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

Kyu, Hmwe Hmwe; Vongpradith, Avina; Sirota, Sarah Brooke; Novotney, Amanda; Troeger, Christopher; Doxey, Matthew C; Bender, Rose G; Ledesma, Jorge R.; Biehl, Molly H; Albertson, Samuel B; Frostad, Joseph; Burkart, Katrin; Bennitt, Fiona B; Zhao, Jeff T; Gardner, William M.; Hagins, Hailey; Bryazka, Dana; Dominguez, Regina-Mae Villanueva; Abate, Semagn Mekonnen; Abdelmasseh, Michael; Abdoli, Amir; Abdoli, Gholamreza; Abedi, Aidin; Abedi, Vida; Abegaz, Tadesse Melaku; Abidi, Hassan; Aboagye, Richard Gyan; Abolhassani, Hassan; Abtew, Yonas Derso; Ali, Hiwa Abubaker; Abu‐Gharbieh, Eman; Abu‐Zaid, Ahmed; Adamu, Kidist; Addo, Isaac Yeboah; Adegboye, Oyelola A; Adnan, Mohammad; Adnani, Qorinah Estiningtyas Sakilah; Afzal, Muhammad Sohail; Afzal, Saira; Ahinkorah, Bright Opoku; Ahmad, Aqeel; Ahmad, Araz Ramazan; Ahmad, Sajjad; Ahmadi, Ali; Ahmadi, Sepideh; Ahmed, Haroon; Ahmed, Jivan Qasim; Rashid, Tarik Ahmed; Akbarzadeh-Khiavi, Mostafa; Hamad, Hanadi Al; Albano, Luciana; Aldeyab, Mamoon A.; Alemu, Bezatu Mengistie; Alene, Kefyalew Addis; Algammal, Abdelazeem M.; Alhalaiqa, Fadwa Alhalaiqa Naji; Alhassan, Robert Kaba; Ali, Beriwan Abdulqadir; Ali, Liaqat; Ali, Musa Mohammed; Ali, Syed Shujait; Alimohamadi, Yousef; Alipour, Vahid; Al-Jumaily, Adel; Aljunid, Syed Mohamed; Almustanyir, Sami; Al‐Raddadi, Rajaa; Al-Rifai, Rami H Hani; AlRyalat, Saif Aldeen; Alvis‐Guzmán, Nelson; Alvis-Zakzuk, Nelson J.; Ameyaw, Edward Kwabena; Dehkordi, Javad Javad Aminian; Amuasi, John; Amugsi, Dickson A; Anbesu, Etsay Woldu; Ansar, Adnan; Anyasodor, Anayochukwu Edward; Arabloo, Jalal; Areda, Demelash; Mamo, Ayele; Argaw, Zeleke Gebru; Arulappan, Judie; Aruleba, Raphael Taiwo; Asemahagn, Mulusew Andualem; Athari, Seyyed Shamsadin; Atlaw, Daniel; Attia, Engi F.; Attia, Sameh; Aujayeb, Avinash; Awoke, Tewachew; Ayana, Tegegn Mulatu; Ayanore, Martin Amogre; Azadnajafabad, Sina; Azangou‐Khyavy, Mohammadreza; Azari, Samad; Jafari, Amirhossein Azari; Badar, Muhammad; Badiye, Ashish D; Baghcheghi, Nayereh; Bagherieh, Sara; Baig, Atif Amin; Banach, Maciej; Banerjee, Indrajit; Bardhan, Mainak; Barone-Adesi, Francesco; Barqawi, Hiba Jawdat; Barrow, Amadou; Bashiri, Azadeh; Bassat, Quique; Batiha, Abdul-Monim Mohammad; Belachew, Abate Bekele; Belete, Melaku Ashagrie; Belgaumi, Uzma Iqbal; Bhagavathula, Akshaya Srikanth; Bhardwaj, Nikha; Bhardwaj, Pankaj; Bhatt, Parth; Bhojaraja, Vijayalakshmi S; Bhutta, Zulfiqar Ahmed; Bhuyan, Soumitra S.; Bijani, Ali; Bitaraf, Saeid; Boda, Belay; Брико, Н. 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doi:10.1016/s1473-3099(22)00510-2

Cited by 72 publications

(15 citation statements)

References 53 publications

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“…Moreover, another study using GBD 2019 data reported that globally there was an average annual decrease of 2.39% in the age-standardized death rate attributable to LRIs over the period 1990–2019 ( 8 ). In addition, decreases in the incidence and deaths attributable to LRIs were observed at the global level for both sexes, and in almost all age groups, over the period 1990–2019 ( 7 ). The Sub-Saharan African regions were among the top five regions with the highest age-standardized burden in 2019.…”

Section: Discussionmentioning

confidence: 99%

“…These papers primarily concentrated on the burden of LRIs by etiological agents, while the burden of LRIs attributable to potential risk factors have not been previously reported, which is important from a preventative perspective ( 1 , 3 ). Furthermore, a recently published article reported the incidence and deaths attributable to LRIs at the global, regional and national levels, with a focus on age and sex patterns ( 7 ). This study also reported the population-attributable fractions for each risk factor ( 7 ), but did not report the LRI attributable burden by sociodemographic index (SDI) or the disability-adjusted life-years (DALYs) ( 7 ).…”

Section: Introductionmentioning

confidence: 99%

“…Furthermore, a recently published article reported the incidence and deaths attributable to LRIs at the global, regional and national levels, with a focus on age and sex patterns ( 7 ). This study also reported the population-attributable fractions for each risk factor ( 7 ), but did not report the LRI attributable burden by sociodemographic index (SDI) or the disability-adjusted life-years (DALYs) ( 7 ). Furthermore, another study using GBD 2019 data reported the global number of deaths, mortality rates and their temporal trends, by estimating the annual percent change over the period 1990–2019 ( 8 ).…”

Section: Introductionmentioning

confidence: 99%

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Global burden of lower respiratory infections during the last three decades

Safiri

Mahmoodpoor²,

Kolahi³

et al. 2023

Front. Public Health

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BackgroundLower respiratory infections (LRIs) cause a substantial mortality, morbidity and economic burden. The present study reported the global, regional and national burden of LRIs and their attributable risk factors in 204 countries and territories, between 1990 and 2019, by age, sex, etiology, and Socio-demographic Index (SDI).MethodsUsing publicly available data from the Global Burden of Disease (GBD) study 2019, we reported the incidence, deaths and disability-adjusted life-years (DALYs), due to LRIs. Estimates were presented as counts and age-standardized rates per 100,000 population with their associated uncertainty intervals (UIs).ResultsGlobally, in 2019 there were 488.9 million (95% UI: 457.6 to 522.6) incident cases and 2.4 million (2.3–2.7) deaths due to LRIs. The global age-standardized incidence and death rates for LRIs were 6,295 (5,887.4–6,737.3) and 34.3 (31.1–37.9) per 100,000 in 2019, which represents a 23.9% (22.5–25.4) and 48.5% (42.9–54.0) decrease, respectively since 1990. In 2019, Guinea [12,390.4 (11,495.5–13,332.8)], Chad [12,208.1 (11,289.3–13,202.5)] and India [11,862.1 (11,087.0–12,749.0)] had the three highest age-standardized incidence rates of LRI. Equatorial Guinea [−52.7% (95% UI: −55.8 to −49.3)], Chile [−50.2% (95% UI: −53.4 to −47.0)] and Albania [−48.6% (95% UI: −51.7 to −45.3)] showed the largest decreases from 1990 to 2019. In 2019, a decrease in the incidence rate of LRI was observed at the global level up to the 25–29 age group, then the incidence rates increased with age. The burden of LRIs decreased with increasing SDI at both the regional and national levels. Globally, child wasting (33.1%), household air pollution from solid fuels (24.9%) and a lack of access to handwashing facilities (14.4%) made the largest contributions to the LRI burden in 2019.ConclusionsAlthough the burden of LRIs decreased over the period 1990–2019, LRIs still contribute to a large number of incident cases, deaths and DALYs. Preventative programs with a focus on reducing exposure to attributable risk factors should be implemented, especially in less developed countries.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Global burden of lower respiratory infections during the last three decades

Safiri

Mahmoodpoor²,

Kolahi³

et al. 2023

Front. Public Health

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“…streptococcus pneumonia, Hib, RSV, and influenza) using data from the Global Burden of Disease 2015 and 2016 projects, which are in need of updating [12,13]. There has also been a recent global study which investigated age and sex differences in LRIs, along with their risk factors [14]. Nevertheless, to our best of knowledge there has been no comprehensive epidemiological study of LRIs in the Middle East and North Africa (MENA) region and the countries that comprise this region.…”

Section: Introductionmentioning

confidence: 99%

The burden of lower respiratory infections and their underlying etiologies in the Middle East and North Africa region, 1990–2019: results from the Global Burden of Disease Study 2019

et al. 2023

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Background Lower 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). Methods The 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. Results In 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. Conclusions The 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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“…Lower respiratory infection (LRI), defined as pneumonia or bronchitis, is the leading cause of death worldwide, causing more than 2 million deaths in 2019 [ 1 , 2 ]. Between 1990 and 2019, the rates of incidence and mortality for LRI declined significantly by 23.9% and 48.5%, respectively [ 3 ].…”

Section: Introductionmentioning

confidence: 99%

Trends of Incidence, Mortality, and Risk Factors for Lower Respiratory Infections among Children under 5 Years in China from 2000 to 2019

Shi

Jia

et al. 2023

IJERPH

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Background: Understanding the temporal trends in the burden of lower respiratory tract infections (LRI) and their attributable risk factors in children under 5 years is important for effective prevention strategies. Methods: We used incidence, mortality, and attributable risk factors of LRI among children under 5 years from the Global Burden of Diseases database to analyze health patterns in 33 provincial administrative units in China from 2000 to 2019. Trends were examined using the annual average percentage change (AAPC) by the joinpoint regression method. Results: The rates of incidence and mortality for under-5 LRI in China were 18.1 and 4134.3 per 100,000 children in 2019, with an AAPC decrease of 4.1% and 11.0% from 2000, respectively. In recent years, the under-5 LRI incidence rate has decreased significantly in 11 provinces (Guangdong, Guangxi, Guizhou, Hainan, Heilongjiang, Jiangxi, Qinghai, Sichuan, Xinjiang, Xizang, and Zhejiang) and remained stable in the other 22 provinces. The case fatality ratio was associated with the Human Development Index and the Health Resource Density Index. The largest decline in risk factors of deaths was household air pollution from solid fuels. Conclusions: The burden of under-5 LRI in China and the provinces has declined significantly, with variation across provinces. Further efforts are needed to promote child health through the development of measures to control major risk factors.

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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

Cited by 72 publications

References 53 publications

Global burden of lower respiratory infections during the last three decades

Global burden of lower respiratory infections during the last three decades

The burden of lower respiratory infections and their underlying etiologies in the Middle East and North Africa region, 1990–2019: results from the Global Burden of Disease Study 2019

Trends of Incidence, Mortality, and Risk Factors for Lower Respiratory Infections among Children under 5 Years in China from 2000 to 2019

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