Forecasting the impact of population ageing on tuberculosis incidence

Abstract

Background: Tuberculosis (TB) disease reactivates from distant latent infection or recent (re)infection. Progression risks increase with age. Across the World Health Organisation Western Pacific region, many populations are ageing and have the highest per capita TB incidence rates in older age groups. However, methods for analysing age-specific TB incidence and forecasting epidemic trends while accounting for demographic change remain limited. Methods: We applied the Lee-Carter models, which were originally developed for mortality modelling, to model the temporal trends in age-specific TB incidence data from 2005 to 2018 in Taiwan. Females and males were modelled separately. We combined our demographic forecasts, and age-specific TB incidence forecasts to project TB incidence until 2035. We compared TB incidence projections with demography fixed in 2018 to projections accounting for demographic change. Results: Our models quantified increasing incidence rates with age and declining temporal trends. By 2035, the forecast suggests that the TB incidence rate in Taiwan will decrease by 54% (95% Prediction Interval (PI): 45%-59%) compared to 2015, while most age-specific incidence rates will reduce by more than 60%. In 2035, adults aged 65 and above will make up 78% of incident TB cases. Forecast TB incidence in 2035 accounting for demographic change will be 39% (95% PI: 36%-42%) higher than without population ageing. Conclusions: Age-specific incidence forecasts coupled with demographic forecasts can inform the impact of population ageing on TB epidemics. The TB control programme in Taiwan should develop plans specific to older age groups and their care needs.

Tuberculosis Forecasting and Temporal Trends by Sex and Age in a High Endemic City in Northeast Brazil: Where Were we Before the Covid-19 Pandemic?

“…1C and 1E). This result is in line with other studies that found that older adults are more susceptible to falling ill, since they have a decline in immunity, as well as other comorbidities [17,27,34,37,38].…”

Tuberculosis forecasting and temporal trends by gender and age in a high endemic city of Northeast Brazil: Are we achieving the disease elimination stage?

“…Furthermore, women working in the informal sector need to work long hours to earn their income, not having time to respond to their health needs in a timely manner and being more likely to visit health facilities only when they are seriously ill [26].Regarding the cases of tuberculosis in the population over 59 years of age in the city of Imperatriz, the present study showed a high incidence in both genders, especially in the initial years of the study ( Figure 1D and 1G). This result is in line with other studies that found that older adults are more susceptible to falling ill, since they present a decline in immunity, as well as having other comorbidities [16,26,33,36,37].…”

Impact of population aging on the global burden of tuberculosis: A systematic review

“…Chu-change Ku et al [20] applied the Lee-Carter model to simulate temporal trends in age-specific TB incidence in Taiwan from 2005 to 2018, and the model predicted that elder Taiwanese TB patients will account for 78% of all TB cases by 2035 and that TB incidence will be 39% higher in 2035 than it would have been in the absence of an aging population. This shows that early adoption of TB surveillance and prevention in the elderly population is essential.…”