ORIGINAL RESEARCH article
Front. Public Health
Sec. Aging and Public Health
Volume 13 - 2025 | doi: 10.3389/fpubh.2025.1647139
Effect of Population Aging on Pulmonary Tuberculosis Burden in Zhejiang Province, China: A Population-Based Study
Provisionally accepted
Yuxiao Ling1
Wei Wang2
Songhua Chen3
Yu Zhang3
Qian Wu3
Xinyi Chen3
Kui Liu3
Ke Yang3
Dan Luo4Yang Li5
Yiqing Zhou4
Bin Chen3*
Jianmin Jiang3*- 1Ningbo University, Ningbo, China
- 2Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
- 3Zhejiang Center for Disease Control and Prevention (Zhejiang CDC), Hangzhou, China
- 4Hangzhou Medical College, Hangzhou, China
- 5Hangzhou Normal University, Hangzhou, China
Select one of your emails
You have multiple emails registered with Frontiers:
Notify me on publication
Please enter your email address:
If you already have an account, please login
You don't have a Frontiers account ? You can register here
Background: China’s aging population poses a growing challenge to disease burden. This study aims to evaluate the impact of population aging on the incidence of pulmonary tuberculosis (PTB) in Zhejiang Province, China. Methods: PTB notified incidence data reported to the National Notifiable Diseases Reporting System from 2005 to 2022 were analyzed. The notified incidence from 2023 to 2035 was estimated using exponential regression models. The decomposition algorithm was applied to decompose and quantify the effects of population aging, population growth, and age-specific incidence on the PTB incidence. Results: Between 2005 and 2022, the notified incidence of PTB in Zhejiang Province declined from 93.5 per 100,000 to 33.99 per 100,000. The highest notified incidence was observed in those aged 60 years and older, with the population attributable fraction increasing from 18.76% to 27.92%. During this period, PTB cases decreased by 51.22% compared to 2005, driven by a 23.83% increase due to population growth, a 10.26% increase due to age structure, and an 85.31% decrease due to age-specific incidence. The contribution of age structure to the increase in the number of cases was -1.92%, -1.69%, 3.28%, and 10.60% in the age groups 0-19, 20-39, 40-59, and ≥60 years, respectively. Conclusions: Notified incidence of PTB in Zhejiang Province is expected to decrease. However, this decrease may be affected by demographic changes, particularly in older adults. Thus, strengthening public health measures and policies is crucial to achieving the End TB Strategy goal by 2035, emphasizing the need to enhance PTB screening in older adults.
Keywords: Aging, demographic factors, Incidence, prediction, pulmonary tuberculosis
Received: 16 Jun 2025; Accepted: 13 Oct 2025.
Copyright: © 2025 Ling, Wang, Chen, Zhang, Wu, Chen, Liu, Yang, Luo, Li, Zhou, Chen and Jiang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Bin Chen, bchen@cdc.zj.cn
Jianmin Jiang, jmjiang@cdc.zj.cn
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.