB were obtained from the Global Burden of Disease (GBD) 2019 database. The prevalence and burden of MDR-TB in 2019 were illustrated in the population and regional distribution. Temporal trends were analyzed by using Joinpoint regression analysis to calculate the annual percentage change (APC), average annual percentage change (AAPC) and its 95% confidence interval(CI).
The estimates of the number of cases were 687,839(95% UIs: 365,512 to 1223,262), the ASPR were 8.26 per 100,000 (95%UIs: 4.61 to 15.20), the ASR of DALYs were 52.38 per 100,000 (95%UIs: 22.64 to 97.60) and the ASDR were 1.36 per 100,000 (95%UIs: 0.54 to 2.59) of MDR-TB at global in 2019. Substantial burden was observed in Africa and Southeast Asia. Males exhibited higher ASPR, ASR of DALYs, and ASDR than females across most age groups, with the burden of MDR-TB increasing with age. Additionally, significant increases were observed globally in the ASIR (AAPC = 5.8; 95%CI: 5.4 to 6.1; P < 0.001), ASPR (AAPC = 5.9; 95%CI: 5.4 to 6.4; P < 0.001), ASR of DALYs (AAPC = 4.6; 95%CI: 4.2 to 5.0; P < 0.001) and ASDR (AAPC = 4.4; 95%CI: 4.0 to 4.8; P < 0.001) of MDR-TB from 1990 to 2019.
This study underscored the persistent threat of drug-resistant tuberculosis to public health. It is imperative that countries and organizations worldwide take immediate and concerted action to implement measures aimed at significantly reducing the burden of TB.
结核病（TB）仍然是一个紧迫的公共卫生挑战，耐多药结核病（MDR-TB）的出现更是一个主要威胁。医疗保健当局需要可靠的流行病学证据作为有效解决这一问题的重要参考。本研究旨在全面评估全球 1990 年至 2019 年 MDR-TB 的流行率和负担。
从全球疾病负担（GBD）2019 数据库中获得 MDR-TB 的年龄标准化患病率（ASPR）、年龄标准化发病率（ASIR）、年龄标准化残疾调整生命年率（ASR of DALYs）和年龄标准化死亡率（ASDR）的估计值和 95%置信区间（UI）。2019 年 MDR-TB 的流行率和负担在人口和区域分布中进行了说明。通过使用 Joinpoint 回归分析来分析时间趋势，以计算每年的百分比变化（APC）、平均每年百分比变化（AAPC）及其 95%置信区间（CI）。
2019 年 MDR-TB 的病例数估计为 687839 例（95%UI：365512 至 1223262），ASPR 为 8.26/100000（95%UI：4.61 至 15.20），ASR of DALYs 为 52.38/100000（95%UI：22.64 至 97.60），ASDR 为 1.36/100000（95%UI：0.54 至 2.59）。2019 年，非洲和东南亚地区的负担较重。在大多数年龄组中，男性的 ASPR、ASR of DALYs 和 ASDR 均高于女性，且 MDR-TB 的负担随年龄增长而增加。此外，全球范围内的 ASIR（AAPC=5.8；95%CI：5.4 至 6.1；P<0.001）、ASPR（AAPC=5.9；95%CI：5.4 至 6.4；P<0.001）、ASR of DALYs（AAPC=4.6；95%CI：4.2 至 5.0；P<0.001）和 ASDR（AAPC=4.4；95%CI：4.0 至 4.8；P<0.001）均呈显著上升趋势。
本研究强调了耐多药结核病对公共卫生的持续威胁。全世界各国和组织必须立即采取协调一致的行动，实施旨在显著降低结核病负担的措施。
