Disease burden of extensively drug-resistant tuberculosis attributable to tobacco in China from 1993 to 2021
10.19485/j.cnki.issn2096-5087.2025.12.016
- Author:
MA Xiao
;
NING Shilong
- Publication Type:Journal Article
- Keywords:
extensively drug-resistant tuberculosis;
tobacco;
mortality;
disability-adjusted life years;
age-period-cohort model
- From:
Journal of Preventive Medicine
2025;37(12):1266-1271
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To analyze the trends in age-standardized mortality rate (ASMR) and age-standardized disability-adjusted life year rate (ASDR) of extensively drug-resistant tuberculosis (XDR-TB) attributable to tobacco in China from 1993 to 2021, and to evaluate their age, period, and cohort effects, so as to provide the evidence for formulating targeted prevention and control strategies for XDR-TB.
Methods:Data on the disease burden of XDR-TB attributable to tobacco in China from 1993 to 2021 were collected from the Global Burden of Disease (GBD) 2021 database, including ASMR and ASDR. The estimated annual percentage change (EAPC) was calculated to analyze trends in ASMR and ASDR from 1993 to 2021. An age-period-cohort model was employed to analyze age, period, and cohort effects on ASMR and ASDR.
Results:From 1993 to 2021, the ASMR of XDR-TB attributable to tobacco in China showed an overall declining trend (EAPC=-2.412%, P<0.05), while the trend in ASDR was not statistically significant (EAPC=3.971%, P>0.05). The age-period-cohort model analysis revealed that both the ASMR and ASDR initially increased and then decreased with advancing age. The highest ASMR was observed in the age group of 75-<80 years, at 0.084 5/100 000, and the highest ASDR was observed in the age group of 70-<75 years, at 1.680 1/100 000. The lowest ASMR and ASDR were both found in the age group of 95-<100 years, at 0.039 0/100 000 and 0.365 2/100 000, respectively. Using the 2003-2007 period as the reference, the risks of mortality and disability showed an initial increase followed by a decrease over time. The risks peaked in the 2003-2007 period and subsequently declined, reaching their lowest point in the 2013-2017 period, with corresponding RR values of 0.369 (95%CI: 0.289-0.473) for mortality and 0.382 (95%CI: 0.359-0.408) for disability. Using the 1943-1947 birth cohort as the reference, the risks of mortality and disability exhibited a declining trend with later birth years. The lowest risk was observed in the 1973-1977 birth cohort for mortality, with an RR value of 0.534 (95%CI: 0.311-0.917), and in the 1983-1987 birth cohort for disability, with an RR value of 0.446 (95%CI: 0.386-0.516).
Conclusions:From 1993 to 2021, the overall disease burden of XDR-TB attributable to tobacco in China demonstrated a declining trend. The disease burden was more pronounced among the elderly, and the risks of mortality and disability showed an initial rise followed by a decline across periods, exhibiting a consistent downward trend across successive birth cohorts.
- Full text:20260104150625569471993——2021年中国归因于烟草的广泛耐药结核病疾病负担分析.pdf
