Age-standardised Disability-adjusted Life-years Rates Research Articles

Burden of Food-Borne Trematodiases in China: Trends from 1990 to 2021 and Projections to 2035

To assess the burden of food-borne trematodiases in China from 1990 to 2021 and project the burden through 2035, data were captured from the Global Burden of Disease Study (GBD) 2021 datasets. The estimated prevalent food-borne trematodiase cases were 33.32 million (95% uncertainty interval (UI): 29.25–38.35 million) in China in 2021, contributing to 768,297.4 disability-adjusted life years (DALYs) (95% UI: 383,882.8–1,367,826.1). The number of prevalent cases and DALYs declined by 9.02% and 18.11%, and a downward decline was seen in age-standardized prevalence and DALY rates (estimated annual percentage change: −0.96% and −1.21%, respectively). A higher prevalence and DALY rates were observed among males than females, and the middle-aged group bore the highest burden, while the older population showed the most rapid increase in prevalent cases and DALY numbers. Projected DALY counts and rates remain stable through 2035 using the Bayesian age–period–cohort (BAPC) model. These findings demonstrate a decline in the burden of food-borne trematodiases in China from 1990 to 2021; however, the prevalence remained high, which contributed considerably to disability and premature death. Continued control efforts and targeted interventions are essential to further reducing the burden of food-borne trematodiases in China.

Temporal trend and attributable risk factors of cardiovascular diseases burden for adults 55 years and older in 204 countries/territories from 1990 to 2021: an analysis for the Global Burden of Disease Study 2021.

The aging global population and overall population growth have significantly increased the burden of cardiovascular diseases (CVDs). This study aims to examine global temporal trends in the incidence, disability-adjusted life years (DALY), and mortality rates of both overall and type-specific CVDs among adults aged 55 and older from 1990 to 2021, with a focus on identifying changes over time, regional disparities, and the key risk factors contributing to this burden. We analyzed data from the Global Burden of Disease (GBD) Study 2021, covering 204 countries and territories. Trends in age-standardized rates of incidence, DALY, and mortality for both overall and specific types of CVDs were assessed, alongside the impact of key risk factors. Between 1990 and 2021, global age-standardized incidence, DALY, and mortality rates showed a declining trend, with estimated annual percentage changes (EAPCs) of -0.39, -1.30, and -1.11, respectively. However, due to overall population growth and aging, the absolute number of CVD cases continued to rise. Regions with high-middle Socio-demographic Index (SDI) exhibited the highest incidence and mortality rates, while high SDI regions saw the greatest declines. Men had higher age-standardized rates of CVDs incidence, DALY, and mortality compared to women. The burden increased with age, with the oldest age groups (80+ years) showing the highest rates. High systolic blood pressure was the leading modifiable risk factor, contributing to more than half of the CVD-related DALY globally. Other major risk factors included high low-density lipoprotein cholesterol, smoking, and ambient particulate matter pollution. While age-standardized rates of CVD incidence, DALY, and mortality have declined over the past three decades, the total burden of CVDs continues to rise due to population aging and growth. These findings highlight the need for targeted prevention strategies in regions with high CVD burden, particularly those with lower socioeconomic status.

Temporal trends in the burden of musculoskeletal diseases in China from 1990 to 2021 and predictions for 2021 to 2030

BackgroundMusculoskeletal (MSK) diseases represent a significant global public health challenge. Conducting comprehensive research on MSK diseases in China holds profound implications for public health. MethodsThis study utilized data from the Global Burden of Disease 2021 (GBD 2021) to analyze the incidence rate, prevalence rate, mortality rate, disability-adjusted life years (DALYs), years lived with disability (YLDs), and years of life lost (YLLs) of MSK diseases in China from 1990 to 2021. Trends were evaluated using annual percentage change (APC), average annual percentage change (AAPC), and estimated annual percentage change (EAPC). Future disease trends were predicted using the Bayesian Age-Period-Cohort (BAPC) model. ResultsChina had the highest number of DALYs cases globally, totaling 30.4194 million. Low back pain (LBP) represented the largest burden, while hand osteoarthritis exhibited the fastest growth. Differences in disease burden were observed across various genders and age groups. Predictions indicate that between 2021 and 2030, the age-standardized DALYs rate in China will increase annually, reaching 1779.08 per 100,000 population by 2030. Environmental (occupational) factors had the most significant impact on the age-standardized DALYs rate, whereas renal dysfunction had the least impact. The SDI showed a moderately strong positive correlation with the age-standardized DALYs rate of MSK diseases. ConclusionOver the past 20 years, the prevalence of MSK diseases in China has experienced a slight increase, while other epidemiological burden indicators have shown a downward trend. Projections indicate that the overall disease burden of MSK in China will continue to rise over the next decade, underscoring the need for early intervention strategies. Moreover, substantial differences in MSK disease burden across genders and age groups highlight the importance of developing targeted policy interventions to mitigate this burden.

Burden of gastrointestinal cancers among adolescent and young adults in Asia-Pacific region: trends from 1990 to 2019 and future predictions to 2044

Background Gastrointestinal cancer is a significant cause of cancer incidence and mortality. Nevertheless, the epidemiology of the burden among adolescents and young adults (AYAs, aged 15–39 years) remains limited in the Asia-Pacific region, despite the region’s significant population. This study aims to explore the gastrointestinal cancer burden among AYAs in the Asia-Pacific region for the year 2019, while also analysing trends from 1990 to 2019 and projecting future trends up to 2044. Methods Annual case numbers, age-standardized rates of incidence, death, and disability-adjusted life-years (DALYs) and their estimated annual percentage changes (EAPCs) for gastrointestinal cancers were derived from the Global Burden of Disease, Injuries, and Risk Factors Study 2019. Trends over the next 25 years have also been predicted. Results In 2019, there were 117,714 incident cases, 61,578 deaths and 3,483,053 DALYs due to gastrointestinal cancers in the Asia-Pacific region, accounting for 68.5%, 67.6% and 72.4%, respectively, of global gastrointestinal cancers in this population. The highest age­standardized rates occurred in countries with a middle Socio-demographic Index. From 1990 to 2019, there was a decline in the age-standardized rates of incidence, death and DALY attributed to gastrointestinal cancers, with EAPC of −1.10, −2.48 and −2.44, respectively. These rates are expected to stabilize over 25 years, with notable variations in individual gastrointestinal cancers. Conclusions Gastrointestinal cancers among AYAs in the Asia-Pacific region have posed a significant burden over the past 30 years and are expected to persist in the coming years.

Evaluation of the osteoarthritis disease burden in China from 1990 to 2021: based on the Global Burden of Disease Study 2021.

This study aims to understand the current status and trend of the disease burden of osteoarthritis (OA) in people over 30 years old in China from 1990 to 2021 and identify the priority population groups, to provide reference data for the prevention and treatment of OA in China. The Global Burden of Disease Study 2021 was used to describe the incidence, prevalence, and disability-adjusted life years (DALYs) of OA in adult aged 30 years or older in China by sex and age groups, which was used to analyze the disease burden of OA from 1990 to 2021. The joinpoint regression model and age-period-cohort model were used to characterize the temporal trend. In 2021, the number of OA prevalence in China was about 152.85 million, and the number of incidences was about 11.65 million. The age-standardized prevalence rate (ASPR), age-standardized incidence rate (ASIR) and age-standardized DALYs rate (ASDR) of OA in China are lower than those in developed countries such as Korea, the United States of America and Japan, but higher than those in India. Knee osteoarthritis had the highest ASPR and ASDR. The highest incidence rate was 50-54 years, and the highest prevalence and DALYs rate were in the age group of patients over 95 years old. The incidence rate of women in all age groups is higher than that of men. From 1990 to 2021, the ASIR, ASPR and ASDR of OA in China roughly showed an increasing trend year by year. The age-period-cohort analysis showed that the peak age groups for longitudinal age incidence of OA in China from 1992 to 2021 were 50-54 years and 80-84 years. We found that the OA incidence was highest in the period 2017-2021. The disease burden of OA in those over 30 years old in China from 1990 to 2021 will become more and more serious, and the target population for primary prevention is the female population under 50 years old. The development of a scientific and effective comprehensive prevention and treatment program for OA is imminent.

Projected epidemiological trends and burden of liver cancer by 2040 based on GBD, CI5plus, and WHO data

Incidence of liver cancer as one of the most common cancers worldwide and become the significant contributor for the mortality among cancer patients. The disease burden, risk factors, and trends in incidence and mortality of liver cancer globally was described subsequently estimated the projections of liver cancer incidence or mortality by 2040. Data regarding age-standardized incidence and mortality rates for liver cancer was obtained from multiple databases, including GLOBOCAN 2020, CI5 volumes I–XI, WHO mortality database, and Global Burden of Disease (GBD)-2019. Concentrating on worldwide variations, this thorough analysis offers insights into patterns of incidence and mortality based on gender and age. Our findings encompass significant indicators, including age-standardized rates (ASRs), average annual percentage change (AAPC), and future projections extending up to the year 2040. Liver cancer holds the sixth position in terms of most frequently diagnosed cancers and stands as the sixth leading cause of cancer-related deaths worldwide in 2020, accounting for 905,677 new cases and 782,000 fatalities. Additionally, liver cancer contributed to 12,528,421 age-standardized disability-adjusted life years (DALYs), with an age-standardized DALYs rate of 161.92 in 2019 worldwide. The age-specific incidence rates exhibited significant variations across different regions, showing a fivefold difference in males and females. A significant increase in incidence was observed in North Europe and Asia, while North African countries reported a higher mortality burden (ASR, 10 per 100,000) compared to developed countries. Since last few years, the incidence and mortality rates have increased and attained Annual Average Percentage Change (AAPC) incidence rate of 7.7 (95% CI 3.9–11.6) for men and the highest AAPC mortality rate of 12.2 (95% CI 9.5–15.0) for women. In 2019, Western Europe emerged as the high-risk region for DALYs related to smoking and alcohol consumption, while high-income North America carried a high risk for DALYs associated with a high body-mass index. The projected trend indicates a surge in new liver cancer incident cases, expected to rise from around 905,347 to an estimated 1,392,474 by 2040. This study described the evidence pertinent to higher incidence trends in liver cancer, particularly among both young and older adults, encompassing males and females, as well as those who are HIV-infected and HBsAg positive. A significant rise in the young population poses a significant public health concern that warrants attention from healthcare professionals to prioritize the promotion of health awareness and the development of effective cancer prevention strategies, particularly in many developing countries.

Global burden of low back pain and its attributable risk factors from 1990 to 2021: a comprehensive analysis from the global burden of disease study 2021.

This study aimed to examine the evolving trends in the global burden of low back pain (LBP) from 1990 to 2021 and predicted disease burden until 2035. LBP-related data were obtained from the Global Health Data Exchange (GHDx) query tool. All estimates and their 95% uncertainty intervals (UIs) were generated using DisMod-MR 2.1, a Bayesian meta-regression tool in Global Burden of Disease, Injury, and Risk Factor Study (GBD) 2021. Data processing and visualization were conducted using The R Programming Language software version 4.3.2 and Joinpoint 4.7. In 2021, approximately 628.8 million people worldwide were affected by LBP, with approximately 266.9 million new incident cases and age-standardized incidence rate (ASIR) of 3176.6 per 100,000. Compared with 1990, although the ASIR and age-standardized disability-adjusted life years rate (ASDALYsR) decreased, absolute numbers increased significantly. Projections for 2035 reveal a continued decline in ASIR and ASDALYsR for LBP. The LBP burden varied by the sociodemographic index quintile and GBD region, with the highest ASIR and ASDALYsR observed in Central Europe and the greatest decrease in East Asia. Globally, women bear a higher burden of LBP than men, with middle-aged populations experiencing the heaviest burden. Occupational ergonomic factors, high body mass index, and smoking remain the primary risk factors for LBP, with occupational ergonomic factors contributing the most to the overall burden. Despite a projected decline in incidence, the global burden of LBP persists, exhibiting significant regional and gender disparities. To mitigate its future burden, precise and effective prevention and control strategies targeting high-risk factors are imperative.

Global burden associated with rare infectious diseases of poverty in 2021: findings from the Global Burden of Disease Study 2021

BackgroundRare infectious diseases of poverty (rIDPs) involve more than hundreds of tropical diseases, which dominantly affect people living in impoverished and marginalized regions and fail to be prioritized in the global health agenda. The neglect of rIDPs could impede the progress toward sustainable development. This study aimed to estimate the disease burden of rIDPs in 2021, which would be pivotal for setting intervention priorities and mobilizing resources globally.MethodsLeveraging data from the Global Burden of Disease Study 2021, the study reported both numbers and age-standardized rates of prevalence, mortality, disability-adjusted life-years (DALYs), years lived with disability, and years of life lost of rIDPs with corresponding 95% uncertainty intervals (UIs) at global, regional, and national levels. The temporal trends between 1990 and 2021 were assessed by the joinpoint regression analysis. A Bayesian age-period-cohort model was used to project the disease burden for 2050.ResultsIn 2021, there were 103.76 million (95% UI: 102.13, 105.44 million) global population suffered from rIDPs with an age-standardized DALY rate of 58.44 per 100,000 population (95% UI: 42.92, 77.26 per 100,000 population). From 1990 to 2021, the age-standardized DALY rates showed an average annual percentage change of − 0.16% (95% confidence interval: − 0.22, − 0.11%). Higher age-standardized DALY rates were dominated in sub-Saharan Africa (126.35 per 100,000 population, 95% UI: 91.04, 161.73 per 100,000 population), South Asia (80.80 per 100,000 population, 95% UI: 57.31, 114.10 per 100,000 population), and countries with a low socio-demographic index. There was age heterogeneity in the DALY rates of rIDPs, with the population aged under 15 years being the most predominant. Females aged 15–49 years had four-times higher age-standardized DALY rates of rIDPs than males in the same age. The projections indicated a slight reduction in the disease burden of rIDPs by 2050.ConclusionsThere has been a slight reduction in the disease burden of rIDPs over the past three decades. Given that rIDPs mainly affect populations in impoverished regions, targeted health strategies and resource allocation are in great demand for these populations to further control rIDPs and end poverty in all its forms everywhere.Graphical

Worldwide burden of retinoblastoma from 1990-2021.

To report the global, regional, and national burden of retinoblastoma between 1990 and 2021, by age, sex, and sociodemographic index (SDI). We leveraged the Global Burden of Disease 2021 Study to elucidate the epidemiological landscape of retinoblastoma, encompassing prevalence, incidence, mortality, and disability-adjusted life years (DALYs) across 204 nations and territories spanning the period from 1990 to 2021. The SDI was employed to evaluate the interplay between socio-economic development and the burden of retinoblastoma. In 2021, global estimates unveiled 57,333 prevalent cases of retinoblastoma, yielding 6,274 incident cases, 2,762 deaths, and 243,204 DALYs. Globally, the age-standardized prevalence, incidence, mortality, and DALY rates for retinoblastoma in 2021 were 0.86, 0.09, 0.04, and 3.65 per 100,000 population, respectively. Tokelau, Kenya, and Portugal demonstrated the highest age-standardized prevalence and incidence rates of retinoblastoma in 2021. The global prevalence of retinoblastoma peaks among children aged 2 to 4 years and subsequently declines with increasing age. At the regional level, the correlation between SDI and age-standardized prevalence rates for retinoblastoma manifested a V-shaped pattern. This comprehensive examination of retinoblastoma epidemiological trends underscores the imperative for heightened vigilance and more efficacious therapeutic interventions, especially within resource-limited environments. The findings accentuate the need for targeted strategies to address the disparate burden of retinoblastoma across diverse socioeconomic landscapes.

Global, regional, and national burden of ischemic stroke attributable to active smoking, 1990-2021.

Ischemic stroke is a major global health issue, with active smoking identified as a key modifiable risk factor. This study examines the burden of ischemic stroke due to active smoking from 1990 to 2021, across different sociodemographic contexts. Data from the Global Burden of Disease (GBD) 2021 database were used to extract information on mortality and disability-adjusted life years (DALYs) attributable to active smoking-related ischemic stroke. Countries and regions were categorized by the sociodemographic index (SDI) into five levels. Statistical analyses were conducted using R Studio, including the calculation of estimated annual percentage change (EAPC) and joinpoint regression models. In 2021, there were 342674 deaths globally due to ischemic stroke caused by active smoking, with an age-standardized mortality rate (ASMR) of 4.06 and a population-attributable fraction (PAF) of 9.54%. The number of deaths increased by 35.59% from 1990 to 2021, with males aged ≥70 years experiencing the largest increase. The global age-standardized DALY rate in 2021 was 98.29, with an overall increase in DALYs by 33.55% from 1990. Regional analysis revealed significant disparities, with the middle SDI region reporting the highest number of deaths and DALYs, while the high SDI region reported the lowest. Geographically, East Asia had the highest burden in 2021. Nationally, China had the highest number of deaths and DALYs due to smoking-related ischemic stroke. This study highlights the significant global burden of ischemic stroke attributable to active smoking and the critical need for targeted smoking cessation programs and stroke prevention strategies. Despite overall declines in ASMR and age-standardized DALY rates, the burden varies significantly across different regions and sociodemographic groups. Effective public health interventions, particularly in low- to middle-SDI regions, are essential to mitigate the impact of smoking-related ischemic stroke and improve global health outcomes.

Global trends in ischemic stroke burden attributable to high BMI.

We aimed to assess the worldwide burden of ischemic stroke (IS) associated with high body mass index (BMI) using data from the Global Burden of Disease 2019. This study examined the impact of high BMI on IS-related age-standardized death rates (ASDR) and disability-adjusted life years (DALYs). Estimated annual percentage changes (EAPC) is estimated annual percentage change. Trends were assessed using EAPCs. Over the past 3 decades, there has been a declining trend in the global burden of IS associated with high BMI, especially in Western Europe (EAPC = -3.09 for DALYs) and high-income Asia Pacific (EAPC = -4.6 for ASDR). However, certain developing regions, notably Southeast Asia, have experienced significant increases in ASDR (EAPC = 3.7) and age-standardized DALY rates (EAPC = 3.64). The most substantial increase in burden was observed in Southeast Asia for both males (EAPC = 3.85) and females (EAPC = 3.53). Importantly, the burden was most pronounced in regions with low to middle sociodemographic index. The rising disease burden linked to high BMI is largely due to insufficient medical infrastructure and ineffective public health policies in the region. Urgent action is needed from decision-makers to improve these areas and implement effective interventions. This study reveals a consistent global decline in IS related to high BMI, with a more significant burden observed in males under the age of 65, particularly in Southeast Asia, where increases in IS associated with high BMI are notable. Public health officials and global policymakers need timely and reliable quantitative data. This information is essential for implementing effective behavioral interventions, such as monitoring diet and physical activity, to address identified risk factors and reduce the burden of high BMI.

Global burden and cross-country inequalities in diseases associated with high body mass index from 1990 to 2019: Result from the Global Burden of Disease Study 2019.

High body mass index (BMI) has gradually become an increased risk factor for the global burden of diseases (GBD). As the disease burden and the number of elders globally increase, it is crucial for policymakers to realise the associations between high BMI and disease burden worldwide in a timely manner and to develop effective interventions for different countries and ages. We used the GBD 2019 database to analyse the deaths and disability-adjusted life-years (DALYs) in the disease burden associated with high BMI and indicated the health inequality at the global, regional, and national levels. We applied the slope index of inequality and concentration index, two standard metrics of absolute and relative gradient inequality recommended by the World Health Organization (WHO), to quantify the distributive inequalities in the burden of diseases associated with high BMI. These rates were reported per 100 000 population as crude incidence rates, death rates, and DALYs rates. All the estimates were generated with a 95% uncertainty interval (UIs). Globally, we revealed that an estimated age-standardised mortality rate associated with high BMI is 6.26 million (95% UIs = 3.99, 8.91). The age-standardised DALYs rate is 19.32 million (95% UIs = 12.77, 26.40), and the global population attributable fraction was 9% (95% UIs = 5, 12) in 2019. The largest number of high-BMI-related deaths in women mainly concentrated in the age group of 65-79 years, whereas the largest number in men was in the age group of 60-69 years. The age-standardised DALYs rate of diseases associated with high BMI was larger in the high-middle and middle socio-demographic index (SDI) (population attributable fraction (PAF) = 11 and PAF = 9) regions than those with high SDI (PAF = 1) and low SDI (PAF = 5) regions. In this study, our results showed that the disease burden of global deaths and DALYs associated with high BMI has substantially increased between 1990-2019. Furthermore, we demonstrated that countries with higher SDI development levels shoulders higher burden of diseases associated with high BMI. Future policies to prevent and reduce the burden should be developed and implemented based on country-specific development status.

Quantifying the Strain: A Global Burden of Disease (GBD) Perspective on Musculoskeletal Disorders in the United States Over Three Decades: 1990-2019.

Background: Musculoskeletal (MSK) disorders significantly contribute to global disability, especially in high-income countries. Yet, comprehensive studies on their epidemiological burden in the United States (US) are limited. Our study aims to fill this gap by characterizing the MSK disease burden in the US using Global Burden of Disease (GBD) data from 1990 to 2019. Methods: We conducted an ecological study using descriptive statistical analyses to examine age-standardized prevalence and disability-adjusted life years (DALY) rates of MSK disorders across different demographics and states. The study also assessed the impact of risk factors segmented by age and sex. Results: From 1990 to 2019, the burden of MSK disorders in the US increased significantly. Low back pain was the most prevalent condition. Age-standardized prevalence and DALY rates increased by 6.7% and 17.6%, respectively. Gout and other MSK disorders saw the most significant rise in DALY rates. Females experienced higher rates than males, and there were notable geographic disparities, with the District of Columbia having the lowest and North Dakota and Iowa the highest DALY rates. Smoking, high BMI, and occupational risks emerged as primary risk factors. Conclusions: Our study highlights the escalating burden of MSK disorders in the US, revealing significant geographic and sex disparities. These findings highlight the urgent need for targeted health interventions, policy formulation, and public health initiatives focusing on lifestyle and workplace modifications. Region- and sex-specific strategies are crucial in effectively managing MSK conditions, considering the influence of various risk factors.

Analysis of Stroke Burden in China from 1990 to 2021 and Projections for the Next Decade

Introduction: This study aimed to describe the temporal trends of stroke burden in different age and sex groups in China from 1990 to 2021, including incidence, prevalence, mortality, and disability-adjusted life years (DALYs), and to compare these data with global figures. Methods: Using data from the Global Burden of Disease database from 1990 to 2021, we analyzed changes in stroke burden in China and globally. The average annual percentage change (AAPC) was calculated using Joinpoint software to reflect trends. Stroke burden differences across various age groups and sexes were compared, and the ARIMA model was utilized for future projections. Results: Between 1990 and 2021, the age-standardized incidence rate (ASIR) of stroke in China decreased from 226.938 to 204.753 per 100,000, while the global ASIR decreased from 180.973 to 141.553 per 100,000. The age-standardized prevalence rate (ASPR) in China increased from 1,167.425 to 1,301.42 per 100,000, whereas the global ASPR decreased from 1,201.111 to 1,099.31 per 100,000. The age-standardized mortality rate (ASMR) in China fell from 242.18 to 138.029 per 100,000, while the global ASMR decreased from 144.313 to 87.454 per 100,000. China’s age-standardized DALY rate (ASDR) declined from 4,834.791 to 2,648.025 per 100,000, whereas the global ASDR decreased from 3,078.952 to 1,886.196 per 100,000. The AAPCs for ASIR, ASPR, ASMR, and ASDR in China were −0.370%, 0.326%, −1.793%, and −1.933%, respectively, compared to −0.291%, −0.807%, −1.601%, and −1.570% globally from 1990 to 2021. Age and sex significantly influenced the stroke burden, with higher incidence and mortality rates in males than in females. Projections for the next decade indicate that stroke incidence in China will remain stable, with an expected rise in ASPR, and declines in ASMR and ASDR. Globally, ASIR is expected to decline, while ASPR will rise, and ASMR and ASDR will continue to decrease. Conclusion: From 1990 to 2021, the incidence, mortality, and DALYs of stroke in China have decreased, while the prevalence has increased. Stroke burden is age-related, with higher prevalence in older adults and higher mortality in the elderly. Males are more susceptible to stroke and have a higher risk of death. Over the next decade, stroke prevalence in China is expected to rise, posing challenges due to population aging, even as mortality and disability rates decline. Sustained public health efforts will be necessary.

Global burden of zoonotic infectious diseases of poverty, 1990–2021

BackgroundThe zoonotic infectious diseases of poverty (zIDPs) are a group of diseases contributing to global poverty, with significant impacts on a substantial population. This study aims to describe the global, regional, and national burden of zIDPs—schistosomiasis, cystic echinococcosis, cysticercosis, and food-borne trematodiases (FBTs)—to support policy making and resource allocation for their control and elimination.MethodsData of zIDPs from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 were retrieved from 1990 to 2021. The age-standardized prevalence rate (ASPR), age-standardized mortality rate (ASMR), and age-standardized disability-adjusted life-year (DALY) rate were described and the estimated annual percentage changes (EAPCs) were calculated to quantify their burden and temporal trends. Spearman correlation analysis was conducted to examine the relationship between age-standardized rates and Socio-demographic Index (SDI).ResultsIn 2021, these zIDPs exhibited a certain level of ASPRs and age-standardized DALY rates, while maintaining relatively low ASMRs. Noticeably, schistosomiasis presented the highest ASPR of 1914.299 (95% UI: 1378.920, 2510.853 per 100,000 population) and an age-standardized DALY rate of 21.895 (95% UI: 12.937, 37.278 per 100,000 population) among the zIDPs. The tapestry of burden—woven predominantly through low and lower-middle SDI regions—stretched across Africa, Latin America, and parts of Asia. From 1990 to 2021, a kaleidoscopic shift was observed globally as ASPRs, ASMRs, and age-standardized DALY rates declined significantly, as reflected by the EAPC values. Negative correlations were observed between the ASPRs, ASMRs, age-standardized DALY rates of schistosomiasis (r value = − 0.610, − 0.622 and − 0.610), cystic echinococcosis (− 0.676 of ASMR, − 0.550 of age-standardized DALYs), cysticercosis (− 0.420, − 0.797 and − 0.591) and the SDI. In contrast, a slight positive correlation was noted between the ASPR, age-standardized DALY rates of FBTs and SDI with r value of 0.221 and 0.213, respectively.ConclusionThe burden of zIDPs declined across almost all endemic regions from 1990 to 2021, yet still predominated in low and low-middle SDI regions. Substantial challenges exist to achieve the goal of control and elimination of zIDPs, and integrated approaches based on One Health need to be strengthened to improve health outcomes.Graphical

Global health inequalities in the burden of interstitial lung disease and pulmonary sarcoidosis from 1990 to 2021

BackgroundInterstitial lung disease and pulmonary sarcoidosis remain serious medical problems worldwide. This study aims to assess the global burden and health inequalities of interstitial lung disease and pulmonary sarcoidosis between 1990 and 2021.MethodsData on disability-adjusted life years (DALYs) due to interstitial lung disease and pulmonary sarcoidosis were obtained from the Global Burden of Diseases, Injuries and Risk Factors Study 2021. The slope index of inequality (SII) and concentration index were used to assess cross-national health inequality.ResultsThere were 2,237,269 (95% uncertainty interval: 1,839,500 to 2,555,200) DALYs due to interstitial lung disease and pulmonary sarcoidosis in males and 1,804,881 DALYs (1,465,707 to 2,216,376) in females in 2021. The age-standardized DALY rate of interstitial lung disease and pulmonary sarcoidosis increased from 37.1 (30.6 to 45.4) per 100,000 in 1990 to 47.6 (41.3 to 53.2) per 100,000 in 2021. Countries with high socio-demographic index (SDI) showed the greatest increase in the age-standardized DALY rate of interstitial lung disease and pulmonary sarcoidosis during the past 32 years (53.4%, 45.1 to 62.2%). The SII increased from 19.6 (95% confidence interval: 11.6 to 27.5) in 1990 to 53.4 (39.7 to 67.1) in 2021. The concentration index increased from 0.15 (0.08 to 0.21) in 1990 to 0.23 (0.16 to 0.32) in 2021.ConclusionThe burden of interstitial lung disease and pulmonary sarcoidosis increased and remained high in the high-SDI quintile. More attention must be given to reducing the burden of interstitial lung disease and pulmonary sarcoidosis.

Total burden of hepatitis B and C attributed to injecting drug use in 204 countries and territories from 1990 to 2021: Analyses based on the Global Burden of Disease Study 2021

This study assesses the global, regional, and national burden of hepatitis B (HBV) and hepatitis C (HCV) related to injecting drug use (IDU) from 1990 to 2021. Data from the global burden of disease study 2021 were analyzed to quantify deaths, age-standardized mortality rates (ASMR), disability-adjusted life years (DALYs), and age-standardized DALYs rates (ASDR) due to HBV and HCV from IDU across 204 countries. Trends was evaluated using estimated annual percentage change. Analyzing the association between ASDR and SDI using a loess regression model. From 1990 to 2021, the global burden of deaths and DALYs due to HBV and HCV attributed to IDU showed an increasing trend, especially among males, whose mortality rates were significantly higher than females. In 2021, global deaths due to HBV from IDU were 13,050.8, with an ASMR of 0.15 per 100,000 and an ASDR of 5.3, both showing an increasing trend with estimated annual percentage changes (EAPCs) of 1.09 and 0.96, respectively. HCV deaths reached 231,764.4, with an ASMR of 2.68 (EAPC: 0.38) and a relatively stable ASDR trend (EAPC: 0.01). Although raw death rates for HCV have increased, the ASMR and ASDR have remained stable or slightly declined, highlighting different trends across sexes and regions. India had the highest national deaths, while the highest ASDRs were in the Republic of Moldova (HBV) and Mongolia (HCV). South Asia recorded the highest regional deaths for both HBV and HCV. Positive correlations between ASDRs for HBV and HCV with SDI were observed. The burden of HBV and HCV due to IDU has increased from 1990 to 2021, especially among males, with significant regional and national disparities. Targeted drug prohibition interventions and policies are needed.

The burden of refraction disorders in 204 countries and territories from 1990 to 2021: A systematic analysis from the Global Burden of Disease 2021

BackgroundRefraction disorders are common eye conditions that cause blurred vision and, if left uncorrected, remain a leading cause of moderate to severe visual impairment worldwide. Despite this, a comprehensive assessment of the associated burden is lacking. This study aims to describe and predict the burden and regional distribution of refraction disorders using data from the 2021 Global Burden of Disease (GBD) study. MethodsThis study utilised data from the Global Burden of Disease (GBD) 2021 on refraction disorders from 1990 to 2021. We analysed the prevalence and disability-adjusted life years (DALYs) of refraction disorders and calculated the corresponding average annual percentage changes (AAPCs) in different gender and age groups across 204 countries and territories and 21 geographical regions. We employed the Bayesian Age-Period-Cohort (BAPC) model to predict the future burden of refraction disorders. ResultsFrom 1990 to 2021, the global age-standardized prevalence rate (ASPR) of refraction disorders decreased from 2053.56 (95% Uncertainty Interval [UI], 1835.31 to 2275.80) to 1919.66 (95% UI, 1715.24 to 2135.28), with an average annual percentage change (AAPC) of -0.21% (95% Confidence Interval [CI], -0.23% to -0.19%). The age-standardized DALY (Disability-Adjusted Life Years) rate also declined from 88.04 (95% UI, 62.19 to 125.15) to 79.11 (95% UI, 54.94 to 114.14) with an AAPC of -0.33% (95% CI, -0.36% to -0.31%). Refraction disorders remain a significant burden in regions with lower Socio-demographic Index (SDI), particularly in parts of South Asia and Western Sub-Saharan Africa. Older individuals and females are disproportionately affected. The age-standardized DALY rate is expected to decline steadily before stabilising at approximately 77.94 per 100,000 by 2030.

Global trends in the burden of rheumatoid arthritis by sociodemographic index: a joinpoint and age–period–cohort analysis based on the Global Burden of Disease Study 2019

ObjectiveTo describe temporal trends in the incidence and disability-adjusted life years (DALYs) of rheumatoid arthritis (RA) across sociodemographic index (SDI) quintiles and sexes from 1990 to 2019.MethodsData on RA incidence...

Global trends and projections of occupational trichloroethylene (TCE) exposure-associated kidney cancer: Insights of the Global Burden of Disease (GBD) Study 2021 from 1990 to 2021 and prediction to 2050

BackgroundExposure to trichloroethylene (TCE) in occupations is associated with an increased risk of kidney cancer (KC). However, there is a lack of comprehensive study on the global burden of occupational exposure to TCE-related KC. MethodsEpidemiological data on occupational TCE exposure-associated KC from 1990 to 2021 were obtained from Global Burden of Disease (GBD) 2021 study, including death counts and disability-adjusted life years (DALYs). Global burden of this disease was stratified by genders, age, socio-demographic index (SDI) quintiles, GBD subcontinental regions, and countries. The estimated annual percentage change (EAPC) was calculated to illustrate trends over the last 32 years, and forecasts were conducted to predict the disease burden until 2050. ResultsIn 2021, the global age-standardized death rate (ASDR) of occupational TCE exposure-related KC was 0.0009 (95 %UI: 0.0002–0.0016) per 100,000 persons, and the age-standardized DALY rate (ASDAR) was 0.0284 (95 %UI: 0.0062–0.0522) per 100,000 individuals. The disease showed significant heterogeneity by sex and age, with males bearing a notably higher burden, and the burden being concentrated in the 50–79 year-old group. Major burdens were focused in middle to high-middle SDI regions, especially in Southern Latin America (Uruguay, Argentina, and Chile). Over 32 years, the burden of occupational TCE exposure-associated KC has gradually increased, with projections indicating continued growth to 2050, particularly among males and individuals aged 50–79. Regions like high-middle SDI areas, North America, High-income North America, Southern Sub-Saharan Africa, saw the most significant increases. Correlation analyses indicated a positive association between ASDR and ASDAR with SDI, while EAPC showed a notable negative correlation with SDI. Decomposition analyses reveals three global population determinants that positively contributed to the increase in deaths, but negatively impacted DALYs. ConclusionThis study highlights a significant rising trend of occupational TCE exposure-associated KC from 1990 to 2021 and projected to 2050, with an emphasis on the disease burden in men, elderly population, and middle to high-middle SDI regions, underscoring the impact of occupational TCE exposure on KC.