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• W2771249420 abstract "Abstract Background With the rapid pace of population ageing, tuberculosis in older people has become a public health challenge in China. However, the age-structured epidemiological transition and its impact on achieving the end tuberculosis targets by 2035 have not been understood well. We analysed the age-structured incidence and mortality of pulmonary tuberculosis reported in China to inform current and future control programmes. Methods In this longitudinal study, we compared the trends of age-specific reported incidence and mortality of pulmonary tuberculosis from 2005 to 2015 in China. In addition to crude rates, we calculated age-adjusted rates from 2006 to 2015 by taking the population in 2005 as reference. We determined the annual crude and age-adjusted rates of reduction by fitting an exponential linear regression model, and extrapolated up to 2035 given fixed decline rates. All data were collected from national Infectious Disease Reporting System and Diseases Surveillance System. Findings We noted overall downward trends of reported tuberculosis incidence and mortality in all age and sex groups since 2005, whereas the proportion of older people (aged 65 years and older) among reported patients with tuberculosis and deaths increased gradually. The total tuberculosis incidence and mortality were significantly higher in older people (193·0 cases per 100 000 people and 18·7 deaths per 100 000 people, respectively) than in younger groups (66·6 cases per 100 000 and 1·7 deaths per 100 000 people). The average annual decline in crude incidence was 4·2% (95% CI 3·5–4·9) and 5·1% (4·3–5·9%) in age-adjusted incidence; the annual decline in crude mortality was 9·7% (95% CI 8·4–10·9) and 12·4% (10·9–13·8) in age-adjusted mortality. Extrapolating this trend, by 2035, the crude incidence of tuberculosis was expected to reach 26·8 cases per 100 000 people and the age-adjusted incidence to reach 20·6 cases per 100 000 people, which would result in a total reduction of 57·8% and 65·0%, respectively, compared with the rates in 2015. By 2035, the crude mortality was expected to reach 0·33 deaths per 100 000 people and the age-adjusted mortality to reach 0·15 deaths per 100 000 people, which would result in a total reduction of 86·0% and 92·0%, respectively, compared with the rates in 2015. Interpretation These findings demonstrated an age transition of tuberculosis epidemic and the effects of population ageing on slowing down tuberculosis control progress made in China. An average 6–7% reduction would be cancelled out by 2035 given current tuberculosis decline trend and demographic change. An enhanced surveillance with age-sensitive analysis of patients with tuberculosis and a targeted response are needed. Funding None." @default.
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• W2771249420 date "2017-12-01" @default.
• W2771249420 modified "2023-09-22" @default.
• W2771249420 title "The age-structured incidence and mortality of pulmonary tuberculosis reported in China, in 2005–15: a longitudinal analysis of national surveillance data" @default.
• W2771249420 doi "https://doi.org/10.1016/s0140-6736(17)33150-1" @default.
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