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Further analysis of tuberculosis in eight high-burden countries based on the Global Burden of Disease Study 2021 data
Open accessAbstract
BACKGROUNDS: Most significant findings from the Global Tuberculosis (TB) Report 2023 indicate that India, Indonesia, China, the Philippines, Pakistan, Nigeria, Bangladesh, and the Democratic Republic of the Congo (DRC) collectively contribute to approximately two-thirds of global TB cases. This study aims to provide crucial data-driven insights and references to improve TB control measures through a comprehensive analysis of these eight high-burden countries. METHODS: The eight high-burden TB countries analyzed in this study include India, Indonesia, China, the Philippines, Pakistan, Nigeria, Bangladesh, and the DRC. Age-standardized incidence rates (ASIR) of TB were derived from the Global Burden of Diseases Study 2021 data. Temporal trends were analyzed using Joinpoint regression. An age-period-cohort model was applied to examine the risk ratios (RR) of TB across diverse age groups, periods, and birth cohorts. A Bayesian age-period-cohort framework was employed to predict the ASIR of TB by 2030. RESULTS: The study found that the Philippines (average annual percentage change = 3.1%, P < 0.001) exhibited an upward trend from 1990 to 2021. In India, the Philippines, Pakistan, and Bangladesh, the RR of TB incidence exceeded 1 after individuals reached 25 years old. Notably, the RR has shown a consistent upward trend since 2001, peaking during the period of 2017-2021 with an estimated RR of 1.5 (P < 0.001) in the Philippines. Similarly, the highest RR was observed during the period of 2017-2021 reaching 1.1 (P < 0.001) in the DRC. In the Philippines, the markedly increasing RR values for TB have been observed among individuals born after 1997-2001. Projections suggest that the ASIR of TB is expected to follow a continued upward trajectory, with an estimated rate of 392.9 per 100,000 by 2030 in the Philippines; India and Indonesia are projected to achieve less than 20.0% of the target set by the World Health Organization (WHO). CONCLUSIONS: Among the eight high-burden countries, the Philippines, India and Indonesia are diverging from the goals set by the WHO, and the risk of TB in the Philippines and the DRC shows a trend toward affecting younger populations, which suggests that the management strategies for TB patients need to be further strengthened.
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“The incidence of head and neck TB is higher in developing countries, where TB continues to be a significant public health concern [3].”
From Head and Neck Tuberculosis: A Rare Diagnosis and the Role of Surgical Biopsy and Histopathological Evaluation in Extrapulmonary Disease (2025) · cites this paper as [3]
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Ferrari, A. J., Santomauro, D. F., Aali, A., Abate, Y. H., Abbafati, C., Abbastabar, H., Abd ElHafeez, S., Abdelmasseh, M., Abd-Elsalam, S., Abdollahi, A., et al. (2024) · The Lancet · doi:10.1016/s0140-6736(24)00757-8 · Cited by 5,112
Self-citationThe Global Burden of Latent Tuberculosis Infection: A Re-estimation Using Mathematical Modelling
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WHO's Global Tuberculosis Report 2022
Bagcchi, S. (2022) · The Lancet Microbe · doi:10.1016/s2666-5247(22)00359-7 · Cited by 1,174
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The Intrinsic Estimator for Age‐Period‐Cohort Analysis: What It Is and How to Use It
Yang, Y., Schulhofer‐Wohl, S., Fu, W. J., & Land, K. C. (2008) · American Journal of Sociology · doi:10.1086/587154 · Cited by 506
Air pollution and development in Africa: impacts on health, the economy, and human capital
Fisher, S., Bellinger, D. C., Cropper, M., Kumar, P., Binagwaho, A., Koudenoukpo, J. B., Park, Y., Taghian, G., & Landrigan, P. J. (2021) · The Lancet Planetary Health · doi:10.1016/s2542-5196(21)00201-1 · Cited by 300
Haakenstad, A., Yearwood, J. A., Fullman, N., Bintz, C., Bienhoff, K., Weaver, M. R., Nandakumar, V., LeGrand, K. E., Knight, M., Abbafati, C., et al. (2022) · The Lancet Global Health · doi:10.1016/s2214-109x(22)00429-6 · Cited by 258
Africa and the Nexus of poverty, malnutrition and diseases
Adeyeye, S. A. O., Ashaolu, T. J., Bolaji, O. T., Abegunde, T. A., & Omoyajowo, A. O. (2021) · Critical Reviews in Food Science and Nutrition · doi:10.1080/10408398.2021.1952160 · Cited by 191
Trimmed constrained mixed effects models: formulations and algorithms
Zheng, P., Barber, R., Sorensen, R. J. D., Murray, C. J. L., & Aravkin, A. Y. (2021) · Journal of Computational and Graphical Statistics · doi:10.1080/10618600.2020.1868303 · Cited by 174
Tuberculosis origin: The Neolithic scenario
Hershkovitz, I., Donoghue, H. D., Minnikin, D. E., May, H., Lee, O. Y.-C., Feldman, M., Galili, E., Spigelman, M., Rothschild, B. M., & Bar‐Gal, G. K. (2015) · Tuberculosis · doi:10.1016/j.tube.2015.02.021 · Cited by 174
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Mogoantă, C. A., Osman, A., Georgescu, A.-M., Mitroi, A. M., Busuioc, C. I., Tănase, I., Cioboată, R., Liliac, I. M., Cimpeanu, O. L., & Ciolofan, M. S. (2025) · Pathogens · doi:10.3390/pathogens14050479 · Cited by 2
“The incidence of head and neck TB is higher in developing countries, where TB continues to be a significant public health concern [3].”
Metadata
- Authors
- Lv, H., Wang, L., Zhang, X., Dang, C., Liu, F., Zhang, X., Bai, J., You, S., Chen, H., Zhang, W., & Xu, Y.
- Affiliations
- Chinese Center For Disease Control and Prevention (CN)
- Army Medical University (CN)
- Chinese People's Liberation Army (CN)
- Corresponding author
- Chen, Hui
- Zhang, Wenyi
- Xu, Yuanyong
- Venue
- Infectious Diseases of Poverty
- Published
- 2024-09-30
- Volume
- 13
- Issue
- 1
- Pages
- 70-70
- ISSN
- 2049-9957 (ISSN-L)
- PMC
- PMC11440896
- OpenAlex
- W4402956134
- Cited by
- 54
- References
- 45
- Citations by year
- 2026: 32 · 2025: 19 · 2024: 3
- FWCI
- 18.55
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- Infectious Diseases of Poverty (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
- Funders
- National Natural Science Foundation of China (12031010)
- Topics
- Health Sciences › Medicine › Infectious Diseases › Tuberculosis Research and Epidemiology
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › HIV, TB, and STIs Epidemiology
- Health Sciences › Medicine › Oncology › Global Cancer Incidence and Screening
- Keywords
- tuberculosis, tuberculosis incidence, high-burden countries, age-standardized incidence rate, age-period-cohort model, temporal trends, tuberculosis control, Global Burden of Disease 2021, India, Indonesia, Philippines, Pakistan, Nigeria, Bangladesh, Democratic Republic of the Congo
- MeSH terms
- Global Burden of Disease, Adolescent, Adult, Aged, Aged, 80 and over, Bangladesh, Bayes Theorem, Child, Child, Preschool, China, Female, Humans, India, Indonesia, Infant, Infant, Newborn, Male, Middle Aged, Pakistan, Philippines, Tuberculosis, Democratic Republic of the Congo, Incidence, Young Adult
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