Abstract:

Objective To analyze the epidemiological characteristics and changing trends of pulmonary tuberculosis(PTB) in the elderly aged 60 and above in Wuhan City, for evidences to optimize the tuberculosis prevention and control strategies targeting. Methods Data on the elderly PTB cases reported in Wuhan City from 2010 to 2025 were retrieved through the Chinese Disease Prevention and Control Information System. Descriptive epidemiological methods were used to analyze the patterns of temporal, regional and demographic distribution.The Joinpoint regression model was used to analyze the overall incidence trend and stratified trend grouped by different demographic characteristics. Results From 2010 to 2025, a total of 31 038 cases of PTB were identified among the elderly aged 60 and above in Wuhan City, with an average annual reported incidence rate of 108.00 per 100 000 population. The reported incidence rate was decreased from 125.80/100 000 in 2010 to 111.53/100 000 in 2025. The number of reported cases was relatively high from March to October (n=21 944; 70.70%). The reported incidence rate was higher in males than in females (173.89/100 000 vs. 56.71/100 000), and was the highest in 80-84 years age group (145.60/100 000). Additionally, the reported incidence rate was higher in the population living in the remote urban area than those living in the central urbran districts (138.26/100 000 vs. 87.89/100 000), and retirees constituted the highest proportion of cases (n=10 830; 34.89%). Joinpoint analysis results showed that the overall trend of the reported incidence rate of PTB among the elderly in Wuhan City from 2010 to 2025 had no statistical significance (AAPC=-0.94%, 95%CI: -2.05% to 0.18%, t=-1.64, P>0.05). The incidence presented a decline trend from 2010 to 2020 (APC=-3.08%, 95%CI: -4.13% to -2.03%, t=-6.36, P<0.001), followed by an upward trend from 2020 to 2025 (APC=3.49%, 95%CI: 0.33% to 6.77%, t=2.43, P<0.05). The overall trend of the reported incidence rate of bacteriologically positive PTB among the elderly was not statistically significant (AAPC=0.20%, 95%CI:-1.84% to 2.28%, t=0.19, P>0.05), among which there was a downward trend from 2010 to 2016 (APC=-6.80%, 95%CI: -10.89% to -2.53%, t=-3.46, P<0.05), and an upward trend from 2016 to 2025 (APC=5.15%, 95%CI: 2.64% to 7.73%, t=4.57, P<0.001). The overall reported incidence rate of PTB among males showed a downward trend (AAPC=-3.20%, 95%CI: -4.32% to -2.07%, t=-5.99, P<0.001), and among those in the 60-64 and 70-74 years age groups presented a downward trend (AAPC=-2.30%, -2.43%, 95%CI: -4.43% to -1.54%, -3.66% to -1.19%, t=-4.38, -4.18, both P<0.001). The overall reported incidence rate in the elderly population living in the central urban area exhibited an overall upward trend (AAPC=6.41%, 95%CI: 4.37% to 8.50%, t=6.28, P<0.001). Conclusion The PTB epidemic among the elderly in Wuhan City remains severe. Special attention should be paid to male residents and those living in outer suburban areas. Targeted measures, including strengthened active screening, standardized diagnosis and treatment, as well as follow-up management, are recommended to curb the tuberculosis epidemic among the elderly.

Key words: Pulmonary tuberculosis, Elderly population, Epidemiological characteristics, Wuhan City