Disability-adjusted Life Years Rate Research Articles

Epidemiology of urinary tract infections in the Middle East and North Africa, 1990–2021

ObjectiveThis research reports the incidence, mortality, and disability-adjusted life years (DALYs) associated with urinary tract infections (UTIs) in the Middle East and North Africa (MENA) region, stratified by sex, age, and Socio-demographic Index (SDI) from 1990 to 2021.MethodsData were sourced from the Global Burden of Disease 2021 study, encompassing all 21 countries in the region. Metrics such as absolute counts, age-standardised rates, and percentage changes from 1990 to 2021 are presented with 95% uncertainty intervals (UIs).ResultsIn 2019, the MENA region recorded an incidence rate of 4,033.4 per 100,000 (95% UIs: 3,553.7–4,548.7) and 7,687 deaths (95% UIs: 6,663–8,969). The DALY rate was 41.3 per 100,000 (95% UIs: 36.1–47.2), which was highest among older adults, reaching a peak in the 80–89 age range, and increasing with age, particularly from the 50 + age groups. A non-linear relationship was identified between the burden of UTIs and the SDI, with higher-than-expected rates in lower SDI countries such as Syria and Lebanon.ConclusionDespite a substantial increase in the total number of UTI cases and DALYs in the region from 1990 to 2021, the age-standardised rates remained stable. The larger burden in lower SDI countries highlights the urgent need for targeted public health interventions. Improving healthcare access and antibiotic stewardship is crucial to mitigating the growing burden of UTIs, particularly among older populations in the region.

Evaluation of pulmonary tuberculosis disease burden in Shenyang, China, 2023

BackgroundPulmonary tuberculosis (PTB) is one of the most serious infectious diseases worldwide and poses a great threat to people’s health. China has a vast territory with substantial regional disparities in the PTB disease burden. However, there have been no studies conducted to evaluate the PTB disease burden in Shenyang. The aim was to elucidate the magnitude, composition, and distribution of PTB disease burden in Shenyang.MethodsThe disability-adjusted life years (DALYs) calculated based on Global Burden of Disease (GBD) framework was used to assess the disease burden of PTB in Shenyang in 2023, and descriptive epidemiological methods were employed to elucidate the magnitude, composition, and distribution characteristics of PTB disease burden in Shenyang.ResultsIn 2023, 4,169 PTB cases were reported in Shenyang, including 2,901 males and 1,268 females. The incidence of PTB was 45.50/105, of which 64.29/105 for males and 27.30/105 for females. The incidence among males was higher than that among females (X2 = 688.56, p<0.001). The highest incidence was 107.00/105 in the group of the population aged 80 and above (X2 = 1171.75, p<0.001). In 2023, 189 PTB deaths were reported in Shenyang, including 156 males and 33 females. The mortality of PTB was 2.06/105 of which 3.46/105 for males and 0.71/105 for females. The mortality among males was higher than that among females (X2 = 83.69, p<0.001). The highest mortality was 16.04/105 in the group of the population aged 80 and above (X2 = 285.61, p<0.001). The PTB DALYs rate was 58.25/105, of which 91.73/105 for males and 21.22/105 for females. The DALYs rate among males was higher than that among females (X2 = 44.04, p<0.001). The highest DALYs rate was 149.86/105 in the group of the population aged 80 and above (X2 = 305.35, p<0.001). Years of life lost (YLLs) due to PTB accounted for 71.38% of total DALYs, of which 74.33% for males and 52.89% for females.ConclusionThe PTB DALYs rate in Shenyang was 58.25/105, which was lower than that in China, equivalent to 80% of the national PTB disease burden rate. The disease burden showed a characteristic of increasing with age, and the PTB DALYs rate for males was higher than that for females, being equivalent to 4 times the female rate. The predominant disease burden of PTB was attributed to YLLs, accounting for as much as 71.38%, indicating that PTB primarily results in premature mortality rather than disability. Therefore, the focus should be shifted towards early intervention to reduce transmission, especially for the aged males.

Health loss and economic burden of asthma in China: a qualitative review based on existing literature.

Asthma is a significant public health issue that cannot be ignored in China and around the world, bringing a huge social burden. To evaluate the disease burden of asthma in China, including health loss and cost of illness, and identify its influencing factors. A systematic literature review and qualitative descriptive analysis were conducted, Literature was accessed through PubMed, EMBASE, Web of Science, CNKI, Wangfang Data, and VIP databases, with a cutoff date of April 3, 2024. The analysis focused on two main aspects: health loss burden, measured by disability-adjusted life years (DALYs), including years of life lost (YLLs) and years lived with disability (YLDs); and economic burden, assessed through direct and indirect costs. The risk of bias in economic studies was assessed using an 11-item methodological checklist for cost of illness, while cross-sectional studies were evaluated using the Agency for Healthcare Research and Quality's recommendation rating tool. The analysis included 50 studies, with eight focused on health loss and 42 on economic burden. The health loss studies showed a 51% decrease in asthma's age-standardized DALYs rate over 30 years, from 209.24 to 102.81 per 100,000 person-years. The health loss burden is influenced by factors such as high BMI, smoking, and occupational exposure. Economic burden studies reported annual direct costs from $348 to $1187 per capita, indirect costs from $7 to $1195, and hospitalization costs from $177 to $1547, influenced by frequency and severity of acute exacerbation, comorbidities, and treatment adherence. Quality assessment revealed moderate overall quality, with gaps in sensitivity analyses and cost data transparency. The health loss burden of asthma in China has significantly decreased from 1990 to 2019, with males experiencing a higher burden. However, regional disparities in the economic burden persist, highlighting the need for improved management and adherence to standardized treatment protocols to address these disparities.

The global burden of chronic respiratory diseases attributable to tobacco from 1990 to 2021: a global burden of disease study 2021

BackgroundTobacco is a major risk factor for chronic respiratory diseases (CRDs), yet the global distribution and trends of tobacco-related CRD burdens remain inadequately explored.MethodsThis study extracted data on mortality, disability-adjusted life years (DALYs), age-standardized mortality rate (ASMR), and age-standardized DALY rate (ASDR) related to tobacco-attributable CRDs from the 2021 Global Burden of Disease (GBD) study. Joinpoint regression was used to identify temporal trends in age-standardized rates (ASR), while autoregressive integrated moving average (ARIMA) forecasting was applied to project future trends in ASMR and ASDR for tobacco-related CRDs.ResultsIn 2021, global tobacco-related CRD deaths and DALYs reached 1,545,686 (95% UI: 1,144,476-1,942,541) and 33,014,429 (95% UI: 24,275,462 − 40,930,821), representing increases of 25.43% and 15.64%, respectively, since 1990. Elderly individuals and males showed a higher disease burden. Between 1990 and 2021, ASMR [average annual percentage change (AAPC) = -2.009 (95% CI: -1.8915 to -2.1263)] and ASDR [AAPC = -2.1057 (95% CI: -2.0123 to -2.199)] for tobacco-related CRDs showed a declining trend globally, with autoregressive integrated moving average forecasting suggesting continued declines in ASMR and ASDR in the future. Regionally, South Asia, East Asia, and Oceania had the highest CRD burdens, while country-specific data indicated that Nepal, Myanmar, Papua New Guinea, Kiribati, and the Democratic People’s Republic of Korea bore significant burdens. The ASMR and ASDR of tobacco-related CRDs were highest in regions and countries with Socio-Demographic Index values between 0.4 and 0.5.ConclusionAlthough global tobacco-related CRD deaths and DALYs have continued to increase, ASMR and ASDR are on the decline, with variations across geographic regions. Prevention and control strategies tailored to country-specific disease prevalence are essential to mitigate these burdens.

Global, regional, and national burden of pancreatic cancer from 1990 to 2021, its attributable risk factors, and projections to 2050: a systematic analysis of the global burden of disease study 2021

BackgroundThe incidence and mortality rates of pancreatic cancer are rising globally. This study examines global and regional trends in pancreatic cancer incidence, Disability Adjusted Life Years (DALYs), and mortality from 1990 to 2021, utilizing data from the most recent Global Burden of Disease (GBD) 2021 database.MethodsData were sourced from the GBD database over the period from 1990 to 2021. Age-standardized rates for incidence, DALYs, and mortality were calculated per 100,000 population. We also calculated the proportion of DALYs and mortality attributable to risk factors. The Bayesian age-period-cohort model was applied to project future trends until 2050.ResultsBetween 1990 and 2021, the global incidence of pancreatic cancer increased significantly, with the number of cases rising from approximately 207,905 to 508,533 and the age-standardized incidence rate (ASIR) increasing from 5.47 to 5.96 per 100,000 population. The global burden of pancreatic cancer, measured in DALYs, rose from 5.21 million to 11.32 million. Mortality rates showed a similar upward trend, with the number of deaths increasing from around 211,613 to 505,752, and the age-standardized mortality rate (ASMR) rising from 5.655 to 5.948 per 100,000 population. Notable increases in ASIR and ASMR were observed in low-middle and low sociodemographic index regions with males experienced higher rates compared to females. Age-standardized DALYs rate (ASDR) and ASMR worldwide were attributable to tobacco smoking, high BMI, and high fasting plasma glucose. Furthermore, our projection model estimates that the ASIR and ASMR of pancreatic cancer will significantly decline, while the ASDR is anticipated to maintain a steady downward trend by 2050.ConclusionThis study offers a comprehensive analysis of pancreatic cancer trends, providing crucial insights for public health planning and policy-making. Addressing identified risk factors and targeting high-risk populations are essential for effective strategies to reduce the global burden of pancreatic cancer.

Fungal Skin Disease Incidence, Prevalence and Disability-Adjusted Life Years in Four Asian Countries (1990-2019).

Fungal skin diseases are a significant burden in Asia, with varying trends from 1990 to 2019, highlighting the need for targeted interventions. To investigate long-term trends in the incidence, prevalence and disability-adjusted life-year rates for fungal skin diseases in China, India, Japan and Singapore from 1990 to 2019. Data were obtained from the 2019 Global Burden of Disease Study. Independent age, period and cohort effects were calculated using age-period-cohort analysis. Age-standardised incidence, prevalence and disability-adjusted life-year rates of fungal skin diseases in China, India, Japan and Singapore decreased from 1990 to 2019. India has the highest standardised incidence, prevalence and disability-adjusted life-year rates. The crude incidence, prevalence and disability-adjusted life-year rates showed an increasing trend in China, Japan and Singapore, and a decreasing trend in India. The age-period-cohort analysis found that the age effect increased in China, Japan and Singapore at ages 45-94 years, and India showed higher risk coefficients at ages 5-20 and 45-94 years. The period effect increased in the four countries, with more pronounced increases in Japan and Singapore. The cohort effect showed a monotonic decline with birth cohort in the four countries, with a slightly slower decline in India. Fungal skin diseases pose a serious burden in Asian countries. We recommend raising awareness and providing specialised interventions for fungal skin diseases, especially for high-risk groups, such as middle-aged and older adults aged ≤ 45 years and young Indians aged ≤ 20 years.

The burden of dengue in South American countries, 1990-2019: Estimates from the Global Burden of Disease study 2019.

To describe the main dengue metrics generated by the Global Burden of Disease (GBD) Study 2019 for South American countries between 1990 and 2019. A descriptive study was carried out using the metrics obtained by the GBD Study 2019. The metrics of incidence, years of life lost due to premature death (YLLs), years lived with disability (YLDs) and disability-adjusted life years (DALYs) were evaluated, grouped by sex and country, between 1990 and 2019. The metrics were presented with age-standardized rates per 100,000 inhabitants and their respective uncertainty intervals (95%UI). The five countries with the highest DALY rates in 2019 were Suriname [78.60 DALYs per 100,000 inhabitants (95%UI 20.06-117.82)], Colombia [57.76 DALYs per 100,000 inhabitants (95%UI 44.35-69.97)], Guyana [29.21 DALYs per 100,000 inhabitants (95%UI 18.21-31.13)], Venezuela [22.58 DALYs per 100,000 inhabitants (95%UI 12.68-31.13)] and Brazil [18.86 DALYs per 100,000 inhabitants (95%UI 12.33-23.43)]. Between 2000 and 2010, there was a relative increase in DALY rates in practically all countries, with the highest percentages in Bolivia (222.5%), Venezuela (158.66%), Brazil (127.50%), Paraguay (90.22%) and Suriname (36.04%). Between 2010 and 2019, all countries showed a relative reduction in DALY rates. This study contributed to the understanding of the dengue burden on the South American continent, pointing to a relative increase between 2000 and 2010 and a relative reduction between 2010 and 2019 in practically all countries.

Assessing human toxicity and ecotoxicity impacts of agricultural pesticide use in Iran based on the USEtox model.

The human health and ecotoxicity impacts of agricultural pesticide use in Iran in 2022 were estimated. The impacts of agricultural pesticide use in Iran by pesticide, crop, and province were assessed based on the USEtox model in terms of disability-adjusted life year (DALY) for human health and potentially disappeared fraction of freshwater ecosystem species (PDF) for ecotoxicity. The annual mass of agricultural pesticide use in Iran in 2022 was 17,188 tons, consisting of herbicides (46.2 %), insecticides (30.0 %), and fungicides (23.8 %). The DALYs and DALY rate (per 100,000 people) of agricultural pesticide use in Iran were determined to be 25,140 and 29.4, respectively. The ecotoxicity impact of agricultural pesticide use in Iran was calculated to be 3.35 × 10+12 PDFm3 d. Over 79 % of the human health and ecotoxicity impacts of agricultural pesticide use were attributed to six pesticides (chlorpyrifos, deltamethrin, ethion, phosalone, thiodicarb, and abamectin) and eight crops (pistachio, apple, fig, vegetables, date, orange, wheat and barley, and cotton). While the contributions of the pesticides to the human health and ecotoxicity impact were not the same, chlorpyrifos ranked highest in both human health (28.8 %) and ecotoxicity (49.9 %) impacts. The highest provincial human health and ecotoxicity impacts of agricultural pesticide use were observed in Tehran (4,201 DALYs) and Fars (3.66 ×10+11 PDFm3 d), respectively. The provincial human health and ecotoxicity impacts were mainly driven by population and cropland area, respectively. Given the considerable human health and ecotoxicity impacts, developing national and provincial action plans for more sustainable use of pesticides in Iran is strongly recommended.

Analysis and prediction of the age-period-cohort model of disease burden of rheumatoid arthritis in China from 1990 to 2019

Using the Global Burden of Disease Study 2019 (GBD 2019) database, the Joinpoint regression model was used to analyze the trend of rheumatoid arthritis (RA) incidence and the standardized disability-adjusted life years (DALY) rate in China. The age, period, and cohort effects were discussed based on the age-period-cohort model. The grey prediction model GM (1, 1) was used to fit the trend of incidence and the standardized DALY rate of RA and predict the incidence and standardized DALY rate of RA in China from 2020 to 2034. From 1990 to 2019, the incidence, standardized incidence, and standardized DALY rate of RA showed a gradual upward trend, with an average annual increase of 1.41% (95%CI 1.32%-1.44%, P<0.001); 0.10% (95%CI 0.01%-0.14%, P<0.001); and 1.91% (95%CI 1.82%-2.12%, P<0.001). The results of the age-period-cohort model showed that the longitudinal age curve of the incidence of RA from 1990 to 2019 showed a trend of increasing first and then decreasing, reaching a peak in the 60-64 years age group. The longitudinal age curve of the standardized DALY rate showed a gradual upward trend, reaching the peak in the 85-89 years age group. The results of period effect showed that the risk of RA increased first and then decreased from 1990 to 2019, with the highest risk from 2010 to 2014, and the risk of incidence was RR=1.03 (95%CI 1.00-1.06). The risk of DALY showed a fluctuating change, with a trend of decreasing first, then increasing, and then decreasing again. The highest risk of DALY in 2005-2009 period was RR=1.03 (95%CI 1.02-1.05). The results of the cohort effect showed that the later the birth, the higher the risk of morbidity and DALY. From 2020 to 2034, the projected incidence and standardized DALY rate of RA in China showed an upward trend. RA remains a major public health challenge. From 1990 to 2019, the incidence, standardized incidence, and standardized DALY rate of RA in China showed an increasing trend, which were affected by age, period effect, and cohort effect to varying degrees. Although the burden of RA in China is lower than the global average, it is still essential to take active preventive measures to reduce the burden of RA and identify and treat RA early.

Global burden and cross-country inequalities of nutritional deficiencies in adults aged 65 years and older, 1990–2021: population-based study using the GBD 2021

Background/objectivesNutritional deficiencies remain significant public health issues in older populations globally. This study evaluates the burden, trends, and cross-country inequalities of four common nutritional deficiencies (protein-energy malnutrition, iodine deficiency, vitamin A deficiency, and dietary iron deficiency) in older adults from 1990 to 2021.MethodsAge-standardised prevalence, disability-adjusted life years (DALYs), and average annual percentage changes (AAPCs) of these deficiencies in people aged ≥ 65 years at global, regional, and national levels were estimated from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021. Cross-country inequalities in disease burden were quantified using the slope index and concentration index, standard health equity methods recommended by the World Health Organization.ResultsGlobally, age-standardised prevalence rates of protein-energy malnutrition increased from 1407.16 per 100 000 population in 1990 to 2015.58 in 2021, with an AAPC of 1.18 (1.08–1.28), showing significant changes in 2015 and 2019, which were turning points in the joinpoint regression. Age-standardised prevalence rates of iodine, vitamin A, and dietary iron deficiencies decreased, with AAPCs of -0.49 (-0.53 to -0.44), -3.24 (-3.27 to -3.20), and − 0.14 (-0.17 to -0.12), respectively. Except for an increase in the DALY rate of vitamin A deficiency (AAPC 0.40), the DALY rates of the other three deficiencies decreased. Inequality in the burden of protein-energy malnutrition and iodine deficiency between high- and low-income countries narrowed, while inequality for vitamin A and dietary iron deficiencies remained stable. Age-standardised DALY rates for all deficiencies decreased as sociodemographic index increased.ConclusionsThe global status of nutritional deficiency among older adults has improved since 1990, but the increasing prevalence of protein-energy malnutrition requires attention. Additionally, cross-country health inequalities persist, necessitating more efficient public health measures.

Global, regional and national burden of lung cancer attributable to occupational carcinogens, 1990-2019: A study of trends, inequalities and predictions based on GBD 2019.

Lung cancer, a leading cause of cancer-related mortality, is significantly influenced by occupational carcinogens. This study aimed to assess and predict global, regional and national trends of lung cancer burden attributable to occupational carcinogens. Data on the lung cancer burden attributable to nine occupational carcinogens were obtained from the Global Burden of Disease Study 2019. Regions were categorized by the Socio-Demographic Index (SDI). Descriptive statistics, Joinpoint regression, and Age-Period-Cohort (APC) models were employed to analyze trends in mortality and Disability-Adjusted Life Years (DALYs). Using the Slope Index of Inequality and Concentration Index, health inequalities were quantified. The ARIMA-LSTM model was developed to predict the burden from 2020 to 2030. From 1990-2019, lung cancer deaths and DALYs due to occupational carcinogens increased. Global age-standardized mortality (ASMR) and DALY (ASDR) rates declined, while middle and lower SDI regions increased. Joinpoint regression and APC analysis revealed that the local drift, period, and cohort effects exhibited increasingly unfavorable trends in lower SDI regions, while they were decreasing trends in higher SDI regions. Conversely, age effects increased similarly across all SDI regions. Health inequalities worsened over time. The ARIMA-LSTM model demonstrated global ASMR and ASDR would decrease, while low-middle and low SDI regions were expected to experience substantial increases from 2020 to 2030. Health inequality of lung cancer burden attributable to occupational carcinogens remained a critical concern, underscoring the urgent need for targeted occupational health policies for low and low-middle SDI regions.

Incidence, mortality, and global burden of retinoblastoma in 204 countries worldwide from 1990 to 2021: Data and systematic analysis from the Global Burden of Disease Study 2021.

Retinoblastoma (Rb), the primary intraocular malignancy in children, poses significant risks, yet its overall burden remains inadequately assessed. This study aims to analyze global Rb trends using Global Burden of Disease, Injuries, and Risk Factors study (GBD) 2021 data. GBD 2021 data was analyzed to assess Rb incidence, mortality, and disability-adjusted life years (DALYs) from 1990 to 2021. Average annual percentage changes (AAPCs) were calculated across genders, age groups (0-9 years), and geographic regions categorized by socio-demographic index (SDI) quintiles. From 1990 to 2021, the global Rb age-standardized incidence rate (ASIR) increased from 0.08 (per 100,000, range: 0.05 to 0.10) to 0.09 (per 100,000, range: 0.06 to 0.13). ASIR was not significantly correlated with SDI (R = -0.095, P = 0.18), while age-standardized DALYs rate (R = -0.693, P < 0.001) and age-standardized mortality rate (ASMR) (R = -0.71, P < 0.001) were significantly and negatively correlated with SDI. Increases in ASIR were concentrated in Asia, Europe, and northern and southern Africa. The highest standardized DALYs and ASMR were noted in certain countries in Asia, Europe, and South Africa. Among age groups, the highest disease burdens were observed in the "0-6 days" and "2-4 years" groups. There were no significant gender differences in Rb burden globally. Despite global progress, regions with lower SDI face elevated Rb burden and mortality. Females exhibit higher burdens during infancy, necessitating further investigation. Effective Rb management in resource-limited areas requires international collaboration focused on health education, early diagnosis, and prenatal screening for high-risk families.

Global, Regional, and National Burden of Male Breast Cancer, 1990-2021: A Systematic Analysis for the Global Burden of Disease Study 2021.

Male breast cancer (MBC) is rare and often treated using evidence from female breast cancer (BC) trials due to limited male participation. Previous estimates lacked global coverage and completeness. We aimed to quantify the global MBC burden from 1990 to 2021 and evaluate its current status and trends. Based on the global burden of disease (GBD) database, we gathered and analyzed data on the incidence, death, and disability-adjusted life years (DALYs) of MBC while utilizing age-standardized rates (ASRs) as indicators for these measurements. Our study calculated the estimated annual percentage change (EAPC), aiming at measuring the average change in ASRs. Additionally, we evaluated the attributable risk factors (RFs) and trends of MBC across different regions and age groups worldwide. In 2021, the global MBC age-standardized incidence rates (ASIR), age-standardized death rates (ASDR), and age-standardized DALY rates (ASDALY) per 100,000 persons were 0.941 (95% UI, 0.605-1.155), 0.335 (95% UI, 0.232-0.409), and 9.157 (95% UI, 6.116-11.423), respectively. In comparison to 1990, these rates have increased by 2.212 (95% UI, 2.047-2.378), 0.664 (95% UI, 0.562-0.767), and 0.853 (95% UI, 0.750-0.956) respectively. In Uganda 2021, the ASIR and ASDR of MBC were the highest at 4.541 (95% UI, 3.028-6.808) and 3.510 (95% UI, 2.301-5.195) per 100,000 persons, respectively. Moreover, the burden of MBC exhibited an increase with age. Globally, dietary risk was the most important attributable RF for MBC deaths, with a death percentage of 11.690% (95% UI, -0.003%-24.838%), followed by alcohol use and tobacco. From 1990 to 2021, the ASIR, ASDR, and ASDALY of MBC have shown significant disparities and an increasing trend. Committing to healthy lifestyle choices, such as decreasing tobacco and alcohol consumption and making positive changes to dietary habits, can assist in reducing MBC risk. The development and execution of robust and effective public health policies are crucial for alleviating the global disease burden.

Global, regional and national burden of asthma attributable to NO2from 1990 to 2021: an analysis from the Global Burden of Disease Study 2021

ObjectivesThis study aims to systematically assess the global, regional, and national burden of asthma attributable to nitrogen dioxide (NO₂) pollution.Design and settingAnalysis of population-level data from 1990 to 2021 obtained from the Global Burden of Disease Study 2021, covering 204 countries and territories.ParticipantsParticipants included patients with asthma attributable to NO₂ pollution.Main outcomes and measuresAsthma-related disability-adjusted life-years (DALYs) and age-standardised DALY rates (ASDR) attributable to NO₂ pollution across 204 countries and territories. The estimated annual percentage change (EAPC) was used to assess temporal trends to identify regions with increasing or decreasing asthma burdens.ResultsIn 2021, NO₂ pollution contributed to approximately 176.73 thousand DALYs globally, with an ASDR of 2.48 per 100 000 population (95% uncertainty interval (UI) −2.26 to 10.30). The global ASDR declined significantly from 1990 to 2021, with an EAPC of −1.93% (95% CI −2.14% to −1.72%). High-income North America had the highest ASDR (10.74 per 100 000; 95% UI 10.12 to 46.56), while Australasia experienced the most significant reduction in ASDR over the study period (EAPC −3.92%; 95% CI −4.46% to −3.37%). In contrast, Oceania and Southeast Asia showed increasing trends in asthma burden, with EAPCs of 2.33% (95% CI 1.57% to 3.10%) and 1.14% (95% CI 0.81% to 1.47%), respectively. The 5–9 age group carried the highest asthma burden, reflecting the vulnerability of younger children to NO₂ exposure. A positive correlation between ASDR and sociodemographic index (SDI) was observed (R=0.637, p&lt;0.001), indicating a greater asthma burden in higher SDI regions.ConclusionThe findings highlight significant regional and demographic disparities in asthma burden attributable to NO₂ pollution. Tailored public health strategies are needed to address the rising burden in vulnerable regions. Future research should focus on identifying effective interventions to reduce NO₂ exposure and improve asthma outcomes, especially in rapidly developing areas.

The global, regional burden of pancreatic cancer and its attributable risk factors from 1990 to 2021

BackgroundPancreatic cancer is the 12th most common type of cancer, and the sixth leading cause of cancer-related mortality, worldwide. Up-to-date statistics on pancreatic cancer would provide us with a better understanding of epidemiology and identify the causative risk factors for the prevention of this disease.MethodsThe degree and change patterns of exposure as well as the attributable cancer burden, including incidence, mortality, disability-adjusted life years (DALYs), and prevalence in global and regional, by sex, age, year, for pancreatic cancer, with the data extracted from the Global Burden of Diseases Study (GBD) 2021. All data analyses were conducted using linear regression analysis and the Joinpoint software (version 5.0.1).ResultsIn 2021, 508,533 new cases of pancreatic cancer have been reported; the mortality and prevalence rate increased to 5.95, and 5.12 respectively; and the global DALYs rate increased to 130.33 this year. Besides, the pancreatic cancer-associated rates of incidence, mortality, DALYs, and prevalence were higher in males than in females. In addition, these indicators in the high SDI (Sociodemographic index) region were higher than the global mean. To date, the high fasting plasma glucose remained the major risk factor that influenced the incidence, mortality, DALYs, and prevalence of pancreatic cancer, followed by tobacco and high body mass index (BMI).ConclusionsResults of this study suggest that the burden of pancreatic cancer is increasing generally, therefore, more attention and measures should be taken to cope with this situation.

Global regional and national burden of intracerebral hemorrhage between 1990 and 2021

Intracerebral hemorrhage (ICH) represents one of the most devastating forms of stroke, characterized by spontaneous bleeding into the brain parenchyma. This neurological emergency carries a substantial burden of mortality and long-term disability worldwide. A comprehensive understanding of ICH’s evolving global impact from 1990 to 2021 remains essential for healthcare planning and resource allocation. We conducted a systematic analysis of ICH burden utilizing data from the Global Burden of Disease (GBD) Study 2021. Key epidemiological indicators were extracted, including prevalence, incidence, mortality, and disability-adjusted life-years (DALYs). Temporal trends were quantified through estimated annual percentage changes (EAPCs) in age-standardized rates of prevalence (ASPR), incidence (ASIR), mortality (ASDR), and DALYs across the study period. The association between disease burden and socioeconomic development was examined using the sociodemographic index (SDI) as a metric of societal development. This analytical framework enabled assessment of ICH burden across global, regional, and national scales while accounting for demographic and socioeconomic variations. From 1990 to 2021, while absolute ICH cases increased globally, age-standardized incidence rates declined. Our novel geographic analysis revealed East Asia bearing the highest burden, with Eastern Europe showing the highest age-standardized rates. Gender analysis identified distinct age-specific patterns, with males above 35 showing higher risk, particularly in Eastern Europe, while South Asia demonstrated minimal gender differences. Our innovative analysis during COVID-19 revealed healthcare system strength significantly impacted ICH outcomes, with well-resourced countries maintaining better outcomes. Regional risk factor assessment showed varying impacts of high systolic blood pressure across regions, highest in Southern Sub-Saharan Africa and lowest in Oceania. Future projections through 2030 indicate improving survival rates in most regions, except in low-income areas, highlighting persistent healthcare disparities. While the absolute number of ICH cases, deaths, and DALYs increased globally from 1990 to 2021, age-standardized rates showed a decreasing trend. This suggests improvements in prevention and management strategies over time. However, the burden of ICH remains substantial and unevenly distributed across regions, with lower SDI areas facing a disproportionately higher burden. These findings highlight the need for targeted interventions and resource allocation, particularly in regions with higher ICH burden, to further reduce the global impact of this devastating condition.

Global Burden of Cardiovascular Diseases and its Risk Factors, 1990-2021: A Systematic Analysis for the Global Burden of Disease Study 2021.

Cardiovascular diseases (CVD) represent a major global health challenge, necessitating up-to-date data on its burden for effective care planning and resource allocation. This study comprehensively analyzes the global, regional, and national CVD burden and associated risks from 1990 to 2021. We performed a secondary analysis of CVD burden and risk factors using the Global Burden of Disease (GBD) 2021 study. In 2021, there were 612 million cases of CVD globally, accounting for 26.8% of all deaths. From 1990 to 2021, the global age-standardized prevalence rate of CVD rose by 0.88% to 7,179 cases per 100,000 individuals, while mortality and DALY rates fell by 34.3% and 33.0% to 235 and 5,056 cases per 100,000 individuals, respectively. The highest CVD burden is seen in low-middle SDI levels. Regional disparities, differences in health system outcomes, and SDI-related inequalities persist. Ischemic heart disease (IHD) and stroke are significant contributors among CVD subtypes. The burden is more pronounced in older age groups and men. Notably, 79.5% of total CVD disability-adjusted life years (DALYs) were attributable to 11 risk factors, with high Body Mass Index (BMI) showing the most significant increase. Despite advancements, CVD remains a significant global burden, especially in low and lower-middle SDI regions. Rising prevalence and the impact of COVID-19 underscore ongoing challenges. The diverse burden across health systems highlights the need for sustained investment in healthcare infrastructure and targeted interventions. Addressing modifiable risk factors and socio-economic inequalities is essential.

Global, regional, and national burden of young COPD, 1990–2021, with forecasts to 2050: a systematic analysis for the global burden of disease study 2021

BackgroundYoung chronic obstructive pulmonary disease (COPD) refers to people with COPD between the ages of 20 and 50 years. Current epidemiological studies focus on local geography, and there is a lack of global-level analysis. This study provides in-depth analyses of the disease burden of young COPD at global, regional, and national levels.MethodsThis study used the Global Burden of Disease Study 2021 (GBD). The age-standardised prevalence rate (ASPR), age-standardised incidence rate (ASIR), age-standardised death rate (ASDR), and age-standardised disability-adjusted life years (DALYs) rate were used to describe the disease burden. The estimated annual percentage change (EAPC) during the study period was calculated. Joinpoint regression analysis examined the time trend from 1990 to 2021. Annual percentage change (APC) and average annual percentage change (AAPC) were calculated. Risk factors were reported by region and sex.ResultsIn 2021, the global number of young COPD cases was 30,384,539, and the ASPR, ASIR, ASDR, and age-standardised DALYs rates fell slightly. Oceania reported the highest ASPR, ASDR, and age-standardised DALYs rate. High-income North America has the highest ASIR. In 2021, the prevalence, incidence, death, and DALYs rates exhibited similar trends, increasing with age. From 1990 to 2021, both the prevalence and death rates showed a consistent downward trend across all age groups. Joinpoint regression analysis indicated a slight increase in both the ASPR (APC: 0.13; 95% CI: 0.06 to 0.19) and the ASIR (APC: 0.17; 95% CI: 0.10 to 0.24) during the period from 1990 to 1994. The leading DALYs attributable to risk factors for young COPD are household air pollution from solid fuels (20.4%), ambient particulate matter pollution (17.9%), and smoking (13.5%).ConclusionsThe global burden of ASPR, ASIR, ASDR, and age-standardised DALYs rates in young COPD has decreased, however, the absolute number of patients has increased. The global burden shows noticeable regional differences, with particularly high burdens observed in Oceania. Improving air quality, promoting smoking cessation, and increasing access to lung function tests, raising awareness of young COPD are key strategies for alleviating the burden of young COPD.

Global leukemia burden and trends: a comprehensive analysis of temporal and spatial variations from 1990—2021 using GBD (Global Burden of Disease) data

BackgroundLeukemia, a group of malignant tumors, has been a significant public health concern due to its high incidence and mortality rates. This study aimed to provide an in-depth analysis of the global leukemia burden from 1990 to 2021 using the Global Burden of Disease (GBD) database, focusing on trends in incidence, mortality, and Disability-Adjusted Life Years (DALYs) across different regions, genders, and age groups including forecasting future trends.MethodsData were sourced from the GBD study, utilizing the Global Health Data Exchange (GHDx) query tool. We employed descriptive, trend, cluster, and forecasting analyses using age-standardized rates (ASRs) and the Estimated Annual Percentage Change (EAPC) to quantify changes over time. Hierarchical clustering and forecasting models, including ARIMA and Exponential Smoothing (ES), were utilized to predict future trends. Notably, ARIMA and ES smoothing parameters were meticulously identified and estimated.ResultsThe analysis of global leukemia burden from 1990 to 2021, as reflected by DALYs, indicates a downward trend, with the number of DALYs estimated to have decreased from 578,020 (401,241–797,570) in 1990 to 302,902 (206,475–421,952) in 2021, corresponding to an EAPC of -0.94 (-1.01—-0.88). Notably, it is important to highlight that there is variability in these estimates across different regions and demographic groups, which should be interpreted with caution due to potential data limitations. High-income regions generally showed a decreased leukemia burden, while some middle- and low-income countries exhibited an opposite trend. Males displayed higher leukemia incidence, mortality, and DALY rates compared to females. The oldest age groups, mainly those aged 95 and above, experienced the most significant changes, with the highest EAPC observed in this demographic. Geographical and Socio-demographic Index (SDI)–based analyses further highlighted the heterogeneity in leukemia burden. Additionally, forecasting models project a continued decrease in leukemia burden, emphasizing the importance of ongoing public health strategies.ConclusionThe study indicates overall progress in reducing the leukemia burden at a global level due to medical advancements. However, specific regions and demographic groups, particularly males and the elderly, continue to face challenges. Socioeconomic status significantly impacts healthcare outcomes, with a need for resource distribution and healthcare system strengthening in low-income areas. The findings call for nuanced public health strategies tailored to socioeconomic contexts and sustained research and healthcare infrastructure efforts.

Low back pain trends attributable to high body mass index over the period 1990-2021 and projections up to 2036.

High body mass index (BMI) is a crucial determinant in low back pain (LBP) incidence and progression. However, the effect of increased BMI on LBP has been largely overlooked at the global, regional, and national levels. This research aimed to use data from the 2021 global burden of disease (GBD) study to determine trends associated with LBP due to high BMI from 1990 to 2021, thereby providing evidence for developing targeted policies. Epidemiological data on the association between high BMI and LBP is obtained from the GBD 2021. Disability-adjusted life-years (DALYs) attributable to high BMI-related LBP are stratified by year, age, country, and socio-demographic index (SDI). The estimated annual percentage change (EAPC) was calculated to evaluate the trends from 1990 to 2021. A Bayesian age-period cohort (BAPC) model was used to assess the corresponding trends from 2022 to 2036. Additionally, statistical models, such as decomposition analysis and frontier analysis, were used. According to the GBD 2021, the number of DALYs caused by LBP attributed to high BMI reached 8,363,759 in 2021, which is an increase of 170.97% since 1990. The age-standardized rate of disability-adjusted life years (ASDR) for LBP caused by high BMI has been increasing from 1990 to 2021, with an EAPC of 1.14%. Among the five SDI regions, ASDR has increased. High-income North Americans exhibited the highest risk of LBP caused by high BMI, with Hungary being the most affected. Frontier analysis highlights the urgent need for intervention in countries such as the Netherlands, Germany, and Canada. Finally, the burden of LBP related to high BMI will continue to rise from 2022 to 2036. Between 1990 and 2021, there was a global increase in lower back pain due to high BMI, with a projected continuation of this trend. Monitoring BMI is crucial for developing region-specific and national strategies, and research emphasizes the urgency of reducing the health burden of high BMI and improving the quality of life for the global population.