Global, regional, and national burden and trends of multidrug-resistant tuberculosis and extensively drug-resistant tuberculosis in adolescents and adults aged 15-49 years from 2010 to 2021: insights from the Global Burden of Disease Study 2021
Authors: Cui Kunping , Zhao Xiaoxiao , Liu Wei , Bai Lang 
Published: December 2024

Abstract

Background: In recent decades, the Global burden of multidrug-resistant tuberculosis (MDR-TB) and extensively drug-resistant tuberculosis (XDR-TB) among adolescents and young adults remains very severe, making it a major public health problem. However, our understanding of the disease burden in this population remains insufficient. This study aimed to assess the trends in MDR-TB and XDR-TB burden among adolescents and young adults aged 15–49 years from 2010 to 2021 at the global, regional, and national levels.
Methods: This study extracted four main indicators, including incidence, prevalence, deaths, and disability-adjusted life years (DALYs) rate per 100 000 population, related to MDR-TB and XDR-TB among adolescents and young adults aged 15–49 years from the 2021 Global Burden of Disease (GBD) study database from 2010 to 2021. Our study evaluated the changing trends in the burden of MDR-TB and XDR-TB among adolescents and young adults using the percentage change (PC) and estimated annual percentage change (EAPC). These global trends were further analyzed by age, sex, and sociodemographic index (SDI).
Results: In 2021, the global incidence, prevalence, deaths, and DALYs cases of MDR-TB among adolescents and young adults were 241399, 336746, 33285, and 1896002, respectively, with percentage changes of -0.017%, 0.007%, -0.194%, and -0.189% compared to 2010. Over the past 12 years, global incidence rates and DALYs rates of MDR-TB globally have decreased, with an EAPC of -0.76 (95% CI, -1.45 to -0.07) and -2.61 (95% CI, -3.26 to -1.96), while prevalence rates and deahs rates have not changed ( all P > 0.02). In 2021, the global incidence, prevalence, deaths, and DALYs cases of XDR-TB among adolescents and young adults were 12861, 14039, 2442, and 133610, respectively, with percentage changes of 0.156%, 0.007%, 0.091%, and -0.199% compared to 2010. Over the past 12 years, global incidence rates of XDR-TB globally have increased, with an EAPC of 0.57 (95% CI, 0.19 to 0.97), while prevalence rates and deahs rates have decreased with an EAPC of -2.67 (95%CI, -3.27 to -2.05) and -2.87(95%CI, -3.25 to -2.48), respectively. The incidence and prevalence rates of MDR-TB were significantly decreased from 2010 to 2021 in high SDI, high-middle and low SDI regional. The prevalence rates of XDR-TB was significantly decreased from 2010 to 2021 in the high SDI and middle-high SDI regions, while a significant increase was observed in the low SDI, middle-low SDI and low SDI regions. Besides, as the SDI level increases, there is a trend of slow decline in the burden of MDR-TB and XDR-TB.
Conclusion: Overall, the burden of MDR-TB and XDR-TB among adolescents and young adults remained very severe over the past 12 years, particularly in the middle SDI and low-middle SDI regions. The findings highlight the importance of customised interventions targeted at addressing the burden of MDR-TB and extensively drug-resistant TB among adolescents and young adults.