Accurate and comprehensive data on the incidence, mortality, and burden of ischemic heart disease (IHD), as well as the associated risk factors, are essential for informed decision-making in healthcare policy. This study aimed to estimate IHD incidence, deaths, and disability-adjusted life years (DALYs) stratified by country, gender, age group, and sociodemographic status from 1990 to 2019. Through statistical analysis of the global population and IHD data from the GBD database from 1990 to 2019, we analyzed the region, sex, age characteristics, and temporal development of IHD. At the same time, we also included the relevant influencing factors of the sociodemographic index (SDI) and analyzed the incidence of IHD in regions with different SDI levels. Furthermore, we examined the primary risk factors for IHD during the same period and employed statistical models to predict the global IHD incidence through 2044.

ObjectivesTo quantify the burden and variation trends of cancers in children under 5 years at the global, regional, and national levels from 1990 to 2019.MethodsEpidemiological data for children under 5 years who were diagnosed with any one childhood cancer were obtained from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) from 1990 to 2019. The outcomes were the absolute numbers and rates of incidence, prevalence, mortality, and disability-adjusted life-years (DALYs) for different types of cancer.ResultsIn 2019, 8,774,979.1 incident cases (95% uncertainty interval [UI]: 6,243,599.2 to11,737,568.5) and 8,956,583.8 (6,446,323.9 to 12,364,520.8) prevalent cases of cancer in children under 5 years were identified worldwide; these cancers resulted in 44,451.6 (36,198.7 to 53,905.9) deaths and 3,918,014.8 (3,196,454.9 to 4,751,304.2) DALYs. From 1990 to 2019, although the numbers of incident and prevalent cases only decreased by −4.6% (−7.0 to −2.2) and −8.3% (−12.6 to −3.4), respectively, the numbers of deaths and DALYs clearly declined by −47.8% (−60.7 to −26.4) and −47.7% (−60.7 to −26.2), respectively. In 2019, the middle sociodemographic index (SDI) regions had the highest incidence and prevalence, whereas the low SDI regions had the most mortality and DALYs. Although all of the SDI regions displayed a steady drop in deaths and DALYs between 1990 and 2019, the low-middle and low SDI regions showed increasing trends of incidence and prevalence. Leukemia remained the most common cancer globally in 2019. From 1990 to 2019, the burdens of leukemia, liver cancer, and Hodgkin's lymphoma declined, whereas the incidence and prevalence of other cancers grew, particularly testicular cancer.ConclusionsThe global childhood cancer burden in young children has been steadily decreasing over the past three decades. However, the burdens and other characteristics have varied across different regions and types of cancers. This highlights the need to reorient current treatment strategies and establish effective prevention methods to reduce the global burden of childhood cancer.

BackgroundThe burden of chronic respiratory diseases has changed over the three decades. This study aims to describe the spatiotemporal trends of prevalence, mortality, and disability-adjusted life years (DALY) due to chronic respiratory diseases (CRDs) worldwide during 1990–2019 using data from the Global Burden of Disease Study 2019 (GBD 2019).MethodsThe prevalence, mortality, and DALY attributable to CRDs and risk factors from 1990 to 2019 were estimated. We also assessed the driving factors and potentiality for improvement with decomposition and frontier analyses, respectively.ResultsIn 2019, 454.56 [95% uncertainty interval (UI): 417.35–499.14] million individuals worldwide had a CRD, showing a 39·8% increase compared with 1990. Deaths due to CRDs were 3.97 (95%UI: 3.58–4.30) million, and DALY in 2019 was 103.53 (95%UI: 94.79–112.27) million. Declines by average annual percent change (AAPC) were observed in age-standardized prevalence rates (ASPR) (0.64% decrease), age-standardized mortality rates (ASMR) (1.92%), and age-standardized DALY rates (ASDR) (1.72%) globally and in 5 socio-demographic index (SDI) regions. Decomposition analyses represented that the increase in overall CRDs DALY was driven by aging and population growth. However, chronic obstructive pulmonary disease (COPD) was the leading driver of increased DALY worldwide. Frontier analyses witnessed significant improvement opportunities at all levels of the development spectrum. Smoking remained a leading risk factor (RF) for mortality and DALY, although it showed a downward trend. Air pollution, a growing factor especially in relatively low SDI regions, deserves our attention.ConclusionOur study clarified that CRDs remain the leading causes of prevalence, mortality, and DALY worldwide, with growth in absolute numbers but declines in several age-standardized estimators since 1990. The estimated contribution of risk factors to mortality and DALY demands the need for urgent measures to improve them.Systematic review registrationhttp://ghdx.healthdata.org/gbd-results-tool.

ObjectiveTo examine the incidence of cardiomyopathy including both alcoholic cardiomyopathy (AC) and other cardiomyopathy (OC) in 204 nations and regions over the 1990–2019 period.MethodsThe present study was conducted using data derived from the GBD 2019 study coordinated by the Institute for Health Metrics and Evaluation (IHME). The GBD 2019 study included epidemiological data pertaining to 369 diseases/injuries, 286 causes of death, and 87 risk factors in 204 nations and regions. For this study, we adopt published estimates pertaining to the prevalence rates, mortality rates, and disability-adjusted life years (DALYs) associated with cardiomyopathy. The Bayesian mixed-effects DisMod-MR 2.1 meta-regression tool, which was designed to analyze GBD data, was used to estimate the prevalence of OC and AC. The GBD data are subdivided into 21 global regions based on characteristics such as geographical proximity and epidemiological similarity. The overall burden of cardiomyopathy was assessed by combining AC- and OC-related data, 95% confidence intervals were calculated based on standardized error values determined based upon the width of the 95% UI divided by 1.96 × 2.ResultsGlobally, there were an estimated 0.71 million (95% UI: 0.55–0.92) AC cases and 3.73 million (95% UI: 2.92–4.72) OC cases in 2019. The age-standardized cardiomyopathy, AC, and OC prevalence rates (per 100,000 persons) in 2019 were 56.0 (95% CI: 43.82–71.17), 8.51 (95% UI: 6.6–11.01), and 47.49 (95% UI: 37.22–60.16), respectively. In total, the respective numbers of global deaths attributed to AC and OC were 0.07 million (95% UI: 0.06–0.08) and 0.24 million (95% UI: 0.19–0.26). The age-standardized mortality rate for cardiomyopathy in 2019 was 3.97 (95% CI: 3.29–4.39), with respective mortality rates of 0.86 (95% UI: 0.72–0.99) and 3.11 (95% UI: 2.57–3.4) for AC and OC. At the global level in 2019, 2.44 million (95% UI: 2.04–2.78) DALYs were attributed to AC, while 5.72 million (95% UI: 4.89–6.33) DALYs were attributed to OC. From 1990 to 2019, cardiomyopathy age-standardized prevalence rates declined by −0.49% (95% CI: −0.57 to −0.41), with those for AC and OC having respectively declined by −0.32% (95% UI: −0.36 to −0.28) and −0.17% (95% UI: −0.21 to −0.13). The age-standardized AC and OC mortality rates declined by −0.36% (95% UI: −0.5 to −0.26) and −0.39% (95% UI: −0.44 to −0.29), despite 24.8 and 30.2% increases, respectively, in the numbers of AC- and OC-related deaths during the same period.ConclusionPrevious studies have estimated the risk factors that influence the burden of multiple cardiovascular diseases (CVD). Among them, some studies related to the GBD database on cardiomyopathy data suggest that alcohol intake, gender are factors in the development of AC, and the burden of AC and OC is not limited to developed or less developed countries. Otherwise, this study mainly focused on cardiomyopathy, and analyzed multiple indicators from national, regional, and age-standard dimensions to identify potential risk factors including prevalence, deaths, years lived with Disability-adjusted life years (DALYs) that influence the development of AC and OC. To our knowledge, this study is the first to have systematically assessed the burden of AC and OC as of 2019 at the national, regional, and global levels and calculated DALYs to achieve a better evaluation of disease risk and quality of life of the population. The number of cases, deaths and DALYs of cardiomyopathy showed an overall increasing trend and obvious geographical differences in the past three decades. The burden of cardiomyopathy remains a persistent threat to global public health. These results provide an epidemiological foundation that can guide public health efforts and policymakers.

BackgroundTraumatic central nervous system (CNS) injuries—particularly traumatic brain injury (TBI), spinal cord injury (SCI), and skull fractures—represent a significant global health challenge. Previous estimates have lacked a comprehensive global analysis of these injuries and their associated risk factors. Herein, we aimed to examine the epidemiological patterns, temporal trends and risk factors of TBI, SCI, and skull fractures globally from 1990 to 2021.MethodsWe extracted data from the Global Burden of Disease Study (GBD) 2021, including the prevalence, incidence, and years lived with disability (YLDs) of TBI, SCI, and skull fractures across 204 countries and territories from 1990 to 2021. Data were presented as both numerical counts and age-standardized rates (ASRs) per 100,000 population, with corresponding uncertainty intervals. To assess temporal trends in disease burden, we calculated the estimated annual percentage change (EAPC) with associated 95% confidence intervals.ResultsCompared with 1990, the number of global incident cases in 2019 changed by 122.56, 121.29, and 97.49% for TBI, SCI, and skull fracture, respectively. During the 30-year study period, there was a downward trend in the ASR of prevalence, incidence and YLDs for TBI (EAPC = −0.68, −0.8 and −0.66, respectively), SCI (EAPC = −0.73, −0.81 and −1.01, respectively) and skull fracture (EAPC = −1.37, −1.15 and −1.38, respectively). Regions with higher sociodemographic indices had higher incidences, incidence rates, and YLDs for all three types of CNS injury. The burden of CNS injury varies notably among regions and nations. Eastern Europe, Central Europe, southern Latin America, Australasia, and high-income North America were the GBD regions with the highest burden of CNS injury, and the burdens of TBI, SCI, and skull fracture showed the most significant increasing trends in the Caribbean. Young-to-middle-aged men (15–39 years) bore the primary burden of TBI, SCI, and skull fractures. Falls were the leading specific risk factor for all three types of CNS injury, followed by motor vehicle road injuries. The global burden of TBI, SCI, and skull fractures is projected to decline through 2040, both in terms of absolute case counts and age-standardized incidence rates.ConclusionThe global, regional, and national burdens of TBI, SCI, and skull fractures—reflected by their prevalence, incidence, and YLDs—exhibit significant disparities. Our findings can inform policymakers in formulating future strategies for managing traumatic CNS injuries, with priority given to targeted preventive measures against risk factors to mitigate the burden of these life-threatening and disabling CNS conditions.

ObjectiveFalls in older people have become a major public health, economic and societal problem. Osteoporosis predisposes older adults to high risk of falls, which were the most common outcome attributable to low bone mineral density (LBMD). In this study, we analyze the long-term trends in falls burden attributable to LBMD among people aged 60 years and over from 1990 to 2019, using data from the Global Burden of Diseases, Injuries, and Risk Factors Study 2019 (GBD 2019).MethodsData from GBD 2019 were used to assess the long-term trends in mortality and disability-adjusted life-year (DALY) rates by Joinpoint regression. The age-period-cohort (APC) model was used to evaluate the effects of age, period and cohort on mortality rate of falls attributable to LBMD.ResultsThe mortality and DALYs rates of falls attributable to LBMD among people aged 60 years and over increased from 1990 to 2019, with average annual percentage changes (AAPCs) of 1.74% (95% CI: −1.47 to 2.01%) and 0.99% (95% CI: 0.80–1.19%), respectively. APC analysis revealed that the mortality rate due to LBMD significantly increased among the older people over the age of 75 years. The risk of falls mortality due to LBMD during the period of 1990–2019 initially declined but later elevated. An overall increasing risk for falls death attributable to LBMD was presented across birth cohorts, but in cohorts born after 1930, the upward trend has slowed down. The overall net drift per year attributable to LBMD was above 0. The corresponding results showed that the negative impact of period and cohort effects among males was more pronounced than those among females.ConclusionsFalls attributable to LBMD remain an ongoing health burden in the older people in China, and the mortality has been on the rise from 1990 to 2019, especially among the older people aged 80+ years group. The prevention and treatment of LBMD should be emphasized, especially among males and oldest-old people. Furthermore, there is an urgent need to strengthen the implementation of system-wide, integrated and effective public health policies and other health interventions in China.

BackgroundLiver cancer due to hepatitis C (LCDHC) is one of the leading causes of cancer-related deaths worldwide, and the burden of LCDHC is increasing. We aimed to report the burden of LCDHC at the global, regional, and national levels in 204 countries from 1990 to 2019, stratified by etiology, sex, age, and Sociodemographic Index.MethodsData on LCDHC were available from the Global Burden of Disease, Injuries, and Risk Factors (GBD) study 2019. Numbers and age-standardized mortality, incidence, and disability-adjusted life year (DALY) rates per 100,000 population were estimated through a systematic analysis of modeled data from the GBD 2019 study. The trends in the LCDHC burden were assessed using the annual percentage change.ResultsGlobally, in 2019, there were 152,225 new cases, 141,810 deaths, and 2,878,024 DALYs due to LCDHC. From 1990 to 2019, the number of incidences, mortality, and DALY cases increased by 80.68%, 67.50%, and 37.20%, respectively. However, the age-standardized incidence, mortality, and DALY rate had a decreasing trend during this period. In 2019, the highest age-standardized incidence rates (ASIRs) of LCDHC were found in high-income Asia Pacific, North Africa and the Middle East, and Central Asia. At the regional level, Mongolia, Egypt, and Japan had the three highest ASIRs in 2019. The incidence rates of LCDHC were higher in men and increased with age, with a peak incidence in the 95+ age group for women and the 85–89 age group for men in 2019. A nonlinear association was found between the age-standardized rates of LCDHC and sociodemographic index values at the regional and national levels.ConclusionsAlthough the age-standardized rates of LCDHC have decreased, the absolute numbers of incident cases, deaths, and DALYs have increased, indicating that LCDHC remains a significant global burden. In addition, the burden of LCDHC varies geographically. Male and older adult/s individuals have a higher burden of LCDHC. Our findings provide insight into the global burden trend of LCDHC. Policymakers should establish appropriate methods to achieve the HCV elimination target by 2030 and reducing the burden of LCDHC.

ObjectiveTo estimate the burden of potential productivity losses due to uncorrected and under-corrected presbyopia in LMICs among the working-age population in both the cross-sectional and longitudinal manner.MethodsWe extracted data for the prevalence of presbyopia from the Global Burden of Diseases (GBD), Injuries, and Risk Factors Study 2019. Data for the gross domestic product (GDP) per capita were extracted from the World Bank database and Central Intelligence Agency's World Factbook. We introduced life table models to construct age cohorts (in 5-year age groups) of the working-age population (aged from 40 to 64 years old) in LMICs, with simulated follow-up until 65 years old in people with and without uncorrected presbyopia. The differences in productivity-adjusted life years (PALYs) lived and productivity between these two cohorts were calculated. The potential productivity loss was estimated based on GDP per capita. The WHO standard 3% annual discount rate was applied to all years of life and PALYs lived.ResultsIn 2019, there were 238.40 million (95% confidence interval [CI]: 150.92–346.78 million) uncorrected and under-corrected presbyopia cases in LMICs, resulting in 54.13 billion (current US dollars) (95% confidence interval [CI]: 34.34–79.02 billion) potential productivity losses. With simulated follow-up until retirement, those with uncorrected and under-corrected presbyopia were predicted to experience an additional loss of 155 million PALYs (an average loss of 0.7 PALYs per case), which was equivalent to a total loss of US$ 315 billion (an average loss of US$ 1453.72 per person).ConclusionsOur findings highlight the considerable productivity losses due to uncorrected and under-corrected presbyopia in LMICs, especially in a longitudinal manner. There is a great need for the development of enabling eye care policies and programs to create access to eye care services, and more healthcare investment in the correction of presbyopia in the working-age population in LMICs. This study could provide evidences for some potential health-related strategies for socio-economic development.