Temporal trends in tuberculosis incidence among the aging population in Southwest China: a retrospective study

Chongqing bears a substantial burden of tuberculosis, particularly among the elderly population. This study aimed to explore the epidemiological trends of pulmonary tuberculosis (PTB) among the elderly, In light of the ageing population, thereby providing a basis for the targeted prevention and control strategies for PTB in the elderly. All notified PTB cases aged ≥ 65 years from Chongqing from 2013 to 2023 were analyzed. The Joinpoint regression model was employed to identify significant trend changes. Construct the SARIMA model and Holt-Winters exponential smoothing model, compare their forecasting performance, and select the optimal model to forecast the case burden for 2024 and 2025. From 2013 to 2023, a total of 57,140 cases were reported. Despite an overall declining trend in the incidence of PTB (APC = -5.47, 95% CI: -8.18 to -2.68), the incidence among the elderly remained stable. Notably, while elderly males exhibited a higher incidence, their declining trend did not reach statistical significance. Regionally, the Southeast Region showed the most significant decline in PTB incidence (2019–2023, APC = -14.94, 95% CI: -23.63 to -5.26), albeit with the highest incidence rate. Furthermore, there was a remarkable increase in the bacteriological confirmed elderly patients, with an APC of 11.54 (95% CI: 6.83 to 16.45). The SARIMA model outperformed the Holt-Winters exponential smoothing model in terms of predictive performance (MAPE: 8.33 vs. 21.45), forecasting a burden of 5783 elderly PTB cases for 2024 (95% CI: 4319 ~ 7249) and 5864 cases (95% CI: 4141 ~ 7585) for 2025. Between 2013 and 2023, the reported incidence of PTB among the elderly in Chongqing remained at a relatively high level. Comprehensive measures, including active screening for case detection, standardized diagnosis and treatment, and management, should be implemented among high-risk populations such as males and those in the Southeast Region. Furthermore, adequate attention should be paid to the continuously increasing number of pathogen-positive patients observed in recent years.