Global Trends, Regional Disparities, and the Role of Case Detection in Tuberculosis Mortality

Abstract

Tuberculosis (TB) is a significant health issue in the whole world, as it can be prevented and treated, and there are still regional inequalities, late diagnosis, and differences in case detection that prevent the achievement of effective control. This study examined global trends in TB incidence, mortality, and case detection from 2000 to 2024, assessed regional disparities, and evaluated the association between case detection ratio (CDR) and TB mortality. An ecological longitudinal design was employed using country-level panel data from the World Health Organization global TB database, comprising 5,322 country–year observations across 217 countries. Descriptive statistics, log-linear regression, and correlation analyses were conducted to assess trends and relationships. Findings showed that TB incidence declined by 3.15% annually and mortality by 5.59% annually, while CDR increased by 1.32% per year. High-burden regions, particularly Africa and South-East Asia, exhibited lower detection rates and higher disease burden. A significant inverse association was observed between CDR and TB mortality (r = −0.436; p < 0.001), indicating that improved detection is associated with reduced mortality. Although global TB outcomes have improved, substantial inequalities persist, highlighting the need for strengthened early detection, particularly in high-burden regions. Achieving TB elimination will require integrated, context-specific strategies addressing both health system performance and broader social determinants.