Evidence map›Paper›PMID 42237966›Full record

ArticleSaudi medical journal2026

Epidemiological mapping of drug-susceptible and resistant tuberculosis in 30 WHO high-burden countries:

Azfar A Ishaqui, Salman A Ahmad, Shoaib Alam, Narendar Kumar, Javeria Farooq, Khalid Orayj, Rabbiya Ahmad, Mohammed Zawiah, Mustapha Mohammed, Muhammad Imran and 5 more

Abstract read
In one paragraph

Article in Saudi medical journal, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

15 authors.

Azfar A IshaquiDepartment of Clinical Pharmacy, College of Pharmacy, King Khalid University, Abha 61421, Saudi Arabia.ORCID 0000-0003-0688-2625
Salman A AhmadFaculty of Pharmacy, Iqra University, Karachi 75500, Pakistan.ORCID 0000-0002-0866-7040
Shoaib AlamDepartment of Pharmacology, Faculty of Pharmacy & Pharmaceutical Sciences, University of Karachi, Karachi 75270, Pakistan.
Narendar KumarDepartment of Pharmacy Practice, Faculty of Pharmacy, University of Sindh, Jamshoro 76080, Pakistan.
Javeria FarooqDepartment of Pharmacognosy, Faculty of Pharmacy & Pharmaceutical Sciences, University of Karachi, Karachi 75270, Pakistan.
Khalid OrayjDepartment of Clinical Pharmacy, College of Pharmacy, King Khalid University, Abha 61421, Saudi Arabia.
Rabbiya AhmadDepartment of Pharmacy, University of Lahore, Lahore 54000, Pakistan.
Mohammed ZawiahDepartment of Clinical Practice, Faculty of Pharmacy, Northern Border University, Rafha 73213, Saudi Arabia.
Mustapha MohammedBiomedical Research Center, QU Health, Qatar University, Doha 2713, Qatar.
Muhammad ImranFaculty of Pharmacy, Iqra University, Karachi 75500, Pakistan.
Asaad A Asaad KhalilQuality and Performance Administration, Eastern Health Cluster, Ministry of Health, Dammam, Saudi Arabia.
Mohammed A KaddouraClinical Excellence Administration, King Fahad Specialist Hospital, Dammam, Saudi Arabia.
Sultan M AlshahraniDepartment of Clinical Pharmacy, College of Pharmacy, King Khalid University, Abha 61421, Saudi Arabia.
Adnan IqbalDepartment of Pharmacology, Faculty of Pharmacy & Pharmaceutical Sciences, University of Karachi, Karachi 75270, Pakistan.
Muhammad B MaqsoodQuality and Performance Administration, Eastern Health Cluster, Health Holding Company, Dammam, Saudi Arabia.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Objectives: Tuberculosis (TB) continues to drive infectious mortality worldwide. The study characterized the evolution of drug-susceptible TB (DS-TB), multidrug-resistant TB (MDR-TB), and extensively drug-resistant TB (XDR-TB) in 30 WHO high-burden countries, linking current patterns to long-term trends, age structure, and forward-looking scenarios to 2043. Methods: Using GBD 2023 estimates for 1990-2023, we extracted incidence, mortality, and DALYs as age-standardized rates (ASR) per 100,000 with 95% uncertainty intervals. Temporal dynamics were summarized with Estimated Annual Percent Change (EAPC) and extended linearly to 2043. GBD incidence and mortality were compared against WHO national TB series for 2010-2023. Results: Overall TB incidence ASR declined in 28/30 countries between 1990 and 2023, ranging from a 79.2% reduction in Bangladesh to a 24.9% increase in the Philippines. Mortality and DALY ASR decreased in 29/30 countries. DS-TB incidence dropped in 28/30 settings, while MDR-TB incidence rose in 28/30, from -62.5% in China to +23,603% in Kyrgyzstan. The MDR/RR-TB burden shifted toward older adults (≥55 years) in countries such as China (+22 percentage points), whereas youth contributions remained high in Nigeria (~40%). Projections assuming constant EAPC suggest continued DS-TB declines but sustained MDR-TB in Eastern Europe and Central Asia. Conclusion: The MDR-TB remains concentrated and often increasing with limited detectable XDR-TB. Age-tailored interventions, universal drug-susceptibility testing, scale-up of all-oral second-line regimens, and adherence support are critical to reverse resistant-TB trajectories while preserving gains against DS-TB.

Indexed as

TuberculosisTuberculosis, Multidrug-ResistantAntitubercular AgentsDisability-Adjusted Life YearsExtensively Drug-Resistant TuberculosisGlobal HealthHumansIncidenceWorld Health OrganizationAntitubercular AgentsCentral Asiadeveloping countriesdrug-resistant tuberculosisEastern EuropeGlobal Burden of DiseaseTuberculosis

Identifiers

PMID42237966
PMCPMC13227437

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.