Evaluation of pulmonary tuberculosis disease burden in Shenyang, China, 2023

Evaluation of pulmonary tuberculosis disease burden in Shenyang, China, 2023 | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Evaluation of pulmonary tuberculosis disease burden in Shenyang, China, 2023 Huijie Chen, Peng Li, Zhixing Yang, Lihai Wen, Baijun Sun, Wei Sun, and 1 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-4323453/v1 This work is licensed under a CC BY 4.0 License Status: Published Journal Publication published 04 Feb, 2025 Read the published version in BMC Infectious Diseases → Version 1 posted 15 You are reading this latest preprint version Abstract Background Pulmonary tuberculosis (PTB) is one of the most serious infectious diseases worldwide and poses a great threat to people’s health. China has a vast territory with substantial regional disparities in the PTB disease burden. However, there have been no studies conducted to evaluate the PTB disease burden in Shenyang. The aim was to elucidate the magnitude, composition, and distribution of PTB disease burden in Shenyang. Methods The disability-adjusted life years (DALYs) calculated based on Global Burden of Disease (GBD) framework was used to assess the disease burden of PTB in Shenyang in 2023, and descriptive epidemiological methods were employed to elucidate the magnitude, composition, and distribution characteristics of PTB disease burden in Shenyang. Results In 2023, 4,169 PTB cases were reported in Shenyang, including 2,901 males and 1,268 females. The incidence of PTB was 45.50/10 5 , of which 64.29/10 5 for males and 27.30/10 5 for females. The incidence among males was higher than that among females ( X 2 = 688.56, p <0.001). The highest incidence was 107.00/10 5 in the group of the population aged 80 and above ( X 2 = 1171.75, p <0.001). In 2023, 189 PTB deaths were reported in Shenyang, including 156 males and 33 females. The mortality of PTB was 2.06/10 5 of which 3.46/10 5 for males and 0.71/10 5 for females. The mortality among males was higher than that among females ( X 2 = 83.69, p <0.001). The highest mortality was 16.04/10 5 in the group of the population aged 80 and above ( X 2 = 285.61, p <0.001). The PTB DALYs rate was 58.25/10 5 , of which 91.73/10 5 for males and 21.22/10 5 for females. The DALYs rate among males was higher than that among females ( X 2 = 44.04, p <0.001). The highest DALYs rate was 149.86/10 5 in the group of the population aged 80 and above ( X 2 = 305.35, p <0.001). Years of life lost (YLLs) due to PTB accounted for 71.38% of total DALYs, of which 74.33% for males and 52.89% for females. Conclusion The disease burden of PTB in Shenyang in 2023 was lower than that in China, showing characteristics of that the disease burden increased with age, and males was higher than that of females. The predominant disease burden of PTB was attributed to YLLs, accounting for as much as 71.38%, indicating that PTB primarily results in premature mortality rather than disability. Therefore, the focus should be shifted towards early intervention to reduce transmission, especially for the aged males. Pulmonary Tuberculosis Disease Burden Disability-adjusted life year Shenyang Introduction Pulmonary tuberculosis (PTB) was a chronic respiratory infection caused by Mycobacterium tuberculosis, presenting with typical symptoms such as fever, night sweats, abnormal fatigue, productive cough, and hemoptysis [1] . PTB had a wide incidence range, a long treatment cycle, and high incidence and mortality [2] , which had caused great harm to public health. According to the Global Tuberculosis Report, approximately 8.8 million individuals were afflicted with PTB annually, resulting in 1 million PTB-related fatalities. The incidence of PTB was reported as high as 110/10 5 , with a mortality rate reaching up to 16.32/10 5 [3, 4] . The epidemiological situation of PTB in China was also concerning. According to reports, the incidence and mortality of PTB both ranked second among the notifiable infectious diseases in China, with an average annual notification rate of approximately 62.10/10 5 and a mortality rate of about 0.14/10 5 [5, 6] . The incidence of PTB in China was highest in the western region, followed by the central region, and then the eastern region, where presented the lowest incidence of 47.90/10 5 [6] . It is clear that PTB presents a significant threat to public health and has emerged as a pressing issue, necessitating an assessment of its disease burden. In terms of disease burden assessment, traditional indicators such as incidence and mortality were commonly utilized before the 1980s, while disability-adjusted life years (DALYs) emerged as a representative measure of disease burden in the 1990s [7] . The DALYs method, which combines years lived with disability (YLDs) and years of life lost (YLLs), was widely utilized in the assessment of disease burden. According to the Global Burden of Tuberculosis Disease Study, the disease burden was higher in low-income countries as compared to high-income countries, higher in males than in females, and increased gradually with age [8,9] . Previous studies had indicated that PTB contributes to approximately 83% of the total disease burden of tuberculosis (TB) [4] . Accordingly, it was estimated that the global DALYs rate of PTB was approximately 490.05/10 5 [8] . China had a DALYs rate of PTB of 71.76/10 5 [10] , which exceeded that of high-income countries [11] but fell below that of low- and middle-income countries, positioning it in the intermediate to lower range on a global scale [8] . Local assessments of the PTB disease burden had also been carried out in some parts of China. For example, a study conducted in Guizhou revealed an average annual DALYs rate of 60/10 5 for PTB [12] . Another study in Harbin found the PTB DALYs rate to be 37.88/10 5 [13] , while a study in Inner Mongolia reported a TB DALYs rate of 33/10 5 [14] . China is a vast territory with substantial regional disparities in PTB disease burden. However, there have been no studies conducted to evaluate the PTB disease burden in Shenyang. Shenyang, located in the eastern region of China, includes about 9 million permanent residents. A study in Shenyang found that the average annual incidence of PTB was 49.46/10 5 [15] , which was lower than the global [3] and national levels [6] , but higher than the levels of Beijing [16] , Tianjin [17] , Yantai [18] , and Sihui City [19] . In this study, the aim was to elucidate the magnitude, composition, and distribution of PTB disease burden in Shenyang, thus providing scientific evidence for PTB control. DATA The incidence data of PTB between January 1, 2023 and December 31, 2023 in Shenyang was obtained from the Nationwide Notifiable Infectious Diseases Reporting Information System (NIDRIS) and the death data between January 1, 2023 and December 31, 2023 was obtained from the National Cause Registration System. The data was all extracted on January 5, 2024. The life expectancy data was sourced from the Shenyang Bureau of Statistics. PTB cases include laboratory-confirmed cases and clinically confirmed cases. Patients were diagnosed according to the Diagnosis for Pulmonary Tuberculosis (WS 288–2017) [20] in China. According to the International Classification of Diseases version-10 (ICD-10), PTB were coded as A15.0-A15.3 and A16.0-A16.2. Method Descriptive epidemiological methods were employed to analyze the magnitude and distribution characteristics of the PTB disease burden in Shenyang in 2023. According to the computing framework of GBD, DALYs were calculated as the sum of YLDs and YLLs. YLDs were calculated by multiplying the number of cases by the disease duration and disability weight (DW). In this study, the PTB DW was 0.333 and the disease duration was 1.1 years [21] . YLLs were estimated by multiplying the number of PTB deaths at each age by the standard life expectancy at the age of death. The DALYs rate is the proportion of DALYs in the total population and the composition of YLLs is the proportion of YLLs in DALYs. DALYs, YLDs, and YLLs were calculated as follows: DALYs=YLLs+YLDs (1) YLDs = I × DW × L (2) Here, I represents the number of PTB incidence, DW represents the disability weight, and L represents the duration of PTB in patients. YLLs = N×L (3) Here, N represents the number of PTB death, and L represents the value of life lost. Results General situation A total of 4,169 PTB patients were reported in Shenyang in 2023, of which 2,901 were males and 1,268 were females. The incidence of PTB was 45.50/10 5 , 64.29/10 5 in males, and 27.30/10 5 in females. The incidence for males was higher than that for females ( X 2 = 688.56, p <0.001). The incidence of PTB increased with age, with the highest incidence of 107.00/10 5 in the group of the population aged 80 and above and the lowest incidence of 1.05/10 5 among the population aged 0 to 9 years ( X 2 = 1171.75, p <0.001). (Table 1 ) Table 1 PTB incidence by gender and age group in Shenyang in 2023 Age group (Years) Male Female Total Cases Incidence (1/10 5 ) Cases Incidence (1/10 5 ) Cases Incidence (1/10 5 ) 0–9 5 1.46 2 0.61 7 1.05 10–19 53 14.70 60 18.10 113 16.30 20–29 197 37.64 157 31.80 354 34.80 30–39 317 41.88 196 25.80 513 33.80 40–49 384 54.08 132 18.70 516 36.40 50–59 680 85.55 214 25.90 894 55.20 60–69 758 121.56 253 36.80 1011 77.20 70–79 322 110.21 152 42.90 474 73.30 ≥ 80 185 169.97 102 64.00 287 107.00 Total 2901 64.29 1268 27.30 4169 45.50 A total of 189 PTB deaths were reported in Shenyang in 2023, of which 156 were males and 33 were females. The PTB mortality was 2.06/10 5 , 3.46/10 5 in males and 0.71/10 5 in females. The mortality for males was higher than that for females ( X 2 = 83.69, p <0.001). The mortality of PTB increased with age, with the highest mortality of 16.04/10 5 in the group of the population aged 80 and above and the lowest mortality of 0.39/10 5 among the population aged 20 to 29 years ( X 2 = 285.61, p <0.001). (Table 2 ). Table 2 PTB mortality by gender and age group in Shenyang in 2023 Age group (Years) Male Female Total Cases Mortality (1/10 5 ) Cases Mortality (1/10 5 ) Cases Mortality (1/10 5 ) 0–9 0 0 0 0 0 0 10–19 0 0 0 0 0 0 20–29 4 0.76 0 0 4 0.39 30–39 10 1.32 1 0.13 11 0.72 40–49 12 1.69 2 0.28 14 0.99 50–59 29 3.65 2 0.24 31 1.91 60–69 51 8.18 6 0.87 57 4.35 70–79 20 6.85 9 2.54 29 4.48 ≥ 80 30 27.56 13 8.16 43 16.04 Total 156 3.46 33 0.71 189 2.06 Disease burden In 2023, the PTB DALYs rate in Shenyang was 58.25/10 5 , 91.73/10 5 for males and 21.22/10 5 for females. The DALYs rate for males was higher than that for females ( X 2 = 44.04, p <0.001). YLLs accounted for 71.38% of total DALYs, 74.33% of males and 52.89% of females. The PTB DALYs rate increased with age. The highest DALYs rate was 149.86/10 5 in the group of the population aged 80 and above, and the lowest DALYs rate was 0.38/10 5 among the population aged 0 to 9 years ( X 2 = 305.35, p <0.001). The gender and age-specific distribution of PTB YLDs, YLLs, DALYs, YLLs composition ratio, and DALYs rate were shown in Table 3 . Table 3 PTB disease burden by gender and age group in Shenyang in 2023 Age group (Years) Male Female Total YLDs (person-years) YLLs (person-years) DALYs (person-years) YLLs composition ratio (1/100) DALY rate (1/10 5 ) YLDs (person-years) YLLs (person-years) DALYs (person-years) YLLs composition ratio (1/100) DALY rate (1/10 5 ) YLDs (person-years) YLLs (person-years) DALYs (person-years) YLLs composition ratio (1/100) DALY rate (1/10 5 ) 0–9 1.83 0 1.83 0 0.53 0.73 0 0.73 0 0.22 2.56 0 2.56 0 0.38 10–19 19.41 0 19.41 0 5.38 21.98 0 21.98 0 6.61 41.39 0 41.39 0 5.97 20–29 72.16 212.72 284.88 74.67 54.43 57.51 0 57.51 0 11.63 129.67 223.36 353.03 63.27 34.69 30–39 116.12 434.40 550.52 78.91 72.73 71.79 48.85 120.64 40.49 15.86 187.91 506.44 694.35 72.94 45.75 40–49 140.66 406.80 547.46 74.31 77.09 48.35 78.08 126.43 61.76 17.87 189.01 509.18 698.19 72.93 49.25 50–59 249.08 725.00 974.08 74.43 122.54 78.39 59.00 137.39 42.94 16.66 327.47 842.58 1170.05 72.01 72.24 60–69 277.66 880.77 1158.43 76.03 185.78 92.67 123.30 215.97 57.09 31.44 370.33 1076.73 1447.06 74.41 110.43 70–79 117.95 224.80 342.75 65.59 117.31 55.68 117.27 172.95 67.81 48.77 173.63 352.93 526.56 67.03 81.42 ≥ 80 67.77 192.30 260.07 73.94 238.94 37.36 95.03 132.39 71.78 83.11 105.13 296.70 401.83 73.84 149.86 Total 1062.64 3076.79 4139.43 74.33 91.73 464.46 521.53 985.99 52.89 21.22 1527.10 3807.92 5335.02 71.38 58.25 Discussion In this study, we found that the PTB DALYs rate was 58.25/10 5 , which was lower than that in China [22] and similar to that in Guizhou Province [12] , but higher than that in Harbin [13] and Inner Mongolia [14] , both of which were northern cities. This highlighted the ongoing necessity to improve efforts for the prevention and control of PTB in Shenyang. In this study, we found that the PTB DALYs rate of males was higher than that of females, which was consistent with the higher incidence and mortality of PTB in males as found in this study and previous studies [12,14,23,24] . This may be related to i) males were prone to unhealthy habits such as drinking and smoking, which can lead to infection [25] , ii) males experienced higher work and social pressure and had more social activities, which increased the risk of disease infection and transmission [26] , iii) males tended to initiate treatment late and exhibited poor adherence to treatment [27] . This suggested that the necessity of implementing interventions to actively communicate the importance of modifying unhealthy lifestyles, as well as promoting early diagnosis and treatment, particularly targeting male individuals. In this study, we found that the PTB DALYs rate increased with age, and the disease burden of PTB in people over 60 years old was significantly higher than that in other age groups, which was consistent with previous research results [28,29] . This may be related to i) the reduced immunity in the elderly led more susceptible to PTB infection and reinfection [30] , ii) the low tolerance of anti-TB drugs in the elderly, most of whom suffered from chronic comorbidities, resulting in increased difficulty in disease treatment and poor prognosis [31] . This indicated that the elderly should be considered a priority population in the prevention and control of PTB. In this study, we found that the YLLs were the predominant contributor to the PTB DALYs in Shenyang in 2023, accounting for about 71.38%, which was consistent with the findings in China [10] , Brazil [32] , and India [33] . It suggested that PTB was more likely to lead to premature death rather than disability, possibly due to its older age of onset [34] , high drug resistance, and a higher rate of delayed diagnosis (64.54%) [31, 35] . Therefore, the focus should be shifted towards early intervention to reduce transmission. Despite the above findings, our study has some limitations. Firstly, there was typically a lag in reporting infectious diseases following their onset, and the PTB incidence data we collected through the NIDRIS on January 5, 2024 may not encompass the complete number of cases in 2023. Because additional PTB cases occurred in 2023 may be reported after January 5, 2024. This may lead to an underestimation of the PTB disease burden in Shenyang in 2023. Secondly, the disease duration utilized in this study for calculating the prevalence of PTB was based on the global average, however, due to Shenyang's significant aging population, it was possible that the average disease duration of PTB may be prolonged. This could also potentially result in an underestimation of the disease burden of PTB in Shenyang in 2023. Conclusion In 2023, the PTB DALYs rate in Shenyang was 58.25/10 5 , lower than that in China. The disease burden of PTB in males and the elderly was higher and should be paid more attention. The disease burden of PTB was predominantly due to YLLs, accounting for as much as 71.38%, indicating that PTB primarily led to premature mortality rather than disability in Shenyang. Therefore, efforts should be focused on advancing the threshold for infection control to alleviate the disease burden of PTB, especially for the aged males. Abbreviations DALYs: Disability-Adjusted Life Years; DW: Disability Weight; GBD: Global Burden of Disease; NIDRIS: Notifiable Infectious Diseases Reporting Information System; PTB: Pulmonary Tuberculosis; TB Tuberculosis; YLDs: Years Lived with Disability; YLLs: Years of Life Lost Declarations Ethics approval and consent to participate Not applicable. Consent for publication Not applicable. Availability of data and materials The datasets used and analyzed during the current study is available from the corresponding author Haiyan Bi(E-mail: [email protected] ) on reasonable request. Competing Interests The authors declare that they have no conflict of interest. Funding This work was not supported by any funding. Authors' Contributions Conceived and designed the experiments: BS, HC, HB, PL, ZY. Performed the experiments: HC, HB, LW. Analyzed the data: HC, HB, WS. Wrote the paper: HC, HB. All authors read and approved the final manuscript. Acknowledgments Not applicable. 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Cite Share Download PDF Status: Published Journal Publication published 04 Feb, 2025 Read the published version in BMC Infectious Diseases → Version 1 posted Editorial decision: Revision requested 18 Nov, 2024 Reviews received at journal 17 Nov, 2024 Reviewers agreed at journal 01 Nov, 2024 Reviews received at journal 10 Oct, 2024 Reviewers agreed at journal 01 Oct, 2024 Reviewers agreed at journal 30 Sep, 2024 Reviewers agreed at journal 30 Sep, 2024 Reviewers agreed at journal 11 Jul, 2024 Reviewers agreed at journal 24 Jun, 2024 Reviewers agreed at journal 24 Jun, 2024 Reviewers invited by journal 24 Jun, 2024 Editor invited by journal 02 May, 2024 Submission checks completed at journal 30 Apr, 2024 Editor assigned by journal 30 Apr, 2024 First submitted to journal 25 Apr, 2024 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. 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PTB had a wide incidence range, a long treatment cycle, and high incidence and mortality \u003csup\u003e[2]\u003c/sup\u003e, which had caused great harm to public health. According to the Global Tuberculosis Report, approximately 8.8\u0026nbsp;million individuals were afflicted with PTB annually, resulting in 1\u0026nbsp;million PTB-related fatalities. The incidence of PTB was reported as high as 110/10\u003csup\u003e5\u003c/sup\u003e, with a mortality rate reaching up to 16.32/10\u003csup\u003e5 [3, 4]\u003c/sup\u003e. The epidemiological situation of PTB in China was also concerning. According to reports, the incidence and mortality of PTB both ranked second among the notifiable infectious diseases in China, with an average annual notification rate of approximately 62.10/10\u003csup\u003e5\u003c/sup\u003e and a mortality rate of about 0.14/10\u003csup\u003e5 [5, 6]\u003c/sup\u003e. The incidence of PTB in China was highest in the western region, followed by the central region, and then the eastern region, where presented the lowest incidence of 47.90/10\u003csup\u003e5 [6]\u003c/sup\u003e. It is clear that PTB presents a significant threat to public health and has emerged as a pressing issue, necessitating an assessment of its disease burden.\u003c/p\u003e \u003cp\u003eIn terms of disease burden assessment, traditional indicators such as incidence and mortality were commonly utilized before the 1980s, while disability-adjusted life years (DALYs) emerged as a representative measure of disease burden in the 1990s \u003csup\u003e[7]\u003c/sup\u003e. The DALYs method, which combines years lived with disability (YLDs) and years of life lost (YLLs), was widely utilized in the assessment of disease burden.\u003c/p\u003e \u003cp\u003eAccording to the Global Burden of Tuberculosis Disease Study, the disease burden was higher in low-income countries as compared to high-income countries, higher in males than in females, and increased gradually with age \u003csup\u003e[8,9]\u003c/sup\u003e. Previous studies had indicated that PTB contributes to approximately 83% of the total disease burden of tuberculosis (TB) \u003csup\u003e[4]\u003c/sup\u003e. Accordingly, it was estimated that the global DALYs rate of PTB was approximately 490.05/10\u003csup\u003e5 [8]\u003c/sup\u003e. China had a DALYs rate of PTB of 71.76/10\u003csup\u003e5 [10]\u003c/sup\u003e, which exceeded that of high-income countries \u003csup\u003e[11]\u003c/sup\u003e but fell below that of low- and middle-income countries, positioning it in the intermediate to lower range on a global scale \u003csup\u003e[8]\u003c/sup\u003e.\u003c/p\u003e \u003cp\u003eLocal assessments of the PTB disease burden had also been carried out in some parts of China. For example, a study conducted in Guizhou revealed an average annual DALYs rate of 60/10\u003csup\u003e5\u003c/sup\u003e for PTB \u003csup\u003e[12]\u003c/sup\u003e. Another study in Harbin found the PTB DALYs rate to be 37.88/10\u003csup\u003e5 [13]\u003c/sup\u003e, while a study in Inner Mongolia reported a TB DALYs rate of 33/10\u003csup\u003e5 [14]\u003c/sup\u003e. China is a vast territory with substantial regional disparities in PTB disease burden. However, there have been no studies conducted to evaluate the PTB disease burden in Shenyang.\u003c/p\u003e \u003cp\u003eShenyang, located in the eastern region of China, includes about 9\u0026nbsp;million permanent residents. A study in Shenyang found that the average annual incidence of PTB was 49.46/10\u003csup\u003e5 [15]\u003c/sup\u003e, which was lower than the global \u003csup\u003e[3]\u003c/sup\u003eand national levels \u003csup\u003e[6]\u003c/sup\u003e, but higher than the levels of Beijing \u003csup\u003e[16]\u003c/sup\u003e, Tianjin \u003csup\u003e[17]\u003c/sup\u003e, Yantai \u003csup\u003e[18]\u003c/sup\u003e, and Sihui City \u003csup\u003e[19]\u003c/sup\u003e. In this study, the aim was to elucidate the magnitude, composition, and distribution of PTB disease burden in Shenyang, thus providing scientific evidence for PTB control.\u003c/p\u003e \u003cdiv id=\"Sec2\" class=\"Section2\"\u003e \u003ch2\u003eDATA\u003c/h2\u003e \u003cp\u003eThe incidence data of PTB between January 1, 2023 and December 31, 2023 in Shenyang was obtained from the Nationwide Notifiable Infectious Diseases Reporting Information System (NIDRIS) and the death data between January 1, 2023 and December 31, 2023 was obtained from the National Cause Registration System. The data was all extracted on January 5, 2024. The life expectancy data was sourced from the Shenyang Bureau of Statistics. PTB cases include laboratory-confirmed cases and clinically confirmed cases. Patients were diagnosed according to the Diagnosis for Pulmonary Tuberculosis (WS 288\u0026ndash;2017) \u003csup\u003e[20]\u003c/sup\u003e in China. According to the International Classification of Diseases version-10 (ICD-10), PTB were coded as A15.0-A15.3 and A16.0-A16.2.\u003c/p\u003e \u003c/div\u003e"},{"header":"Method","content":"\u003cp\u003eDescriptive epidemiological methods were employed to analyze the magnitude and distribution characteristics of the PTB disease burden in Shenyang in 2023. According to the computing framework of GBD, DALYs were calculated as the sum of YLDs and YLLs. YLDs were calculated by multiplying the number of cases by the disease duration and disability weight (DW). In this study, the PTB DW was 0.333 and the disease duration was 1.1 years\u003csup\u003e[21]\u003c/sup\u003e. YLLs were estimated by multiplying the number of PTB deaths at each age by the standard life expectancy at the age of death. The DALYs rate is the proportion of DALYs in the total population and the composition of YLLs is the proportion of YLLs in DALYs. DALYs, YLDs, and YLLs were calculated as follows:\u003c/p\u003e \u003cp\u003e \u003cem\u003eDALYs=YLLs+YLDs\u003c/em\u003e (1)\u003c/p\u003e \u003cp\u003e \u003cem\u003eYLDs\u0026thinsp;=\u0026thinsp;I \u0026times; DW \u0026times; L\u003c/em\u003e (2)\u003c/p\u003e \u003cp\u003eHere, \u003cem\u003eI\u003c/em\u003e represents the number of PTB incidence, \u003cem\u003eDW\u003c/em\u003e represents the disability weight, and \u003cem\u003eL\u003c/em\u003e represents the duration of PTB in patients.\u003c/p\u003e \u003cp\u003e \u003cem\u003eYLLs\u0026thinsp;=\u0026thinsp;N\u0026times;L\u003c/em\u003e (3)\u003c/p\u003e \u003cp\u003eHere, \u003cem\u003eN\u003c/em\u003e represents the number of PTB death, and \u003cem\u003eL\u003c/em\u003e represents the value of life lost.\u003c/p\u003e"},{"header":"Results","content":"\u003cdiv id=\"Sec5\" class=\"Section2\"\u003e \u003ch2\u003eGeneral situation\u003c/h2\u003e \u003cp\u003eA total of 4,169 PTB patients were reported in Shenyang in 2023, of which 2,901 were males and 1,268 were females. The incidence of PTB was 45.50/10\u003csup\u003e5\u003c/sup\u003e, 64.29/10\u003csup\u003e5\u003c/sup\u003e in males, and 27.30/10\u003csup\u003e5\u003c/sup\u003e in females. The incidence for males was higher than that for females (\u003cem\u003eX\u003c/em\u003e\u003csup\u003e2\u003c/sup\u003e\u0026thinsp;=\u0026thinsp;688.56, \u003cem\u003ep\u003c/em\u003e\u0026lt;0.001). The incidence of PTB increased with age, with the highest incidence of 107.00/10\u003csup\u003e5\u003c/sup\u003e in the group of the population aged 80 and above and the lowest incidence of 1.05/10\u003csup\u003e5\u003c/sup\u003e among the population aged 0 to 9 years (\u003cem\u003eX\u003c/em\u003e\u003csup\u003e2\u003c/sup\u003e\u0026thinsp;=\u0026thinsp;1171.75, \u003cem\u003ep\u003c/em\u003e\u0026lt;0.001). (Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e)\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003ePTB incidence by gender and age group in Shenyang in 2023\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"7\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eAge group\u003c/p\u003e \u003cp\u003e(Years)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c7\" namest=\"c6\"\u003e \u003cp\u003eTotal\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCases\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eIncidence\u003c/p\u003e \u003cp\u003e(1/10\u003csup\u003e5\u003c/sup\u003e)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eCases\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eIncidence\u003c/p\u003e \u003cp\u003e(1/10\u003csup\u003e5\u003c/sup\u003e)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003eCases\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e \u003cp\u003eIncidence\u003c/p\u003e \u003cp\u003e(1/10\u003csup\u003e5\u003c/sup\u003e)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e0\u0026ndash;9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1.46\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.61\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e1.05\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e10\u0026ndash;19\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e53\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e14.70\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e60\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e18.10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e113\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e16.30\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e20\u0026ndash;29\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e197\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e37.64\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e157\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e31.80\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e354\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e34.80\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e30\u0026ndash;39\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e317\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e41.88\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e196\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e25.80\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e513\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e33.80\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e40\u0026ndash;49\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e384\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e54.08\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e132\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e18.70\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e516\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e36.40\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e50\u0026ndash;59\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e680\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e85.55\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e214\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e25.90\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e894\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e55.20\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e60\u0026ndash;69\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e758\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e121.56\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e253\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e36.80\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e1011\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e77.20\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e70\u0026ndash;79\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e322\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e110.21\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e152\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e42.90\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e474\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e73.30\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026ge;\u0026thinsp;80\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e185\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e169.97\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e102\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e64.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e287\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e107.00\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTotal\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e2901\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e64.29\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e1268\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e27.30\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e4169\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e45.50\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eA total of 189 PTB deaths were reported in Shenyang in 2023, of which 156 were males and 33 were females. The PTB mortality was 2.06/10\u003csup\u003e5\u003c/sup\u003e, 3.46/10\u003csup\u003e5\u003c/sup\u003e in males and 0.71/10\u003csup\u003e5\u003c/sup\u003e in females. The mortality for males was higher than that for females (\u003cem\u003eX\u003c/em\u003e\u003csup\u003e2\u003c/sup\u003e\u0026thinsp;=\u0026thinsp;83.69, \u003cem\u003ep\u003c/em\u003e\u0026lt;0.001). The mortality of PTB increased with age, with the highest mortality of 16.04/10\u003csup\u003e5\u003c/sup\u003e in the group of the population aged 80 and above and the lowest mortality of 0.39/10\u003csup\u003e5\u003c/sup\u003e among the population aged 20 to 29 years (\u003cem\u003eX\u003c/em\u003e\u003csup\u003e2\u003c/sup\u003e\u0026thinsp;=\u0026thinsp;285.61, \u003cem\u003ep\u003c/em\u003e\u0026lt;0.001). (Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003ePTB mortality by gender and age group in Shenyang in 2023\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"7\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eAge group\u003c/p\u003e \u003cp\u003e(Years)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c7\" namest=\"c6\"\u003e \u003cp\u003eTotal\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCases\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eMortality\u003c/p\u003e \u003cp\u003e(1/10\u003csup\u003e5\u003c/sup\u003e)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eCases\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eMortality\u003c/p\u003e \u003cp\u003e(1/10\u003csup\u003e5\u003c/sup\u003e)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003eCases\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e \u003cp\u003eMortality\u003c/p\u003e \u003cp\u003e(1/10\u003csup\u003e5\u003c/sup\u003e)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e0\u0026ndash;9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e10\u0026ndash;19\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e20\u0026ndash;29\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.76\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.39\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e30\u0026ndash;39\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.32\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.13\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e11\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.72\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e40\u0026ndash;49\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e12\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.69\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.28\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e14\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.99\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e50\u0026ndash;59\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e29\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e3.65\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.24\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e31\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e1.91\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e60\u0026ndash;69\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e51\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e8.18\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.87\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e57\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e4.35\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e70\u0026ndash;79\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e20\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e6.85\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e2.54\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e29\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e4.48\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026ge;\u0026thinsp;80\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e30\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e27.56\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e13\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e8.16\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e43\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e16.04\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTotal\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e156\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e3.46\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e33\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.71\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e189\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e2.06\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec6\" class=\"Section2\"\u003e \u003ch2\u003eDisease burden\u003c/h2\u003e \u003cp\u003eIn 2023, the PTB DALYs rate in Shenyang was 58.25/10\u003csup\u003e5\u003c/sup\u003e, 91.73/10\u003csup\u003e5\u003c/sup\u003e for males and 21.22/10\u003csup\u003e5\u003c/sup\u003e for females. The DALYs rate for males was higher than that for females (\u003cem\u003eX\u003c/em\u003e\u003csup\u003e2\u003c/sup\u003e\u0026thinsp;=\u0026thinsp;44.04, \u003cem\u003ep\u003c/em\u003e\u0026lt;0.001). YLLs accounted for 71.38% of total DALYs, 74.33% of males and 52.89% of females.\u003c/p\u003e \u003cp\u003eThe PTB DALYs rate increased with age. The highest DALYs rate was 149.86/10\u003csup\u003e5\u003c/sup\u003e in the group of the population aged 80 and above, and the lowest DALYs rate was 0.38/10\u003csup\u003e5\u003c/sup\u003e among the population aged 0 to 9 years (\u003cem\u003eX\u003c/em\u003e\u003csup\u003e2\u003c/sup\u003e\u0026thinsp;=\u0026thinsp;305.35, \u003cem\u003ep\u003c/em\u003e\u0026lt;0.001). The gender and age-specific distribution of PTB YLDs, YLLs, DALYs, YLLs composition ratio, and DALYs rate were shown in Table\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003ePTB disease burden by gender and age group in Shenyang in 2023\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"16\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c9\" colnum=\"9\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c10\" colnum=\"10\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c11\" colnum=\"11\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c12\" colnum=\"12\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c13\" colnum=\"13\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c14\" colnum=\"14\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c15\" colnum=\"15\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c16\" colnum=\"16\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eAge group\u003c/p\u003e \u003cp\u003e(Years)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"5\" nameend=\"c6\" namest=\"c2\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"5\" nameend=\"c11\" namest=\"c7\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"5\" nameend=\"c16\" namest=\"c12\"\u003e \u003cp\u003eTotal\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYLDs\u003c/p\u003e \u003cp\u003e(person-years)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eYLLs\u003c/p\u003e \u003cp\u003e(person-years)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eDALYs\u003c/p\u003e \u003cp\u003e(person-years)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eYLLs composition ratio (1/100)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003eDALY rate (1/10\u003csup\u003e5\u003c/sup\u003e)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e \u003cp\u003eYLDs\u003c/p\u003e \u003cp\u003e(person-years)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c8\"\u003e \u003cp\u003eYLLs\u003c/p\u003e \u003cp\u003e(person-years)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c9\"\u003e \u003cp\u003eDALYs\u003c/p\u003e \u003cp\u003e(person-years)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c10\"\u003e \u003cp\u003eYLLs composition ratio (1/100)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c11\"\u003e \u003cp\u003eDALY rate (1/10\u003csup\u003e5\u003c/sup\u003e)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c12\"\u003e \u003cp\u003eYLDs\u003c/p\u003e \u003cp\u003e(person-years)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c13\"\u003e \u003cp\u003eYLLs\u003c/p\u003e \u003cp\u003e(person-years)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c14\"\u003e \u003cp\u003eDALYs\u003c/p\u003e \u003cp\u003e(person-years)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c15\"\u003e \u003cp\u003eYLLs composition ratio (1/100)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c16\"\u003e \u003cp\u003eDALY rate (1/10\u003csup\u003e5\u003c/sup\u003e)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e0\u0026ndash;9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1.83\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e1.83\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.53\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.73\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e0.73\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c11\"\u003e \u003cp\u003e0.22\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c12\"\u003e \u003cp\u003e2.56\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c13\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c14\"\u003e \u003cp\u003e2.56\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c15\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c16\"\u003e \u003cp\u003e0.38\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e10\u0026ndash;19\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e19.41\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e19.41\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e5.38\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e21.98\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e21.98\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c11\"\u003e \u003cp\u003e6.61\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c12\"\u003e \u003cp\u003e41.39\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c13\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c14\"\u003e \u003cp\u003e41.39\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c15\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c16\"\u003e \u003cp\u003e5.97\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e20\u0026ndash;29\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e72.16\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e212.72\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e284.88\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e74.67\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e54.43\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e57.51\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e57.51\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c11\"\u003e \u003cp\u003e11.63\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c12\"\u003e \u003cp\u003e129.67\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c13\"\u003e \u003cp\u003e223.36\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c14\"\u003e \u003cp\u003e353.03\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c15\"\u003e \u003cp\u003e63.27\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c16\"\u003e \u003cp\u003e34.69\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e30\u0026ndash;39\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e116.12\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e434.40\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e550.52\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e78.91\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e72.73\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e71.79\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e48.85\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e120.64\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e40.49\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c11\"\u003e \u003cp\u003e15.86\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c12\"\u003e \u003cp\u003e187.91\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c13\"\u003e \u003cp\u003e506.44\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c14\"\u003e \u003cp\u003e694.35\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c15\"\u003e \u003cp\u003e72.94\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c16\"\u003e \u003cp\u003e45.75\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e40\u0026ndash;49\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e140.66\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e406.80\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e547.46\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e74.31\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e77.09\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e48.35\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e78.08\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e126.43\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e61.76\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c11\"\u003e \u003cp\u003e17.87\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c12\"\u003e \u003cp\u003e189.01\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c13\"\u003e \u003cp\u003e509.18\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c14\"\u003e \u003cp\u003e698.19\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c15\"\u003e \u003cp\u003e72.93\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c16\"\u003e \u003cp\u003e49.25\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e50\u0026ndash;59\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e249.08\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e725.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e974.08\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e74.43\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e122.54\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e78.39\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e59.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e137.39\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e42.94\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c11\"\u003e \u003cp\u003e16.66\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c12\"\u003e \u003cp\u003e327.47\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c13\"\u003e \u003cp\u003e842.58\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c14\"\u003e \u003cp\u003e1170.05\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c15\"\u003e \u003cp\u003e72.01\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c16\"\u003e \u003cp\u003e72.24\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e60\u0026ndash;69\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e277.66\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e880.77\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e1158.43\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e76.03\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e185.78\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e92.67\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e123.30\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e215.97\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e57.09\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c11\"\u003e \u003cp\u003e31.44\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c12\"\u003e \u003cp\u003e370.33\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c13\"\u003e \u003cp\u003e1076.73\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c14\"\u003e \u003cp\u003e1447.06\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c15\"\u003e \u003cp\u003e74.41\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c16\"\u003e \u003cp\u003e110.43\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e70\u0026ndash;79\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e117.95\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e224.80\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e342.75\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e65.59\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e117.31\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e55.68\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e117.27\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e172.95\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e67.81\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c11\"\u003e \u003cp\u003e48.77\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c12\"\u003e \u003cp\u003e173.63\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c13\"\u003e \u003cp\u003e352.93\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c14\"\u003e \u003cp\u003e526.56\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c15\"\u003e \u003cp\u003e67.03\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c16\"\u003e \u003cp\u003e81.42\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026ge;\u0026thinsp;80\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e67.77\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e192.30\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e260.07\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e73.94\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e238.94\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e37.36\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e95.03\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e132.39\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e71.78\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c11\"\u003e \u003cp\u003e83.11\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c12\"\u003e \u003cp\u003e105.13\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c13\"\u003e \u003cp\u003e296.70\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c14\"\u003e \u003cp\u003e401.83\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c15\"\u003e \u003cp\u003e73.84\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c16\"\u003e \u003cp\u003e149.86\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTotal\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1062.64\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e3076.79\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e4139.43\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e74.33\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e91.73\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e464.46\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e521.53\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e985.99\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e52.89\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c11\"\u003e \u003cp\u003e21.22\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c12\"\u003e \u003cp\u003e1527.10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c13\"\u003e \u003cp\u003e3807.92\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c14\"\u003e \u003cp\u003e5335.02\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c15\"\u003e \u003cp\u003e71.38\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c16\"\u003e \u003cp\u003e58.25\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e"},{"header":"Discussion","content":"\u003cp\u003eIn this study, we found that the PTB DALYs rate was 58.25/10\u003csup\u003e5\u003c/sup\u003e, which was lower than that in China \u003csup\u003e[22]\u003c/sup\u003e and similar to that in Guizhou Province \u003csup\u003e[12]\u003c/sup\u003e, but higher than that in Harbin \u003csup\u003e[13]\u003c/sup\u003e and Inner Mongolia \u003csup\u003e[14]\u003c/sup\u003e, both of which were northern cities. This highlighted the ongoing necessity to improve efforts for the prevention and control of PTB in Shenyang.\u003c/p\u003e \u003cp\u003eIn this study, we found that the PTB DALYs rate of males was higher than that of females, which was consistent with the higher incidence and mortality of PTB in males as found in this study and previous studies \u003csup\u003e[12,14,23,24]\u003c/sup\u003e. This may be related to i) males were prone to unhealthy habits such as drinking and smoking, which can lead to infection \u003csup\u003e[25]\u003c/sup\u003e, ii) males experienced higher work and social pressure and had more social activities, which increased the risk of disease infection and transmission \u003csup\u003e[26]\u003c/sup\u003e, iii) males tended to initiate treatment late and exhibited poor adherence to treatment \u003csup\u003e[27]\u003c/sup\u003e. This suggested that the necessity of implementing interventions to actively communicate the importance of modifying unhealthy lifestyles, as well as promoting early diagnosis and treatment, particularly targeting male individuals.\u003c/p\u003e \u003cp\u003eIn this study, we found that the PTB DALYs rate increased with age, and the disease burden of PTB in people over 60 years old was significantly higher than that in other age groups, which was consistent with previous research results \u003csup\u003e[28,29]\u003c/sup\u003e. This may be related to i) the reduced immunity in the elderly led more susceptible to PTB infection and reinfection \u003csup\u003e[30]\u003c/sup\u003e, ii) the low tolerance of anti-TB drugs in the elderly, most of whom suffered from chronic comorbidities, resulting in increased difficulty in disease treatment and poor prognosis \u003csup\u003e[31]\u003c/sup\u003e. This indicated that the elderly should be considered a priority population in the prevention and control of PTB.\u003c/p\u003e \u003cp\u003eIn this study, we found that the YLLs were the predominant contributor to the PTB DALYs in Shenyang in 2023, accounting for about 71.38%, which was consistent with the findings in China \u003csup\u003e[10]\u003c/sup\u003e, Brazil \u003csup\u003e[32]\u003c/sup\u003e, and India \u003csup\u003e[33]\u003c/sup\u003e. It suggested that PTB was more likely to lead to premature death rather than disability, possibly due to its older age of onset\u003csup\u003e[34]\u003c/sup\u003e, high drug resistance, and a higher rate of delayed diagnosis (64.54%) \u003csup\u003e[31, 35]\u003c/sup\u003e. Therefore, the focus should be shifted towards early intervention to reduce transmission.\u003c/p\u003e \u003cp\u003eDespite the above findings, our study has some limitations. Firstly, there was typically a lag in reporting infectious diseases following their onset, and the PTB incidence data we collected through the NIDRIS on January 5, 2024 may not encompass the complete number of cases in 2023. Because additional PTB cases occurred in 2023 may be reported after January 5, 2024. This may lead to an underestimation of the PTB disease burden in Shenyang in 2023. Secondly, the disease duration utilized in this study for calculating the prevalence of PTB was based on the global average, however, due to Shenyang's significant aging population, it was possible that the average disease duration of PTB may be prolonged. This could also potentially result in an underestimation of the disease burden of PTB in Shenyang in 2023.\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eIn 2023, the PTB DALYs rate in Shenyang was 58.25/10\u003csup\u003e5\u003c/sup\u003e, lower than that in China. The disease burden of PTB in males and the elderly was higher and should be paid more attention. The disease burden of PTB was predominantly due to YLLs, accounting for as much as 71.38%, indicating that PTB primarily led to premature mortality rather than disability in Shenyang. Therefore, efforts should be focused on advancing the threshold for infection control to alleviate the disease burden of PTB, especially for the aged males.\u003c/p\u003e"},{"header":"Abbreviations","content":"\u003cp\u003eDALYs: Disability-Adjusted Life Years; DW: Disability Weight; GBD: Global Burden of Disease; NIDRIS: Notifiable Infectious Diseases Reporting Information System; PTB: Pulmonary Tuberculosis; TB Tuberculosis; YLDs: Years Lived with Disability; YLLs: Years of Life Lost\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eEthics approval and consent to participate\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAvailability of data and materials\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe datasets used and analyzed during the current study is available from the corresponding author Haiyan Bi(E-mail:[email protected]) on reasonable request.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting Interests\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare that they have no conflict of interest.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis work was not supported by any funding.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors\u0026apos; Contributions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eConceived and designed the experiments: BS, HC, HB, PL, ZY. Performed the experiments: HC, HB, LW. Analyzed the data: HC, HB, WS. Wrote the paper: HC, HB. All authors read and approved the final manuscript.\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgments\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable.\u0026nbsp;\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eSu\u0026aacute;rez I, F\u0026uuml;nger SM, Kr\u0026ouml;ger S, et al. The Diagnosis and Treatment of Tuberculosis. Dtsch Arztebl Int. 2019;116(43):729-35.\u003c/li\u003e\n\u003cli\u003eLv H, Zhang X, Zhang W, et al. Progress in research of epidemiological characteristics of pulmonary tuberculosis and influencing factors. Dis Surveill. 2024;39(02):207-14.\u003c/li\u003e\n\u003cli\u003eWorld Health Organization. Global Tuberculosis Report 2023. https://www.who.int/teams/global-tuberculosis-programme/tb-reports/global-tuberculosis-report-2023. 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The burden of infectious diseases in the Brazilian Southern state of Santa Catarina. J Infect Public Health.\u003cem\u003e \u003c/em\u003e2016,9(2):181-91.\u003c/li\u003e\n\u003cli\u003eMenon GR, Singh L, Sharma P, et al. National Burden Estimates of healthy life lost in India, 2017: an analysis using direct mortality data and indirect disability data. Lancet Glob Health\u003cem\u003e. \u003c/em\u003e2019;7(12):e1675-84.\u003c/li\u003e\n\u003cli\u003eJiang H, Liu M, Zhang Y, et al. Changes in Incidence and Epidemiological Characteristics of Pulmonary Tuberculosis in Mainland China, 2005-2016. JAMA Netw Open. 2021;4(4):e215302.\u003c/li\u003e\n\u003cli\u003eLiang S, Jiang Y, Yang G, et al. Epidemic characteristics and treatment outcomes of etiologically positive pulmonary tuberculosis in Liaoning Province from 2016 to 2022. Chin Trop Med\u003cem\u003e. \u003c/em\u003e2023;23:1127-33.\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":true,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"bmc-infectious-diseases","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"infd","sideBox":"Learn more about [BMC Infectious Diseases](http://bmcinfectdis.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/infd","title":"BMC Infectious Diseases","twitterHandle":"#bmcinfectdis","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"Pulmonary Tuberculosis, Disease Burden, Disability-adjusted life year, Shenyang","lastPublishedDoi":"10.21203/rs.3.rs-4323453/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-4323453/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground\u003c/h2\u003e \u003cp\u003ePulmonary tuberculosis (PTB) is one of the most serious infectious diseases worldwide and poses a great threat to people\u0026rsquo;s health. China has a vast territory with substantial regional disparities in the PTB disease burden. However, there have been no studies conducted to evaluate the PTB disease burden in Shenyang. The aim was to elucidate the magnitude, composition, and distribution of PTB disease burden in Shenyang.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e \u003cp\u003eThe disability-adjusted life years (DALYs) calculated based on Global Burden of Disease (GBD) framework was used to assess the disease burden of PTB in Shenyang in 2023, and descriptive epidemiological methods were employed to elucidate the magnitude, composition, and distribution characteristics of PTB disease burden in Shenyang.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e \u003cp\u003eIn 2023, 4,169 PTB cases were reported in Shenyang, including 2,901 males and 1,268 females. The incidence of PTB was 45.50/10\u003csup\u003e5\u003c/sup\u003e, of which 64.29/10\u003csup\u003e5\u003c/sup\u003e for males and 27.30/10\u003csup\u003e5\u003c/sup\u003e for females. The incidence among males was higher than that among females (\u003cem\u003eX\u003c/em\u003e\u003csup\u003e2\u003c/sup\u003e\u0026thinsp;=\u0026thinsp;688.56, \u003cem\u003ep\u003c/em\u003e\u0026lt;0.001). The highest incidence was 107.00/10\u003csup\u003e5\u003c/sup\u003e in the group of the population aged 80 and above (\u003cem\u003eX\u003c/em\u003e\u003csup\u003e2\u003c/sup\u003e\u0026thinsp;=\u0026thinsp;1171.75, \u003cem\u003ep\u003c/em\u003e\u0026lt;0.001). In 2023, 189 PTB deaths were reported in Shenyang, including 156 males and 33 females. The mortality of PTB was 2.06/10\u003csup\u003e5\u003c/sup\u003e of which 3.46/10\u003csup\u003e5\u003c/sup\u003e for males and 0.71/10\u003csup\u003e5\u003c/sup\u003e for females. The mortality among males was higher than that among females (\u003cem\u003eX\u003c/em\u003e\u003csup\u003e2\u003c/sup\u003e\u0026thinsp;=\u0026thinsp;83.69, \u003cem\u003ep\u003c/em\u003e\u0026lt;0.001). The highest mortality was 16.04/10\u003csup\u003e5\u003c/sup\u003e in the group of the population aged 80 and above (\u003cem\u003eX\u003c/em\u003e\u003csup\u003e2\u003c/sup\u003e\u0026thinsp;=\u0026thinsp;285.61, \u003cem\u003ep\u003c/em\u003e\u0026lt;0.001). The PTB DALYs rate was 58.25/10\u003csup\u003e5\u003c/sup\u003e, of which 91.73/10\u003csup\u003e5\u003c/sup\u003e for males and 21.22/10\u003csup\u003e5\u003c/sup\u003e for females. The DALYs rate among males was higher than that among females (\u003cem\u003eX\u003c/em\u003e\u003csup\u003e2\u003c/sup\u003e\u0026thinsp;=\u0026thinsp;44.04, \u003cem\u003ep\u003c/em\u003e\u0026lt;0.001). The highest DALYs rate was 149.86/10\u003csup\u003e5\u003c/sup\u003e in the group of the population aged 80 and above (\u003cem\u003eX\u003c/em\u003e\u003csup\u003e2\u003c/sup\u003e\u0026thinsp;=\u0026thinsp;305.35, \u003cem\u003ep\u003c/em\u003e\u0026lt;0.001). Years of life lost (YLLs) due to PTB accounted for 71.38% of total DALYs, of which 74.33% for males and 52.89% for females.\u003c/p\u003e\u003ch2\u003eConclusion\u003c/h2\u003e \u003cp\u003eThe disease burden of PTB in Shenyang in 2023 was lower than that in China, showing characteristics of that the disease burden increased with age, and males was higher than that of females. The predominant disease burden of PTB was attributed to YLLs, accounting for as much as 71.38%, indicating that PTB primarily results in premature mortality rather than disability. Therefore, the focus should be shifted towards early intervention to reduce transmission, especially for the aged males.\u003c/p\u003e","manuscriptTitle":"Evaluation of pulmonary tuberculosis disease burden in Shenyang, China, 2023","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2024-05-07 05:45:08","doi":"10.21203/rs.3.rs-4323453/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Revision requested","date":"2024-11-18T19:35:02+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2024-11-17T08:35:09+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"81540067688008281603618685546716155775","date":"2024-11-01T07:09:32+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2024-10-10T16:05:52+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"295746295722362414768751755381349046117","date":"2024-10-02T03:36:17+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"12854342330680311809440841494667415094","date":"2024-09-30T20:03:43+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"206327122059590099078423009743568091832","date":"2024-09-30T06:15:27+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"125818542545332503694291841324031062298","date":"2024-07-11T13:35:30+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"246811961575500740228784584089557779496","date":"2024-06-24T15:18:50+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"190836453161525783571938800307675517813","date":"2024-06-24T13:11:56+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2024-06-24T10:43:37+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2024-05-02T12:30:48+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2024-04-30T11:43:47+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2024-04-30T11:43:47+00:00","index":"","fulltext":""},{"type":"submitted","content":"BMC Infectious Diseases","date":"2024-04-25T10:15:47+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-infectious-diseases","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"infd","sideBox":"Learn more about [BMC Infectious Diseases](http://bmcinfectdis.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/infd","title":"BMC Infectious Diseases","twitterHandle":"#bmcinfectdis","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"4914944f-4351-4bde-9f8c-676cd815f539","owner":[],"postedDate":"May 7th, 2024","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"published-in-journal","subjectAreas":[],"tags":[],"updatedAt":"2025-02-10T16:08:33+00:00","versionOfRecord":{"articleIdentity":"rs-4323453","link":"https://doi.org/10.1186/s12879-025-10572-8","journal":{"identity":"bmc-infectious-diseases","isVorOnly":false,"title":"BMC Infectious Diseases"},"publishedOn":"2025-02-04 15:57:50","publishedOnDateReadable":"February 4th, 2025"},"versionCreatedAt":"2024-05-07 05:45:08","video":"","vorDoi":"10.1186/s12879-025-10572-8","vorDoiUrl":"https://doi.org/10.1186/s12879-025-10572-8","workflowStages":[]},"version":"v1","identity":"rs-4323453","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-4323453","identity":"rs-4323453","version":["v1"]},"buildId":"qtupq5eGEP_6zYnWcrvyt","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}