Tuberculosis in South Asia: A regional analysis of burden, progress, and future projections using the global burden of disease (1990–2021)

Background: Tuberculosis (TB) is a major public health issue in South Asia and accounts for a large share of the global TB burden. Despite global efforts to curb TB incidence and mortality, progress in South Asia has been uneven, necessitating focused regional analysis to guide effective interventio...

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Main Authors: Vijay Kumar, Mahalaqua Nazli Khatib, Amit Verma, Sorabh Lakhanpal, Suhas Ballal, Sanjay Kumar, Mahakshit Bhat, Aryantika Sharma, M. Ravi Kumar, Aashna Sinha, Abhay M. Gaidhane, Muhammed Shabil, Mahendra Pratap Singh, Sanjit Sah, Kiran Bhopte, Kamal Kundra, Shailesh Kumar Samal
Format: Article
Language:English
Published: Elsevier 2024-12-01
Series:Journal of Clinical Tuberculosis and Other Mycobacterial Diseases
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Online Access:http://www.sciencedirect.com/science/article/pii/S2405579424000676
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author Vijay Kumar
Mahalaqua Nazli Khatib
Amit Verma
Sorabh Lakhanpal
Suhas Ballal
Sanjay Kumar
Mahakshit Bhat
Aryantika Sharma
M. Ravi Kumar
Aashna Sinha
Abhay M. Gaidhane
Muhammed Shabil
Mahendra Pratap Singh
Sanjit Sah
Kiran Bhopte
Kamal Kundra
Shailesh Kumar Samal
author_facet Vijay Kumar
Mahalaqua Nazli Khatib
Amit Verma
Sorabh Lakhanpal
Suhas Ballal
Sanjay Kumar
Mahakshit Bhat
Aryantika Sharma
M. Ravi Kumar
Aashna Sinha
Abhay M. Gaidhane
Muhammed Shabil
Mahendra Pratap Singh
Sanjit Sah
Kiran Bhopte
Kamal Kundra
Shailesh Kumar Samal
author_sort Vijay Kumar
collection DOAJ
description Background: Tuberculosis (TB) is a major public health issue in South Asia and accounts for a large share of the global TB burden. Despite global efforts to curb TB incidence and mortality, progress in South Asia has been uneven, necessitating focused regional analysis to guide effective interventions. This study aims to analyse the trends in the TB burden in South Asia from 1990 to 2021 and project future TB incidence rates up to 2031. Methods: This study utilized data from the Global Burden of Disease (GBD) 2021 results to analyse trends in age-standardized incidence (ASIR), prevalence (ASPR), mortality (ASMR), and disability-adjusted life years (DALYs) rates (ASDR) associated with TB in South Asia from 1990 to 2021. Joinpoint regression analysis was employed to identify significant trends, whereas ARIMA models were used to project future TB incidence rates up to 2031. Results: This study revealed significant declines in the ASIR, ASPR, ASDR, and ASMR related to TB in South Asia over the past three decades. Prominent reductions were found in Bangladesh and Bhutan, whereas India, Pakistan, and Nepal continue to bear the highest TB burdens. The ARIMA model projections indicate a continued decline in TB incidence across the region, although the extent of the decline varies by country, with less favourable trends observed in Nepal and Pakistan. The analysis also highlights tobacco use, high fasting plasma glucose, and high body mass index as significant risk factors contributing to the TB burden. Conclusions: Substantial progress has been made in reducing the TB burden in South Asia; however, sustained and intensified efforts are needed, particularly in countries with inconsistent progress. These findings emphasize the need for targeted interventions to meet the WHO End TB Strategy (WETS) targets by 2035. Continuous monitoring and adaptive strategies will be crucial in maintaining and accelerating progress toward TB elimination in South Asia.
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spelling doaj-art-dfa107073c7a4d238a279f3d4eb29bd62025-08-20T01:58:56ZengElsevierJournal of Clinical Tuberculosis and Other Mycobacterial Diseases2405-57942024-12-013710048010.1016/j.jctube.2024.100480Tuberculosis in South Asia: A regional analysis of burden, progress, and future projections using the global burden of disease (1990–2021)Vijay Kumar0Mahalaqua Nazli Khatib1Amit Verma2Sorabh Lakhanpal3Suhas Ballal4Sanjay Kumar5Mahakshit Bhat6Aryantika Sharma7M. Ravi Kumar8Aashna Sinha9Abhay M. Gaidhane10Muhammed Shabil11Mahendra Pratap Singh12Sanjit Sah13Kiran Bhopte14Kamal Kundra15Shailesh Kumar Samal16Evidence for Policy and Learning, Global Center for Evidence Synthesis, Chandigarh, IndiaDivision of Evidence Synthesis, Global Consortium of Public Health and Research, Datta Meghe Institute of Higher Education, Wardha, IndiaDepartment of Medicine, Graphic Era Institute of Medical Sciences, Graphic Era (Deemed to be University), Clement Town, Dehradun, IndiaSchool of Pharmaceutical Sciences, Lovely Professional University, Phagwara, IndiaDepartment of Chemistry and Biochemistry, School of Sciences, JAIN (Deemed to be University), Bangalore, Karnataka, IndiaDepartment of Allied Healthcare and Sciences, Vivekananda Global University, Jaipur, Rajasthan 303012, IndiaDepartment of Medicine, National Institute of Medical Sciences, NIMS University Rajasthan, Jaipur, IndiaChandigarh Pharmacy College, Chandigarh Group of Colleges-Jhanjeri, Mohali 140307, Punjab, IndiaDepartment of Chemistry, Raghu Engineering College, Visakhapatnam, Andhra Pradesh 531162, IndiaUttaranchal Institute of Pharmaceutical Sciences, Division of Research and Innovation, Uttaranchal University, IndiaJawaharlal Nehru Medical College, and Global Health Academy, School of Epidemiology and Public Health, Datta Meghe Institute of Higher Education, Wardha, IndiaUniversity Center for Research and Development, Chandigarh University, Mohali 140413 Punjab, India; Medical Laboratories Techniques Department, AL-Mustaqbal University, 51001 Hillah, Babil, IraqEvidence for Policy and Learning, Global Center for Evidence Synthesis, Chandigarh, India; Center for Global Health Research, Saveetha Medical College and Hospital, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, IndiaSR Sanjeevani Hospital, Kalyanpur, Siraha 56517, Nepal; Department of Paediatrics, Dr. D. Y. Patil Medical College, Hospital and Research Centre, Dr. D. Y. Patil Vidyapeeth, Pune 411018, Maharashtra, India; Department of Public Health Dentistry, Dr. D.Y. Patil Dental College and Hospital, Dr. D.Y. Patil Vidyapeeth, Pune 411018, Maharashtra, IndiaIES Institute of Pharmacy, IES University, Bhopal, Madhya Pradesh 462044, IndiaNew Delhi Institute of Management, Delhi, IndiaUnit of Immunology and Chronic Disease, Institute of Environmental Medicine, Karolinska Institutet, 17177 Stockholm, Sweden; Corresponding author.Background: Tuberculosis (TB) is a major public health issue in South Asia and accounts for a large share of the global TB burden. Despite global efforts to curb TB incidence and mortality, progress in South Asia has been uneven, necessitating focused regional analysis to guide effective interventions. This study aims to analyse the trends in the TB burden in South Asia from 1990 to 2021 and project future TB incidence rates up to 2031. Methods: This study utilized data from the Global Burden of Disease (GBD) 2021 results to analyse trends in age-standardized incidence (ASIR), prevalence (ASPR), mortality (ASMR), and disability-adjusted life years (DALYs) rates (ASDR) associated with TB in South Asia from 1990 to 2021. Joinpoint regression analysis was employed to identify significant trends, whereas ARIMA models were used to project future TB incidence rates up to 2031. Results: This study revealed significant declines in the ASIR, ASPR, ASDR, and ASMR related to TB in South Asia over the past three decades. Prominent reductions were found in Bangladesh and Bhutan, whereas India, Pakistan, and Nepal continue to bear the highest TB burdens. The ARIMA model projections indicate a continued decline in TB incidence across the region, although the extent of the decline varies by country, with less favourable trends observed in Nepal and Pakistan. The analysis also highlights tobacco use, high fasting plasma glucose, and high body mass index as significant risk factors contributing to the TB burden. Conclusions: Substantial progress has been made in reducing the TB burden in South Asia; however, sustained and intensified efforts are needed, particularly in countries with inconsistent progress. These findings emphasize the need for targeted interventions to meet the WHO End TB Strategy (WETS) targets by 2035. Continuous monitoring and adaptive strategies will be crucial in maintaining and accelerating progress toward TB elimination in South Asia.http://www.sciencedirect.com/science/article/pii/S2405579424000676TuberculosisSouth AsiaGlobal burden of diseaseARIMAJoinpoint regression
spellingShingle Vijay Kumar
Mahalaqua Nazli Khatib
Amit Verma
Sorabh Lakhanpal
Suhas Ballal
Sanjay Kumar
Mahakshit Bhat
Aryantika Sharma
M. Ravi Kumar
Aashna Sinha
Abhay M. Gaidhane
Muhammed Shabil
Mahendra Pratap Singh
Sanjit Sah
Kiran Bhopte
Kamal Kundra
Shailesh Kumar Samal
Tuberculosis in South Asia: A regional analysis of burden, progress, and future projections using the global burden of disease (1990–2021)
Journal of Clinical Tuberculosis and Other Mycobacterial Diseases
Tuberculosis
South Asia
Global burden of disease
ARIMA
Joinpoint regression
title Tuberculosis in South Asia: A regional analysis of burden, progress, and future projections using the global burden of disease (1990–2021)
title_full Tuberculosis in South Asia: A regional analysis of burden, progress, and future projections using the global burden of disease (1990–2021)
title_fullStr Tuberculosis in South Asia: A regional analysis of burden, progress, and future projections using the global burden of disease (1990–2021)
title_full_unstemmed Tuberculosis in South Asia: A regional analysis of burden, progress, and future projections using the global burden of disease (1990–2021)
title_short Tuberculosis in South Asia: A regional analysis of burden, progress, and future projections using the global burden of disease (1990–2021)
title_sort tuberculosis in south asia a regional analysis of burden progress and future projections using the global burden of disease 1990 2021
topic Tuberculosis
South Asia
Global burden of disease
ARIMA
Joinpoint regression
url http://www.sciencedirect.com/science/article/pii/S2405579424000676
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