Global tuberculosis (TB) incidence, mortality, and disability-adjusted life years (DALYs) have decreased significantly in adolescents and young adults since 1990, but the incidence of drug-resistant TB increased, Chinese researchers reported in Pediatrics.
Using data from the Global Burden of Disease Study 2019, researchers from Peking University and Tsinghua University calculated the percentage of relative changes in TB incidence, deaths, and DALYs in people aged 10 to 24 from 1990 to 2019. They assessed temporal changes using estimated annual percentage changes (EAPCs).
Globally, the number of incident TB cases in adolescents fell from 2.23 million in 1990 to 1.82 million in 2019, while the number of TB deaths fell from 0.11 million to 0.6 million. The number of DALYs declined from 8.74 million to 4.87 million. Incidence, deaths, and DALYs per 100,000 population saw relative declines of 32.3%, 56.6%, and 53.7%, respectively, with EAPCs of 1.28%, 3.06%, and 2.83%.
Similar decreasing trends occurred across sex, age, sociodemographic index regions, and in most regions and countries. But TB incidence decreased faster in female adolescents than male, and increases in incidence were observed in sub-Saharan African countries, with the largest seen in South Africa (EAPC, 3.51).
In contrast to those trends, the incidence of extensively drug-resistant TB rose 11.2% each year, and multidrug-resistant TB without extensive resistance climbed 3.3% each year.
The study authors say the declines are primarily because of increased investment in TB prevention and control, along with improvements in TB diagnosis and treatment. Increased incidence of drug-resistant TB, meanwhile, is likely from advances in detection technology and drug-susceptibility testing. But they note that the actual incidence of drug-resistant TB may be underestimated, since data from the World Health Organization Global Tuberculosis Program has shown that only one third of people with drug-resistant TB are detected worldwide.
"TB remains a concern in adolescents and young adults, especially in low- and middle-income countries," they wrote. "Thus, efforts to reduce the incidence and mortality of TB in adolescents and young adults are essential worldwide."
Source: CIDRAP