Publication date: Jun 19, 2026
Multidrug- and rifampicin-resistant tuberculosis (MDR/RR-TB) in older individuals remains a significant public health challenge in China. This study evaluated the epidemiological characteristics and spatiotemporal patterns of MDR/RR-TB in individuals aged ≥65 years in China between 2019 and 2025. Data were obtained from the China Information System for Disease Control and Prevention (CISDCP). Spatiotemporal distribution and demographic characteristics of MDR/RR-TB cases in China were analyzed using descriptive epidemiological methods. Global Moran’s I and local indicators of spatial association were employed to assess spatial clustering, and spatiotemporal scanning was performed using the SaTScan software to detect high-risk clusters. From 2019 to 2025, 21,569 patients with MDR/RR-TB aged ≥65 years were registered across 31 provincial-level administrative divisions nationwide [1. 72% of all pulmonary tuberculosis (PTB) in older patients]. The notification rate of MDR/RR TB among older people declined in 2022 and then rebounded in 2025. The proportion of MDR/RR-TB among older patients with PTB increased. The patients were predominantly male (73. 3%) in the 65-69-year age group. Of the cases, 46. 0% were retreated, and 83. 3% underwent molecular diagnostic testing. Heilongjiang and Gansu were persistent high-high cluster areas, whereas Xinjiang presented the highest risk. Spatiotemporal scanning identified significant clusters in Xinjiang, the three northeastern provinces, Chongqing-Guizhou, and Ningxia-Shaanxi-Gansu. The proportion of MDR/RR-TB among older patients with PTB in China increased significantly. The clusters were mainly located in the central-western and northeastern regions. We recommend strengthening drug resistance surveillance, expanding molecular testing coverage in high-risk areas, and optimizing treatment strategies for retreated patients.
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| Concepts | Keywords |
|---|---|
| elderly | |
| epidemiological characteristics | |
| rifampicin-resistant tuberculosis | |
| spatiotemporal cluster analysis |
Semantics
| Type | Source | Name |
|---|---|---|
| drug | DRUGBANK | Rifampicin |
| disease | MESH | Tuberculosis |
| pathway | KEGG | Tuberculosis |
| disease | MESH | pulmonary tuberculosis |