Trends in tuberculosis incidence and mortality and risk factors for death in the Belt and Road partner countries from 1990 to 2021: based on GBD 2021 database

ObjectiveTo understand the trends in tuberculosis (TB) incidence and mortality and the main risk factors for TB deaths in Belt and Road Initiative (BRI) partner countries from 1990 to 2021, thus providing a reference for the rational allocation of health resources and the development of more scientific and reasonable prevention and control strategies for TB. MethodsData on TB incidence, mortality, and deaths attributable to TB risk factors in 155 BRI partner countries from 1990 to 2021 were extracted from the Global Burden of Disease Study 2021 (GBD 2021) database. Descriptive analysis and Joinpoint regression model were employed to analyze the trends of TB incidence and mortality and the attribution of risk factors for TB death in the BRI partner countries. ResultsThe incidence and mortality of TB in the BRI partner countries showed an overall downward trend from 1990 to 2021. From 1990 to 2021, the incidence and mortality of TB decreased from 294.607 per 100 000 and 71.189 per 100 000 to 164.704 per 100 000 and 27.482 per 100 000 in Africa (52 countries), from 216.976 per 100 000 and 45.161 per 100 000 to 123.890 per 100 000 and 17.706 per 100 000 in Asia (41 countries), from 68.702 per 100 000 and 5.301 per 100 000 to 39.278 per 100 000 and 2.655 per 100 000 in Europe (27 countries), from 45.607 per 100 000 and 8.652 per 100 000 to 25.072 per 100 000 and 3.471 per 100 000 in North America (13 countries), from 79.327 per 100 000 and 22.496 per 100 000 to 72.417 per 100 000 and 15.767 per 100 000 in Oceania (12 countries), and from 61.993 per 100 000 and 10.340 per 100 000 to 33.563 per 100 000 and 3.172 per 100 000 in South America (10 countries). The average annual percentage changes (AAPCs) in TB incidence and mortality from 1990 to 2021 were –1.87% and –3.05%, –1.78% and –2.98%, –1.97% and –2.25%, –1.95% and –2.92%, –0.21% and –1.04%, –1.95% and –3.69%, respectively (all P ConclusionsThe incidence and mortality of TB in the 155 BRI partner countries showed an overall downward trend from 1990 to 2021. Smoking remained the key risk factor for TB death, while the number of deaths attributable to diabetes increased.