Global burden of MDR-TB and XDR-TB: trends, inequities, and future implications for public health planning

作者：En-Li Tan, Yu Qin, Jian Yang, Xiaojie Li, Tianqi Liu, Guo-Bing Yang, Yongjun Li, Zhenzhen Zhang, Zhenhui Lu, Ji-Chun Wang, Jinxin Zheng, Shun-Xian Zhang · 发表于：BMC Infectious Diseases · 年份：2025 · DOI：10.1186/s12879-025-11566-2 · 被引用次数：19 · 研究领域：Tuberculosis Research and Epidemiology、Healthcare Facilities Design and Sustainability、Antibiotic Use and Resistance

BACKGROUND: Drug-resistant tuberculosis (TB) remains a major global health threat, reflecting disparities in healthcare capacity, access, and socioeconomic development. Previous research often lacks geographic breadth. This study provides a comprehensive assessment of the global, regional, and national burden of Multidrug-resistant TB without extensive drug resistance (MDR-TB) and extensively drug-resistant TB(XDR-TB) from in Global Burden of Disease Study (GBD) 2021 Study 1990 to 2021, with a focus on distributional inequities. The findings aim to guide resource prioritization, inform targeted interventions, and reduce the burden in high-risk populations. METHODS: We systematically assessed the global, regional, and national burden of MDR-TB and XDR-TB, along with their change trends from 1990 to 2021, using data from the GBD 2021 database. The indicators included age-standardized incidence rate (ASIR), prevalence rate (ASPR), mortality rate (ASMR), and disability-adjusted life-years rate (ASDR). ASDR was analyzed in conjunction with the sociodemographic index (SDI) for a comprehensive assessment. Health inequalities were quantified using the slope index of inequality (SII) and concentration index (CCI). Frontier analysis estimated the achievable outcomes across different development levels, while decomposition analysis identified the key factors driving changes in disease burden. RESULTS: In 2021, the global ASIR of MDR-TB was 5.42 per 100,000 population [95% uncertainty in...