Abstract
Background: 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 during a long time period.
Study design: A registry-based cross-sectional study.
Methods: In this study we examined the trend of ten TB indicators separately for 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 3+ smears; treatment success rate; and TB diagnosis rate by the private sector in Hamadan province during the 2011-2022-time period. The trend analysis of TB was conducted using Joinpoint regression model which outputs the Annual Percentage Change (APC) and the Average Annual Percentage Change (AAPC).
Results: A total of 481 females and 554 males were eligible for analysis. The incidence of smear-positive pulmonary TB in females showed a decreasing trend (AAPC: -7.72; 95% CI: -15.63, -1.10; P=0.008). The rates of extra-pulmonary tuberculosis and treatment success showed a significant downward trend for 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).
Conclusion: The findings of this study suggest that the epidemiological profile of tuberculosis has exhibited a relatively favorable trend in several of the examined indicators since 2011, with observed declines in both smear-positive pulmonary tuberculosis and extra-pulmonary tuberculosis.