Regional Disease Burden Research Articles

Global, regional, and national disease burden attributable to high systolic blood pressure in youth and young adults: 2021 Global Burden of Disease Study analysis

BackgroundHigh systolic blood pressure (HSBP) can cause adverse cardiovascular events and is therefore associated with a heavy global disease burden. However, this disease burden is poorly understood in youth and young adults. We aimed to explore this population to better understand the evolving trends in HSBP-related disease burden, which is crucial for effectively controlling and mitigating harmful effects.MethodsThis systematic analysis used data from the 2021 Global Burden of Disease Study, spanning 1990–2021. Participants were aged 15–39 years from 204 countries/territories. We analysed HSBP-related disease burden by region, sex, age, and temporal trends. The primary outcomes were disability-adjusted life years (DALYs), mortality rates, and estimated annual percentage change.ResultsGlobally, the number of HSBP-related deaths among youth and young adults has increased by 36.11% (95% uncertainty interval [95% UI], 20.96–52.37%), whereas the number of DALYs has increased by 37.68% (95% UI, 22.69–53.65%); however, global mortality and DALY rates have remained relatively stable. In 2021, the mortality and DALY rates were 4.29 (95% UI, 3.29–5.28) and 263.37 (95% UI, 201.40–324.46) per 100,000 population, respectively. The overall HSBP-related burden was higher in males than in females, with increasing and decreasing trends for males and females, respectively. Regionally, significant improvements in HSBP-related burden were observed in most high-sociodemographic index (SDI) regions, including high-income Asia Pacific (deaths: percentage change, − 72.65%; DALYs: percentage change, − 69.30%) and Western Europe (deaths: percentage change, − 72.89%; DALYs: percentage change, − 67.48%). In contrast, middle-SDI regions had the highest number of deaths and DALYs in 2021, whereas low-middle-SDI regions had the highest mortality and DALY rates. Furthermore, low-SDI regions experienced the largest increase in the number of deaths and DALYs. The HSBP-related burden increased with age; in addition, the proportion of deaths or DALYs due to ischaemic heart disease and stroke increased with age, reaching > 75% for those > 25 years of age.ConclusionsThe increase in global HSBP-related burden among youth and young adults indicates that current preventative efforts are insufficient. Therefore, targeted measures are needed to counter the trends in HSBP-related diseases and reduce disparities across regions and sexes.

Absolute risk prediction for esophageal squamous cell carcinoma adaptable to regional disease burden across diverse regions.

Esophageal squamous cell carcinoma (ESCC) exhibits a long latency period and has a significant geographical disparity in incidence, which underscores the need for models predicting the long-term absolute risk adaptable to regional disease burden. 31,883 participants in a large-scale population-based screening trial (Hua County, China) were enrolled to develop the model. Severe dysplasia and above (SDA) identified at screening or follow-up were defined as the outcome. We calculated the absolute risk in three steps: 1) constructing a relative risk model using logistic regression, 2) calculating the age-specific baseline hazard, and 3) adjusting for the competing risk of all-cause death excluding ESCC. Flexible incidence rate parameters were integrated into the model to ensure its relevance across diverse regions worldwide. A total of 295 SDAs were detected. The relative risk model consisted of old age, male gender, irregular meal pattern, preference for hot or hard food, BMI of less than 22 kg/m2, and ESCC family history. The area under the receiver operating characteristic curve was 0.753 (95% CI: 0.749-0.757). The averaged 5-year and 10-year absolute risk were 0.53% and 1.30% among participants. Based on our model, we developed an online calculator incorporated flexible incidence rate parameters, demonstrating ideal risk stratification tailored to regions with varying disease burdens (https://pkugenetics.shinyapps.io/escc_risk_prediction/). We developed an absolute risk model to predict individualized long-term risk of ESCC, accounting for local disease burden. This model has the potential to mitigate the global burden of ESCC by enabling targeted screening and personalized prevention strategies.

P1009 Enhancing Inflammatory Bowel Disease care: The role of mobile applications in disease management

Abstract Background Managing Inflammatory Bowel Disease (IBD) can be challenging, requiring a careful balance of medication adherence, symptom tracking, and lifestyle adjustments. Mobile applications offer a promising avenue to support individuals with IBD in navigating these complexities. This study investigates the impact of the “My IBD Under Control” mobile application on patient education and self-management. Methods The “My IBD Under Control” app provides a comprehensive suite of features designed to improve patient outcomes. Users can record and monitor symptoms such as abdominal pain, diarrhea, and constipation, enabling early detection of potential flares and timely intervention. Timely notifications help ensure adherence to prescribed treatment plans, improving disease control and reducing the risk of complications. Access to reliable information about IBD, its causes, and management strategies empowers patients to make informed decisions about their health and take an active role in their care. The nearby restroom locator is a valuable tool, especially during flare-ups, providing peace of mind and reducing anxiety. Data on user demographics, app usage patterns, and symptom tracking were collected through the app’s built-in analytics tools. Descriptive statistics were used to analyze user demographics and app usage patterns. Data privacy was ensured through secure data storage and anonymization techniques. Results Since its launch in February 2022, the “My IBD Under Control” app has attracted a significant user base of over 5900 individuals with IBD in Turkey. The user base is predominantly male (58%) with a mean age of 38, while female users (42%) have a mean age of 33. The app’s high interaction rate of 63.4% indicates strong user engagement. Although only 7% of users have specified their IBD type, of those who did, ulcerative colitis was more prevalent (60%) than Crohn’s disease (40%). The higher engagement rate among younger users suggests that this demographic may be more receptive to digital health tools. Figure 1 illustrates the growth of the app’s user base since its launch in February 2022. The figure shows a significant increase in the total active user count and new users. Conclusion Mobile applications have the potential to revolutionize IBD care by empowering patients to take an active role in their health. The “My IBD Under Control” app offers a comprehensive suite of features to improve patient outcomes. Further research is needed to explore such apps’ long-term impact and identify strategies to optimize their use. By incorporating innovative technologies such as artificial intelligence and machine learning, future mobile health applications can enhance patient care and improve the quality of life for individuals with IBD. References Wang R, Li Z, Liu S, Zhang D. Global, regional and national burden of inflammatory bowel disease in 204 countries and territories from 1990 to 2019: a systematic analysis based on the Global Burden of Disease Study 2019. BMJ open. 2023;13(3):e065186.

N30 Exploring the effects of nurse-led clinics on the Inflammatory Bowel Disease service

Abstract Background The increasing incidence of inflammatory bowel disease (IBD) has led to greater demands on the healthcare system.1 Lack of access due to longer wait times for new referrals to tertiary IBD services can lead to worse health outcomes and reduced quality of life for people affected.2 We sought to determine whether introducing a nurse-led clinic (NLC), can improve clinic wait times and enable new referrals (category 1 <30 days and category 2 <90 days) to be reviewed within their allocated time frame. We also explored the experience and satisfaction of people with IBD reviewed by their usual consultants compared to NLC. Methods Individuals were triaged to NLC based on strict inclusion and exclusion criteria: recent pathology with normal inflammatory markers (faecal calprotectin <200mcg/g, C-reactive protein <8mg/L), a review with consultant in the last 18 months, and have stable IBD over the previous 12 months. People with active perianal disease, significant end-organ damage, coexistent liver disease, other severe comorbidities or those transitioning from paediatric to adult services were ineligible for NLC. Data on clinic wait times was collected over 6 months, from August 2023 to February 2024 and compared to a one-year period from August 2022 to July 2023, prior to the introduction of the NLC. All people attending both NLC and consultant reviews were invited to complete an anonymous patient satisfaction survey where they could rate their experience on a scale of 1-10. (Table 1) Results Of the 65 people seen in NLC, median age 39 years (IQR 23-76); 35 (54%) were female. In this cohort, 41 (63%) had Crohn’s Disease (CD), 23 (35%) Ulcerative Colitis (UC), and 1 (2%) IBD-Unclassified (IBD-U). During the same period, 358 people were seen in consultant clinics; median age 43.5 years (IQR 18-87); 198 (55%) male. In this cohort, 211 (59%) had CD, 126 (35%) UC, 8 (2%) IBD-U and 13 (4%) did not have IBD. Following the introduction of NLC, 80% of urgent category 1 referrals were seen within the recommended timeframe, compared to 60% prior. For semi-urgent category 2 referrals, 95% were reviewed on time, up from 79% at baseline. When combining both categories, the overall proportion of referrals reviewed on time increased from 71% at baseline to 89% during the NLC period, reflecting an 18% statistically significant improvement (p-value = 0.0486). (Figure 1) Surveys were completed by 69 people (52 consultant clinic; 17 NLC). The overall mean score calculated for consultants was 9.1/10, while the overall mean score for nurses was 9.4/10. (Table 1) Conclusion This pilot study showed the potential value of a nurse-led clinic to improve clinic wait times in an IBD service, whilst maintaining patient satisfaction. References Wang R, Li Z, Liu S, Zhang D. Global, regional and national burden of inflammatory bowel disease in 204 countries and territories form 1990 to 2019: a systematic analysis based on the Global Burden of Disease Study 2019. BMJ Open, 2023; 13:e065186. doi: 10.1136/bmjopen-2022-065186. Prentice JC, Pizer SD. Delayed access to health care and mortality. HSR. 2007; Apr;42(2):644-62. doi: 10.1111/j. 1475-6773.2006.00626.x.

The global, regional, and national disease burden of colorectal cancer attributable to low physical activity from 1990 to 2021: an analysis of the Global Burden of Disease Study 2021

ObjectivesThis study aims to estimate the spatiotemporal variation in the burden of colorectal cancer (CRC) attributable to low physical activity (LPA) at global, regional, and national levels from 1990 to 2021.Study designCross-sectional study.MethodsAnnual data on deaths of CRC related to LPA, age-standardized mortality rate (ASMR), disability-adjusted life years (DALYs), and the age-standardized DALYs rate (ASDR) for 204 countries and territories from 1990 to 2021 was extracted from the Global Health Data Exchange website. They were retrieved by age (5-year age groups from 25 to 94 years, and 95+ years), gender (male and female), and Socio-demographic Index (SDI). The association between age-standardized rates and SDI values was assessed by Spearman’s correlation.ResultsBetween 1990 and 2021, there was nearly a twofold increase in DALYs and mortality globally for CRC related to LPA, despite decreases in ASMR and ASDR (EAPC: −0.82% and −0.83%, respectively). However, on a national scale, ASMR and ASDR increased in more than half of the world’s countries and territories. Moreover, a greater burden of CRC related to LPA was observed in older populations, females, and those residing in regions with an SDI near 0.77.ConclusionThese findings indicate the critical need to raise awareness about the preventive role of physical activity in CRC. Policymakers should prioritize developing and implementing strategies that ensure equitable access to sports resources, enabling more people to meet the World Health Organization guidelines.

The burden of chronic kidney disease attributable to high sodium intake: a longitudinal study in 1990-2019 in China.

Elevated sodium consumption is associated with increased risk for chronic kidney disease (CKD) and data for this disease burden attributable to high sodium intake in China from 1990 to 2019 are scarce in China. Our study aims to estimate and present the national burden of CKD attributable to high sodium intake, as well as its profile. The regional disease burden data from the China Center for Food Safety Risk Assessment (CFSA) from 1990 to 2019 were compiled based on the methodology of GBD 2019. CKD burden [deaths and disability-adjusted life years (DALYs)] was quantified according to population group (age, gender) and regions categories (province, SDI). The estimated annual percentage change (EAPC) in age-standardized mortality rate (ASMR) and age-standardized DALYs rate (ASDR) were calculated to describe long-term trends. Totally, the number of deaths of CKD attributable to high sodium intake reached 95,000, with DALYs amounting to 2.59 million person-years in 2019, while the trends of ASMR (EAPC: -0.31, 95%CI: -0.46, -0.17%) and ASDR (-0.33, 95%CI: -0.48, -0.18%) were down during the observation period. The age-specific numbers and rates of deaths, as well as DALYs increase with age are higher in males than in females. Significant disparities in CKD burden attributable to high sodium intake were observed across provinces and SDI regions. In both 1990 and 2019, the number of deaths and DALYs were higher in middle SDI regions, while low-middle SDI regions had highest ASMR and ASDR. The EAPC of ASDR was found to be significantly negatively correlated with the 1990 ASDR (ρ = -0.393, p = 0.024), and the EAPC of ASMR and ASDR were also significantly negatively correlated with the 2019 SDI (ASMR:ρ = -0.571, p < 0.001; ASDR:ρ = -0.368, p = 0.035). High sodium intake accounted for a sizeable burden of disease from 1990 to 2019 in China, also presents sexual and geographic variations. Despite a slight decreasing trend exists, the absolute number increased as much as twofold, particularly among males and seniors. Targeting to reduce sodium intake remains a priority, and progress requires systematic monitoring and evaluation, particularly in middle SDI regions that are experiencing rising trends and low-middle SDI regions being susceptible to approaches.

Global, regional, and national burden of chronic obstructive pulmonary disease and its attributable risk factors from 1990 to 2021: an analysis for the Global Burden of Disease Study 2021

BackgroundChronic obstructive pulmonary disease (COPD) continues to be a significant issue, leading to premature death or reduced quality of life. It’s important to assess the current burden of COPD and its risk factors on a geographical basis to guide health policy.MethodsData on the prevalence, deaths, and disability-adjusted life years (DALYs) related to COPD, and risk-attributable burden were obtained from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 database. The relationship between COPD DALYs and the sociodemographic index (SDI) was estimated using Smoothing Splines models.ResultsBetween 1990 and 2021, the changes were -1.46% (95% uncertainty interval [UI] -3.36% to 0.39%) in age-standardized prevalence, -37.12% (-43.37% to -27.68%) in mortality, and -36.98% (-42.37% to -28.54%) in DALYs rate. In 2021, a total of 213.39 million prevalent cases of COPD were estimated. The age-standardized prevalence of COPD increased with age and was more common in males. The age-standardized COPD DALYs had a reversed U-shaped relationship with SDI at the regional level, with the highest burden at an SDI of about 0.45. At the global level, smoking had the highest influence on COPD DALYs, accounting for 34.8%, followed by ambient particulate matter pollution (22.2%), household air pollution from solid fuels (19.5%), and occupational particulate matter, gases, and fumes (15.8%).ConclusionsThe overall burden of COPD has been increasing despite improvements in some rates since 1990. It’s crucial to focus on interventions such as smoking cessation and addressing environmental and occupational exposures.

Global, regional, and national cardiovascular disease burden attributable to smoking from 1990 to 2021: Findings from the GBD 2021 Study.

Smoking poses a serious threat to cardiovascular health. The aim of the study is to evaluate the global, regional, and national burden of smoking-attributable cardiovascular disease (CVD) and set priorities for future tobacco control. Data on deaths and years lived with disability (YLDs) for smoking-related CVD from 1990 to 2021, including age-standardized rates (ASRs), were sourced from the Global Burden of Disease (GBD) 2021. This study is a secondary descriptive analysis of the GBD 2021 data. We used the estimated annual percentage change (EAPC) to reflect temporal trends in disease burden and conducted a sensitivity analysis using the average annual percentage change (AAPC) to corroborate the findings. We also analyzed the relationship between disease burden and the Sociodemographic Index (SDI). In 2021, smoking-related CVD caused 2.25 million deaths and 3.09 million YLDs globally, marking increases of 26.16% and 59.73% from 1990, respectively. However, from 1990 to 2021, the global age-standardized mortality rate (ASMR) and age-standardized years lived with disability rate (ASYR) for smoking-related CVDs decreased, with EAPCs of -1.94 and -0.92, respectively. Between 1990 and 2021, Australasia and Tropical Latin America experienced the largest declines in ASMR and ASYR, with EAPCs of -5.54 and -2.63, respectively, while Lesotho and Mali had the largest increases, with EAPCs of 2.68 and 1.67, respectively. Throughout the period, the burden of smoking-related CVD was consistently higher in men. Moreover, the trend of decline in disease burden was slower in men compared to women (EAPC for ASMR: -1.78 for men vs -3.25 for women). In 2021, countries with higher SDI also had higher ASYR. Although the global burden of smoking-related CVD has declined over the past three decades, the challenge remains severe, particularly in less developed countries and regions. More proactive and effective tobacco control measures should be urgently implemented in countries where the burden of smoking-related CVD is severe.

Burden of Fungal Skin Diseases in Five East Asian Countries: An Analysis of the Global Burden of Disease Study 2021

ABSTRACTIntroductionThe unique natural and social environments of East Asia may shape the characteristics of fungal skin diseases. However, there is a notable absence of thorough comparative analyses on this subject.MethodsThis research undertook a comprehensive analysis of the epidemiology and disease burden of fungal dermatoses across five East Asian countries (China, Japan, Republic of Korea, Democratic People's Republic of Korea and Mongolia) via the Global Burden of Disease (GBD) database from 1990 to 2021. Descriptive statistical analyses, joinpoint analyses and age‐period‐cohort (APC) modelling techniques were applied. Systematic assessments were conducted for trends in the incidence, prevalence and disability‐adjusted life‐years (DALYs) of fungal skin diseases within each country.ResultsThis study revealed an overall declining trend in the burden of fungal skin diseases across five East Asian countries from 1990 to 2021, with a particularly marked decrease from 2000 to 2010. In China, the average annual percentage change (AAPC) was −0.1333%, whereas in Japan, it was −0.0281%. However, a notable rise in DALYs among individuals aged 70 and above, particularly in China and Japan. Conversely, Democratic People's Republic of Korea and Mongolia experienced less substantial declines in incidence. These shifts underscore marked intercountry differences, illustrating the influence of socioeconomic factors and health policies.ConclusionFungal skin diseases remain a public threat in East Asian countries. It is important to develop regional, targeted strategies for the prevention and control of fungal skin diseases, with the potential to improve the effectiveness of public health interventions and reduce the regional burden of disease.

Global, regional and national disease burden of food-borne trematodiases: projections to 2030 based on the Global Burden of Disease Study 2021

BackgroundFood-borne trematodiases (FBTs), mainly encompassing clonorchiasis, fascioliasis, fasciolopsiasis, opisthorchiasis, and paragonimiasis, is a neglected public health problem, particularly in the WHO South-East Asia and the Western Pacific regions. This study evaluates the global, regional, and national disease burden of FBTs from 1990 to 2021 and projects trends to 2030, underscore the need for targeted prevention and control.MethodsUsing the Global Burden of Disease 2021 database, the crude and the age-standardized prevalence rate (ASPR) and age-standardized prevalence disability-adjusted life years rate (ASDR) of FBTs at the global, regional and national level from 1990 to 2021 were described. The pivotal years of trend changes were identified using joinpoint regression analysis. The effects of age, period, cohort on FBTs prevalence and correlation with the sociodemographic index (SDI) was analyzed. Finally, the worldwide disability-adjusted life years (DALYs) for FBTs, projected up to 2030 using the Bayesian age-period-cohort model, were analyzed.ResultsIn 2021, 44,466,329 FBTs cases [95% uncertainty interval (UI): 40,017,217, 50,034,921], and 998,028 DALYs [95% UI: 569,766, 1,638,112] were estimated across 17 countries. The Western Pacific region exhibited the highest ASPR and ASDR, with the values of 1649.26 (95% UI: 1461.95, 1881.64) and 36.54 (95% UI: 19.77, 64.16), respectively. From 1990 to 2021, Lao PDR, Thailand, and the Philippines showed the most substantial declines in FBTs, while Kazakhstan had the largest average annual percentage change in DALYs (− 6.60, 95% UI: − 7.10, − 6.10). High-middle and middle SDI countries exhibited higher burden, with ASDR values of 28.03 (95% UI: 15.41, 48.73) and 16.63 (95% UI: 9.32, 27.68), respectively. The disease burden was greater among males, peaking in the 50–59 age group. The projected ASDR in 2030 is 13.10 for males and 8.40 for females.ConclusionsFBTs remain a public health threat, with the global ASDR projected to remain stable, showing only a slight decrease by 2030. Low-income countries face ambiguous mortality rates and underestimated disease burdens, highlighting the need for improved surveillance. To achieve the 2030 NTD goal, comprehensive surveillance and integrated strategies derived using a One Health approach should be prioritized to control FBTs effectively.Graphical

Global, regional, and national burden of childhood cardiovascular disease: trends from 1990 to 2021.

Childhood cardiovascular disease (CVD) is an emerging public health concern, with rising incidence linked to obesity and diabetes. Despite advancements in care, significant disparities persist across regions and socioeconomic groups. This study analyzed the global, regional, and national burden of childhood CVD from 1990 to 2021. A cross-sectional study utilizing data from the Global Burden of Disease (GBD) 2021 was conducted. We analyzed children aged 0-14 years, categorizing them into age groups and assessing trends in incidence, mortality, and disability-adjusted life years (DALYs) across 204 countries. Statistical analyses included linear regression to calculate estimated annual percentage changes and assess temporal trends. The study revealed a 25% global increase in childhood CVD incidence over three decades, with significant disparities observed across different socioeconomic regions. Mortality and DALYs associated with CVD had decreased globally by 59% and 55% respectively, reflecting advances in medical technology and healthcare access. However, these improvements were not uniformly distributed, with low socio-demographic index regions exhibiting both the highest incidences and slowest declines in CVD-related health burdens. Environmental risks, such as extreme temperatures, also contributed to CVD mortality. While mortality and DALYs due to childhood CVD have declined globally, rising incidence and persistent disparities highlight the need for targeted interventions. Addressing socio-economic factors and enhancing access to quality care are crucial for reducing the global burden of childhood CVD.

Bibliometric analysis of myelomeningocele management: National disease burden versus publication volume

Myelomeningocele (MMC) disproportionately affects low-resource areas and regions without mandatory folic acid fortification. No specific literature exists on the distribution of research output regarding neurosurgical management of myelomeningocele worldwide in relation to regional disease burden. We aimed to examine the country of origin and patient population of published papers on MMC and topics related to neurosurgical management of MMC, to determine whether these were proportionate to disease burden. A systematic literature search was conducted on neurosurgical aspects of MMC care. The geographic distribution of neurosurgical MMC research output was examined against the national burden of disease. Bibliometric analysis quantified author and patient country affiliations stratified by World Bank income group classification and folic acid fortification status, juxtaposed with disease burden. From 9692 titles, 1843 were included, representing 107,446 patients and 2650 authorship instances. High-income countries (HICs) constituted 3% of 2019's global neuraltube defect (NTD) births, 74% of authorships, and 83% of patients represented. Upper-middle-income countries (UMICs) represented 9% of NTD births, 16% of authorships, and 9% of published patients. Lower-middle-income countries (LMICs) represented 55% of NTD births but only 8.6% of authorships and 7% of patients. Low-income countries (LICs) shouldered 32% of NTD births and contributed 1.3% of authorships and 1.6% of patients. Countries with mandatory folic acid fortification represented 75% of patients and 54% of authorships. Postnatal repair, hydrocephalus, and postoperative complications were the most frequently studied topics. The global literature concerning neurosurgical management of myelomeningocele originates predominantly from HICs. Published experiences of myelomeningocele patients from LICs/LMICs are scarce, even though they constitute the majority of the affected population. Neurosurgeons and other health professionals must address this mismatch between disease burden and publication volume in order to inform practice, policy, and advocacy for MMC care worldwide.

Global and Regional Disease Burden of Hypertensive CKD, 1980-2021: An Analysis of GBD Study 2021

Global and Regional Disease Burden of Hypertensive CKD, 1980-2021: An Analysis of GBD Study 2021

The global and regional disease burden of breast cancer from 1980 to 2021: An analysis of GBD study 2021.

146 Background: Breast cancer (BC) is the most common malignancy in women and presents a huge disease burden worldwide. Early detection, via mammographic screening, improves outcomes significantly. We present estimates from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021, delineating the trajectory of BC from 1980 - 2021. This analysis considers the impact of screening practices on the incidence and mortality of patients worldwide, offering comprehensive examination of trends over the past 4 decades. Methods: Data were methodically retrieved from GBD study, which included age-standardized death rates and Disability-Adjusted Life Years (DALY). Dataset was stratified globally and by continent, with further regional analysis of the African continent into Northern, Southern, Eastern, Western, and Central, and by World Bank income classifications of countries. We examined global age-standardized mortality rates (ASMR), followed by an analysis of global disability-adjusted life years (DALY). Finally, we identified which countries, stratified by income levels, demonstrate the highest rates. Analytical processing was conducted using Joinpoint regression to determine average annual percentage changes (AAPC). Results: Globally, Age Adjusted Death Rates (ASDR) continuously declined from 1980-2021. In 1980, the ASDR was 16.33 (95% UI: 15.39-17.22) and it declined continuously to 14.54 (AAPC: -0.28; 95% CI: -0.3, -0.27) in 2021. Globally, DALYs rate was 503.8 (95% UI: 475.9-532.2) per 100,000 people in 1990 and it decreased to 455.5 (AAPC: 3.22; 95% CI: -0.33, -0.30) in 2021. In geographical analysis, America and Europe had uniformly declining ASDRs while Africa and Asia had a steady rise in ASDR. From 1980 to 2021, America had decreasing death rates with an AAPC of -0.78 (95% CI: -0.80, -0.76). Europe also had a declining trend, albeit nonsignificant, with an AAPC of -0.53 (95% CI: -0.55, -0.49). Conversely, the AAPC for Asia was 0.42 (95% CI: 0.41-0.43) showing a continuous incline in deaths related to BC from 1980 to 2021. The highest increase in ASDRs was observed in Africa with an AAPC of 0.90 (95% CI: 0.89-0.91). Upon sub-analysis of Africa, we observed Western and Southern Africa had highest ASDRs compared to other parts of Africa. According to World Bank income levels, high income countries had declining death rates while upper-middle, lower-middle, and low-income countries all had increasing deaths rates with the highest rise in lower middle income countries. Conclusions: Asia and Africa have limited implementation of BC screening protocols and correspondingly exhibit higher BC associated mortality. Enhanced screening programs are imperative for the timely diagnosis and management of BC, ultimately improving survival rate. The enormous discrepancy in mortality rates underscores the critical importance of accessible and comprehensive BC screening initiatives globally.

Global Burden of Inflammatory Bowel Disease Among Children and Adolescents: A Comprehensive Analysis (1990-2019).

We summarize the global, regional, and national burden of inflammatory bowel disease (IBD) in children and adolescents from 1990 to 2019. Based on the Global Burden of Disease Study 2019, the data of IBD in children and adolescents were analyzed by sex, age, year, and location. Joinpoint analysis was applied to assess the temporal trend of the disease burden. From 1990 to 2019, the incidence of IBD in children and adolescents increased by 22.8%, from 20,897.42 to 25,658.55 cases, especially in high SDI region. During the same period, the DALY numbers decreased by 53.5%, from 243,081.06 to 113,119.86, with all SDI regions experiencing a clear drop in DALYs except high SDI regions. In 2019, early-onset IBD incidence and DALY numbers were reported at 2,053.52 (95% UI: 1,575.62 to 2,677.49) and 73,797.46 (95% UI: 43,655.86 to 105,998.63), respectively. Early-onset IBD in children and adolescents remains a significant global health concern. The disease burden has not improved in developed countries over the past 30 years, highlighting the need for targeted interventions.

Global, regional, and national burden of inflammatory bowel disease, 1990–2021: Insights from the global burden of disease 2021

PurposeThe prevalence of inflammatory bowel disease (IBD) is on the rise worldwide. We utilizes data from the Global Burden of Diseases (GBD) 2021 to analyze the national-level burden of IBD, trends in disease incidence, and epidemiological characteristics.MethodsDetailed information on IBD was gathered from 204 countries and territories spanning 1990 to 2021, sourced from the GBD 2021. Calculations were performed for incidence rates, mortality rates, disease-adjusted life years (DALYs), and estimated annual percentage changes (EAPCs). These trends were analyzed based on region, nationality, age, gender, and World Bank income level stratifications.ResultsThe global age-standardised incident rate (ASIR) of IBD increased from 4.22 per 100000 in 1990 to 4.45 per 100000 in 2021. However, the age-standardised mortality rate (ASMR) decreased from 0.60 per 100000 in 1990 to 0.52 per 100000 in 2021. Similarly, the age-standardised DALYs rate decreased from 21.55 per 100000 in 1990 to 18.07 per 100000 in 2021. Gender comparisons showed negligible differences in disease burden. The greatest increase in IBD-associated ASIR and ASMR occurred in World Bank upper-middle income region (EAPCs, 1.25) and World Bank high-income region (EAPCs, 1.00), respectively. Regionally, East Asia experienced the largest increase in ASIR (EAPCs, 2.89). Among 204 countries, China had the greatest increases in ASIR (EAPCs, 2.93), Netherlands had the highest ASMR in 2021 (2.21 per 100000).ConclusionsGlobal incidence rate of IBD have been increasing from 1990 to 2021, while the DALYs and mortality have been decreasing. The escalating incident rates in select Asian regions deserves further attention.

Prevalence of dengue, Zika, and chikungunya virus infections among mosquitoes in Asia: A systematic review and meta-analysis

BackgroundDengue virus (DENV), Zika virus (ZIKV), and chikungunya virus (CHIKV) continue to pose significant public health risks. This study aims to assess the prevalence of these arbovirus infections in field-caught mosquitoes across Asia. MethodsStudies published after the year 2000 on DENV, ZIKV, and/or CHIKV infections in Asian mosquitoes were identified from Embase, Scopus, PubMed, and Ovid. A random-effects model estimated the pooled prevalence, defined as the overall prevalence from included studies, adjusted for variability among the studies. Meta-regression models were used to evaluate the association between predictors and their prevalence. ResultsA total of 2529 articles were retrieved; 57 met the inclusion criteria. Pooled prevalence of DENV, ZIKV, and CHIKV infections in Asian mosquitoes were 5.85%, 2.15%, and 1.26%, respectively. Subgroup analysis revealed varying DENV prevalence across regions: East Asia (3.32%), South Asia (5.26%), and Southeast Asia (6.92%). Univariate regression analysis demonstrated significant associations between mosquito capture site and DENV prevalence (P < 0.001), and between study region and ZIKV prevalence (P = 0.005). However, no significant predictors were identified for CHIKV prevalence. ConclusionOur findings provide reference pooled summary estimates of arbovirus infections in mosquitoes, offering crucial insight into the regional disease burden and - guidance in the development and implementation of arbovirus surveillance in mosquitoes.

The burden, causes, and determinants of blindness and vision impairment in Asia: An analysis of the Global Burden of Disease Study.

Asia accounts for more than half of the world's population and carries a substantial proportion of the global burden of blindness and vision impairment. Characterising this burden, as well as its causes and determinants, could help with devising targeted interventions for reducing the occurrence of blindness and visual impairment. Using the Global Burden of Disease Study 2019 database, we retrieved data on the number of disability-adjusted life years (DALYs); crude and age-standardised rates; and the prevalence (with 95% uncertainty intervals (95%UIs)) of blindness and vision loss due to six causes (age-related macular degeneration, cataracts, glaucoma, near-vision impairment, refractive error, and other vision loss) for Asian countries for the period between 1990 and 2019. We defined DALYs as the sum of the years lost due to disability and years of life lost, and calculated age-standardised figures for the number of DALYs and prevalence by adjusting for population size and age structure. We then evaluated the time trend of the disease burden and conducted subgroup analyses by gender, age, geographic locations, and socio-demographic index (SDI). In 2019, the DALYs and prevalence of blindness and vision loss had risen by 90.1% and 116% compared with 1990, reaching 15.84 million DALYs (95% UI = 15.83, 15.85) and 506.71 million cases (95% UI = 506.68, 506.74). Meanwhile, the age-standardised rate of DALYs decreased from 1990 to 2019. Cataracts, refractive error, and near vision impairment were the three most common causes. South Asia had the heaviest regional disease burden (age-standardised rate of DALYs = 517 per 100 000 population; 95% UI = 512, 521). Moreover, the burden due to cataracts ranked high in most Asian populations. Being a woman; being older; and having a lower national SDI were factors associated with a greater vision loss burden. The burden due to vision loss remains high in Asian populations. Cataracts, refractive error, and near vision loss were the primary causes of blindness and vision loss. Greater investment in ocular disease prevention and care by countries with lower socioeconomic status is needed, as well as specific strategies targeting cataract management, women and the elderly.

Global, Regional and National Burden of Human Cystic Echinococcosis from 1990 to 2019: A Systematic Analysis for the Global Burden of Disease Study 2019.

Cystic echinococcosis (CE) is a neglected tropical parasitic disease that poses huge disease, social and economic burdens worldwide; however, there has been little knowledge on the global morbidity, mortality and disability-adjusted life years (DALYs) of CE until now. This study aimed to collect the most up-to-date data about the global, regional and national disease burden due to CE from 1990 to 2019 and to project trends in the next 10 years. We measured the global, regional and national morbidity, mortality and DALYs of CE from 1990 to 2019 based on the Global Burden of Disease Study 2019 (GBD 2019) data, and we examined the correlation between socioeconomic development levels and the disease burden of CE. In addition, the disease burden due to CE was projected from 2020 to 2030. The age-standardized incidence rate (ASIR) of CE reduced from 2.65/105 [95% UI: (1.87/105 to 3.7/105)] in 1990 to 2.6/105 [95% UI: (1.72/105 to 3.79/105)] in 2019 (EAPC = -0.18%). The number of deaths, DALYs, age-standardized mortality rate (ASMR) and age-standardized DALY rate due to CE all showed a tendency to decline from 1990 to 2019. A higher disease burden of CE was measured in women than in men in 2019. There was a significant difference in the ASMR of CE by region according to the socio-demographic index (SDI), and lower burdens of CE were estimated in high-SDI regions. The global ASIR of CE is projected to decline from 2020 to 2030; however, the ASMR and age-standardized DALY rate are projected to rise. The global burden of CE remains high, and it is recommended that more health resources are allocated to low-SDI regions, women and the elderly aged 55 to 65 years to reduce the disease burden of CE.

Characteristics of Pathogenic Escherichia coli Associated with Diarrhea in Children under Five Years in Northwestern Ethiopia.

Diarrheagenic Escherichia coli (DEC) are the leading cause of infectious diarrhea and pose a significant global, regional, and national burden of disease. This study aimed to investigate the prevalence of six DEC pathotypes in children with diarrhea and determine their antibiotic resistance patterns. Samples from 107 diarrheagenic children were collected and processed for Escherichia coli (E. coli). Single-plex PCR was used to detect target virulence genes as well as characterize and categorize DEC pathotypes. Antibiotic resistance patterns were determined by the Kirby-Bauer disk diffusion method. E. coli was detected in 79 diarrheal stool samples, accounting for 73.8% of the samples collected. Additionally, 49.4% (39 out of 79) of the isolates harbored various typical virulence factors. Results revealed six pathotypes of virulence: enterotoxigenic E. coli (ETEC) (53.8%), enteropathogenic E. coli (EPEC) (12.8%), enteroaggregative E. coli (EAEC) (10.3%), Heteropathotypes (7.8%), Shiga toxin-producing E. coli (STEC), and enterohemorrhagic E. coli (EHEC) (7.7% each). The isolates exhibited high antibiotic resistance against trimethoprim/sulfamethoxazole (82.1%), amoxicillin (79.5%), ampicillin (74.4%), gentamicin (69.2%), and streptomycin (64.1%). An overall occurrence of 84.6% of multiple-drug resistance was observed in the isolates, with resistance ranging from three to four antibiotic classes. Our findings revealed a high level of pathogenic E. coli that were highly resistant to multiple categories of antibiotics among children in the Awi zone. These findings highlight the potential role of pathogenic E. coli in childhood diarrhea in tropical low-resource settings and underscore the need for continued research on the characteristics of pathogenic and antibiotic-resistant strains.