Global Prevalence and Burden of Multidrug-Resistant Tuberculosis from 1990 to 2019

AbstractBackground:Tuberculosis(TB) has already threat to public health, especially drug-resistant TB, however, recent literature on multidrug-resistant tuberculosis (MDR-TB) from a global perspective is scarce. This study aims to provide comprehensive epidemiological evidence regarding the prevalence and burden of MDR-TB worldwide from 1990 to 2019.Methods:Estimates and 95% uncertainty intervals (UI) for the age-standardized prevalence rate (ASPR), age-standardized incidence rate (ASIR), age-standardized disability-adjusted life years rate (ASR of DALYs), and age-standardized death rate (ASDR) of MDR-TB were obtained from the Global Burden of Disease (GBD) 2019 database. The prevalence and burden of MDR-TB in 2019 were illustrated in the population and regional distribution. Temporal trends were analyzed by using Joinpoint regression analysis to calculate the annual percentage change (APC) , average annual percentage change (AAPC) and its 95% confidence interval(CI).Results: The estimates of the number of cases were 687,839(95% UI: 365,512 to 1223,262), the ASPR were 8.26 per 100,000 (95% UI: 4.61 to 15.20), the ASR of DALYs were 52.38 per 100,000 (95% UI: 22.64 to 97.60) and the ASDR were 1.36 per 100,000 (95% UI: 0.54 to 2.59) of MDR-TB at global in 2019. Substantial burden was observed in Africa and Southeast Asia. Males exhibited higher ASPR, ASR of DALYs, and ASDR than females across most age groups, with the burden of MDR-TB increasing with age. Additionally, significant increases were observed globally in the ASIR (AAPC = 5.8; 95% CI: 5.4 to 6.1;P< 0.001), ASPR (AAPC = 5.9; 95% CI: 5.4 to 6.4;P< 0.001), ASR of DALYs (AAPC = 4.6; 95% CI: 4.2 to 5.0;P< 0.001) and ASDR (AAPC = 4.4; 95% CI: 4.0 to 4.8;P< 0.001) of MDR-TB from 1990 to 2019.Conclusions:This study underscores the persistent threat of drug-resistant tuberculosis to public health. It is imperative that countries and organizations worldwide take immediate and concerted action to implement measures aimed at significantly reducing the burden of TB.