Clustering and modeling joint-trajectories of HIV/AIDS and tuberculosis mortality rates using bayesian multi-process latent growth model: A global study from 1990 to 2021

Abstract Background The bidirectional association of HIV/AIDS and Tuberculosis (TB) presents significant global health challenges. However, the relationship between these dual epidemics and the heterogeneity in their mortality rate patterns have not been properly addressed. Therefore, the aim of thi...

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Main Authors: Tofigh Mobaderi, Anoshirvan Kazemnejad, Masoud Salehi
Format: Article
Language:English
Published: BMC 2025-03-01
Series:BMC Infectious Diseases
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Online Access:https://doi.org/10.1186/s12879-025-10715-x
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author Tofigh Mobaderi
Anoshirvan Kazemnejad
Masoud Salehi
author_facet Tofigh Mobaderi
Anoshirvan Kazemnejad
Masoud Salehi
author_sort Tofigh Mobaderi
collection DOAJ
description Abstract Background The bidirectional association of HIV/AIDS and Tuberculosis (TB) presents significant global health challenges. However, the relationship between these dual epidemics and the heterogeneity in their mortality rate patterns have not been properly addressed. Therefore, the aim of this study was to cluster and model the joint trajectories of HIV/AIDS and TB mortality rates from 1990 to 2021 worldwide. Methods In this longitudinal study, the HIV/AIDS and TB mortality rates data for 204 countries from 1990 to 2021 were obtained from the global burden of disease database. The longitudinal k-means clustering approach was utilized to categorize countries into homogeneous subgroups based on the joint patterns of HIV/AIDS and TB mortality rates. Subsequently, the Bayesian multi-process nonlinear Latent Growth Model (LGM) was conducted to concurrently estimate the patterns of HIV/AIDS and TB mortality rates. Results The average global TB mortality rates dropped from 30.61 to 13.34 per 100,000 between 1990 and 2021. Meanwhile, the average HIV/AIDS mortality rates rose from 10.94 to 48.42 per 100,000 by 2000 before declining to 16.90 per 100,000 in 2021. The Bayesian multi-process nonlinear LGM indicated that the intercepts for the overall HIV/AIDS and TB models were 11.168 and 30.184, and the slopes were 16.104 and − 1.040, respectively. This suggests that the initial HIV/AIDS and TB mortality rates were 11.168 and 30.184 persons per 100,000, and the rates of change were 16.104 and − 1.040 persons per 100,000 every five years. However, the strength and direction of the rate of change were dependent on the factor loading scores, as they exhibited a nonlinear trend. Finally, the 204 countries were clustered into three distinct subgroups, each with different intercepts and slopes. Cluster A demonstrated the lowest HIV/AIDS and TB mortality rates throughout the study, while Cluster C exhibited the highest mortality rates. Conclusions Although the overall global HIV/AIDS and TB mortality rates have declined, Southern African countries continue to bear a significant burden of HIV/AIDS and TB, with no significant reduction observed in TB mortality rates from 1990 to 2021. Therefore, prioritizing these countries is crucial to achieving the Sustainable Development Goals (SDGs) of eradicating the global HIV/AIDS and TB epidemics by 2030 and 2035, respectively.
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spelling doaj-art-bdb942d76ea94c798dca5372a61a448c2025-08-20T02:56:15ZengBMCBMC Infectious Diseases1471-23342025-03-0125111310.1186/s12879-025-10715-xClustering and modeling joint-trajectories of HIV/AIDS and tuberculosis mortality rates using bayesian multi-process latent growth model: A global study from 1990 to 2021Tofigh Mobaderi0Anoshirvan Kazemnejad1Masoud Salehi2Minimally Invasive Surgery Research Center, Iran University of Medical SciencesDepartment of Biostatistics, Faculty of Medical Sciences, Tarbiat Modares UniversityNutritional Sciences Research Center, Iran University of Medical SciencesAbstract Background The bidirectional association of HIV/AIDS and Tuberculosis (TB) presents significant global health challenges. However, the relationship between these dual epidemics and the heterogeneity in their mortality rate patterns have not been properly addressed. Therefore, the aim of this study was to cluster and model the joint trajectories of HIV/AIDS and TB mortality rates from 1990 to 2021 worldwide. Methods In this longitudinal study, the HIV/AIDS and TB mortality rates data for 204 countries from 1990 to 2021 were obtained from the global burden of disease database. The longitudinal k-means clustering approach was utilized to categorize countries into homogeneous subgroups based on the joint patterns of HIV/AIDS and TB mortality rates. Subsequently, the Bayesian multi-process nonlinear Latent Growth Model (LGM) was conducted to concurrently estimate the patterns of HIV/AIDS and TB mortality rates. Results The average global TB mortality rates dropped from 30.61 to 13.34 per 100,000 between 1990 and 2021. Meanwhile, the average HIV/AIDS mortality rates rose from 10.94 to 48.42 per 100,000 by 2000 before declining to 16.90 per 100,000 in 2021. The Bayesian multi-process nonlinear LGM indicated that the intercepts for the overall HIV/AIDS and TB models were 11.168 and 30.184, and the slopes were 16.104 and − 1.040, respectively. This suggests that the initial HIV/AIDS and TB mortality rates were 11.168 and 30.184 persons per 100,000, and the rates of change were 16.104 and − 1.040 persons per 100,000 every five years. However, the strength and direction of the rate of change were dependent on the factor loading scores, as they exhibited a nonlinear trend. Finally, the 204 countries were clustered into three distinct subgroups, each with different intercepts and slopes. Cluster A demonstrated the lowest HIV/AIDS and TB mortality rates throughout the study, while Cluster C exhibited the highest mortality rates. Conclusions Although the overall global HIV/AIDS and TB mortality rates have declined, Southern African countries continue to bear a significant burden of HIV/AIDS and TB, with no significant reduction observed in TB mortality rates from 1990 to 2021. Therefore, prioritizing these countries is crucial to achieving the Sustainable Development Goals (SDGs) of eradicating the global HIV/AIDS and TB epidemics by 2030 and 2035, respectively.https://doi.org/10.1186/s12879-025-10715-xMulti-process latent growth modelClusteringHeterogeneityHuman immunodeficiency virus (HIV)Tuberculosis (TB)
spellingShingle Tofigh Mobaderi
Anoshirvan Kazemnejad
Masoud Salehi
Clustering and modeling joint-trajectories of HIV/AIDS and tuberculosis mortality rates using bayesian multi-process latent growth model: A global study from 1990 to 2021
BMC Infectious Diseases
Multi-process latent growth model
Clustering
Heterogeneity
Human immunodeficiency virus (HIV)
Tuberculosis (TB)
title Clustering and modeling joint-trajectories of HIV/AIDS and tuberculosis mortality rates using bayesian multi-process latent growth model: A global study from 1990 to 2021
title_full Clustering and modeling joint-trajectories of HIV/AIDS and tuberculosis mortality rates using bayesian multi-process latent growth model: A global study from 1990 to 2021
title_fullStr Clustering and modeling joint-trajectories of HIV/AIDS and tuberculosis mortality rates using bayesian multi-process latent growth model: A global study from 1990 to 2021
title_full_unstemmed Clustering and modeling joint-trajectories of HIV/AIDS and tuberculosis mortality rates using bayesian multi-process latent growth model: A global study from 1990 to 2021
title_short Clustering and modeling joint-trajectories of HIV/AIDS and tuberculosis mortality rates using bayesian multi-process latent growth model: A global study from 1990 to 2021
title_sort clustering and modeling joint trajectories of hiv aids and tuberculosis mortality rates using bayesian multi process latent growth model a global study from 1990 to 2021
topic Multi-process latent growth model
Clustering
Heterogeneity
Human immunodeficiency virus (HIV)
Tuberculosis (TB)
url https://doi.org/10.1186/s12879-025-10715-x
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