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Trends in tuberculosis incidence and mortality and risk factors for death in the Belt and Road partner countries from 1990 to 2021: based on GBD 2021 database
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Yaping LIU1, Lin WU1, Junping LIU1, Yue ZHOU1, Xinle YIN1, Yiyan TANG2, Lihan ZHANG1, Yunkai LI1, Juan GUAN1, Yanfu WANG3, Libo LIANG1
Chinese Journal of Public Health | 2026, 42(3) : 314 - 318
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Chinese Journal of Public Health | 2026, 42(3): 314-318
• Survey and Report •
Trends in tuberculosis incidence and mortality and risk factors for death in the Belt and Road partner countries from 1990 to 2021: based on GBD 2021 database
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Yaping LIU1, Lin WU1, Junping LIU1, Yue ZHOU1, Xinle YIN1, Yiyan TANG2, Lihan ZHANG1, Yunkai LI1, Juan GUAN1, Yanfu WANG3, Libo LIANG1
Affiliations
  • 1School of Health Management, Harbin Medical University, Harbin 150081, China
  • 2The First Affiliated Hospital of Harbin Medical University, Harbin 150001, China
  • 3Heilongjiang Provincial Center for Disease Control and Prevention, Harbin 150030, China
Published: 2026-03-10 doi: 10.11847/zgggws1147884
Outline
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Objective

To understand the trends in tuberculosis (TB) incidence and mortality and the main risk factors for TB deaths in Belt and Road Initiative (BRI) partner countries from 1990 to 2021, thus providing a reference for the rational allocation of health resources and the development of more scientific and reasonable prevention and control strategies for TB.

Methods

Data on TB incidence, mortality, and deaths attributable to TB risk factors in 155 BRI partner countries from 1990 to 2021 were extracted from the Global Burden of Disease Study 2021 (GBD 2021) database. Descriptive analysis and Joinpoint regression model were employed to analyze the trends of TB incidence and mortality and the attribution of risk factors for TB death in the BRI partner countries.

Results

The incidence and mortality of TB in the BRI partner countries showed an overall downward trend from 1990 to 2021. From 1990 to 2021, the incidence and mortality of TB decreased from 294.607 per 100 000 and 71.189 per 100 000 to 164.704 per 100 000 and 27.482 per 100 000 in Africa (52 countries), from 216.976 per 100 000 and 45.161 per 100 000 to 123.890 per 100 000 and 17.706 per 100 000 in Asia (41 countries), from 68.702 per 100 000 and 5.301 per 100 000 to 39.278 per 100 000 and 2.655 per 100 000 in Europe (27 countries), from 45.607 per 100 000 and 8.652 per 100 000 to 25.072 per 100 000 and 3.471 per 100 000 in North America (13 countries), from 79.327 per 100 000 and 22.496 per 100 000 to 72.417 per 100 000 and 15.767 per 100 000 in Oceania (12 countries), and from 61.993 per 100 000 and 10.340 per 100 000 to 33.563 per 100 000 and 3.172 per 100 000 in South America (10 countries). The average annual percentage changes (AAPCs) in TB incidence and mortality from 1990 to 2021 were –1.87% and –3.05%, –1.78% and –2.98%, –1.97% and –2.25%, –1.95% and –2.92%, –0.21% and –1.04%, –1.95% and –3.69%, respectively (all P < 0.05). The number of TB deaths attributable to smoking, alcohol consumption, and diabetes in the BRI partner countries in 1990 and 2021 were 126 861 and 87 786, 71 705 and 76 814, and 53 808 and 78 468, respectively. Among the risk factors, smoking had consistently been identified as the leading risk factor for TB death. The number of TB deaths attributable to diabetes increased in Africa, Asia, North America, Oceania, and South America in 2021 compared with that in 1990.

Conclusions

The incidence and mortality of TB in the 155 BRI partner countries showed an overall downward trend from 1990 to 2021. Smoking remained the key risk factor for TB death, while the number of deaths attributable to diabetes increased.

tuberculosis  /  incidence  /  mortality  /  trend  /  risk factors  /  attribution analysis  /  Belt and Road Initiative partner countries
刘雅萍, 吴琳, 刘俊萍, 周玥, 尹新乐, 唐易焱, 张莉晗, 李云楷, 管娟, 王彦富, 梁立波. 1990—2021年“一带一路”共建国家结核病发病和死亡变化趋势及其死亡危险因素归因分析:基于GBD 2021数据库. 中国公共卫生, 2026 , 42 (3) : 314 -318 . DOI: 10.11847/zgggws1147884
Yaping LIU, Lin WU, Junping LIU, Yue ZHOU, Xinle YIN, Yiyan TANG, Lihan ZHANG, Yunkai LI, Juan GUAN, Yanfu WANG, Libo LIANG. Trends in tuberculosis incidence and mortality and risk factors for death in the Belt and Road partner countries from 1990 to 2021: based on GBD 2021 database[J]. Chinese Journal of Public Health, 2026 , 42 (3) : 314 -318 . DOI: 10.11847/zgggws1147884
Year 2026 volume 42 Issue 3
111
38
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Article Info
doi: 10.11847/zgggws1147884
  • Receive Date:2025-05-08
  • Online Date:2026-10-23
  • Published:2026-03-10
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History
  • Received:2025-05-08
  • Revised:2025-07-19
  • Accepted:2025-08-28
Affiliations
    1School of Health Management, Harbin Medical University, Harbin 150081, China
    2The First Affiliated Hospital of Harbin Medical University, Harbin 150001, China
    3Heilongjiang Provincial Center for Disease Control and Prevention, Harbin 150030, China

Corresponding:

LIANG Libo, E-mail:
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表12种不同金属材料的力学参数
科
Family
属数
Number of
genus
种数
Number of
species
占总种数比例
Percentage of
total species (%)
属
Genus
种数
Number of
species
占总种数比例
Percentage of total
species (%)
鹅膏菌科Amanitaceae 2 11 5.26 鹅膏菌属 Amanita 10 4.78
小菇科 Mycenaceae 2 12 5.74 丝盖伞属 Inocybe 5 2.39
多孔菌科 Polyporaceae 8 14 6.70 蜡蘑属 Laccaria 5 2.39
红菇科 Russulaceae 3 23 11.00 小皮伞属 Marasmius 6 2.87
小菇属 Mycena 11 5.26
光柄菇属 Pluteus 5 2.39
红菇属 Russula 17 8.13
栓菌属 Trametes 5 2.39
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