南亚的结核病：利用全球疾病负担（1990-2021 年）对负担、进展和未来预测进行区域分析

IF 1.9 Q3 INFECTIOUS DISEASES

Journal of Clinical Tuberculosis and Other Mycobacterial Diseases Pub Date : 2024-10-08 DOI:10.1016/j.jctube.2024.100480

Vijay Kumar , Mahalaqua Nazli Khatib , Amit Verma , Sorabh Lakhanpal , Suhas Ballal , Sanjay Kumar , Mahakshit Bhat , Aryantika Sharma , M. Ravi Kumar , Aashna Sinha , Abhay M. Gaidhane , Muhammed Shabil , Mahendra Pratap Singh , Sanjit Sah , Kiran Bhopte , Kamal Kundra , Shailesh Kumar Samal

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引用次数: 0

摘要

背景结核病（TB）是南亚的一个主要公共卫生问题，在全球结核病负担中占很大比例。尽管全球都在努力遏制结核病的发病率和死亡率，但南亚地区的进展并不均衡，因此有必要进行重点区域分析，以指导采取有效的干预措施。本研究旨在分析 1990 年至 2021 年南亚地区的结核病负担趋势，并预测未来至 2031 年的结核病发病率。本研究利用 2021 年全球疾病负担（GBD）结果中的数据，分析 1990 年至 2021 年南亚地区与结核病相关的年龄标准化发病率（ASIR）、流行率（ASPR）、死亡率（ASMR）和残疾调整生命年（DALYs）率（ASDR）的趋势。这项研究显示，在过去三十年中，南亚与结核病相关的 ASIR、ASPR、ASDR 和 ASMR 显著下降。孟加拉国和不丹的发病率明显下降，而印度、巴基斯坦和尼泊尔的结核病负担仍然最高。ARIMA 模型预测表明，整个地区的肺结核发病率将继续下降，但各国的下降程度不同，尼泊尔和巴基斯坦的趋势较弱。分析还强调，吸烟、空腹血浆葡萄糖过高和体重指数过高是造成结核病负担的重要风险因素。这些发现强调，需要采取有针对性的干预措施，以实现世界卫生组织到 2035 年终结结核病战略 (WETS) 的目标。持续监测和适应性战略对于保持和加快南亚消除结核病的进展至关重要。

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Tuberculosis in South Asia: A regional analysis of burden, progress, and future projections using the global burden of disease (1990–2021)

Background

Tuberculosis (TB) is a major public health issue in South Asia and accounts for a large share of the global TB burden. Despite global efforts to curb TB incidence and mortality, progress in South Asia has been uneven, necessitating focused regional analysis to guide effective interventions. This study aims to analyse the trends in the TB burden in South Asia from 1990 to 2021 and project future TB incidence rates up to 2031.

Methods

This study utilized data from the Global Burden of Disease (GBD) 2021 results to analyse trends in age-standardized incidence (ASIR), prevalence (ASPR), mortality (ASMR), and disability-adjusted life years (DALYs) rates (ASDR) associated with TB in South Asia from 1990 to 2021. Joinpoint regression analysis was employed to identify significant trends, whereas ARIMA models were used to project future TB incidence rates up to 2031.

Results

This study revealed significant declines in the ASIR, ASPR, ASDR, and ASMR related to TB in South Asia over the past three decades. Prominent reductions were found in Bangladesh and Bhutan, whereas India, Pakistan, and Nepal continue to bear the highest TB burdens. The ARIMA model projections indicate a continued decline in TB incidence across the region, although the extent of the decline varies by country, with less favourable trends observed in Nepal and Pakistan. The analysis also highlights tobacco use, high fasting plasma glucose, and high body mass index as significant risk factors contributing to the TB burden.

Conclusions

Substantial progress has been made in reducing the TB burden in South Asia; however, sustained and intensified efforts are needed, particularly in countries with inconsistent progress. These findings emphasize the need for targeted interventions to meet the WHO End TB Strategy (WETS) targets by 2035. Continuous monitoring and adaptive strategies will be crucial in maintaining and accelerating progress toward TB elimination in South Asia.

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来源期刊

Journal of Clinical Tuberculosis and Other Mycobacterial Diseases Medicine-Pulmonary and Respiratory Medicine

CiteScore

4.00

自引率

5.00%

发文量

审稿时长

30 weeks

期刊介绍： Journal of Clinical Tuberculosis and Mycobacterial Diseases aims to provide a forum for clinically relevant articles on all aspects of tuberculosis and other mycobacterial infections, including (but not limited to) epidemiology, clinical investigation, transmission, diagnosis, treatment, drug-resistance and public policy, and encourages the submission of clinical studies, thematic reviews and case reports. Journal of Clinical Tuberculosis and Mycobacterial Diseases is an Open Access publication.