Li Nan, Wei Wei, Lao Yinglin, Zhu Xi, Ye Qi, Chen Junhong, Ji Yating, Chen Ruoqing, Yang Chongguang
School of Public Health (Shenzhen), Shenzhen Campus of Sun Yat-sen University, Shenzhen, Guangdong, China.
School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen, Guangdong, China.
PLoS One. 2025 Jul 17;20(7):e0328255. doi: 10.1371/journal.pone.0328255. eCollection 2025.
China ranks third in estimated TB incidence in 2023, accounting for 6.8% of the global cases. TB in children and adolescents is a public health issue that today warrants priority attention in China.
The purpose of this study was to investigate the burden of TB among Chinese children and adolescents aged 0-19 years from 1990 to 2021 and to estimate the incidence rate, mortality rate, and disability-adjusted life years (DALYs) rate from 2022 to 2031.
The Joinpoint regression analysis was used to identify periods of significant change and autoregressive Integrated Moving Average (ARIMA) modeling was employed to predict the TB burden for 2022-2031.
The study indicated that China has significantly reduced the TB burden among children and adolescents over the past 32 years, the most pronounced reductions in incidence occurred during the periods 2010-2015 (APC = -8.64%, P < 0.05) and 2019-2021 (APC = -6.09%, P < 0.05). Meanwhile, death and DALYs rates showed a consistently rapid decline across the entire 32-year span. Adolescents aged 15-19 years have the highest incidence rates, and children under 5 continue to face high mortality and DALYs rates. Additionally, females experienced a more significant decline compared to males across all age groups. Despite minor fluctuations in some age groups, a downward trend in incidence, death, and DALYs rates was anticipated to continue until 2031, with persistent gender differences in future projections.
Our findings demonstrate a persistent downward trajectory in TB burden among Chinese children and adolescents from 1990 to 2021, with significant gender disparities favoring females across all age groups. Notably, children younger than 5 years and adolescents aged 15-19 years are at higher risk, which emphasizes the importance of tailored interventions to ensure continued progress towards comprehensive TB control goals.
中国在2023年的结核病估计发病率排名第三，占全球病例的6.8%。儿童和青少年结核病是一个公共卫生问题，如今在中国值得优先关注。
本研究的目的是调查1990年至2021年中国0至19岁儿童和青少年的结核病负担，并估计2022年至2031年的发病率、死亡率和伤残调整生命年（DALY）率。
采用Joinpoint回归分析确定显著变化期，并采用自回归积分滑动平均（ARIMA）模型预测2022 - 2031年的结核病负担。
研究表明，在过去32年中，中国已显著降低了儿童和青少年的结核病负担，发病率下降最明显的时期是2010 - 2015年（年度百分比变化[APC] = -8.64%，P < 0.05）和2019 - 2021年（APC = -6.09%，P < 0.05）。与此同时，在整个32年期间，死亡率和DALY率持续快速下降。15至19岁的青少年发病率最高，5岁以下儿童继续面临高死亡率和高DALY率。此外，在所有年龄组中，女性的下降幅度比男性更为显著。尽管某些年龄组有轻微波动，但预计发病率、死亡率和DALY率的下降趋势将持续到2031年，未来预测中仍存在持续的性别差异。
我们的研究结果表明，1990年至2021年中国儿童和青少年的结核病负担呈持续下降趋势，所有年龄组中女性均存在显著的性别差异优势。值得注意的是，5岁以下儿童和15至19岁青少年面临的风险更高，这强调了采取针对性干预措施以确保在实现全面结核病控制目标方面持续取得进展的重要性。
