Disease burden and attributable risk factors of Tuberculosis among adults aged 60 years and older in China from 1990 to 2021 and its prediction to 2041.

Authors

Xiaomin Wang, Peierdun Mijiti, Yujiao Long, Junsheng Fan, Xuhui Liu, Yanlin Zhao, Shuihua Lu

Published in

International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases. Pages 109043. Aug 13, 2026. Epub Aug 13, 2026.

Abstract

TB continues to pose considerable threats to elderly populations worldwide. Drawing on the Global Burden of Disease 2021 dataset spanning three decades, this investigation explores how TB burden has shifted among Chinese seniors aged 60 and above.
Standardized epidemiological metrics for incidence, prevalence, mortality, disability-adjusted life years, age-standardised rate and average annual percent change were calculated. Joinpoint regression analysis was applied to identify periods manifesting notable changes and an age-period-cohort framework was employed to estimate the age, period, and cohort effects. Modifiable contributors were measured through attributable fraction analysis, and Bayesian modeling were used to predict long-term trends to 2041.
Drug-susceptible TB declined steadily (-8.07%), whereas drug-resistant TB escalated dramatically, with XDR-TB rising 2133.81% and MDR-TB increasing by and 20.29% relative to 1990, respectively. Men carried roughly twice the disease burden of women, driven largely by smoking and alcohol. Conversely, obesity and diabetes became the prominent drivers among older women after 2006. HIV-associated TB in the elderly patients showed no signs of abating. Projections suggest drug-susceptible TB will keep declining, whereas drug-resistant TB will keep growing.
Older Chinese adults confront a multifaceted TB epidemic marked by declining drug-susceptible TB cases, rising drug‑resistant cases, gender-specific risk profiles, and an emerging HIV-TB syndemic. Addressing sex-differentiated risk profiles and strengthening resistance surveillance are essential steps toward national elimination goals.

PMID:
42595001
Bibliographic data and abstract were imported from PubMed on 14 Aug 2026.

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