Trends and Disparities in Tuberculosis Burden in Kazakhstan and Mongolia (2017-2021): A Comparative Analysis Using GBD Metrics

OYUNZUL. Amartsengel¹Malika Idayat^2*Alexander Rommel³Natalya Glushkova²Kairat Davletov⁴Malik Adenov⁵Naranzul Dambaa⁶Khorolsuren Lkhagvasuren^1*Elena Von Der Lippe Von Der Lippe³

• ¹Mongolian National University of Medical Sciences, Ulaanbaatar, Mongolia
• ²Al-Farabi Kazakh National University, Almaty, Kazakhstan
• ³Robert Koch Institute (RKI), Berlin, Berlin, Germany
• ⁴Kazakh National Medical University, Almaty, Kazakhstan
• ⁵Research Institute of Phthisiopulmonology, Almaty, Kazakhstan
• ⁶National Center for Communicable Disease, Ulaanbaatar, Mongolia

In Central Asia, respiratory diseases, particularly tuberculosis (TB), are widespread communicable diseases that significantly impact both individuals and health systems, posing a substantial burden. Research highlights the importance of assessing TB’s impact on global morbidity, given its major contribution and over a million deaths annually. Our study aims to assess the patterns and changes in the burden ofTB in Mongolia and Kazakhstan. The design is a retrospective cross-sectional study. We used the Global Burden of Disease framework, which introduced disability-adjusted life years (DALYs) to measure disease burden, combining mortality (Years of Life Lost) and morbidity (Years Lived with Disability). Calculations followed standard GBD formulas using life expectancy, age at death, and disease-specific disability weights. We analyzed national TB registration data from 2017 to 2021. During this period, both countries saw significant declines in TB burden, shown by reductions in YLL and YLD. Kazakhstan’s YLL decreased by 18.2% and YLD by 36%, reflecting improved TB control. Mongolia experienced a 24.9% drop in YLL and a 39.4% reduction in YLD, although premature mortality in older men remains a challenge. These findings underscore the need for targeted interventions and healthcare equity to sustain TB control. YLD rates remained low with minimal impact on total DALYs, highlighting positive trends in reducing TB mortality and disability in both countries. Kazakhstan and Mongolia have significantly reduced the TB burden, as evidenced by declining DALY, YLL, and YLD rates. While TB control has been effective in both, Mongolia still faces high TB-related mortality and morbidity, calling for better access to TB services. This reflects global trends of declining TB burden through improved diagnostics and treatment, yet structural disparities continue to hinder uniform progress. WHO data for the Western Pacific and South-East Asia Regions show a slower rise in TB mortality from 2017 to 2021. Future research should examine factors behind Mongolia’s persistent TB burden—such as healthcare access, treatment adherence, and comorbidities—and expand analysis to other Central Asian countries for a broader regional perspective