Global burden of tuberculosis among adults aged 60 years and older, 1990-2021: Findings from the global burden of disease study 2021

Abstract

Objectives: Tuberculosis (TB) poses a significant threat to global public health, particularly, among elderly individuals. This study aimed to provide a comprehensive analysis of the patterns and temporal trends in the global disease burden of HIV-negative TB among adults aged ≥60 years from 1990 to 2021. Methods: Data on incidence, deaths, and disability-adjusted life-years of TB, drug-susceptible TB, multidrug-resistant TB (MDR-TB), and extensively drug-resistant TB (XDR-TB) were obtained from the Global Burden of Disease 2021. Frontier analysis was carried out to pinpoint areas for enhancement and disparities among nations stratified by development level. The Bayesian age-period-cohort model was used to forecast disease burden trends through 2035. Results: A decreasing trend in age-standardized incidence rate, age-standardized mortality rate, and disability-adjusted life-years rates for TB and drug-susceptible TB was observed among the elderly population worldwide, whereas an upward trend was noted for MDR-TB and XDR-TB. Frontier analyses revealed a potential for burden alleviation among diverse nations and regions, with high socio-demographic index nations, such as the Republic of Korea, showing higher disease burden than expected for their sociodemographic development. The Bayesian age-period-cohort model revealed that by 2035, the MDR-TB and XDR-TB burden will continue increasing in the elderly population. Conclusions: The increasing MDR-TB and XDR-TB burden in older individuals underscores the need for tailored interventions to combat TB burden, such as implementing active case finding among adults aged 60 years and older.

Keywords

• Tuberculosis
• The elderly
• Disease burden
• GBD 2021
• Frontier analysis