Distribution of Extensively Drug-resistant Tuberculosis in the World Health Organization Regions of the World During 1990-2019

Abstract

The rise of drug-resistant tuberculosis (TB) has become a significant public health concern, representing a threat to global TB control programs. Extensively drug-resistant TB (XDR-TB) accounts for approximately 9% of all drug-resistant cases, and its incidence has been increasing. In this study, we aimed to investigate the burden of TB during 1990-2019 in six regions of the World Health Organization according to sex. Geographical distribution and trend of incidence, prevalence, years of life lost (YLL) from mortality, and years lived with disability (YLD) of XDR-TB were evaluated according to sex using geographic maps and trend plots. In both sex groups, the rate of the four indicators were the highest in Europe and the lowest in America (values in the first quartile). In Africa, the incidence, prevalence, YLD values fell in the first quartile. The trend of incidence, prevalence, and YLD generally increased in all the regions. However, a decreasing trend has been observed in recent years in the Western Pacific region and Europe. Additionally, in general, YLL exhibited a stable or decreasing trend in the last few years in all the regions. The strategies that have achieved a decrease in trend in some years should be further analyzed by policymakers to identify appropriate solutions to control XDR-TB. Furthermore, Europe, South-East Asia, and the Eastern Mediterranean region require special attention. Additionally, implementation of effective strategies can greatly improve TB control in the world.

Keywords

• extensively drug-resistant tuberculosis
• incidence
• prevalence
• disability-adjusted life years
• tuberculosis