International journal of women's health · 2026
Global Burden of Tuberculosis and Drug-Resistant Subtypes Among Women of Childbearing Age from 1990 to 2021, with Projections to 2030.
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Chen Jiawang, Peng Xiaozhen, Zheng Yixiang, Chen Ruochan
Аннотация
BACKGROUND: Tuberculosis (TB) poses a major threat to women of childbearing age (WCBA, 15-49 years), yet comprehensive global burden analyses remain limited. This study provides a comprehensive global spatiotemporal analysis of TB and drug-resistant subtypes among WCBA.
METHODS: Using Global Burden of Disease Study 2021 data, we assessed the global incidence and disability-adjusted life years (DALYs) of TB and drug-resistant subtypes among WCBA from 1990 to 2021, and projected trends to 2030 using Bayesian age-period-cohort models.
RESULTS: In 2021, an estimated 1.99 million WCBA developed TB globally. The age-standardized incidence rate (ASIR) and age-standardized DALY rate (ASDR) declined for overall TB and drug-susceptible TB (DS-TB), but increased for multidrug-resistant TB (MDR-TB) and extensively drug-resistant TB (XDR-TB). The large relative increases in XDR-TB should be interpreted cautiously because baseline estimates were very small and case definitions, testing capacity, and surveillance changed over time. The TB burden showed substantial geographic heterogeneity, with the highest age-standardized rates concentrated in Sub-Saharan Africa. Age-specific patterns showed higher ASIRs in younger populations, whereas ASDRs increased with age. Among the four GBD-attributable exposures included in the comparative analysis, high body-mass index had the largest modeled TB-related DALY rate in 2021. This restricted comparison should not be interpreted as ranking all established TB determinants. Projections suggest that overall TB incidence will decline, whereas the modeled XDR-TB ASIR may continue to rise through 2030 globally.
CONCLUSION: Reducing TB among WCBA requires improved access to rapid diagnosis, drug susceptibility testing, effective DR-TB treatment, and risk-based TB screening within reproductive and antenatal care, particularly in low-SDI and high-burden settings. Pregnancy- and postpartum-specific surveillance should also be strengthened, as these populations are not separately identifiable in GBD 2021.
METHODS: Using Global Burden of Disease Study 2021 data, we assessed the global incidence and disability-adjusted life years (DALYs) of TB and drug-resistant subtypes among WCBA from 1990 to 2021, and projected trends to 2030 using Bayesian age-period-cohort models.
RESULTS: In 2021, an estimated 1.99 million WCBA developed TB globally. The age-standardized incidence rate (ASIR) and age-standardized DALY rate (ASDR) declined for overall TB and drug-susceptible TB (DS-TB), but increased for multidrug-resistant TB (MDR-TB) and extensively drug-resistant TB (XDR-TB). The large relative increases in XDR-TB should be interpreted cautiously because baseline estimates were very small and case definitions, testing capacity, and surveillance changed over time. The TB burden showed substantial geographic heterogeneity, with the highest age-standardized rates concentrated in Sub-Saharan Africa. Age-specific patterns showed higher ASIRs in younger populations, whereas ASDRs increased with age. Among the four GBD-attributable exposures included in the comparative analysis, high body-mass index had the largest modeled TB-related DALY rate in 2021. This restricted comparison should not be interpreted as ranking all established TB determinants. Projections suggest that overall TB incidence will decline, whereas the modeled XDR-TB ASIR may continue to rise through 2030 globally.
CONCLUSION: Reducing TB among WCBA requires improved access to rapid diagnosis, drug susceptibility testing, effective DR-TB treatment, and risk-based TB screening within reproductive and antenatal care, particularly in low-SDI and high-burden settings. Pregnancy- and postpartum-specific surveillance should also be strengthened, as these populations are not separately identifiable in GBD 2021.