Abstract:

Objective: Analyze pulmonary tuberculosis caused mortality rate and its changing trend in Guangzhou City from 2011 to 2020, in order to provide a scientific basis for formulating prevention and control strategies and measures. Methods: The Joinpoint regression model was used to analyze the change trend of tuberculosis mortality rates in all age groups in Guangzhou from 2011 to 2020. Annual percent change (APC) and average annual percent change (AAPC) were calculated. Age-period-cohort model was used to analyze the age, period and cohort effects on risk of pulmonary tuberculosis caused death in 20-85 years old populations in Guangzhou. Results: From 2011 to 2020, 2144 cases died of pulmonary tuberculosis were reported in Guangzhou, with an average annual standardized mortality rate of 2.57/100000. The standardized mortality rate of male was 4.19/100000, about 4.4 times of that of females (0.96/100000). The age-standardized mortality rates showed a decreasing trend in the past 10 years, AAPC was ―4.15% (95%CI: ―6.41%-―1.85%, P=0.003). The mortality rates decreased faster in females (AAPC=―6.72%, 95%CI: ―10.38%-―2.92%, P=0.004) than in males (―3.55%, 95%CI: ―6.19%-―0.85%, P=0.017). For different age groups, the mortality rates of pulmonary tuberculosis in 0-49 years old group and ≥65 years old group showed significant downward trends, their AAPC were ―7.05% (95%CI: ―11.52%-―2.34%, P=0.009) and ―3.94% (95%CI: ―6.22%-―1.62%, P=0.005) respectively. The age-period-cohort model showed that risk of tuberculosis death increased with age, particularly in people over 65 years old, from 2.93/100000 in the 66-67 age group to 6.10/100000 in the 84-85 age group. The period effect showed that the overall risk of tuberculosis death showed a downward trend with the change of period, risk ratio (RR) decreased from 1.35 in the 2011—2012 period group to 0.81 in the 2019—2020 period group. The cohort effect showed a lower risk of tuberculosis death for those born later, with RR decreasing from 5.91 in the 1926—1927 born cohort to 0.16 in the 1998—1999 born cohort. Conclusion: The mortality rate of pulmonary tuberculosis in Guangzhou showed a decreasing trend, but there was a large gap between male and female. It is necessary to focus on men and elderly people over 65 years old and implement targeted prevention and treatment measures.

Key words: Tuberculosis, pulmonary, Mortality, Regression analysis, Cohort studies