Tuberculosis (TB) poses a severe public health challenge in China and worldwide. This study evaluated the effects of age, period, and birth cohort on reported incidence trends of TB based on population and refined the characteristics of high-risk groups.
Aggregate data that reported pulmonary tuberculosis (PTB) cases from China Tuberculosis Management Information System (TBIMS) from 2006 to 2020 were used to analyze effect coefficients through the age–period–cohort (APC) model based on intrinsic estimator (IE) method, and converted them into relative risk (RR) to estimate trends.
A total of 14.82 million cases of PTB were reported in China from 2006 to 2020, showing a continuous downward trend. The reporting rate increased with age by age group, with 70–74 years old being 2–3 times higher than that in 20–24 years old. APC analysis model showed that age effects were bimodal in 20–24 years old [RR= 2.29, 95% confidence interval (CI): 1.73–3.03] and 70–74 years old (RR= 1.95, 95%CI:1.67–2.27), and lower than the overall average in the groups under 15 years old. Stratified results showed that the risk was higher for women under age 40 than men and higher for men over 40. The risk was higher in urban than in rural areas under 30 years old and slightly higher in rural than in urban between 30 and 64 years old. The risk for 15–34 years old was significantly higher in the east than in other regions. The period effects showed a decreasing trend, and the risk was higher in rural in recent years. Except for cohorts born in 1961–1965 and 2001–2005, where theRRincreased, the later the cohort was born, the lower the risk. The cohort 1926–1930 in eastern had the highest risk (RR= 3.49, 95%CI:2.44–4.98).
The reported incidence of PTB continued to decline in China from 2006 to 2020. The young (20–24 years old) and the elderly (70–74 years old) were equally at high risk. There were differences in the age, period and cohort effects on PTB incidence among gender, urban–rural and regions. Our findings better reflected the characteristics of high-risk populations, thus contributing to the development of timely and effective intervention strategies, and providing clues for etiological research.

Zhe Dong

Qi-Qi Wang

Shi-Cheng Yu

Fei Huang

Jian-Jun Liu

Hong-Yan Yao

Yan-Lin Zhao

Infectious Diseases of Poverty

INFECTIOUS DISEASES OF POVERTY 是一本开放获取、同行评审的期刊，出版主题领域和方法，解决与贫困传染病相关的基本公共卫生问题。这些包括病原体和载体生物学、诊断和检测、治疗和病例管理、流行病学和建模、人畜共患病宿主和动物宿主、控制策略和实施、新技术和应用的各个方面。还考虑了对卫生系统、生态健康、环境管理和创新技术的跨学科或多部门影响。

Infectious Diseases of Poverty is an open-access, peer-reviewed journal that addresses fundamental public health issues related to infectious diseases of poverty. The journal covers a wide range of topics, including pathogen and vector biology, diagnostics and testing, treatment and case management, epidemiology and modeling, zoonotic hosts and animal reservoirs, control strategies and their implementation, as well as various aspects of new technologies and applications. It also considers the interdisciplinary or multi-sectoral impacts on health systems, ecological health, environmental management, and innovative technologies.

《Infectious Diseases of Poverty》是一本开放获取、同行评审的期刊，专注于与贫困相关的传染病的基本公共卫生问题。期刊涵盖的主题包括病原体和载体生物学、诊断和检测、治疗和病例管理、流行病学和建模、人畜共患病宿主及动物宿主、控制策略及其实施，以及新技术和应用的各个方面。此外，期刊还关注这些问题对卫生系统、生态健康、环境管理和创新技术的跨学科或多部门影响。

Category	Quartile
医学	1
医学, 热带医学	1
医学, 传染病学	2
医学, 寄生虫学	2

Age–period–cohort analysis of pulmonary tuberculosis reported incidence, China, 2006–2020

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Category	Quartile
TROPICAL MEDICINE	1