Temporal Trends and Shifting Age Dynamics in Tuberculosis: A Five-Year Analysis of Case Distribution and Diagnostic Advancements (2018-2023)

Abstract

Background: Tuberculosis (TB) is an infectious disease caused by the tubercle bacilli called Mycobacterium tuberculosis (MTb). According to the World Health Organization (WHO), approximately a quarter (1.7 billion) of the world population are latently infected with MTb, where they have a 5–10% lifetime risk of becoming sick or infectious with TB.

Objective: To analyze the trends in NS+, NS-, and NEP tuberculosis cases from 2018 to 2023. To examine gender differences in tuberculosis prevalence across all categories and to assess the shift in tuberculosis incidence among different age groups. To evaluate the geographical distribution of tuberculosis across key cities in the Thi-Qar governorate and to investigate treatment outcomes, including cure rates and mortality trends, over the five-year period. To explore the impact of diagnostic improvements on the detection of asymptomatic and extrapulmonary tuberculosis cases.

Methods: An analysis was conducted on the electronic records of 2,743 TB patients officially registered at the Thi-Qar Chest and Respiratory Diseases Center. The dataset comprised records spanning from January 2018 to December 2023.

Results: Between 2018 and 2023, TB cases varied significantly. NS+ cases increased from 121 to 151, peaking at 181 in 2022, while NS- cases rose from 62 to 138. NEP cases surged from 182 to 332. Relapse cases fluctuated, and REP cases remained low. Males consistently had higher TB rates than females. The 25-34 age group had the most cases in 2018, but cases in the 35-44 and 45-54 groups grew by 2023. Most cases resulted in completion or cure, with slight increases in fatalities (five deaths in 2023).

Conclusion: The study delineates significant trends in tuberculosis (TB) from 2018 to 2023, indicating an increase in NS- and NEP cases, presumably attributable to advancements in diagnostic methods. The incidence of tuberculosis has risen in older age cohorts, especially individuals aged 35–54, indicating a change in demographic susceptibility.