Zhonghua Liu Xing Bing Xue Za Zhi. 2026 Jan 10;47(1):21-27. doi: 10.3760/cma.j.cn112338-20250609-00388.
ABSTRACT
Objective: To describe the incidence of tuberculosis (TB) in 10 areas where China Kadoorie Biobank (CKB) Study was conducted between 2009 and 2018 and explore the influencing factors. Methods: To comprehensively obtain the incidence data of TB, the CKB cohort was linked with the TB cases registered in the China Information System for Disease Control and Prevention. Poisson regression models were used to analyze the temporal, area, and population distributions of TB incidence and estimate RR of the factors associated with TB. Joinpoint regression model was used to detect temporal trends. Results: The TB incidence rate varied significantly with area, which was highest in the project area in Hunan [167.3 per 100 000 person-years (95%CI: 157.0 per 100 000 person-years-177.7 per 100 000 person-years)] and lowest in the project area in Zhejiang [33.3 per 100 000 person-years (95%CI: 28.6 per 100 000 person-years-38.0 per 100 000 person-years)]. The risk for TB increased with age, and the RRs were 1.39 (95%CI: 1.29-1.50) and 1.50 (95%CI:1.38-1.63), respectively, in age groups 60- years and ≥70 years. Smoking, alcohol consumption, BMI, and diabetes were associated with an elevated risk for TB (RR=1.28, 95%CI: 1.17-1.40), 1.11 (95%CI:1.03-1.20), 2.62 (95%CI: 2.40-2.86), and 1.67 (95%CI: 1.50-1.86), respectively. Women had lower risk for TB (RR=0.55, 95%CI: 0.50-0.60). Overweight (RR=0.57, 95%CI: 0.53-0.62) and obesity (RR=0.48, 95%CI: 0.42-0.55) were also associated with lower risk for TB. Higher education level was associated with reduced risk for TB. For participants with education levels of junior and senior high school, college or university, the RRs were 0.85 (95%CI: 0.79-0.92) and 0.63 (95%CI: 0.54-0.74). Similarly, higher annual household income was associated with lower TB risk, the RR were 0.88 (95%CI: 0.81-0.96) in 10 000- Yuan group and 0.77 (95%CI: 0.71-0.84) in ≥20 000 Yuan group. After adjusting for age, sex, and area, the TB incidence rate initially increased and peaked in 2013 [101.3 per 100 000 person-years (96.8 per 100 000 person-years-105.8 per 100 000 person-years)], then declined [annual percentage change (APC): 5.06% during 2009-2013; APC=-6.71% during 2013-2018]. Conclusions: The incidence of TB was high in adults in the 10 study areas of CKB, the risk was influenced by sociodemographic characteristics, lifestyles and BMI.
PMID:41566262 | DOI:10.3760/cma.j.cn112338-20250609-00388