Abstract:

Objective: To explore the trends and trajectories of pulmonary tuberculosis disease burden among the population aged 60 and above in China (excluding Taiwan, Hong Kong and Macao regions) from 2005 to 2020, across different regions, urban and rural areas, and age groups. Methods: Based on the pulmonary tuberculosis incidence, mortality and demographic data among the elderly population aged 60 years and above in China from 2005 to 2020, which obtained from the China Tuberculosis Information Management System, the National Disease Surveillance System and the China Center for Disease Control and Prevention Information System, the changing tendencies in disability-adjusted life years (DALYs) caused by pulmonary tuberculosis were calculated. After stratifying the data by region, urban/rural area and age, trajectory model was applied to analyze the trends in DALYs rates. Results: The trajectory models of pulmonary tuberculosis DALYs rates for the elderly population in different age groups were fitted into two groups: Group 1 included the elderly population aged 60-64 (t=―5.484, P<0.001), and Group 2 included the elderly population in the remaining age groups (t=―16.464, P<0.001). The trajectory models of standardized tuberculosis DALYs rates for the elderly population in different regions were also fitted into two groups: Group 1 included the elderly population in the eastern region (t=―3.395, P=0.001), and Group 2 included the elderly population in the central and western regions (t=―8.863, P<0.001), both showing a downward trend. After stratifying the elderly population by age group, region, and urban/rural area, a total of 36 combinations were obtained. The trajectory models of pulmonary tuberculosis DALYs rates were fitted into three groups: Group 1 showed a downward trend (the first time item t=110971.711, the second time item t=―17438254.240, the third time item t=150665.213, P<0.001), including all the elderly population in the eastern region, urban elderly population aged 60-64 and 65-69 in the central and western regions, and rural elderly population aged 60-64 in the central region; Group 2 showed a linear downward trend (t=―22.210, P<0.001), which was more obvious than that of Group 1, including all the elderly population in urban areas of the central and western regions except those in Group 1, as well as the elderly population aged 60-64 years and ≥85 years in the western region; Group 3 showed a downward trend (t=―14.923, P<0.001), which had the highest DALYs rate among the three trajectory groups, including the elderly population in the remaining rural groups in the western region. Conclusion: The pulmonary tuberculosis disease burden in the elderly aged 60 years and above in China showed a declining trend from 2005 to 2020. However, the downward trends in different subgroups were heterogeneous. More attentions should be given to the elderly population with advanced age, living in rural areas, and residing in the western regions. More targeted and precise prevention and control strategies and measures should be developed according to the characteristics of each subgroup.

Key words: Tuberculosis, Aged, Disease burden, Models, statistical