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Abstract：
BACKGROUND: Tuberculosis(TB) remains a pressing public health challenge, with multidrug-resistant tuberculosis (MDR-TB) emerging as a major threat. And healthcare authorities require reliable epidemiological evidence as a crucial reference to address this issue effectively. The aim was to offer a comprehensive epidemiological assessment of the global prevalence and burden of MDR-TB from 1990 to 2019.
METHODS: Estimates and 95% uncertainty intervals (UIs) for the age-standardized prevalence rate (ASPR), age-standardized incidence rate (ASIR), age-standardized disability-adjusted life years rate (ASR of DALYs), and age-standardized death rate (ASDR) of MDR-TB were obtained from the Global Burden of Disease (GBD) 2019 database. The prevalence and burden of MDR-TB in 2019 were illustrated in the population and regional distribution. Temporal trends were analyzed by using Joinpoint regression analysis to calculate the annual percentage change (APC), average annual percentage change (AAPC) and its 95% confidence interval(CI).
RESULTS: The estimates of the number of cases were 687,839(95% UIs: 365,512 to 1223,262), the ASPR were 8.26 per 100,000 (95%UIs: 4.61 to 15.20), the ASR of DALYs were 52.38 per 100,000 (95%UIs: 22.64 to 97.60) and the ASDR were 1.36 per 100,000 (95%UIs: 0.54 to 2.59) of MDR-TB at global in 2019. Substantial burden was observed in Africa and Southeast Asia. Males exhibited higher ASPR, ASR of DALYs, and ASDR than females across most age groups, with the burden of MDR-TB increasing with age. Additionally, significant increases were observed globally in the ASIR (AAPC = 5.8; 95%CI: 5.4 to 6.1; P < 0.001), ASPR (AAPC = 5.9; 95%CI: 5.4 to 6.4; P < 0.001), ASR of DALYs (AAPC = 4.6; 95%CI: 4.2 to 5.0; P < 0.001) and ASDR (AAPC = 4.4; 95%CI: 4.0 to 4.8; P < 0.001) of MDR-TB from 1990 to 2019.
CONCLUSIONS: This study underscored the persistent threat of drug-resistant tuberculosis to public health. It is imperative that countries and organizations worldwide take immediate and concerted action to implement measures aimed at significantly reducing the burden of TB.
METHODS: Estimates and 95% uncertainty intervals (UIs) for the age-standardized prevalence rate (ASPR), age-standardized incidence rate (ASIR), age-standardized disability-adjusted life years rate (ASR of DALYs), and age-standardized death rate (ASDR) of MDR-TB were obtained from the Global Burden of Disease (GBD) 2019 database. The prevalence and burden of MDR-TB in 2019 were illustrated in the population and regional distribution. Temporal trends were analyzed by using Joinpoint regression analysis to calculate the annual percentage change (APC), average annual percentage change (AAPC) and its 95% confidence interval(CI).
RESULTS: The estimates of the number of cases were 687,839(95% UIs: 365,512 to 1223,262), the ASPR were 8.26 per 100,000 (95%UIs: 4.61 to 15.20), the ASR of DALYs were 52.38 per 100,000 (95%UIs: 22.64 to 97.60) and the ASDR were 1.36 per 100,000 (95%UIs: 0.54 to 2.59) of MDR-TB at global in 2019. Substantial burden was observed in Africa and Southeast Asia. Males exhibited higher ASPR, ASR of DALYs, and ASDR than females across most age groups, with the burden of MDR-TB increasing with age. Additionally, significant increases were observed globally in the ASIR (AAPC = 5.8; 95%CI: 5.4 to 6.1; P < 0.001), ASPR (AAPC = 5.9; 95%CI: 5.4 to 6.4; P < 0.001), ASR of DALYs (AAPC = 4.6; 95%CI: 4.2 to 5.0; P < 0.001) and ASDR (AAPC = 4.4; 95%CI: 4.0 to 4.8; P < 0.001) of MDR-TB from 1990 to 2019.
CONCLUSIONS: This study underscored the persistent threat of drug-resistant tuberculosis to public health. It is imperative that countries and organizations worldwide take immediate and concerted action to implement measures aimed at significantly reducing the burden of TB.
摘要：
背景：结核病（TB）仍然是一个紧迫的公共卫生挑战，耐多药结核病（MDR-TB）成为主要威胁。医疗保健当局需要可靠的流行病学证据作为有效解决这一问题的关键参考。目的是对1990年至2019年耐多药结核病的全球患病率和负担进行全面的流行病学评估。
方法：年龄标准化患病率（ASPR）的估计和95％不确定度区间（UI），年龄标准化发病率(ASIR)，年龄标准化残疾调整寿命年率(DALYs的ASR)，MDR-TB的年龄标准化死亡率（ASDR）来自全球疾病负担（GBD）2019数据库。2019年耐多药结核病的流行和负担在人群和地区分布上进行了说明。通过使用Joinpoint回归分析计算年度百分比变化（APC）来分析时间趋势，年平均百分比变化(AAPC)及其95%置信区间(CI)。
结果：病例数估计为687,839（95％UI：365,512至1223,262），ASPR为8.26/100,000（95%UI：4.61至15.20），2019年全球MDR-TB中DALYs的ASR为52.38/100,000(95%UI:22.64~97.60),ASDR为1.36/100,000(95%UI:0.54~2.59).在非洲和东南亚观察到了巨大的负担。男性表现出更高的ASPR，DALYs的ASR,和ASDR比大多数年龄组的女性，耐多药结核病的负担随着年龄的增长而增加。此外,在ASIR中观察到全球显着增加（AAPC=5.8；95CI：5.4至6.1；P<0.001），ASPR（AAPC=5.9；95CI：5.4至6.4；P<0.001），从1990年到2019年，MDR-TB的DALYs的ASR（AAPC=4.6；95CI：4.2至5.0；P<0.001）和ASDR（AAPC=4.4；95CI：4.0至4.8；P<0.001）。
结论：本研究强调了耐药结核病对公众健康的持续威胁。全世界的国家和组织必须立即采取一致行动，实施旨在大幅减轻结核病负担的措施。
方法：年龄标准化患病率（ASPR）的估计和95％不确定度区间（UI），年龄标准化发病率(ASIR)，年龄标准化残疾调整寿命年率(DALYs的ASR)，MDR-TB的年龄标准化死亡率（ASDR）来自全球疾病负担（GBD）2019数据库。2019年耐多药结核病的流行和负担在人群和地区分布上进行了说明。通过使用Joinpoint回归分析计算年度百分比变化（APC）来分析时间趋势，年平均百分比变化(AAPC)及其95%置信区间(CI)。
结果：病例数估计为687,839（95％UI：365,512至1223,262），ASPR为8.26/100,000（95%UI：4.61至15.20），2019年全球MDR-TB中DALYs的ASR为52.38/100,000(95%UI:22.64~97.60),ASDR为1.36/100,000(95%UI:0.54~2.59).在非洲和东南亚观察到了巨大的负担。男性表现出更高的ASPR，DALYs的ASR,和ASDR比大多数年龄组的女性，耐多药结核病的负担随着年龄的增长而增加。此外,在ASIR中观察到全球显着增加（AAPC=5.8；95CI：5.4至6.1；P<0.001），ASPR（AAPC=5.9；95CI：5.4至6.4；P<0.001），从1990年到2019年，MDR-TB的DALYs的ASR（AAPC=4.6；95CI：4.2至5.0；P<0.001）和ASDR（AAPC=4.4；95CI：4.0至4.8；P<0.001）。
结论：本研究强调了耐药结核病对公众健康的持续威胁。全世界的国家和组织必须立即采取一致行动，实施旨在大幅减轻结核病负担的措施。
