# Impact of Social Determinants of Health on the Incidence of Tuberculosis in Central Asia

## TL;DR

This paper examines how social factors like poverty and healthcare access affect tuberculosis rates in Central Asia from 2000 to 2030.

## Contribution

The study identifies specific social determinants influencing TB incidence and forecasts future trends in Central Asian countries.

## Key findings

- TB incidence generally declined in Central Asia from 2000–2023, but with country-specific variations.
- Anemia, undernourishment, and population density were positively linked to TB incidence.
- Clean fuel access, physician density, and GDP per capita were inversely related to TB incidence.

## Abstract

Background/Objectives: Tuberculosis (TB) remains a major global health challenge influenced by social determinants of health (SDHs) such as poverty, overcrowding, malnutrition, and limited healthcare access. Although Central Asia (CA) has achieved progress through vaccination, screening, and treatment, the region continues to face severe disease consequences, unstable incidence patterns, and an escalating challenge of TB resistant to first-line drugs. This study aimed to analyze TB incidence dynamics in Kazakhstan, Tajikistan, the Kyrgyz Republic, Turkmenistan, and Uzbekistan from 2000–2023, forecast trends to 2030, and identify key SDHs shaping the epidemic. Methods: Data on TB incidence were obtained from the World Bank DataBank for 2000–2023. Of 61 socioeconomic, environmental, and health-related indicators, 29 were included in the analysis. Statistical procedures in SPSS (v24.0) involved time-series forecasting through 2030, calculation of average annual percentage change (AAPC), correlation testing, and linear regression, with significance set at p < 0.05. Results: TB incidence generally declined across CA during 2000–2023, though trends varied by country. Forecasts suggest continued decreases in Turkmenistan and Uzbekistan, while Kazakhstan, Tajikistan, and the Kyrgyz Republic display fluctuating or nonsignificant patterns, likely influenced by SDHs. Regression analyses indicated that anemia, undernourishment, and population density showed a positive relationship with TB incidence, while clean fuel access, physician density, and Gross Domestic Product per capita (GDP) were inversely related. Conclusions: The findings highlight the heterogeneous nature of TB dynamics in CA and the possible role of SDHs. Enhanced surveillance, nutritional and social interventions are required to sustain progress toward End TB targets.