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Peer-reviewedCC BY 4.0PLOS One

Tuberculosis disease burden trends, drivers, and projections to 2050 in China and the wider Central Asian region, 1990–2023

  • Bahetibieke Tuohetaerbaike1
  • Dina Mulali2
  • Mehdi Borhani3
  • Kai Wang4
  • Wenbao Zhang5
  • Hao Wen6
6 affiliations
  1. 1State Key Laboratory of Pathogenesis, Prevention and Treatment of High Incidence Diseases in Central Asia, Xinjiang Medical University, Urumqi, China
  2. 2Respiratory and Critical Care Medicine Center, People’s Hospital of Xinjiang Uygur Autonomous Region, Urumqi, Xinjiang, China
  3. 3Joint Key Laboratory for International Cooperation on Major Diseases in Central Asia, Xinjiang Medical University, Urumqi, China
  4. 4College of Medical Engineering and Technology, Xinjiang Medical University, Urumqi, Xinjiang, China
  5. 5Institute of Medical Engineering Interdisciplinary Research, Urumqi, Xinjiang, China
  6. 6Clinical Medicine Research Institute, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, China
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Abstract

Background: Tuberculosis (TB) remains a leading infectious killer, with high burden concentrated in China and wider Central Asia. Integrated long-term trend analysis and forecasting for this region are scarce. We aimed to quantify TB burden trends, drivers, inequalities, and 2050 projections across China and wider Central Asia (1990–2023). Methods: We used Global Burden of Disease 2023 data to estimate age-standardized incidence, prevalence, mortality, and disability-adjusted life years (DALYs). Joinpoint, age-period-cohort, decomposition, and Bayesian APC models were applied. Socioeconomic inequalities were assessed via Socio-demographic Index (SDI) and Concentration Index. Results: China achieved steep declines in age-standardized mortality (−94.2%) and DALYs (−92.4%), driven by epidemiological gains offsetting population growth and aging. Central Asia improved moderately but heterogeneously; population growth diluted gains, with Tajikistan showing rising absolute burden. TB burden correlated negatively with SDI; socioeconomic inequality fell markedly, especially for mortality (−69.0%), but persisted among low-SDI groups. By 2050, model projections suggest that mortality targets may be achievable under current trends, although uncertainty remains substantial. Conclusions: China has undergone a substantial TB epidemiological transition characterized by marked declines in mortality and DALYs. Targeted interventions-latent TB treatment in China, accelerated case finding and cross-border collaboration in Central Asia-and strengthened regional cooperation are critical to advance regional TB elimination.

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Cite

BibTeXRIS
BibTeX
@article{tuohetaerbaike2026tuberculosis,
  title = {{Tuberculosis disease burden trends, drivers, and projections to 2050 in China and the wider Central Asian region, 1990–2023}},
  author = {Bahetibieke Tuohetaerbaike and Dina Mulali and Mehdi Borhani and Kai Wang and Wenbao Zhang and Hao Wen},
  journal = {PLOS One},
  year = {2026},
  month = oct,
  doi = {10.1371/journal.pone.0358349},
  url = {https://doi.org/10.1371/journal.pone.0358349},
  note = {CC BY 4.0},
}
RIS
TY  - JOUR
TI  - Tuberculosis disease burden trends, drivers, and projections to 2050 in China and the wider Central Asian region, 1990–2023
AU  - Bahetibieke Tuohetaerbaike
AU  - Dina Mulali
AU  - Mehdi Borhani
AU  - Kai Wang
AU  - Wenbao Zhang
AU  - Hao Wen
PY  - 2026
DA  - 2026/10/09
JO  - PLOS One
DO  - 10.1371/journal.pone.0358349
UR  - https://doi.org/10.1371/journal.pone.0358349
AB  - Background: Tuberculosis (TB) remains a leading infectious killer, with high burden concentrated in China and wider Central Asia. Integrated long-term trend analysis and forecasting for this region are scarce. We aimed to quantify TB burden trends, drivers, inequalities, and 2050 projections across China and wider Central Asia (1990–2023). Methods: We used Global Burden of Disease 2023 data to estimate age-standardized incidence, prevalence, mortality, and disability-adjusted life years (DALYs). Joinpoint, age-period-cohort, decomposition, and Bayesian APC models were applied. Socioeconomic inequalities were assessed via Socio-demographic Index (SDI) and Concentration Index. Results: China achieved steep declines in age-standardized mortality (−94.2%) and DALYs (−92.4%), driven by epidemiological gains offsetting population growth and aging. Central Asia improved moderately but heterogeneously; population growth diluted gains, with Tajikistan showing rising absolute burden. TB burden correlated negatively with SDI; socioeconomic inequality fell markedly, especially for mortality (−69.0%), but persisted among low-SDI groups. By 2050, model projections suggest that mortality targets may be achievable under current trends, although uncertainty remains substantial. Conclusions: China has undergone a substantial TB epidemiological transition characterized by marked declines in mortality and DALYs. Targeted interventions-latent TB treatment in China, accelerated case finding and cross-border collaboration in Central Asia-and strengthened regional cooperation are critical to advance regional TB elimination.
SN  - 1932-6203
ER  -