Trends and annual percentage changes in tuberculosis mortality estimated by Joinpoint regression and age-period-cohort analyses, Taiwan, 1978–2022

Tuberculosis (TB) was a public health problem in the past and remained a threat worldwide, including in Taiwan. We aimed to estimate annual percentage changes (APC) in TB mortality and the age-period-cohort effects on TB mortality. Taiwan TB mortality data from 1978 to 2022 was used to estimate the APC through the Joinpoint regression analysis and age-period-cohort models. Crude and age-standardized mortality rates (ASMR) reduced from 23.46 to 3.02 and 41.70 to 1.59 per 100,000 population in males, while 8.84 to 1.09 and 14.58 to 0.45, respectively, in females. During the COVID-19 pandemic, the crude rates still significantly declined in males from 2020 to 2022 but not in females. APC in ASMR significantly decreased in males and females (-7.17% and -7.64%), while after adjusted age-period-cohort effects, the estimated APC were -8.83% and -9.77%. Age-period-cohort effects were observed, with the highest peaks in the youngest (aged 0-4) and the period 1978-1982 in both sexes and peaks in the male cohort 1898-1902 and female cohort 1903- 1907. TB mortality in Taiwan has declined in all ages, sexes, periods, and cohorts. However, the COVID-19 pandemic stopped TB mortality from decreasing.