Age-period-cohort study of active pulmonary tuberculosis in eastern China: analysis of 15-year surveillance data

Background Tuberculosis remains a major public health challenge worldwide. This study aimed to determine the long-term trends in the notification rate of tuberculosis in Zhejiang Province, and to assess the potential independent risks associated with age, time period, and birth cohort. Methods Data on all pulmonary tuberculosis (PTB) cases in Zhejiang Province from 2008 to 2022 were collected from the Tuberculosis Information Management System. Long-term trends in the notification rate and independent risks associated with quantitatively decomposed variables were determined using joinpoint regression model and age-period-cohort model. Results Between 2008 and 2022, a total of 323,745 PTB cases were notified in Zhejiang Province. Overall, the notification rate declined, with notable turning points in 2010 and 2019. Net drift analysis revealed an average annual decrease of 5.7% (95% CI: -6.8%, -4.6%; P Conclusions Notification rates of PTB declined consistently across various age groups in Zhejiang Province. Young individuals aged 15-29 and older individuals aged 65-74 were identified as high-risk groups requiring active intervention. Additionally, pre-1978 birth cohorts had a relatively higher risk of PTB. These findings provided valuable insights into the age, period, and birth cohort characteristics of patients with PTB in Zhejiang Province, aiding relevant authorities in formulating appropriate policies and implementing targeted preventive control measures.