Changes in The Trends of Tuberculosis-related Indicators in Hamadan Province Using the Join Point Regression Approach From 2011 to 2022

This study was conducted to investigate the trend of some tuberculosis (TB) indices and identify existing gaps in addressing this important public health issue in Hamadan province over a long time period.

 A registry-based cross-sectional study.

In this study, we examined the trend of 10 TB indicators separately in males and females, including the incidence rates of smear-positive pulmonary TB (SPPT), extra-pulmonary TB (EPT), and smear-negative pulmonary TB (SNPT), co-infection with AIDS, relapse rate, smear conversion rate two months after treatment initiation, TB mortality rate, diagnosis rate of pulmonary TB with a smear grade of 3+, treatment success rate, and TB diagnosis rate by the private sector in Hamadan province during 2011-2022. The trend analysis of TB was conducted using Joinpoint regression model, and the annual percentage change (APC) and the average annual percentage change (AAPC) were calculated.

A total of 481 females and 554 males were eligible for analysis. The incidence of SPPT in females showed a decreasing trend (AAPC: -7.72; 95% CI: -15.63, -1.10; P=0.008). The rates of EPT and treatment success showed a significant downward trend in both genders. In contrast, the recurrence rate among females exhibited a notable upward trend during the specified time period (AAPC: 18.45; 95% CI: 3.23, 46.47; P=0.0002).

The findings of this study suggest that the epidemiological profile of TB has exhibited a relatively favorable trend in some of the examined indicators since 2011, with declines observed in both SPPT and EPT.