Age-sex differences in the global burden of lower respiratory infections and risk factors, 1990-2019: results from the Global Burden of Disease Study 2019.
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ABSTRACT:
SUBMITTER: GBD 2019 LRI Collaborators
PROVIDER: S-EPMC9605880 | biostudies-literature | 2022 Nov
REPOSITORIES: biostudies-literature
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Age-sex differences in the global burden of lower respiratory infections and risk factors, 1990-2019: results from the Global Burden of Disease Study 2019.
The Lancet. Infectious diseases 20220811 11
<h4>Background</h4>The global burden of lower respiratory infections (LRIs) and corresponding risk factors in children older than 5 years and adults has not been studied as comprehensively as it has been in children younger than 5 years. We assessed the burden and trends of LRIs and risk factors across all age groups by sex, for 204 countries and territories.<h4>Methods</h4>In this analysis of data for the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019, we used clinician- ...[more]
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Project description:A lack of access to handwashing facilities is a significant risk factor for lower respiratory infections(LRIs). However, no studies have reported epidemiologic changes in the burden of LRIs attributed to the lack of access to handwashing facilities. We conducted an integrated assessment of the burden of LRIs attributable to the lack of handwashing facilities from 1990 to 2019 using data from the Global Burden of Disease Study 2019. In 2019, 270,000 deaths were attributed to LRIs due to a lack of access to handwashing facilities, with DALYs reaching 14.02 million. The age-standardized mortality rate (ASMR) of LRIs caused by a lack of access to handwashing facilities was approximately 3.74, while the age-standardized DALY rate (ASDR) was reported to be 203.55 in 2019. Over the past 30 years, the burden of LRIs attributed to the lack of access to handwashing facilities has shown a global decline. In 2019, this burden was most pronounced in infants under 1 year of age and in those older than 95 years, reflecting the highest DALY (5591.83) and mortality rates (79.43), respectively. The burden of LRIs caused by the lack of access to handwashing facilities was found to be more severe in males and significantly more pronounced in regions with a low sociodemographic index (SDI), such as the Sahara African region. The development of targeted strategies to address the inadequate and unequal distribution of handwashing facilities holds important value in improving the disease burden of LRIs.
| S-EPMC11422025 | biostudies-literature
Project description:BackgroundLower respiratory infections (LRIs) remain a leading cause of mortality among children, yet previous studies have primarily focused on children under 5 years of age as a whole, with limited research on more specific age groups. This study aimed to analyze the trends in mortality associated with lower respiratory infections (LRIs) among children under 14 years of age from 1990 to 2019, with particular attention to regional and age-specific disparities.MethodsWe collected annual lower respiratory infection (LRI) deaths and mortality rates for six age groups of children under 14 years from 1990 to 2019 using data from GBD 2019. Estimated annual percentage changes (EAPCs) were calculated by fitting a linear regression model to quantify temporal trends. Additionally, EAPCs for 12 risk factors by Socio-Demographic Index（SDI） and age group were calculated to assess their impact on changes in LRI mortality.ResultsGlobally, LRI-related deaths among children under 14 years decreased by 68.81 %, from 2,290,115 (95 % UI 2,001,328 to 2,687,160) in 1990 to 714,315 (95 % UI 588,975 to 875,975) in 2019. The most substantial reduction was observed in East Asia, with an EAPC of -9.68 (95 % CI -9.98 to -9.38). The highest mortality occurred in the 28-364 days age group, with significant risk factors including child wasting (26.81 %), household air pollution from solid fuels (16.14 %), and low birth weight (10.15 %). In the low and lower-middle SDI regions, there was an upward trend in mortality due to ambient particulate pollution among children aged 10-14 years.ConclusionDespite a significant global decline in LRI mortality among children under 14 years from 1990 to 2019, regional disparities persist. Addressing these inequalities and considering the developmental stages of children are crucial for further reducing child mortality rates.
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Project description:BackgroundUpper respiratory infections (URIs) are among the most common diseases. However, the related burden has not been comprehensively evaluated. Thus, we designed the present study to describe the global and regional burden of URIs from 1990 to 2019.MethodsA secondary analysis was performed on the incidence, mortality, and disability-adjusted life years (DALYs) of URIs in different sex and age groups, from 21 geographic regions, 204 countries and territories, between 1990 and 2019, using the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019. Countries and territories were categorized according to Socio-demographic Index (SDI) quintiles.FindingsGlobally, the incident cases of URIs reached 17·2 (95% uncertainty interval: 15·4 to 19·3) billion in 2019, which accounted for 42·83% (40·01% to 45·77%) cases from all causes in the GBD 2019 study. The age-standardized incidence rate remained stable from 1990 to 2019, while significant decreases were found in the mortality and DALY rate. The highest age-standardized incidence rates from 1990 to 2019 and the highest age-standardized DALY rates after 2011 were observed in high SDI regions. Among all the age groups, children under five years old suffered from the highest incidence and DALY rates, both of which were decreased with increasing age. Fatal consequences of URIs occurred mostly in the elderly and children under five years old.InterpretationThe present study provided comprehensive estimates of URIs burden for the first time. Our findings, highlighting the substantial incidence and considerable DALYs due to URIs, are expected to attract more attention to URIs and provide future explorations in the prevention and treatment with epidemiological evidence.FundingThe study was funded by the National Natural Science Foundation of China (81770057).
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| S-EPMC8799634 | biostudies-literature
Project description:BackgroundLower respiratory infections (LRIs) cause substantial mortality and morbidity. The present study reported and analysed the burden of LRIs in the Middle East and North Africa (MENA) region between 1990 and 2019, by age, sex, etiology, and socio-demographic index (SDI).MethodsThe data used in this study were sourced from the Global Burden of Disease (GBD) study 2019. The annual incidence, deaths, and disability-adjusted life-years (DALYs) due to LRIs were presented as counts and age-standardised rates per 100,000 population, along with their 95% uncertainty intervals (UIs). The average annual percent changes (AAPC) in the age-standardised incidence, death and DALYs rates were calculated using Joinpoint software and correlations (Pearson's correlation coefficient) between the AAPCs and SDIs were calculated using Stata software.ResultsIn 2019, there were 34.1 million (95% UI 31.7-36.8) incident cases of LRIs in MENA, with an age-standardised rate of 6510.2 (95% UI 6063.6-6997.8) per 100,000 population. The number of regional DALYs was 4.7 million (95% UI 3.9-5.4), with an age-standardised rate of 888.5 (95% UI 761.1-1019.9) per 100,000 population, which has decreased since 1990. Furthermore, Egypt [8150.8 (95% UI 7535.8-8783.5)] and Afghanistan [61.9 (95% UI 52.1-72.6)] had the highest age-standardised incidence and death rates, respectively. In 2019, the regional incidence and DALY rates were highest in the 1-4 age group, in both females and males. In terms of deaths, pneumococcus and H. influenza type B were the most and least common types of LRIs, respectively. From 1990 to 2019, the burden of LRIs generally decreased with increasing SDI. There were significant positive correlations between SDI and the AAPCs for the age-standardised incidence, death and DALY rates (p < 0.05). Over the 1990-2019 period, the regional incidence, deaths and DALYs attributable to LRIs decreased with AAPCs of - 1.19% (- 1.25 to - 1.13), - 2.47% (- 2.65 to - 2.28) and - 4.21% (- 4.43 to - 3.99), respectively.ConclusionsThe LRI-associated burden in the MENA region decreased between 1990 and 2019. SDI had a significant positive correlation with the AAPC and pneumococcus was the most common underlying cause of LRIs. Afghanistan, Yemen and Egypt had the largest burdens in 2019. Further studies are needed to investigate the effectiveness of healthcare interventions and programs to control LRIs and their risk factors.
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Project description:BackgroundEpidemiological trends of lower respiratory infections (LRIs) attributable to secondhand smoke (SHS) among children under 5 years since smoking bans have been increasingly applied globally remain unclear. Here, we aimed to estimate the spatiotemporal trends of the global, regional, and national burden of LRIs attributable to SHS among children under 5 years old between 2010 and 2019.MethodsData on the deaths, and disability adjusted life years (DALYs) of the disease burden was retrieved from the Global Burden of Disease (GBD) 2019 for 204 countries and territories between 2010 and 2019. The rates per 100,000 population, along with 95% uncertainty intervals, as well as population-attributable fraction (PAF) was presented for each estimate.ResultsIn 2019, an estimated 6.94% (3.80-10.12%) of under-5 LRIs deaths were attributable to SHS globally, with an under-5 mortality rate of 7.02 per 100,000, a decrease of 5.77% since 2010. Similarly, 6.95% (3.81-10.13%) of LRIs DALYs were due to SHS among children under 5 years, with a rate in under-5s of 619.36 DALYs per 100,000, and also a 5.77% decrease since 2010. Azerbaijan, Turkmenistan, and Papua New Guinea showed the highest under-5 mortality and DALYs burden rates of LRIs attributable to SHS in 2019. In contrast, the PAF was stagnant over the past ten years and there is even a year-on-year upward trend in South Asia. Nationally, in 2019, Bosnia and Herzegovina, Armenia, and Montenegro showed the highest PAFSHS of LRIs burden among children under 5 years of age. In addition, the burden was heavier in children under 1 year of age and was significantly negatively associated with sociodemographic index.ConclusionsSHS remains a risk factor that cannot be ignored for LRIs burden worldwide. Hence, governments and health systems should continue to take steps to reduce SHS pollution among young children to mitigate this burden.
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Project description:BackgroundLower respiratory infections (LRIs) remain one of the most deadly infectious diseases in the world, and non-optimal temperature is a risk factor for LRIs. The aim of this study was to analyze the global burden of LRI attribute to non-optimal temperature and its trends from 1990 to 2019, and to project long-term trends.MethodsExcerpts from the release of the 2019 Global Burden of Disease (GBD) study, which analyses the burden of lower respiratory infections due to non-optimal temperatures from 1990 to 2019 using data on deaths and disability adjusted life years (DALYs); explores differences across regions, populations and seasons, and projects future trends in burden.ResultsBetween 1990 and 2019, there is a significant downward trend in the global burden of deaths and DALYs, but it remains high in infants and young children, the older adult, African countries and LOW SDI regions. Differences in geographical risk factors and economic levels lead to heterogeneous disease burdens across regions. In 2019, low SDI regions will have the highest burden, but high SDI regions will have the highest number of deaths. In addition, increasing SDI values were associated with decreasing trends in age-standardized mortality rates and disability-adjusted life years. BAPC model projections suggest a downward trend in the future burden of death and DALYs from the disease, but the improvement in the burden of death for women was not significant.ConclusionOur study comprehensively elucidates the distribution and dynamic trends in the burden of lower respiratory tract infections due to non-optimal temperatures from 1990 to 2019 along multiple dimensions. The burden of deaths and DALYs showed an overall decreasing trend, but the improvement was uneven in different regions. In addition, the results suggest that efforts should be made to reduce lower respiratory health losses in infants, young children, and older adult populations. Effective public health policies and interventions to reduce the burden of lower respiratory tract infections should be sustained globally.
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Project description:BackgroundLong-term exposure to fine particulate matter (PM2.5) may increase the risk of neonatal infections. To show the effects of PM2.5 on neonatal infections as well as the trends of the effect, we studied the burden measured by the age-standardized mortality rate (ASMR) and the age-standardized disability-adjusted life years rate (ASDR) and its trends with the socio-demographic index in 192 countries and regions from 1990 to 2019.MethodsThis is a retrospective study that uses the Global Burden of Disease Study 2019 database. The age-standardized mortality rate and age-standardized disability-adjusted life years rate are used to measure the burden of PM2.5-related neonatal infections in different countries and regions. The annual percentage changes and the average annual percentage changes are used to reflect the trends over the years (1990-2019) and are calculated using a Joinpoint model. The relationship of the socio-demographic index with the ASMR and ASDR is calculated and described using Gaussian process regression.ResultsWith the rapid increase in the global annual average of PM2.5, the global burden of PM2.5-related neonatal infections has increased since 1990, especially in early neonates, boys, and low-middle SDI regions. Globally, the ASMR and ASDR of PM2.5-related neonatal infections in 2019 were 0.21 (95% CI: 0.14, 0.31) and 19.06 (95% CI: 12.58, 27.52) per 100,000 people, respectively. From 1990 to 2019, the ASMR and ASDR increased by 72.58% and 73.30%, and their average annual percentage changes were 1.9 (95% CI: 1.3, 2.6) and 2.0 (95% CI: 1.3, 2.6), respectively. When the socio-demographic index was more than 0.60, it was negatively related to the burden of PM2.5-related neonatal infections. Surprisingly, the burden in low SDI regions was lower than it was in low-middle and middle SDI regions, while high-middle and high-SDI regions showed decreasing trends.InterpretationBoys bore a higher PM2.5-related neonatal burden, with male fetuses being more likely to be affected by prenatal exposure to PM2.5 and having less of a biological survival advantage. Poverty was the root cause of the burden. Higher SDI countries devoted more resources to improving air quality, the coverage of medical services, the accessibility of institutional delivery, and timely referral to reduce the disease burden. The burden in low SDI regions was lower than that in low-middle and middle SDI regions. One reason was that the benefits of medical services were lower than the harm to health caused by environmental pollution in low-middle and middle SDI regions. Moreover, the underreporting of data is more serious in low SDI countries.ConclusionsIn the past 30 years, the global burden of PM2.5-related neonatal infections has increased, especially in early neonates, boys, and low-middle SDI regions. The huge difference compared to higher SDI countries means that lower SDI countries have a long way to go to reduce the disease burden. Policy makers should appropriately allocate medical resources to boys and early newborns and pay more attention to data under-reporting in low SDI countries. In addition, it is very necessary to promulgate policies to prevent and control air pollution in countries with large and increasing exposure to PM2.5 pollution.
| S-EPMC9105282 | biostudies-literature
Project description:Rationale & objectivePrevious studies have shown chronic kidney disease (CKD) mortality rates to be lower among females than males. We aimed to examine the extent to which sex differences vary over time, among countries, and with age, using Global Burden of Disease (GBD) Study data.Study designObservational epidemiological study.Setting & participantsGBD Study, which used published literature, vital registration systems, kidney replacement therapy registries, and household surveys.ExposuresSex.OutcomesCKD-associated mortality rate (per 100,000 population).Analytical approachChanges in CKD mortality between 1990 and 2019 were compared between sexes, globally, and separately for the 50 most populous countries. For 2019 only, sex differences in age-standardized and age-specific mortality were compared between countries.ResultsThere was no change in global age-standardized mortality for either sex between 1990 and 2019, with female mortality consistently 30% lower than male mortality. Percentage changes were less favorable among females than males in two-thirds of the 50 countries examined, with the greatest change disparities observed in Egypt, Thailand, and Malaysia. Although Mexico exhibited the greatest overall percentage increase, the increase was smaller in females (81% vs 138%). In 2019, female mortality varied between 47% lower and 60% higher than male mortality (in Angola and Egypt, respectively). In most countries, female mortality was lower across all age groups, with no narrowing of sex differences with age.LimitationsWe were not able to assess the sex differences according to CKD stage and we did not explore other disease metrics (eg, disability-adjusted life years).ConclusionsPercentage changes in age-standardized CKD mortality have tended to be less favorable among females than males, with notable exceptions. Similarly, although female mortality is generally lower than male mortality, there are multiple examples of the opposite. Country-specific assessments of sex differences in CKD-associated outcomes are essential for equitable care.
| S-EPMC9490202 | biostudies-literature
Project description:BackgroundUpdated data on chronic respiratory diseases (CRDs) are vital in their prevention, control, and treatment in the path to achieving the third UN Sustainable Development Goals (SDGs), a one-third reduction in premature mortality from non-communicable diseases by 2030. We provided global, regional, and national estimates of the burden of CRDs and their attributable risks from 1990 to 2019.MethodsUsing data from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019, we estimated mortality, years lived with disability, years of life lost, disability-adjusted life years (DALYs), prevalence, and incidence of CRDs, i.e. chronic obstructive pulmonary disease (COPD), asthma, pneumoconiosis, interstitial lung disease and pulmonary sarcoidosis, and other CRDs, from 1990 to 2019 by sex, age, region, and Socio-demographic Index (SDI) in 204 countries and territories. Deaths and DALYs from CRDs attributable to each risk factor were estimated according to relative risks, risk exposure, and the theoretical minimum risk exposure level input.FindingsIn 2019, CRDs were the third leading cause of death responsible for 4.0 million deaths (95% uncertainty interval 3.6-4.3) with a prevalence of 454.6 million cases (417.4-499.1) globally. While the total deaths and prevalence of CRDs have increased by 28.5% and 39.8%, the age-standardised rates have dropped by 41.7% and 16.9% from 1990 to 2019, respectively. COPD, with 212.3 million (200.4-225.1) prevalent cases, was the primary cause of deaths from CRDs, accounting for 3.3 million (2.9-3.6) deaths. With 262.4 million (224.1-309.5) prevalent cases, asthma had the highest prevalence among CRDs. The age-standardised rates of all burden measures of COPD, asthma, and pneumoconiosis have reduced globally from 1990 to 2019. Nevertheless, the age-standardised rates of incidence and prevalence of interstitial lung disease and pulmonary sarcoidosis have increased throughout this period. Low- and low-middle SDI countries had the highest age-standardised death and DALYs rates while the high SDI quintile had the highest prevalence rate of CRDs. The highest deaths and DALYs from CRDs were attributed to smoking globally, followed by air pollution and occupational risks. Non-optimal temperature and high body-mass index were additional risk factors for COPD and asthma, respectively.InterpretationAlbeit the age-standardised prevalence, death, and DALYs rates of CRDs have decreased, they still cause a substantial burden and deaths worldwide. The high death and DALYs rates in low and low-middle SDI countries highlights the urgent need for improved preventive, diagnostic, and therapeutic measures. Global strategies for tobacco control, enhancing air quality, reducing occupational hazards, and fostering clean cooking fuels are crucial steps in reducing the burden of CRDs, especially in low- and lower-middle income countries.
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