Trends in tuberculosis mortality among older adults in China, 2004–2021: a Joinpoint regression and age–period–cohort analysis
BackgroundTuberculosis (TB) remains a major public health problem in China and globally, particularly among older adults. This study aimed to examine secular trends in TB mortality among older adults in China and the net effects of age, period, and cohort.MethodsData from the National Disease Survei...
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Frontiers Media S.A.
2025-01-01
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fpubh.2024.1500539/full |
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| author | Mengdi Zhang Xin Wang Yiran Xiao Qiqi Wang Fei Huang Xiang Ren Xiaomin Guo Wenshan Sun Jinqi Deng Qi Jiang Jianjun Liu Wenjing Zheng Hongyan Yao |
| author_facet | Mengdi Zhang Xin Wang Yiran Xiao Qiqi Wang Fei Huang Xiang Ren Xiaomin Guo Wenshan Sun Jinqi Deng Qi Jiang Jianjun Liu Wenjing Zheng Hongyan Yao |
| author_sort | Mengdi Zhang |
| collection | DOAJ |
| description | BackgroundTuberculosis (TB) remains a major public health problem in China and globally, particularly among older adults. This study aimed to examine secular trends in TB mortality among older adults in China and the net effects of age, period, and cohort.MethodsData from the National Disease Surveillance Points (DSPs) system were analyzed using Joinpoint regression to determine annual changes in TB mortality among individuals aged 60 years and older from 2004 to 2021. An age–period–cohort (APC) analysis using the intrinsic estimator (IE) method was conducted to estimate the independent effects of age, period, and cohort.ResultsThe age-standardized TB mortality rate was 5.68 per 100,000, with higher rates observed in men, rural areas, and western regions. TB mortality among older adults declined overall from 2004 to 2021, although the rate of decline has slowed in recent years. The APC analysis revealed increased TB mortality with age, with the 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 a higher risk effect in rural areas (RR = 1.51) than in urban areas (RR = 1.16) during 2007–2011, but this trend reversed in the period 2017–2021. The cohort effect generally declined, with the exception of certain demographic groups that showed an increase in the 1952–1956 and 1957–1961 birth cohorts.ConclusionTB mortality among older adults in China decreased from 2004 to 2021, although the decline has 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. |
| format | Article |
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| institution | Kabale University |
| issn | 2296-2565 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Frontiers Media S.A. |
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| series | Frontiers in Public Health |
| spelling | doaj-art-48e965a1e6d34ee9bcea17a0cd06cdab2025-01-06T05:13:14ZengFrontiers Media S.A.Frontiers in Public Health2296-25652025-01-011210.3389/fpubh.2024.15005391500539Trends in tuberculosis mortality among older adults in China, 2004–2021: a Joinpoint regression and age–period–cohort analysisMengdi Zhang0Xin Wang1Yiran Xiao2Qiqi Wang3Fei Huang4Xiang Ren5Xiaomin Guo6Wenshan Sun7Jinqi Deng8Qi Jiang9Jianjun Liu10Wenjing Zheng11Hongyan Yao12Office of Education and Training (Graduate School), Chinese Center for Disease Control and Prevention, Beijing, ChinaOffice of Education and Training (Graduate School), Chinese Center for Disease Control and Prevention, Beijing, ChinaOffice of Epidemiology (Technical Guidance Office for Patriotic Health Work), Chinese Center for Disease Control and Prevention, Beijing, ChinaOffice of Epidemiology (Technical Guidance Office for Patriotic Health Work), Chinese Center for Disease Control and Prevention, Beijing, ChinaCenter for Tuberculosis Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, ChinaDivision of Infectious Diseases, Chinese Center for Disease Control and Prevention, Beijing, ChinaCenter for Logistics Management and Operations, Chinese Center for Disease Control and Prevention, Beijing, ChinaOffice of Education and Training (Graduate School), Chinese Center for Disease Control and Prevention, Beijing, ChinaOffice of Education and Training (Graduate School), Chinese Center for Disease Control and Prevention, Beijing, ChinaOffice of Finance, Chinese Center for Disease Control and Prevention, Beijing, ChinaChinese Antituberculosis Association, Beijing, ChinaOffice of Epidemiology (Technical Guidance Office for Patriotic Health Work), Chinese Center for Disease Control and Prevention, Beijing, ChinaOffice of Education and Training (Graduate School), Chinese Center for Disease Control and Prevention, Beijing, ChinaBackgroundTuberculosis (TB) remains a major public health problem in China and globally, particularly among older adults. This study aimed to examine secular trends in TB mortality among older adults in China and the net effects of age, period, and cohort.MethodsData from the National Disease Surveillance Points (DSPs) system were analyzed using Joinpoint regression to determine annual changes in TB mortality among individuals aged 60 years and older from 2004 to 2021. An age–period–cohort (APC) analysis using the intrinsic estimator (IE) method was conducted to estimate the independent effects of age, period, and cohort.ResultsThe age-standardized TB mortality rate was 5.68 per 100,000, with higher rates observed in men, rural areas, and western regions. TB mortality among older adults declined overall from 2004 to 2021, although the rate of decline has slowed in recent years. The APC analysis revealed increased TB mortality with age, with the 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 a higher risk effect in rural areas (RR = 1.51) than in urban areas (RR = 1.16) during 2007–2011, but this trend reversed in the period 2017–2021. The cohort effect generally declined, with the exception of certain demographic groups that showed an increase in the 1952–1956 and 1957–1961 birth cohorts.ConclusionTB mortality among older adults in China decreased from 2004 to 2021, although the decline has 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.https://www.frontiersin.org/articles/10.3389/fpubh.2024.1500539/fulltuberculosismortalityolder adultJoinpoint regressionage-period-cohort analysis |
| spellingShingle | Mengdi Zhang Xin Wang Yiran Xiao Qiqi Wang Fei Huang Xiang Ren Xiaomin Guo Wenshan Sun Jinqi Deng Qi Jiang Jianjun Liu Wenjing Zheng Hongyan Yao Trends in tuberculosis mortality among older adults in China, 2004–2021: a Joinpoint regression and age–period–cohort analysis Frontiers in Public Health tuberculosis mortality older adult Joinpoint regression age-period-cohort analysis |
| title | Trends in tuberculosis mortality among older adults in China, 2004–2021: a Joinpoint regression and age–period–cohort analysis |
| title_full | Trends in tuberculosis mortality among older adults in China, 2004–2021: a Joinpoint regression and age–period–cohort analysis |
| title_fullStr | Trends in tuberculosis mortality among older adults in China, 2004–2021: a Joinpoint regression and age–period–cohort analysis |
| title_full_unstemmed | Trends in tuberculosis mortality among older adults in China, 2004–2021: a Joinpoint regression and age–period–cohort analysis |
| title_short | Trends in tuberculosis mortality among older adults in China, 2004–2021: a Joinpoint regression and age–period–cohort analysis |
| title_sort | trends in tuberculosis mortality among older adults in china 2004 2021 a joinpoint regression and age period cohort analysis |
| topic | tuberculosis mortality older adult Joinpoint regression age-period-cohort analysis |
| url | https://www.frontiersin.org/articles/10.3389/fpubh.2024.1500539/full |
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