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. 2023 Mar 28:11:1061453.
doi: 10.3389/fpubh.2023.1061453. eCollection 2023.

Global, regional, and national burden of 10 digestive diseases in 204 countries and territories from 1990 to 2019

Rui Wang  1   2 , Zhaoqi Li  1   2 , Shaojun Liu  1   2 , Decai Zhang  1   2
Affiliations

Global, regional, and national burden of 10 digestive diseases in 204 countries and territories from 1990 to 2019

Rui Wang et al. Front Public Health. .

Abstract

Background: Digestive diseases are very common worldwide and account for considerable health care use and expenditures. However, there are no global population-based estimates of the disease burden and temporal trend of digestive diseases.

Methods: Annual case numbers, age-standardized rates of prevalence, incidence, death, and disability-adjusted life-years (DALYs), and their estimated annual percentage changes (EAPCs) for digestive diseases between 1990 and 2019 were derived from the Global Burden of Disease, Injuries, and Risk Factors Study (GBD) 2019. The association between digestive disease burden and the sociodemographic index (SDI) was investigated. We also calculated DALYs attributable to risk factors that had evidence of causation with digestive diseases.

Results: Globally, in 2019, there were 88.99 million DALYs due to digestive diseases (3.51% of global DALYs). Digestive diseases were the 13th leading cause of DALYs globally in 2019. Global digestive disease DALYs were highest in the middle SDI quintile and in South Asia and were higher in males than females in 2019. Cirrhosis and other chronic liver diseases constituted the highest proportion of categorized digestive disease DALY burdens globally. From 1990 to 2019, the global age-standardized DALY rate of digestive diseases decreased from 1570.35 in 1990 to 1096.99 in 2019 per 1,00,000 population, with the EAPC being -1.32 (95% confidence interval [CI] -1.36 to -1.27). In 2019, the largest contributor to digestive disease DALYs at the global level, for both sexes, was alcohol use.

Conclusion: The results of this systematic analysis suggest that the global burden of digestive diseases is substantial and varies markedly according to age, sex, SDI, and geographical region. These results provide comprehensive and comparable estimates that can potentially inform efforts toward digestive disease control worldwide.

Keywords: digestive diseases; disability-adjusted life-years; epidemiology; estimated annual percentage change; global burden of disease.

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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

Figure 1
Figure 1
The global DALY burden of digestive diseases in 204 countries and territories. (A) The age-standardized DALY rate (per 100,000 population) of digestive diseases in 2019. (B) The EAPC of the age-standardized DALY rate for digestive diseases between 1990 and 2019. DALY, disability-adjusted life-year; EAPC, estimated annual percentage change.
Figure 2
Figure 2
Global DALYs by digestive diseases, sex, and age, 2019. DALYs, disability-adjusted life-years.
Figure 3
Figure 3
The absolute (A) and proportional (B) DALYs due to various digestive diseases by GBD world region, both sexes combined, 2019. DALY, disability-adjusted life-year; GBD, Global Burden of Disease, Injuries, and Risk Factors Study.
Figure 4
Figure 4
Digestive diseases ranked by numbers of DALYs for both sexes combined, 2019. Intercategory ranking refers to ranking vertically (ranking between the SDI quintiles and GBD super-regions). Intracategory ranking refers to ranking horizontally (ranking within each SDI quintile and GBD super-region). Number ranking is assigned by total absolute DALYs, with 1 representing the highest rank and greatest absolute DALY burden. DALYs, disability-adjusted life-years; GBD, Global Burden of Disease, Injuries, and Risk Factors Study; SDI, Sociodemographic Index.
Figure 5
Figure 5
The association between SDI and digestive disease age-standardized prevalence rate (A) and mortality rate (B) for both sexes combined, 2019. Each color represents one of the seven GBD super-regions (red represents southeast Asia, east Asia, and Oceania; blue represents central Europe, eastern Europe, and central Asia; green represents high-income; purple represents Latin America and the Caribbean; orange represents North Africa and the Middle East; yellow represents south Asia; and gray represents sub-Saharan Africa). Lighter-colored point estimates without labels in the legend represent countries. The black lines represent locally weighted smoothing based on country-level data, and the gray shading represents locally weighted smoothing of country-level 95% uncertainty intervals. GBD, Global Burden of Disease, Injuries, and Risk Factors Study; SDI, Sociodemographic Index.
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