Tuberculosis mortality trends in Taiwan: A resurgence of non-respiratory tuberculosis

SETTING: Population-based study in Taiwan. OBJECTIVE: To determine the tuberculosis (TB) mortality trends in Taiwan by site and age. DESIGN: Mortality data for the years 1972 to 2001 were used to calculate the age/site-specific mortality rate (deaths per 100 000 population). The year of change in the slope of mortality trends was estimated by iterative piecewise regression analysis. RESULTS: A levelling off in mortality trends was noted in the late 1980s for all age groups except those aged 75 and above. Except in the age group 25-44 years, the trends in respiratory TB mortality showed a smooth decline. However, for non-respiratory TB mortality, a reversal of the decline was noted for all age groups since 1994-1995. A twofold increase in the number of deaths from central nervous system (CNS) and 'other' TB was noted. A marked increase in the number of deaths from old TB was noted since 1992-1996. CONCLUSION: TB mortality trends in Taiwan have not declined as expected over the past decade. The slowing down of the decline in TB mortality was mainly attributable to a levelling off of respiratory TB mortality in the age group 25-44 and a reversal of non-respiratory TB mortality trends, especially in the 25-44 and ≥65 years age groups.