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Journal Article Epublish 3 citations

PubMed: 40434512 DOI: 10.1007/s40520-025-03070-z

The impact of population aging on tuberculosis prevention and control in Shanghai: a prediction based on age-period-cohort models.

Aging Clin Exp Res 37(1):175

Authors: Rong Du, Lixin Rao, Xiao Xiao, Qi Zhao, Xin Shen, Biao Xu

Affiliations

  • Department of Epidemiology, School of Public Health, Fudan University, 130 Dongan Road, Shanghai, 200032, China. Key Laboratory of Health Technology Assessment, National Health Commission of the People's Republic of China (Fudan University), 131 Dongan Road, Shanghai, 200032, China.
  • Division of Tuberculosis and HIV/AIDS Prevention, Shanghai Municipal Center for Disease Control and Prevention, 1380 Zhongshan West Road, Shanghai, 200336, China. Shanghai Institutes of Preventive Medicine, 1380 Zhongshan West Road, Shanghai, 200336, China.
  • Department of Epidemiology, School of Public Health, Fudan University, 130 Dongan Road, Shanghai, 200032, China.
  • Key Laboratory of Health Technology Assessment, National Health Commission of the People's Republic of China (Fudan University), 131 Dongan Road, Shanghai, 200032, China.
  • Division of Tuberculosis and HIV/AIDS Prevention, Shanghai Municipal Center for Disease Control and Prevention, 1380 Zhongshan West Road, Shanghai, 200336, China. Shanghai Institutes of Preventive Medicine, 1380 Zhongshan West Road, Shanghai, 200336, China.

Abstract

BACKGROUND

The number and proportion of people aged 65 and above in Shanghai are increasing, posing challenges to tuberculosis (TB) control. This study aims to assess the impact of this demographic change on the TB epidemic in Shanghai.

METHODS

Data were obtained from the TB Information Management System, with case counts and notification rates calculated by gender, age, and year. TB notification rates and trends were analyzed under two demographic scenarios: a constant aging scenario and an increasing aging scenario. Grey models (GM (1,1)) and age-period-cohort (APC) models were employed to forecast changes in the elderly population as well as age-specific TB notification rates. The estimated annual percentage change (EAPC) quantified trends over time.

RESULTS

From 2015 to 2023, a total of 29,694 TB cases were reported, with males accounting for 69.79%. In 2023, the notification rate was 19.55 per 100,000, with the highest rate observed among individuals aged 65 years and older, reaching 48.47 per 100,000. The proportion of older adults among TB patients increased annually. Predictions indicated a peak notification rate among those aged 70-79 over the next five years. Compared to the constant aging scenario, the increasing aging scenario was associated with a more moderate reduction in TB notification rates (34.49% vs. 42.81%) and a slower declining trend over the study period (EAPC = -3.50, 95% CI: -4.70 to -2.29 vs. EAPC = -4.45, 95% CI: -5.47 to -3.42).

CONCLUSION

Population aging poses challenges to TB control, highlighting the need for targeted strategies for older adults.

MeSH

Aging, Aged, Tuberculosis, Demography