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Observational Study
. 2022 Oct 20;19(1):166.
doi: 10.1186/s12985-022-01898-9.

Global burden and trends of rotavirus infection-associated deaths from 1990 to 2019: an observational trend study

Yuxia Du #  1 , Can Chen #  1 , Xiaobao Zhang #  1 , Danying Yan  1 , Daixi Jiang  1 , Xiaoxiao Liu  1 , Mengya Yang  1 , Cheng Ding  1 , Lei Lan  1 , Robert Hecht #  2 , Changtai Zhu #  3 , Shigui Yang #  4
Affiliations
Observational Study

Global burden and trends of rotavirus infection-associated deaths from 1990 to 2019: an observational trend study

Yuxia Du et al. Virol J. .

Abstract

Background: Rotavirus is the leading global pathogen of diarrhea-associated mortality and poses a great threat to public health in all age groups. This study aimed to explore the global burden and 30-year change patterns of rotavirus infection-associated deaths.

Methods: Based on the Global Burden of Disease 2019 Study (GBD 2019), we analyzed the age-standardized death rate (ASDR) of rotavirus infection by sex, geographical region, and sociodemographic index (SDI) from 1990 to 2019. A Joinpoint regression model was used to analyze the global trends in rotavirus infection over the 30 years, SaTScan software was used to detect the spatial and temporal aggregations, and a generalized linear model to explore the relationship between sociodemographic factors and death rates of rotavirus infection.

Results: Globally, rotavirus infection was the leading cause of diarrheal deaths, accounting for 19.11% of deaths from diarrhea in 2019. Rotavirus caused a higher death burden in African, Oceanian, and South Asian countries in the past three decades. The ASDR of rotavirus declined from 11.39 (95% uncertainty interval [95% UI] 5.46-19.48) per 100,000 people in 1990 to 3.41 (95% UI 1.60-6.01) per 100,000 people in 2019, with an average annual percentage change (AAPC) (- 4.07%, P < 0.05). However, a significant uptrend was found in high-income North America (AAPC = 1.79%, P < 0.05). The death rate was the highest among children under 5 years worldwide. However, the death rates of elderly individuals over 70 years were higher than those of children under 5 years in 2019 among high, high-middle, middle, and low-middle SDI regions. Current health expenditure, gross domestic product per capita, and the number of physicians per 1000 people were significantly negatively correlated with death rates of rotavirus.

Conclusions: Although the global trends in the rotavirus burden have decreased substantially over the past three decades, the burden of rotavirus remained high in Africa, Oceania, and South Asia. Children under 5 years and elderly individuals over 70 years were the populations most at risk for rotavirus infection-associated deaths, especially elderly individuals over 70 years in relatively high SDI regions. More attention should be paid to these areas and populations, and effective public health policies should be implemented in the future.

Keywords: Global burden; Global trends; Joinpoint regression model; Rotavirus.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Fig. 1
Fig. 1
Global burden of rotavirus infection-associated deaths among 204 countries and territories. A ASDRs in 1990; B ASDRs in 2019; C AAPCs from 1990 to 2019; D Spatial and temporal aggregation from 1990 to 2019
Fig. 2
Fig. 2
Age-specific temporal trends of rotavirus infection-associated deaths among SDI quintiles from 1990 to 2019. A–F Temporal trends of ASDRs globally and in different SDI countries over 30 years; G–L Age-specific temporal trends of death rates globally and in different SDI countries over 30 years. The APCs and AAPCs with asterisks (*) are statistically significant (P < 0.05)
Fig. 3
Fig. 3
Age group distribution of the burden of rotavirus infection-associated deaths in 1990 and 2019 among SDI quintiles and worldwide. A Global; B High SDI; C High-middle SDI; D Middle SDI; E Low-middle SDI; F Low SDI
See this image and copyright information in PMC

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