Temporal Trends in Tuberculosis Prevalence and Burden in Iran, 1992–2022: A 30-Year Analysis
Background: Tuberculosis (TB) remains one of the most significant public health challenges, and monitoring its long-term trends is essential for evaluating the effectiveness of disease control programs. This study aimed to assess the 30-year trend of TB prevalence and disease burden in Iran from 1994 to 2023. Methods: This ecological descriptive study was conducted using data from the Global Burden of Disease study. Indicators of TB prevalence and disability-adjusted life years (DALYs) in Iran, the Eastern Mediterranean Region, and globally were extracted and analyzed as age-standardized rates per 100,000 population. Temporal trends were assessed using the Joinpoint regression model and the average annual percent change (AAPC), with a significance level set at 0.05. Results: The findings indicated a decreasing trend in both DALYs and TB prevalence, with AAPCs of −4.50 and −0.39, respectively (P <0.001). In subgroups, both DALYs and prevalence of drug-susceptible TB showed declining trends, whereas multidrug-resistant TB and extensively drug-resistant TB demonstrated increasing trends (P <0.001). Conclusion: Although the overall burden of TB in Iran has declined over the past three decades, the rising trend of drug-resistant forms highlights the continued need for strengthened early detection, surveillance of drug resistance, and targeted treatment strategies.