Spatiotemporal patterns and inter-provincial inequalities of pulmonary tuberculosis in China from 2000 to 2024, with projections to 2030

OBJECTIVES: To provide a timely update on the evolving spatiotemporal patterns of pulmonary tuberculosis (PTB) incidence in China, project trends through 2030, and assess interprovincial inequalities nationwide. METHODS: Using data from the China Public Health Science Data Center and the National PTB Surveillance Report, we employed spatiotemporal approaches to examine the evolving patterns in the incidence of PTB, project PTB incidence to 2030 through five models, and evaluated interprovincial inequalities using the Slope of Inequality Index (SII) and the Concentration Index of Inequality (CII). RESULTS: Nationally, the reported PTB incidence counts and rates were 569,081 cases and 40.4 per 100,000 population in 2024, despite a decrease of -0.3% (95% confidence interval [CI]: -0.7%-0.2%) in rate since 2000, and the rate is projected to declined to 37.7 (95% CI: 18.3-57.1) per 100,000 population by 2030. In 2024, Tibet had the largest incidence rate per 100,000 population of 126.2, followed by 87.2 in Guizhou and 79.4 in Qinghai provinces, respectively. Additionally, both absolute and relative inequalities of PTB incidence rate have widened across provinces from 2000 to 2024, with a diverging trajectory by 2030 under status quo scenarios. CONCLUSION: Without additional interventions, the disparities in PTB incidence rates among provinces are likely to further widen by 2030. Targeted resource allocation and differentiated prevention strategies are urgently needed for high-incidence, economically disadvantaged provinces.