Global, regional and national burden of rheumatoid arthritis 1990–2017: a systematic analysis of the Global Burden of Disease study 2017

Global Disease Burden From Acute Glomerulonephritis 1990–2019

Acne vulgaris is a common skin condition affecting adolescents and young adults worldwide, yet data on the burden and trends of this disease remain limited. We aimed to investigate trends in the burden of acne vulgaris among adolescents and young adults aged 10-24 years at global, regional and national levels. We retrieved data from the Global Burden of Disease Study 2021 for individuals aged 10-24 years in 204 countries and territories from 1990 to 2021. We analysed the numbers, age-standardized rates and average annual percentage changes (AAPCs) of the prevalence, incidence and disability-adjusted life years (DALYs) for acne vulgaris at the global, regional and national levels. Additionally, we examined these global trends by age, sex and Sociodemographic Index (SDI). Globally, the age-standardized prevalence rate of acne vulgaris among adolescents and young adults increased from 8563.4 per 100 000 population [95% uncertainty interval (UI) 7343.5-9920.1] in 1990 to 9790.5 (95% UI 8420.9-11 287.2) per 100 000 population in 2021, with an AAPC of 0.43 [95% confidence interval (CI) 0.41-0.46]. The age-standardized incidence rate and age-standardized DALY rate also showed a similar upward trend. Regionally, Western Europe had the highest age-standardized prevalence, incidence and DALY rates, while North Africa and the Middle East had the largest increase in these rates. By SDI quintile, the high SDI region had the highest age-standardized prevalence, incidence and DALY rates from 1990 to 2021, whereas the low-middle SDI region had the lowest burden of acne vulgaris but experienced the most significant increase in these rates. Globally, the age-standardized prevalence rate of acne vulgaris in 2021 was approximately 25% higher in young women than in young men (10 911.8 per 100 000 population vs. 8727.8 per 100 000 population). Among all age groups, adolescents aged 15-19 years had the highest age-specific prevalence rate, while adolescents aged 10-14 years experienced the largest increase from 1990 to 2021 (AAPC 0.50, 95% CI 0.48-0.52). The burden of acne vulgaris among adolescents and young adults has continued to increase in nearly all countries since the 1990s. Managing this condition remains a significant challenge, necessitating more effective and targeted interventions to control the acne burden.

Analysis of global prevalence, DALY and trends of inflammatory bowel disease and their correlations with sociodemographic index: Data from 1990 to 2019

Objective: To assess the trends in the burden of periodontal disease among individuals aged 60 years and above in China from 1990 to 2021, thereby providing a scientific foundation for the development of targeted prevention and control strategies for periodontal disease in the elderly. Methods: Utilizing data from the Global Burden of Disease Study 2021 (GBD 2021), key indicators including incidence, prevalence, and disability-adjusted life years (DALY) rates were analyzed. Age-standardized rates were determined using the global standard population. Trends in the disease burden of periodontal disease among the elderly population in China from 1990 to 2021 were analyzed using Joinpoint regression analysis, and an autoregressive integrated moving average (ARIMA) model was applied to forecast the disease burden from 2022 to 2036. Results: The annual average percentage changes (AAPC) in the number of incident cases, prevalent cases, and DALYs due to periodontal disease among individuals aged 60 years and above in China from 1990 to 2021 were 3.215% (95%CI: 3.149%-3.281%, P<0.05), 3.161% (95%CI:3.037%-3.286%, P<0.05), and 3.091%(95%CI:2.887%-3.296%, P<0.05), respectively. The results indicated that the average annual change trends of the number of incident cases, number of prevalent cases, and number of DALYs were real upward trends. Compared with other age groups, the number of incident cases, prevalent cases, and DALYs were the highest among the population aged 60-69 years. The AAPC for age-standardized incidence rate, prevalence, and DALY rates were -0.012 (95%CI:-0.031%-0.008%, P>0.05), 0.023% (95%CI:-0.070%-0.116%, P>0.05), and 0.013% (95%CI:-0.089%-0.115%, P>0.05), respectively. This indicated that the average annual change trends of the age-standardized incidence rate, age-standardized prevalence rate, and age-standardized DALY rate might be caused by random fluctuations. Males exhibited higher prevalence and DALY rates than females across all age groups (P<0.05), whereas the incidence rates showed minimal differences between males and females across all age groups. The ARIMA forecast model indicated that the age-standardized incidence rate among males in the elderly population in China was relatively stable, while that among females showed a downward trend; the age-standardized prevalence and DALY rates followed a pattern of "decline-rise-decline". Conclusions: The disease burden of periodontal disease among Chinese adults aged 60 and above showed an overall upward trend from 1990 to 2021, with males and individuals aged 60-69 identified as high-risk groups. With the exacerbation of aging, the prevention and control situation remains severe, necessitating the implementation of gender-differentiated interventions to reduce the disease burden.

BackgroundMigraine is a common neurological disorder that has become an increasingly significant public health issue. This study aims to analyze the burden of migraine in China and globally from 1990 to 2021, exploring epidemiological trends and differences, thus providing scientific evidence for migraine prevention and control.MethodsBased on the 2021 Global Burden of Disease (GBD) study, we assessed migraine burden in China and globally from 1990 to 2021 using indicators including incidence, prevalence, disability-adjusted life years (DALYs), and age-standardized rates. The epidemiological trends were analyzed by calculating the estimated annual percentage change (EAPC). Health inequality analysis was conducted to explore the association between migraine burden and the sociodemographic index (SDI). Decomposition analysis quantified contributions of age structure, population growth, and epidemiological changes to migraine burden. Additionally, the Bayesian Age-Period-Cohort (BAPC) model was applied to predict migraine burden in China and globally over the next 10 years.ResultsCompared with 1990, the number of migraine cases, prevalence, and DALYs in both China and globally significantly increased by 2021, though the global growth rate was considerably higher. Between 1990 and 2021, China experienced greater increases in age-standardized incidence rates (ASIR), age-standardized prevalence rates (ASPR), and age-standardized DALYs rates (ASDR) than the global average. Migraine burden was predominantly concentrated among adolescents and young adults, and females consistently exhibited a higher burden than males. Health inequality analysis revealed increasing disparity across 204 countries and regions, with a concentrated migraine burden in high socio-demographic index (SDI) countries, positively correlated with SDI. Decomposition analysis indicated that population growth was the primary driver of migraine burden changes in both China and globally. BAPC modeling predicted that the age-standardized incidence, prevalence, and DALY rates for migraine will continue to rise in China, whereas these rates are expected to slightly decline globally.ConclusionsMigraine burden is rising in both China and globally, driven by multiple factors such as age, gender, population growth, and SDI. There is an urgent need for precise interventions to reduce migraine's public health impact.

We recently read the article by Shin YH et al., utilizing the Global Burden of Disease Study (GBD) 2019 to analyze the trends in the global burden of asthma and atopic dermatitis (AD) from 1990 to 2021 [1]. This study found that while the total number of cases has been increasing, the age-standardized prevalence rates have been declining. Given that the GBD has been updated to the 2021 version [2], it is essential to uncover the latest burden of asthma and AD. Therefore, we analyzed the prevalence, incidence, mortality, and disability-adjusted life years (DALYs) for asthma and AD, focusing exclusively on the data from 2021. Specifically, we conducted a cross-sectional analysis of the age-, sex-, and socio-demographic index (SDI)-specific burden, which is crucial for understanding the burden and informing strategies for prevention, control, and treatment. It is important to note that the GBD does not provide mortality data for AD. Consequently, our analysis and the presented figures do not include mortality data for this condition. In 2021, the highest age-standardized prevalence (ASP) and age-standardized incidence rate (ASIR) for asthma were observed in the High-income North America region, whereas the highest age-standardized mortality rate (ASMR) and age-standardized disability-adjusted life years (DALY) rate (ASDR) were reported in the Oceania region. For AD, the highest ASP, ASIR, and ASDR were all recorded in the High-income Asia Pacific region (Figure 1; Figure S1). In terms of age distribution, the ASP and ASIR of asthma are primarily concentrated in children and adolescents, whereas the ASMR and ASDR are predominantly observed in the elderly population. In contrast, the disease burden of AD is mainly concentrated in children and adolescents (Figure 2). Regarding gender differences, no significant disparities are observed in the burden of asthma between males and females. However, the burden of AD is notably higher in females compared with males, which may be attributed to multifaceted etiology, encompassing culturally idealized expectations of appearance for females, hormonal influences such as the impact of sex hormones on immune responses and skin barrier function and genetic predispositions with a spotlight on filaggrin gene mutations (Figure 2) [3-5]. When stratified by SDI, the ASP and ASIR of asthma are significantly higher in high-SDI regions than in low-SDI regions, whereas the ASMR and ASDR of asthma are markedly higher in low-SDI regions than in high-SDI regions, which is due to limited access to and affordability of essential asthma treatment medications, leading to severe morbidity [6]. On the contrary, the disease burden of AD is predominantly concentrated in high-SDI regions (Figure S2). Overall, our study underscores the heterogeneity in the burden of asthma and AD across different age groups, genders, and socio-demographic regions. Addressing these disparities requires targeted strategies that consider the specific drivers of burden in each context. For asthma, this should include improving access to preventive care and treatment in lower-income regions, while for AD, interventions aimed at early childhood may be most effective. Additionally, to effectively manage AD, key interventions include regular moisturization to maintain skin hydration and the use of emollients to repair the skin barrier. It is also crucial to avoid irritants and allergens, modify bathing practices by using lukewarm water and gentle, fragrance-free cleansers, and consider environmental controls such as maintaining optimal indoor humidity levels to prevent skin dryness and irritation. Our findings highlight the importance of context-specific interventions and underscore the need for continued monitoring and research to effectively reduce the burden of these common allergic diseases. We appreciate the excellent works by the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 collaborators. The authors have nothing to report. The authors have nothing to report. The authors declare no conflicts of interest. Data sources and code used in the Global Burden of Disease Study 2021 are available on the internet (http://ghdx.healthdata.org/gbd-results-tool). The data presented is unpublished elsewhere and are not duplicated. Figure S1. Age-standardized rates of prevalence, incidence, mortality and DALYs of asthma and atopic dermatitis in 2021 in 21 GBD regions. Error bars indicate the 95% uncertainty interval for age-standardized rates. Abbreviations: Age-standardized prevalence (ASP); Age-standardized incidence rate (ASIR); Age-standardized mortality rate (ASMR); Age-standardized disability-adjusted life years (DALY) rate (ASDR). Figure S2. Age-standardized rates of prevalence, incidence, mortality and DALYs of asthma and atopic dermatitis in 2021 in five SDI regions. Error bars indicate the 95% uncertainty interval for age-standardized rates. Abbreviations: Age-standardized prevalence (ASP); Age-standardized incidence rate (ASIR); Age-standardized mortality rate (ASMR); Age-standardized disability-adjusted life years (DALY) rate (ASDR). Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.

Global burden and risk factors of musculoskeletal disorders among adolescents and young adults in 204 countries and territories, 1990–2019

To investigate the global burden of visceral leishmaniasis (VL) from 1990 to 2021 and predict the trends in the burden of VL from 2022 to 2035, so as to provide insights into global VL prevention and control. The global age-standardized incidence, prevalence, mortality and disability-adjusted life years (DALYs) rates of VL and their 95% uncertainty intervals (UI) were captured from the Global Burden of Disease Study 2021 (GBD 2021) data resources. The trends in the global burden of VL were evaluated with average annual percent change (AAPC) and 95% confidence interval (CI) from 1990 to 2021, and gender-, age-, country-, geographical area- and socio-demographic index (SDI)-stratified burdens of VL were analyzed. The trends in the global burden of VL were projected with a Bayesian age-period-cohort (BAPC) model from 2022 to 2035, and the associations of age-standardized incidence, prevalence, mortality, and DALYs rates of VL with SDI levels were examined with a smoothing spline model. The global age-standardized incidence [AAPC = -0.25%, 95% CI: (-0.25%, -0.24%)], prevalence [AAPC = -0.06%, 95% CI: (-0.06%, -0.06%)], mortality [AAPC = -0.25%, 95% CI: (-0.25%, -0.24%)] and DALYs rates of VL [AAPC = -2.38%, 95% CI: (-2.44%, -2.33%)] all appeared a tendency towards a decline from 1990 to 2021, and the highest age-standardized incidence [2.55/105, 95% UI: (1.49/105, 4.07/105)], prevalence [0.64/105, 95% UI: (0.37/105, 1.02/105)], mortality [0.51/105, 95% UI: (0, 1.80/105)] and DALYs rates of VL [33.81/105, 95% UI: (0.06/105, 124.09/105)] were seen in tropical Latin America in 2021. The global age-standardized incidence and prevalence of VL were both higher among men [0.57/105, 95% UI: (0.45/105, 0.72/105); 0.14/105, 95% UI: (0.11/105, 0.18/105)] than among women [0.27/105, 95% UI: (0.21/105, 0.33/105); 0.06/105, 95% UI: (0.05/105, 0.08/105)], and the highest mortality of VL was found among children under 5 years of age [0.24/105, 95% UI: (0.08/105, 0.66/105)]. The age-standardized incidence (r = -0.483, P < 0.001), prevalence (r = -0.483, P < 0.001), mortality (r = -0.511, P < 0.001) and DALYs rates of VL (r = -0.514, P < 0.001) correlated negatively with SDI levels from 1990 to 2021. In addition, the global burden of VL was projected with the BAPC model to appear a tendency towards a decline from 2022 to 2035, and the age-standardized incidence, prevalence, mortality and DALYs rates were projected to be reduced to 0.11/105, 0.03/105, 0.02/105 and 1.44/105 in 2035, respectively. Although the global burden of VL appeared an overall tendency towards a decline from 1990 to 2021, the burden of VL showed a tendency towards a rise in Central Asia and western sub-Saharan African areas. The age-standardized incidence and prevalence rates of VL were relatively higher among men, and the age-standardized mortality of VL was relatively higher among children under 5 years of age. The global burden of VL was projected to continue to decline from 2022 to 2035.

Global Pediatric Epilepsy Burden: Analysis of the Global Burden of Disease Database (1990-2021) With Projections to 2035.

ObjectiveTo determine the patterns and trends in the global, regional, and national burden of oral disorders among adolescents and young adults (AYA) from 1990 to 2021.MethodsThis is an epidemiological observational study that analyzed annual prevalence and disability-adjusted life years (DALYs) for oral disorders—including dental caries, periodontal disease, edentulism, and other oral conditions—among adolescents and young adults (ages 10–24) from 1990 to 2021. Data were sourced from the Global Burden of Disease Study (GBD) 2021. To assess temporal trends, the estimated annual percentage changes (EAPC) in age-standardized prevalence and DALY rates were calculated at global, regional, and national levels. The GBD 2021 also provides sociodemographic index (SDI) data across 204 countries and territories. Pearson correlation analyses were conducted to explore the relationships between age-standardized prevalence and DALY rates with the SDI and their respective EAPCs.ResultsGlobally, the prevalent cases of oral disorders increased by 17.1%, from 549.2 million in 1990 to 643.3 million in 2021, and DALYs rose by 22.2%, from 1.4 million in 1990 to 1.7 million in 2021. The overall age-standardized prevalence rate (EAPC = − 0.07 [95% CI, − 0.12 to − 0.03]) decreased, while the age-standardized DALY rate (EAPC = 0.06 [0.02 to 0.11]) increased over the same period. While the burden of dental caries declined, the burden of periodontitis and edentulism significantly increased. A negative correlation was observed between age-standardized prevalence and DALY rates and SDI, while a positive correlation was found between the EAPC of age-standardized DALY rates and SDI.ConclusionsThe prevalence and DALYs of oral disorders among AYA have risen over the past three decades, particularly due to the growing burden of periodontitis and edentulism. Notably, the most significant increases have been observed in Southern Latin America and South Asia. While the global decline in dental caries has led to a reduction in ASPR, the escalating burden of periodontal disease and edentulism remains a critical concern. These trends emphasize the urgent need for innovative prevention and intervention strategies to improve oral health for this demographic worldwide.

Dysthymia and major depression disorder impair the wellbeing of older adults, their families, and communities. Understanding its global disease burden and trends in older adults over 60 is fundamental for policy making. Therefore, we obtained data from Global Burden of Diseases Study 2021 in 204 countries and territories from 1990 to 2021. We calculated the age-standardized prevalence, incidence, disability-adjusted life years (DALYs) rates, and estimated annual percentage change by age, sex, and socio-demographic index (SDI) to assess burden and quantify the temporal trends. We then used spearman correlation analysis to examine the relationship between age-standardized rates and SDI, and adopted a Bayesian age-period-cohort model to predict trends to 2030. In 2021, there were over 67.6million cases of dysthymia and major depression disorder in older adults globally, with an age-standardized prevalence rate of 6203.2 per 100,000 (95% Uncertainty Interval: 5128.4-7464.5). Age-standardized prevalence, incidence, and DALY rates increased in high-income Asia Pacific and East Asia. Disease burden negatively correlated with SDI levels. A heavier burden was observed in older females consistently across all regions and age groups. Disease burden in older adults peaked at age 60-64 and declined with aging in most but low SDI regions, where an increasement preceded the decline. By 2030, the age-standardized prevalence, incidence, and DALY rates are predicted to increase globally, with a higher projected burden in older females. In conclusion, the allocation of health resources should focus on addressing regional disparities, with special attention to vulnerable groups such as older females in economically disadvantaged regions.

To comprehensively assess the global burden of syphilis and related risk factors over 1990-2021, forecast future disease trends, and understand the impact of syphilis on global health. Global Burden of Disease Study 2021 (GBD 2021) data were used for age-, sex-, and region-stratified analysis of the numbers and age-standardized rates (per 100,000 population) of syphilis incidence, prevalence, deaths, and disability-adjusted life years (DALYs). Next, a differential analysis of syphilis risk factors was performed. Finally, trends for years after 2021 were predicted using Bayesian age-period-cohort (BAPC) prediction models. In 2021, the total number of syphilis prevalence globally was 70,541,482.80 (95% uncertainty interval: 54,910,897.66-88,207,651.97), with the highest numbers noted in Central Sub-Saharan Africa [4,622.60 (95% uncertainty interval: 3,591.97-5,753.45)]. Over 1990-2021, the global age-standardized prevalence and incidence rates increased, whereas the age-standardized death and DALY rates decreased. Among all groups, infants aged <5 years demonstrated the highest age-standardized DALY rates. Moreover, the lower the sociodemographic index (SDI), the higher was the age-standardized rate. The primary factor contributing to syphilis disease burden was identified to be unsafe sex. BAPC analysis revealed an overall increase in age-standardized prevalence rate in the <5-year age group over 1990-2035, and the highest age-standardized prevalence rate occurred in the 25-34-year age group. Between 1990 and 2021, syphilis occurrence and prevalence increased consistently. Projections indicated a continual increase in syphilis incidence in children aged <5 years, and age-standardized prevalence rates were the highest in adults aged 25-34 years. Our results regarding the epidemiological trends of syphilis and its variations across regions, age groups, and sexes may aid policymakers in addressing the global impact of the disease effectively.

FRI0552 GLOBAL, REGIONAL, AND NATIONAL BURDEN OF LOW BACK PAIN, 1990-2019: A SYSTEMATIC ANALYSIS FOR THE GLOBAL BURDEN OF DISEASE STUDY 2019

BackgroundBy analyzing past disease trends and comparing two time series statistical models, we can predict the global burden of gastrointestinal ulcers in specific populations of adolescents and young adults aged 10–24. This prediction can provide important references for optimizing prevention and control strategies in healthcare systems.MethodsWe collected data on prevalence, incidence, disability-adjusted life years (DALYs), and mortality for specific age groups between 10 and 24 years from 1990 to 2019. The data were then stratified by age, gender, and economic development level. We applied decomposition analysis and frontier analysis, and compared the performance of two statistical prediction models. We used the best-performing model to predict changes in each indicator.ResultsIn 2019, there were 958,842 (95% uncertainty interval [UI]: 639,698–1,371,106) prevalent cases, 407,850 (95% UI: 260,513–577,751) incident cases, 363,862 (95% UI: 309,793–422,230) DALY cases, and 4,404 (95% UI: 3,826–5,042) deaths globally, all showing an increasing trend compared to 1990. However, the age-standardized prevalence rate (ASPR), age-standardized incidence rate (ASIR), age-standardized DALY rate (ASDR), and age-standardized death rate (ASDER) all decreased from 1990 to 2019, with reductions of 6.6, 3.8, 50.86, and 53.8%, respectively. The estimated annual percentage change (EAPC) for these metrics was −0.59 (95% confidence interval [CI]: −0.73 to −0.46), −0.41 (95% CI: −0.51 to −0.31), −2.81 (95% CI: −2.96 to −2.66), and −3.1 (95% CI: −3.28 to −2.92), respectively. The ARIMA model, identified as the most accurate prediction model, suggests that by 2050, the burden of gastrointestinal ulcers in this age group will significantly decrease compared to 2019. Over the next 30 years, the global number of incident cases will initially rise before stabilizing, prevalent cases will fluctuate, and both DALYs and deaths will decline. ASPR, ASIR, ASDR, and ASDER will continue to decrease, with the most notable reductions in ASDR and ASDER.ConclusionIn 2019, the global burden of gastrointestinal ulcers showed significant increases in prevalent and incident cases, DALYs, and deaths compared to 1990. However, when adjusted for age, the prevalence rate (ASPR), incidence rate (ASIR), DALY rate (ASDR), and death rate (ASDER) all demonstrated substantial reductions, indicating improvements in management and prevention. The ARIMA model, identified as the most accurate, projects a significant decline in the burden of gastrointestinal ulcers for this age group by 2050, compared to 2019. While the raw numbers of cases and mortality have risen, age-standardized rates have decreased, reflecting advancements in healthcare strategies. These findings emphasize the need for continued focus on preventive measures and healthcare optimization to further reduce the global burden of gastrointestinal ulcers. The projected decline highlights the potential effectiveness of current strategies and offers a positive outlook for future management.

BackgroundVector-borne parasitic infectious diseases associated with poverty (referred to as vb-pIDP), such as malaria, leishmaniasis, lymphatic filariasis, African trypanosomiasis, Chagas disease, and onchocerciasis, are highly prevalent in many regions around the world. This study aims to characterize the recent burdens of and changes in these vb-pIDP globally and provide a comprehensive and up-to-date analysis of geographical and temporal trends.MethodsData on the prevalence and disability-adjusted life years (DALYs) of the vb-pIDP were retrieved from the Global Burden of Disease, Injuries, and Risk Factors Study (GBD) 2021 for 21 geographical regions and 204 countries worldwide, from 1990–2021. The age-standardized prevalence rate and DALYs rate by age, sex, and sociodemographic index (SDI) were calculated to quantify temporal trends. Correlation analysis was performed to examine the relationship between the age-standardized rate and the SDI.ResultsOver the past 30 years, the age-standardized prevalence rate and DALYs rate of these vb-pIDP have generally decreased, with some fluctuations. The distribution of vb-pIDP globally is highly distinctive. Except for Chagas disease, the age-standardized prevalence rate and DALYs rate of other vb-pIDP were highest in low-SDI regions by 2021. Malaria had the highest age-standardized prevalence rate (2336.8 per 100,000 population, 95% UI: 2122.9, 2612.2 per 100,000 population) and age-standardized DALYs rate (806.0 per 100,000 population, 95% UI: 318.9, 1570.2 per 100,000 population) among these six vb-pIDP globally. Moreover, significant declines in the age-standardized prevalence rate and DALYs rate have been observed in association with an increase in the SDI . Globally, 0.14% of DALYs related to malaria are attributed to child underweight, and 0.08% of DALYs related to malaria are attributed to child stunting.ConclusionsThe age-standardized prevalence rate and DALY rates for the vb-pIDP showed pronounced decreasing trends from 1990–2021. However, the vb-pIDP burden remains a substantial challenge for vector-borne infectious disease control globally and requires effective control strategies and healthcare systems. The findings provide scientific evidence for designing targeted health interventions and contribute to improving the prevention and control of infectious diseases.Graphical