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 agestandardized 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.