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ORIGINAL RESEARCH article

Front. Public Health
Sec. Aging and Public Health
Volume 12 - 2024 | doi: 10.3389/fpubh.2024.1500539
This article is part of the Research Topic Community Insights in Tuberculosis Epidemiology View all articles

Trends in Tuberculosis Mortality among the Elderly in China, 2004-2021: A Jointpoint Regression and Age-Period-Cohort Analysis

Provisionally accepted
Mengdi Zhang Mengdi Zhang 1Xin Wang Xin Wang 1*Yiran Xiao Yiran Xiao 1*Qiqi Wang Qiqi Wang 1Fei Huang Fei Huang 1Xiang Ren Xiang Ren 1*Xiaomin Guo Xiaomin Guo 1*Wenshan Sun Wenshan Sun 1*Jinqi Deng Jinqi Deng 1*Qi Jiang Qi Jiang 1*Jianjun Liu Jianjun Liu 2*Wenjing Zheng Wenjing Zheng 1*Hongyan Yao Hongyan Yao 1*
  • 1 Chinese Center For Disease Control and Prevention, Beijing, China
  • 2 Chinese Antituberculosis Association, Beijing, China

The final, formatted version of the article will be published soon.

    Background: Tuberculosis (TB) remains a major public health problem in China and globally, particularly among the elderly. This study aimed to examine secular trends in TB mortality among the elderly in China and the net effects of age, period, and cohort. Methods: Data from the National Disease Surveillance Points (DSPs) system were analyzed using joinpoint regression to determine annual changes in TB mortality for individuals aged 60 and over from 2004 to 2021. The age-period-cohort (APC) analysis with the intrinsic estimator (IE) method was used to estimate the independent effects of age, period and cohort. Results: The age-standardized TB mortality rate was 5.68 per 100,000, with higher rates in males, rural areas, and western regions. TB mortality among the elderly declined overall from 2004 to 2021, though the rate of decline slowed in recent years. The APC analysis revealed increased TB mortality with age, with relative risk (RR) rising from 0.57 in the 60-64 age group to 1.53 in the 80-84 age group. The period effect decreased from 2007 to 2021, showing higher risk effect in rural areas (RR=1.51) than in urban areas (RR=1.16) in the period 2007-2011, but this trend reversed in the period 2017-2021. The cohort effect generally declined, expect for certain demographic groups increased in the 1952-1956 and 1957-1961 birth cohorts. Conclusions: TB mortality among the elderly in China decreased from 2004 to 2021, although the decline had slowed in recent years. Variations in age, period, and cohort effects highlight differences by gender, urban and rural areas, and regions, providing insights for targeted intervention strategies.

    Keywords: Tuberculosis, Mortality, Elderly, Joinpoint regression, Age-Period-Cohort analysis

    Received: 23 Sep 2024; Accepted: 09 Dec 2024.

    Copyright: © 2024 Zhang, Wang, Xiao, Wang, Huang, Ren, Guo, Sun, Deng, Jiang, Liu, Zheng and Yao. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence:
    Xin Wang, Chinese Center For Disease Control and Prevention, Beijing, China
    Yiran Xiao, Chinese Center For Disease Control and Prevention, Beijing, China
    Xiang Ren, Chinese Center For Disease Control and Prevention, Beijing, China
    Xiaomin Guo, Chinese Center For Disease Control and Prevention, Beijing, China
    Wenshan Sun, Chinese Center For Disease Control and Prevention, Beijing, China
    Jinqi Deng, Chinese Center For Disease Control and Prevention, Beijing, China
    Qi Jiang, Chinese Center For Disease Control and Prevention, Beijing, China
    Jianjun Liu, Chinese Antituberculosis Association, Beijing, China
    Wenjing Zheng, Chinese Center For Disease Control and Prevention, Beijing, China
    Hongyan Yao, Chinese Center For Disease Control and Prevention, Beijing, China

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