Age-standardized Prevalence Research Articles

The congenital birth defects burden in children younger than 14 years of age, 1990 - 2019: An age-period-cohort analysis of the global burden of disease study.

This study aims to delineate the burden of congenital birth defects (CBDs) in children under 14 years of age from 1990 to 2019, using an age-period-cohort framework to analyse data from the Global Burden of Disease Study (GBD). Data on prevalence cases, age-standardised prevalence rates (ASPRs), death cases, and age-standardised death rates (ASDRs) of congenital birth defects (CBDs) from 1990 to 2019 were obtained from GBD 2019. Using this data set, we conducted an age-period-cohort (APC) analysis to examine patterns and trends in mortality, prevalence, and disability-adjusted life years (DALYs) associated with CBDs, while exploring correlations with age, time periods, and generational birth cohorts. Furthermore, to quantify the temporal trends, we calculated the estimated annual percentage changes (EAPCs) for these parameters. The global prevalence of CBDs decreased from 1404.22 to 1301.66 per 100 000 with an EAPC of -0.18% from 1990 to 2019. CBD mortality decreased by 42.52% between 1990 and 2019, with the global age-standardised death rate declining from 49.72 to 25.58 per 100 000. The age-standardised DALY rate decreased from 4529.16 to 2393.61 per 100 000. Prevalence declined most notably among older children. The risk of CBDs reached its lowest during adolescence (10-14 years) across all regions. The most recent period (2015-2019) showed a reduced risk of prevalence compared to 2000-2004. Earlier birth cohorts displayed declining tendencies followed by slight increases in risk. This study demonstrates encouraging global reductions in the burden of CBDs among children over the past three decades. Prevalence, mortality, and DALYs attributable to CBDs have exhibited downward trajectories, although regional disparities remain. APC analysis provides valuable insights to inform prevention and management strategies for pediatric CBDs.

Opioid analgesics prescribing trends 2010-2019 in Slovenia: National database study.

Significant increases in global opioid use have been reported in recent decades. This study analyzed opioid utilization in outpatient care in Slovenia between 2010 and 2019. This retrospective cross-sectional study performed a nationwide database analysis of all outpatient opioid analgesic prescriptions based on Slovenian health insurance claims data. Prevalence was defined as the number of recipients prescribed at least one opioid per 1000 inhabitants. Opioid consumption was presented as the total number of dispensed prescriptions per 1000 inhabitants and dispensed defined daily doses (DDD) per 1000 inhabitants for each year analyzed. The age-standardized prevalence of opioid recipients decreased by 21.5% during the study period. Total opioid consumption decreased both in the number of prescriptions (-9.2%) and DDD (-5.4%). Tramadol consumption decreased in terms of the number of prescriptions (-12.2%) and DDD (-2.7%), whereas prescriptions for strong opioids increased (10.2%) and DDDs decreased (-16.2%). The results suggest less intensive prescribing of strong opioids and more intensive prescribing for tramadol. The most frequently used strong opioids were fentanyl and oxycodone/naloxone. The prevalence of opioid recipients and opioid consumption is decreasing in Slovenia. Further research is needed to understand whether this finding reflects safe use or underuse of these important analgesics.

Global, regional, and national burdens of interpersonal violence in young women aged 10-24 years from 1990 to 2019: a trend analysis based on the global burden of disease study 2019.

Interpersonal violence (IPV) against young women, including physical and sexual violence, poses a major threat to public health. We analyzed global, regional and national trends in violence against females aged 10-24 years from 1990 to 2019. We extracted age-standardized prevalence rates (ASPRs) of physical violence by firearm (PVF), physical violence by other means (PVOM), physical violence by sharp object (PVSO), and sexual violence (SV) from the Global Burden of Diseases, Injuries, and Risk Factors Study 2019. Joinpoint regression analysis calculated annual and average annual percentage changes (AAPCs) in ASPRs. Globally, the ASPRs of the four measures of IPV decreased between 1990 and 2019, with the steepest declines between 2000 and 2009, except for SV, which increased slightly. However, the ASPRs of PVF and PVOM increased slightly between 2010 and 2019. Regionally, PVF prevalence declined most in East Asia (-0.9505, -1.0011 to -0.8975), South Asia (-0.277, -0.3089 to -0.244) and Latin America but PVOM prevalence increased in Oceania (0.6275, 0.6036 to 0.6498) and SV prevalence increased in Caribbean (0.4267, 0.4069 to 0.4495). Nationally, PVF prevalence decreased most in Thailand (-2.4031, -2.4634 to -2.3328) but increased most in Libya (6.8143, 6.6194 to 7.0113). SV prevalence increased most in Oman (0.4561, 0.4338 to 0.478) and the largest increase in Disability-adjusted life years (DALYs) from PVOM was observed in Botswana (6.2725, 6.0951 to 6.4082). DALYs showed similar trends. While global declines over 30 years are encouraging, IPV against young women persists. Urgent, tailored approaches across sectors are critical to curb drivers of violence against young women, including poverty, inequality and sociocultural attitudes. High-quality data and in-depth analyses can inform locally-relevant solutions. Overall, intensified political will and resource investment are needed to overcome this pervasive human rights violation.

Prevalence of urinary incontinence in middle-aged and elderly adults in 10 areas in China

Objective: To describe the population and area distribution differences in the prevalence of urinary incontinence in middle-aged and elderly adults in 10 areas in China. Methods: A total of 24 913 participants aged 45-95 years who completed the third resurvey of China Kadoorie Biobank during 2020-2021 were included. The prevalence of urinary incontinence was assessed by an interviewer-administered questionnaire, and urinary incontinence was classified as only stress urinary incontinence, only urgency urinary incontinence and mixed urinary incontinence. The prevalence of urinary incontinence and its subtypes were reported by sex, age and area, and the severity of urinary incontinence and treatment were described. Results: The average age of the participants was (65.4±9.1) years. According to the seventh national census data in 2020, the age-standardized prevalence rates of urinary incontinence was 25.4% in women and 7.0% in men. The age-standardized prevalence rates of only stress, only urgency and mixed incontinence were 1.7%, 4.2% and 1.2% in men and 13.5%, 5.8% and 6.1% in women, respectively. The prevalence rates of urinary incontinence and all subtypes in men and the prevalence of urinary incontinence and all subtypes except only stress urinary incontinence in women all increased with age (P<0.001). After adjusting for age, the prevalence of urinary incontinence in both men and women were higher in rural area than in urban area (P<0.001). The treatment rates in men and women with urinary incontinence were 15.4% and 8.5%, respectively. Conclusions: The prevalence of urinary incontinence was high in middle-aged and elderly adults in China, and the prevalence rate was higher in women than in men, but the treatment rate of urinary incontinence was low.

Evolución de la prevalencia de consumo de tabaco en España y sus 17 comunidades autónomas (1987-2020)

Background and objectivesContinuous monitoring of smoking prevalence is essential to understand the evolution of the tobacco epidemic in a population. The objective of this study was to analyze the evolution of smoking prevalence in Spain and its 17 Autonomous Regions (ARs) in population ≥15 years during the period 1987-2020. MethodsTobacco consumption data were derived from the National Health Survey of Spain and the European Health Survey in Spain. A smoker was defined as a person who smoked at the time of the survey. The trend in prevalences by sex in Spain and its ARs was analyzed by applying joinpoint models. Age-standardized prevalences were calculated for Spain by applying the direct method. ResultsIn Spain, the prevalence of consumption decreased 29 percentage points in men and 4.5 in women between 1987-2020. In men, the smoking prevalence decreased in all the ARs and the absolute change varied between −19.5% in the Balearic Islands and −33.9% in Andalusia. In women, the evolution of smoking prevalence differed between ARs. The absolute change varied between −15.4% in Basque Country and 0.5% in Andalusia. ConclusionsThe number of men and women smokers has decreased in Spain between 1987-2020. Different patterns of evolution of the prevalence of consumption are observed among the ARs, especially among women. This reinforces the need for policies adapted to more local contexts and that take into account the gender perspective.

Burden of type 2 diabetes mellitus and its risk factors in North Africa and the Middle East, 1990–2019: findings from the Global Burden of Disease study 2019

BackgroundThe prevalence of Type 2 Diabetes Mellitus (T2DM) in the North Africa and Middle East region is alarmingly high, prompting us to investigate the burden and factors contributing to it through the GBD study. Additionally, there is a lack of knowledge about the epidemiological status of T2DM in this region, so our aim is to provide a comprehensive overview of the burden of T2DM and its associated risk factors.MethodsUsing data from the 2019 Global Burden of Disease Study, we calculated the attributable burden of T2DM for each of the 21 countries in the region for the years 1990 and 2019. This included prevalence, mortality, disability-adjusted life years (DALYs), and risk factors.ResultsBetween 1990 and 2019, there was a significant increase in the age-standardized incidence (79.6%; 95% Uncertainty Interval: 75.0 to 84.5) and prevalence (85.5%; [80.8 to 90.3]) rates of T2DM per 100,000 populations. The age-standardized mortality rate (1.7%; [-10.4 to 14.9]), DALYs (31.2%; [18.3 to 42.2]), and years lived with disability (YLDs) (82.6%; [77.2 to 88.1]) also increased during this period. Modifiable risk factors, such as high body mass index (56.4%; [42.8 to 69.8]), low physical activity (15.5%; [9.0 to 22.8]), and ambient particulate matter pollution (20.9%; [15.2 to 26.2]), were the main contributors to the number of deaths.ConclusionThe burden of T2DM, in terms of mortality, DALYs, and YLDs, continues to rise in the region. The incidence rate of T2DM has increased in many areas. The burden of T2DM attributed to modifiable risk factors continues to grow in most countries. Targeting these modifiable risk factors could effectively reduce the growth and disease burden of T2DM in the region.

Trends in ultra-processed food availability and its association with diet-related non-communicable disease health indicators in the Portuguese population.

Broad variations in dietary and physical activity patterns are part of nutritional transition concept. An additional nutritional transition has as main characteristic the change of consumption of processed foods for ultra-processed foods (UPF). This study aims to evaluate trends of UPF availability in Portuguese population and its association with diet-related non-communicable diseases (NCD) health indicators. This ecological study used data from the Household Budget Surveys conducted by the National Statistics Institute each 5 years within a national representative sample of households. The percentage of UPF was calculated based on the total daily amount of food and beverages available per capita (in grams). Data from the years 1990, 1995, 2000 and 2005 were used, which were retrieved from DAFNE-Anemos Software. NCD age-standardised mortality, prevalence and incidence were obtained from the Global Burden of Disease database, for the years 2000, 2005, 2010 and 2015. Between 1990 and 2005, the UPF availability increased from 3·9 % to 13·8 %. Over the years, almost all food and beverages categories increased the UPF availability contribution, mainly noticeable for milk, sugar, cereal and meat products. Positive correlations were observed between UPF availability and digestive diseases both in prevalence (r = 0·062; P = 0·037) and incidence (r = 0·005; P = 0·010) measures. Neoplasms incidence also showed positive correlation with UPF availability (r = 0·002; P = 0·012). Trends in UPF availability in Portugal increased exponentially. At the same time, there is a trend towards a decrease in unprocessed and processed food availability. The Portuguese population should be made aware of the health risks resulting from excessive consumption of UPF.

Association between Tobacco Industry Interference Index (TIII) and MPOWER measures and adult daily smoking prevalence rate in 30 countries

BackgroundThis study aimed to investigate the impact of tobacco industry interference on the implementation and management of tobacco control and the tobacco epidemic using the Tobacco Industry Interference Index (TIII) and MPOWER—a package of measures for tobacco control—and adult daily smoking prevalence in 30 countries.MethodsThe TIII was extracted from the Global Tobacco Industry Interference Index 2019 and Global Center for Good Governance in Tobacco Control (GGTC). MPOWER measures and adult daily smoking prevalence rate were extracted from the World Health Organization (WHO) report on the global tobacco epidemic in 2021. We assessed the ecological cross-lagged association between TIII and MPOWER scores and between TIII and age-standardized prevalence rates for adult daily tobacco users.ResultsTobacco industry interference was inversely correlated with a country’s package of tobacco control measures (β = -0.088, P = 0.035). The TIII was correlated with weaker warnings about the dangers of tobacco (β = -0.016, P = 0.078) and lack of enforcement of bans on tobacco advertising promotion and sponsorship (β = -0.023, P = 0.026). In turn, the higher the TIII, the higher the age-standardized prevalence of adult daily tobacco smokers for both sexes (β = 0.170, P = 0.036). Adult daily smoking prevalence in males (β = 0.417, P = 0.004) was higher in countries where the tobacco industry received incentives that benefited its business.ConclusionWhere the interference of the tobacco industries was high, national compliance with the Framework Convention on Tobacco Control (FCTC) was lower, and the prevalence of adult daily smokers higher. National governments and global society must work together to minimize the tobacco industry’s efforts to interfere with tobacco control policies.

Analysis and prediction of central nervous system tumor burden in China during 1990-2030.

Central nervous system (CNS) tumors, due to their unique locations, pose a serious threat to human health and present challenges to modern medicine. These tumors exhibit notable epidemiological characteristics across various ethnicities, regions, and age groups. This study investigated the trend of disease burden of CNS tumors in China from 1990-2019 and predicted the incidence and death rate from 2020-2030. Employing data from the 2019 Global Burden of Disease (GBD) database, we utilized key indicators to scrutinize the disease burden associated with CNS tumors in China. The analysis employed the Joinpoint model to track the trend in disease burden, calculating both the annual percentage change (APC) and average annual percentage change (AAPC). Additionally, the Matlab software facilitated the creation of a gray model to forecast the incidence and death rate of CNS tumors in China spanning from 2020 to 2030." In 2019, the age-standardized incidence rate, prevalence rate, death rate, and disability-adjusted life years (DALYs) associated with CNS tumors in China were among the high level in the world. The standardized prevalence rate and DALYs of CNS tumors in China residents showed a stable fluctuation trend with age; however, age-standardized death and incidence rate demonstrated a generally upward trend with age. In China, the age-standardized prevalence and incidence rate of males were lower than those for female residents, while the age-standardized death rate and DALYs among males surpassed those of females. From 1990-2019, the age-standardized prevalence and incidence rate of CNS tumors in China exhibited an increasing trend. The age-standardized death rate and DALYs showed a contrasting trend. According to the gray model's prediction, incidence rate of CNS tumors would continue rising while the death rate is expected to decline in China from 2020-2023. The burden of CNS tumors in China has shown an upward trajectory, posing significant challenges to their treatment. It is necessary to pay attention to tertiary prevention, start from the perspective of high-risk groups and high-risk factors to reduce the burden of disease, and achieve "early detection, early diagnosis, and early treatment".

Global, regional, and national burden of syphilis, 1990-2021 and predictions by Bayesian age-period-cohort analysis: a systematic analysis for the global burden of disease study 2021.

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.

Comparison of a 30-year trend of incidence, prevalence, and DALY due to low back pain in Iran with Low- and High-SDI countries; Based on GBD study 2019 Data.

Low back pain (LBP) represents the leading cause of disability worldwide and is a major economic and welfare problem. This study aimed to report incidence, prevalence, and disability-adjusted life years (DALY) rates of LBP in Iran by gender and different sociodemographic index (SDI) countries from 1990 to 2019. The age-standardized LBP and incidence, prevalence, and DALY were extracted based on the Global Burden of Disease (GBD) 2019 in Iran for males and females, and low- and high-SDI countries during 1990- 2019. GBD 2019 data for LBP in Iran indicate a significant downward trend of incidence and prevalence from 1993 to 2019 in males, females, and both, except during the 1999-2002 period for females. A sharp reduction is seen in LBP incidence and prevalence from 1996 to 1999. Gender is not a determining factor in the LBP prevalence in Iran. Regarding the SDI categories, Iran had the highest incidence rate compared to countries with low- and high SDIs. High-SDI countries had the highest prevalence and DALY compared with Iran and low-SDI countries. The age-standardized incidence and prevalence of LBP in Iran showed a downward trend, from 1993 to 2019, especially from 1996 to 1999. Comparing Iran with low- and high-SDI countries, a heavier incidence of LBP was observed in Iran and heavier prevalence and DALY were seen in high-SDI countries. Therefore, more therapeutic healthcare interventions are required to reduce the LBP burden more effectively.

Global, regional, and national burden of upper respiratory infections, 1990–2021: Findings from the Global Burden of Disease study 2021

BackgroundUpper respiratory infections (URIs) are common infectious diseases worldwide. Accurate and timely assessment of the disease burden of URIs is crucial for governments to develop comprehensive prevention and control strategies, and to allocate and utilize healthcare resources more efficiently. MethodsFor URIs in Global Burden of Disease (GBD) 2021 database, age-standardized incidence rates (ASIR), age-standardized prevalence rates (ASPR), age-standardized mortality rates (ASMR), disability-adjusted life-years (DALYs), and case numbers for incidence, prevalence, deaths, and DALYs across the globe, five socio-demographic index (SDI) regions, 21 geographical regions, and 204 countries and territories were provided and analyzed. Trends from 1990 to 2021 were described using the average annual percentage change (AAPC), and future URIs burden was projected with a Bayesian age-period-cohort (BAPC) model. ResultsFrom 1990 to 2021, there was a significant decline in global ASIR (APCC = −289.86, 95% confidence interval [CI]: −298.59 to −281.12), ASPR (AAPC = −4.04, 95% CI: −4.16 to −3.92), ASMR (AAPC = −0.02, 95 % CI: −0.02 to −0.03) and age-standardized DALY rate (AAPC = −0.75, 95% CI: −0.76 to −0.74). The ASIR, ASPR, ASMR, and age-standardized DALY rate were high in elderly for both males and females, and both genders. Similarly, the number of incident cases, prevalence cases, deaths, and DALY cases for URIs was highest in children under five years. The ASMR and age-standardized DALY rate exhibited a negative correlation with SDI across 204 countries and territories in 2021. The ASIR and ASPR for URIs will show an upward trend from 2022 to 2050, while ASMR and age-standardized DALY rate are expected to decline. Low birth weight for gestation remains the leading contributor to deaths related to URIs. ConclusionDespite the global decline in URIs burden, significant challenges remain among the elderly population. These findings support the optimization and implementation of public health policies, including targeted vaccination and integrated One Health approaches to reduce the burden in high-risk populations.

The Burden of Hypertension-Related Chronic Kidney Disease - China, 2010-2019.

The global burden of chronic kidney disease (CKD) is on the rise. In 2019, 5.58 million individuals in China were affected by CKD related to hypertension, leading to 70,260 fatalities and 1.69 million disability-adjusted life years (DALYs). The most affected groups were men, older individuals, and residents of western China. Over the period from 2010-2019, the age-standardized prevalence rate (ASPR) remained constant, and the age-standardized mortality rate (ASMR) and age-standardized DALY rate (ASDR) showed a decreasing trend. However, there was an increase in the number of cases, deaths, and DALYs associated with this condition. Hypertension significantly contributes to the burden of CKD; therefore, raising awareness and implementing early screening measures are essential.

Aging, Cellular Senescence, and Glaucoma.

Aging is one of the most serious risk factors for glaucoma, and according to age-standardized prevalence, glaucoma is the second leading cause of legal blindness worldwide. Cellular senescence is a hallmark of aging that is defined by a stable exit from the cell cycle in response to cellular damage and stress. The potential mechanisms underlying glaucomatous cellular senescence include oxidative stress, DNA damage, mitochondrial dysfunction, defective autophagy/mitophagy, and epigenetic modifications. These phenotypes interact and generate a sufficiently stable network to maintain the cell senescent state. Senescent trabecular meshwork (TM) cells, retinal ganglion cells (RGCs) and vascular endothelial cells reportedly accumulate with age and stress and may contribute to glaucoma pathologies. Therapies targeting the suppression or elimination of senescent cells have been found to ameliorate RGC death and improve vision in glaucoma models, suggesting the pivotal role of cellular senescence in the pathophysiology of glaucoma. In this review, we explore the biological links between aging and glaucoma, specifically delving into cellular senescence. Moreover, we summarize the current data on cellular senescence in key target cells associated with the development and clinical phenotypes of glaucoma. Finally, we discuss the therapeutic potential of targeting cellular senescence for the management of glaucoma.

Global, regional, and national burden of dengue, 1990–2021: Findings from the global burden of disease study 2021

BackgroundDengue is an acute viral infectious disease caused by the dengue virus and transmitted through mosquitoes. Although numerous studies have examined the global burden of dengue, comprehensive and systematic global analyses remain limited. This study uses data from the Global Burden of Disease (GBD) Study 2021 to systematically analyze the global epidemiological trends and disease burden of dengue from 1990 to 2021. MethodsThis study utilized data from the GBD Study 2021 Study to analyze trends in the incidence, prevalence, mortality, and disability-adjusted life years (DALYs) of dengue across 204 countries and territories, stratified by age, sex, and Socio-demographic Index (SDI) levels. In addition, a Bayesian age-period-cohort model was employed to predict the future burden of dengue. The average annual percent change (AAPC) was used to describe the overall trend in rates or counts of indicators between 1990 and 2021. ResultsIn 2021, the global ASIR of dengue was 752.04 per 100,000 population (95 % UI: 196.33–1363.35), and ASMR was 0.38 per 100,000 population (95 % UI: 0.23–0.51). From 1990 to 2021, both the ASIR (AAPC = 7.89, 95 % CI: 7.89–8.91) and ASMR (AAPC = 0.01, 95 % CI: 0.00–0.01) showed an increasing trend. Adolescents under 14 years had the highest ASIR, age-standardized prevalence rate (ASPR), and age-standardized disability-adjusted life years (DALYs) for dengue. By 2035, the projected ASIR of dengue is 862.23 per 100,000 population (95 % CI: 627.84–1096.62 per 100,000 population), the ASPR is 51.60 per 100,000 population (95 % CI: 37.70–65.50 per 100,000 population), and the ASMR is 0.43 per 100,000 population (95 % CI: 0.29–0.56 per 100,000 population). The ASIR, ASPR, ASMR, and age-standardized DALYs for dengue are expected to continue rising in the next 10 years. ConclusionThe global burden of dengue is projected to continue rising in the coming years, underscoring the urgent need for comprehensive control measures, including enhanced vector control, public education, vaccination, and drug development. These findings provide crucial scientific evidence for the formulation of effective public health strategies and interventions aimed at reducing the global threat posed by dengue.

The long-term spatio-temporal trends in burden and attributable risk factors of major depressive disorder at global, regional and national levels during 1990-2019: a systematic analysis for GBD 2019.

Caused by multiple risk factors, heavy burden of major depressive disorder (MDD) poses serious challenges to public health worldwide over the past 30 years. Yet the burden and attributable risk factors of MDD were not systematically known. We aimed to reveal the long-term spatio-temporal trends in the burden and attributable risk factors of MDD at global, regional and national levels during 1990-2019. We obtained MDD and attributable risk factors data from Global Burden of Disease Study 2019. We used joinpoint regression model to assess the temporal trend in MDD burden, and age-period-cohort model to measure the effects of age, period and birth cohort on MDD incidence rate. We utilized population attributable fractions (PAFs) to estimate the specific proportions of MDD burden attributed to given risk factors. During 1990-2019, the global number of MDD incident cases, prevalent cases and disability-adjusted life years (DALYs) increased by 59.10%, 59.57% and 58.57%, respectively. Whereas the global age-standardized incidence rate (ASIR), age-standardized prevalence rate (ASPR) and age-standardized DALYs rate (ASDR) of MDD decreased during 1990-2019. The ASIR, ASPR and ASDR in women were 1.62, 1.62 and 1.60 times as that in men in 2019, respectively. The highest age-specific incidence, prevalence and DALYs rate occurred at the age of 60-64 in women, and at the age of 75-84 in men, but the maximum increasing trends in these age-specific rates occurred at the age of 5-9. Population living during 2000-2004 had higher risk of MDD. MDD burden varied by socio-demographic index (SDI), regions and nations. In 2019, low-SDI region, Central sub-Saharan Africa and Uganda had the highest ASIR, ASPR and ASDR. The global PAFs of intimate partner violence (IPV), childhood sexual abuse (CSA) and bullying victimization (BV) were 8.43%, 5.46% and 4.86% in 2019, respectively. Over the past 30 years, the global ASIR, ASPR and ASDR of MDD had decreased trends, while the burden of MDD was still serious, and multiple disparities in MDD burden remarkably existed. Women, elderly and populations living during 2000-2004 and in low-SDI regions, had more severe burden of MDD. Children were more susceptible to MDD. Up to 18.75% of global MDD burden would be eliminated through early preventing against IPV, CSA and BV. Tailored strategies-and-measures in different regions and demographic groups based on findings in this studywould be urgently needed to eliminate the impacts of modifiable risk factors on MDD, and then mitigate the burden of MDD.

Epidemiological study of pediatric rheumatic heart disease: An analysis from the Global Burden of Disease Study 2019

BackgroundRheumatic heart disease (RHD) is the most common acquired heart disease among children in developing countries. However, there is a lack of systematic studies on the epidemiology of pediatric RHD. This study aimed to report the burden of pediatric RHD at global, regional, and national levels between 1990 and 2019, which may provide some reference for policymakers. MethodsThe numbers and age-standardized rates (ASRs) of incidence, prevalence, mortality, and disability-adjusted life years (DALYs) for childhood RHD from 1990 to 2019 were analyzed based on data obtained from the Global Burden of Disease Study 2019 (GBD 2019). In addition, Joinpoint regression analysis was used to assess temporal trends in the burden of childhood RHD. ResultsGlobally, the number of incidence and prevalence cases of RHD in children increased by 41.89% and 40.88%, respectively, from 1990 to 2019. Age-standardized incidence rate (ASIR) and age-standardized prevalence rate (ASPR) increased with an average annual percentage change (AAPC) of 0.75% and 0.66%, respectively. In contrast, the age-standardized DALY rate and age-standardized mortality rate (ASMR) decreased significantly since 1990 by an AAPC of −3.47% and − 2.65%, respectively. Girls had a significantly higher burden of RHD than boys during the study period. At the age level, the RHD burden was significantly highest in the age group of 10–14 years. Moreover, the ASRs of incidence, prevalence, mortality, and DALYs were negatively associated with sociodemographic index (SDI). Nationally, Fiji had the most significant increase in incidence and prevalence, and Philippines had the most remarkable rise in DALYs and mortality rates. ConclusionFrom 1990 to 2019, although the incidence and prevalence of childhood RHD increased globally, DALYs and mortality rates markedly reduced. Countries with lower levels of sociodemographic development shoulder a higher burden of childhood RHD. Children aged 10–14 years are critical populations for whom targeted measures are needed to reduce the RHD burden, while attention to girls cannot be neglected.

The Australian Eye and Ear Health Survey (AEEHS): Study protocol for a population-based cross-sectional study.

Vision and hearing impairments are highly prevalent and have a significant impact on physical, psychological and social wellbeing. There is a need for accurate, contemporary national data on the prevalence, risk factors and impacts of vision and hearing loss in Australian adults. The Australian Eye and Ear Health Survey (AEEHS) aims to determine the prevalence, risk factors and impacts of vision and hearing loss in both Aboriginal and Torres Strait Islander and non-Indigenous older adults. The AEEHS is a population-based cross-sectional survey which will include 5,000 participants (3250 non-Indigenous aged 50 years or older and 1750 Aboriginal and Torres Strait Islander people aged 40 years or older) from 30 sites covering urban and rural/regional geographic areas, selected using a multi-stage, random cluster sampling strategy. Questionnaires will be administered to collect data on socio-demographic, medical, ocular and ontological history. The testing battery includes assessment of blood pressure, blood sugar, anthropometry, visual acuity (presenting, unaided, pinhole and best-corrected), refraction, tonometry, slit lamp and dilated eye examination, ocular imaging including optical coherence tomography (OCT), OCT-angiography and retinal photography, and automated visual fields. Audiometry, tympanometry and video otoscopy will also be performed. The primary outcomes are age-standardised prevalence of cause-specific vision and hearing impairment. Secondary outcomes are prevalence of non-blinding eye diseases (including dry eye disease), patterns in health service utilisation, universal health coverage metrics, risk factors for vision and hearing impairment, and impact on quality of life.

Heart Failure Statistics 2024 Update: A Report From the Korean Society of Heart Failure.

The number of people with heart failure (HF) is increasing worldwide, and the social burden is increasing as HF has high mortality and morbidity. We aimed to provide updated trends on the epidemiology of HF in Korea to shape future social measures against HF. We used the National Health Information Database of the National Health Insurance Service to determine the prevalence, incidence, hospitalization rate, mortality rate, comorbidities, in-hospital mortality, and healthcare cost of patients with HF from 2002 to 2020 in Korea. The prevalence of HF in the total Korean population rose from 0.77% in 2002 to 2.58% (1,326,886 people) in 2020. Although the age-standardized incidence of HF decreased over the past 18 years, the age-standardized prevalence increased. In 2020, the hospitalization rate for any cause in patients with HF was 1,166 per 100,000 persons, with a steady increase from 2002. In 2002, the HF mortality was 3.0 per 100,000 persons, which rose to 15.6 per 100,000 persons in 2020. While hospitalization rates and in-hospital mortality for patients with HF increased, the mortality rate for patients with HF did not (5.8% in 2020), and the one-year survival rate from the first diagnosis of HF improved. The total healthcare costs for patients with HF were approximately $2.4 billion in 2020, a 16-fold increase over the $0.15 billion in 2002. The study's results underscore the growing socioeconomic burden of HF in Korea, driven by an aging population and increasing HF prevalence.

Global burden of inflammatory bowel disease in the elderly: trends from 1990 to 2021 and projections to 2051.

This study aims to analyze the historical trends of inflammatory bowel disease (IBD) burden in the elderly from 1990 to 2021 and forecast future trends up to 2051. Data from the Global Burden of Disease Study 2021 were utilized. Age-standardized rates (ASR) for incidence, prevalence, mortality, and disability-adjusted life years (DALYs) were calculated. Estimated annual percentage changes (EAPCs) were computed to quantify temporal trends. A Bayesian Age-Period-Cohort model was employed to project future trends. From 1990 to 2021, the global number of elderly IBD increased from 573,500 to 1,278,190. The age-standardized incidence rate (ASIR) rose from 8.01 to 8.77 per 100,000, while the age-standardized prevalence rate (ASPR) slightly decreased from 118.14 to 117.29 per 100,000. Death number increased from 14,400 to 33,490, but the age-standardized mortality rate decreased from 3.21 to 2.84 per 100,000. DALYs increased from 324,100 to 683,750, with the age-standardized DALYs rate declining from 68.78 to 60.88 per 100,000. Significant geographical variations were observed, with high Socio-demographic Index regions showing the highest burden. Projections suggest that by 2051, elderly IBD prevalence number may reach 2,316,000, with ASIR and ASPR potentially rising after 2035 and 2042, respectively. Deaths and DALYs are projected to increase to 75,000 and 1,401,000 respectively, despite continued declines in ASRs. The absolute burden of IBD in the elderly population is projected to increase substantially by 2051, despite decreasing ASRs. These findings underscore the need for tailored healthcare strategies and resource allocation to address the growing challenge of elderly IBD globally.