Trends of the global, regional and national incidence of malaria in 204 countries from 1990 to 2019 and implications for malaria prevention.
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ABSTRACT: Background
Malaria is a life-threatening disease worldwide, but lacks studies on its incidence at the global level. We aimed to describe global trends and regional diversities in incidence of malaria infection, to make global tailored implications for malaria prevention.Methods
We used the data from the Global Burden of Disease Study 2019. The age-standardized incidence rate (ASR) and absolute number of malaria episodes showed the epidemic status of malaria infection. The estimated annual percentage change of ASR and changes in malaria episodes quantified the malaria incidence trends. The connection between ASRs and traveller number indicated infection risk for travellers.Results
Globally, the malaria ASR decreased by an average 0.80% (95% confidence interval 0.58-1.02%) per year from 1990 to 2019; however, it slightly increased from 3195.32 per 100 000 in 2015 to 3247.02 per 100 000 in 2019. The incidence rate of children under 5 was higher than other age groups. A total of 40 countries had higher ASRs in 2019 than in 2015, with the largest expansion in Cabo Verde (from 2.02 per 100 000 to 597.00 per 100 000). After 2015, the ASRs in high-middle, middle and low-middle Socio-demographic Index regions began to rise and the uptrends remained in 2019. Central, Western and Eastern Sub-Saharan Africa had the highest ASRs since 1990, and traveller number in Eastern and Western Sub-Saharan Africa increased by 31.24 and 7.58%, respectively, from 2017 to 2018. Especially, most countries with ASR over 10 000 per 100 000 had increase in traveller number from 2017 to 2018, with the highest change by 89.56% in Mozambique.Conclusions
Malaria is still a public health threat for locals and travellers in Sub-Saharan Africa and other malaria-endemic areas, especially for children under 5. There were unexpected global uptrends of malaria ASRs from 2015 to 2019. More studies are needed to achieve the goal of malaria elimination.
SUBMITTER: Liu Q
PROVIDER: S-EPMC8271200 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:BackgroundThe mental disorders included in the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 were depressive disorders, anxiety disorders, bipolar disorder, schizophrenia, autism spectrum disorders, conduct disorder, attention-deficit hyperactivity disorder, eating disorders, idiopathic developmental intellectual disability, and a residual category of other mental disorders. We aimed to measure the global, regional, and national prevalence, disability-adjusted life-years (DALYS), years lived with disability (YLDs), and years of life lost (YLLs) for mental disorders from 1990 to 2019.MethodsIn this study, we assessed prevalence and burden estimates from GBD 2019 for 12 mental disorders, males and females, 23 age groups, 204 countries and territories, between 1990 and 2019. DALYs were estimated as the sum of YLDs and YLLs to premature mortality. We systematically reviewed PsycINFO, Embase, PubMed, and the Global Health Data Exchange to obtain data on prevalence, incidence, remission, duration, severity, and excess mortality for each mental disorder. These data informed a Bayesian meta-regression analysis to estimate prevalence by disorder, age, sex, year, and location. Prevalence was multiplied by corresponding disability weights to estimate YLDs. Cause-specific deaths were compiled from mortality surveillance databases. The Cause of Death Ensemble modelling strategy was used to estimate death rate by age, sex, year, and location. The death rates were multiplied by the years of life expected to be remaining at death based on a normative life expectancy to estimate YLLs. Deaths and YLLs could be calculated only for anorexia nervosa and bulimia nervosa, since these were the only mental disorders identified as underlying causes of death in GBD 2019.FindingsBetween 1990 and 2019, the global number of DALYs due to mental disorders increased from 80·8 million (95% uncertainty interval [UI] 59·5-105·9) to 125·3 million (93·0-163·2), and the proportion of global DALYs attributed to mental disorders increased from 3·1% (95% UI 2·4-3·9) to 4·9% (3·9-6·1). Age-standardised DALY rates remained largely consistent between 1990 (1581·2 DALYs [1170·9-2061·4] per 100 000 people) and 2019 (1566·2 DALYs [1160·1-2042·8] per 100 000 people). YLDs contributed to most of the mental disorder burden, with 125·3 million YLDs (95% UI 93·0-163·2; 14·6% [12·2-16·8] of global YLDs) in 2019 attributable to mental disorders. Eating disorders accounted for 17 361·5 YLLs (95% UI 15 518·5-21 459·8). Globally, the age-standardised DALY rate for mental disorders was 1426·5 (95% UI 1056·4-1869·5) per 100 000 population among males and 1703·3 (1261·5-2237·8) per 100 000 population among females. Age-standardised DALY rates were highest in Australasia, Tropical Latin America, and high-income North America.InterpretationGBD 2019 showed that mental disorders remained among the top ten leading causes of burden worldwide, with no evidence of global reduction in the burden since 1990. The estimated YLLs for mental disorders were extremely low and do not reflect premature mortality in individuals with mental disorders. Research to establish causal pathways between mental disorders and other fatal health outcomes is recommended so that this may be addressed within the GBD study. To reduce the burden of mental disorders, coordinated delivery of effective prevention and treatment programmes by governments and the global health community is imperative.FundingBill & Melinda Gates Foundation, Australian National Health and Medical Research Council, Queensland Department of Health, Australia.
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