In a recent study published in the journal Pediatric Research, researchers leveraged secondary datasets (specifically, the Global Burden of Disease 2019 database) to elucidate global trends in multidrug-resistant tuberculosis (MDR-TB) incidence and prevalence. Their study focused on children and adolescents (<20 years) between 1990 and 2019.

Their findings revealed that while MDR-TB incidence showed different trends over time, the overall estimated annual percentage change (EAPC) was 4.15% (95% uncertainty interval [UI]: 1.10–12.19%), with a sharp rise from 1990 to 2005, a slight decline from 2005 to 2015, and a resurgence from 2015 to 2019. Eastern Europe, Southern sub-Saharan Africa, and South Asia bore the most significant burden.

Among affected children, females exhibited higher prevalence and incidence rates than males. Children below the age of five were found to be highly susceptible to MDR-TB-associated mortality (0.62 per 100,000 in 2019, the highest among all age groups) when compared with their older counterparts. These results highlight the need for extensive research and policy change to combat this growing disease and protect our children.

Tuberculosis (TB) is a lung infection caused by the bacterium Mycobacterium tuberculosis. Multidrug-resistant tuberculosis (MDR-TB) is a type of tuberculosis resistant to both rifampicin and isoniazid, the two most common treatments for the infection. The disease is linked to previous TB infections and early stoppage of antibiotic treatment. MDR-TB prolongs infection duration, hampers treatment and recovery, and results in a significantly more severe prognosis, potentially resulting in mortality and a substantial economic burden to patients and their families.

Unfortunately, the global incidence of MDR-TB is rapidly rising – reports from 2014 estimate that ~3.5% of all TB cases were multidrug-resistant. Nations with high populations and low to low-medium socioeconomic status are the worst affected, with India, China, South Africa, and Russia accounting for more than 60% of confirmed cases.

“The World Health Organization launched the ‘End TB’ strategy in 2014 to achieve a 90% decline in TB incidence by 2035. To achieve this goal, it is essential to develop efficient strategies and increase the investment and commitment to MDR-TB control.”

Researchers speculate that children and adolescents are the most vulnerable age group to MDR-TB infections. Surprisingly, despite their known susceptibility, hitherto, no attempts have been made to estimate global trends in MDR-TB prevalence and incidence in this subpopulation.

About the study

The present study aims to elucidate global trends in MDR-TB incidence among children and adolescents (age = <20) to inform future research efforts and policy implementations better. Secondary study data was obtained from the Global Burden of Disease Study 2019 (GBD 2019), an extensive health database comprising epidemiology data from 369 nations, classified by age, sex, and sociodemographic regions.

“The latest GBD database (GBD 2019) has a user-friendly approach and provides data on various factors, such as all causes, risks, impairments, injuries, and mortality rates. Consequently, it has become a valuable resource for assessing and comparing disease burden across various countries and territories.”

Data of interest included annual incidence rates, disease prevalence, mortality rates, and disability-adjusted life years (DALYs) rates for the age group under investigation. Data from 1990 to 2019 were included in statistical analyses to establish annual trends. The statistical analyses comprised randomized Markov–Chain Monte-Carlo models to estimate disease burden trends, as well as estimated annual percentage change (EAPC) analyses to identify patterns in the dataset.