ORIGINAL RESEARCH article
Front. Public Health
Sec. Infectious Diseases: Epidemiology and Prevention
This article is part of the Research TopicWorld TB Day 2025: Yes! We Can End TB: Commit, Invest, DeliverView all 15 articles
Latent Tuberculosis Infection in China, 1990-2050: GBD-Informed Projections for Age-Targeted Screening
Provisionally accepted
- 1Qishan Hospital of Yantai, Yantai, China
- 2Yantai Center for Disease Control and Prevention, Yantai, China
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Objective: China bears high latent tuberculosis infection (LTBI) caseload, yet its longitudinal trends and age-specific burden remain unquantified, hindering targeted control. Methods: Leveraging data from the Global Burden of Disease Study 2021, we analyzed age-standardized LTBI prevalence rate (ASPR) and cases in mainland China (1990–2021). Joinpoint regression quantified temporal trends, while age-period-cohort (APC) modeling disentangled age/cohort effects. Bayesian age-period-cohort (BAPC) projected prevalence and cases to 2050. Results: From 1990 to 2021, China's LTBI cases rose by 33.28% (1990-2021) despite declining ASPR (EAPC=−0.39). This contrasts with global trends. APC analysis indicated that the risk peak was more prolonged in mainland China, spanning the age range 25-60 years, while 20–29 years age globally. Over the next three decades, China's prevalence will decline until 2036 (29,396.35/100,000), then rebound, reaching 30,184.31 by 2050. Cases peak earlier (2029: 0.42 billion) than globally (2036: 1.80 billion). Conclusions: Mainland China faces a uniquely prolonged LTBI risk window and an impending burden resurgence after 2036. Prioritizing age-targeted screening for 50–69-year-olds and strengthening surveillance are critical to achieving TB elimination.
Keywords: latent tuberculosis infection, Age-Period-Cohort analysis, Diseaseburden, targeted screening, Public Health
Received: 23 Aug 2025; Accepted: 17 Nov 2025.
Copyright: © 2025 Jiang, Zhang, Li, Yu, Liu, Pan and Xue. 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: Jian Xue, xuejianwf@126.com
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