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. 2024 Aug 8;10(16):e35841.
doi: 10.1016/j.heliyon.2024.e35841. eCollection 2024 Aug 30.

Global epidemiological trends in the incidence and deaths of acute respiratory infections from 1990 to 2021

Can Chen  1 , Yue You  1   2 , Yuxia Du  1 , Wenkai Zhou  1 , Daixi Jiang  1 , Kexin Cao  1 , Mengya Yang  1 , Xiaoyue Wu  1 , Mengsha Chen  1 , Jiaxing Qi  1 , Dingmo Chen  1 , Rui Yan  1 , Shigui Yang  1 , Mingxia Ji  3 ; RIDPHE Group&: Innovation group on intelligent response to infectious diseases and public health emergencies; Dong Yan  4 ; RIDPHE Group: Innovation group on intelligent response to infectious diseases and public health emergencies
Collaborators, Affiliations

Global epidemiological trends in the incidence and deaths of acute respiratory infections from 1990 to 2021

Can Chen et al. Heliyon. .

Abstract

The aim of this study was to investigate the global epidemiological trends in the incidence and deaths of acute respiratory infections (ARIs), encompassing both upper respiratory infections (URIs) and lower respiratory infections (LRIs), from 1990 to 2021. Using data from the Global Burden of Disease study 2021 (GBD 2021), we utilized the average annual percentage change (AAPC) to examine the trends in the age-standardized incidence rate and deaths rate (ASIR and ASDRs) of URIs and LRIs. In 2021, the global ASIR of URIs and LRIs were 166,770.73 (95 % UI: 148,098.16-189,487.93) per 100,000 and 4283.61 (95 % UI: 4057.03-4524.89) per 100,000, respectively. The highest ASIR of URIs occurred in high-sociodemographic index (SDI) regions (232744.64, 95 % UI: 206887.07-261694.81) per 100,000, whereas LRIs occurred in low-SDI regions (9261.1, 95 % UI: 8741.61-9820.86) per 100,000. In 2021, the global ASDRs of URIs and LRIs were 0.28 (95 % UI: 0.09-0.61) per 100,000 and 28.67 (95 % UI: 25.92-31.07) per 100,000, respectively. The highest ASDRs of both URIs and LRIs were observed in low-SDI regions, with 1.1 (95 % UI: 0.08-2.78) per 100,000 and 70.68 (95 % UI: 62.56-78.62) per 100,000, respectively. From 1990 to 2021, the global ASIR for URIs and LRIs decreased, with AAPCs of -0.17 % (95 % CI: 0.17 % to -0.16 %) and -1.28 % (95 % CI: -1.37 % to -1.22 %), respectively. The global ASDRs also decreased (-3.39 % for URIs; -2.46 % for LRIs). However, during the COVID-19 pandemic, the ASIR of URIs increased in many countries, especially in high-SDI regions (rate difference before and during the COVID-19 pandemic in ASIR was 2210.19 per 100,000.) and low-SDI regions (rate difference in ASIR: 111.26 per 100,000). The global incidence and deaths related to ARIs have decreased over the past 32 years. However, it remains a significant public health concern, particularly due to the notable incidence of URIs in high SDI regions and the deaths associated with both URIs and LRIs in low SDI regions. Furthermore, an increase in the incidence of URIs was observed in both high- and low-SDI regions during the COVID-19 pandemic, highlighting the need for increased attention.

Keywords: Acute respiratory infections; Epidemiological trends; High-SDI regions; Low-SDI regions; Lower respiratory infections; Upper respiratory infections.

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Conflict of interest statement

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Figures

Fig. 1
Fig. 1
Global Incidence and Deaths rates of Upper Respiratory Infections among 204 Countries and Territories. (A) ASIR in 1990; (B) ASIR in 2019; (C) ASIR in 2021; (D) AAPC in ASIR from 1990 to 2021; (E) ASDR in 1990; (F) ASDR in 2019; (G) ASDR in 2021; (H) AAPC in ASDR from 1990 to 2021.
Fig. 2
Fig. 2
Global Incidence and Deaths rates of Lower Respiratory Infections among 204 Countries and Territories. (A) ASIR in 1990; (B) ASIR in 2019; (C) ASIR in 2021; (D) AAPC in ASIR from 1990 to 2021; (E) ASDR in 1990; (F) ASDR in 2019; (G) ASDR in 2021; (H) AAPC in ASDR from 1990 to 2021.
Fig. 3
Fig. 3
Age-specific Incidence and Trends of Upper Respiratory Infections from 1990 to 2019 among Each SDI Regions. (A) Global incidence; (B) Incidence in high SDI regions; (C) Incidence in high-middle SDI regions; (D) Incidence in middle SDI regions; (E) Incidence in low-middle SDI regions; (F) Incidence in low SDI regions; (G) Global deaths; (H) Deaths in high SDI regions; (I) Deaths in high-middle SDI regions; (J) Deaths in middle SDI regions; (K) Deaths in low-middle SDI regions; (L) Deaths in low SDI regions.
Fig. 4
Fig. 4
Age-specific Deaths and Trends of Lower Respiratory Infections from 1990 to 2019 among Each SDI Regions. (A) Global death; (B) Death in high SDI regions; (C) Death in high-middle SDI regions; (D) Death in middle SDI regions; (E) Death in low-middle SDI regions; (F) Death in low SDI regions; (G) Global deaths; (H) Deaths in high SDI regions; (I) Deaths in high-middle SDI regions; (J) Deaths in middle SDI regions; (K) Deaths in low-middle SDI regions; (L) Deaths in low SDI regions.
Fig. 5
Fig. 5
Rate Differences in the Incidence and Deaths of ARIs Before and After the COVID-19 pandemic. (A) Rate differences in ASIR of URIs; (B) Rate differences in ASDRs of URIs; (C) Rate differences in ASIR of LRIs; (D) Rate differences in ASDR of LRIs.
Fig. 6
Fig. 6
Rate Differences in the Incidence and Deaths of ARIs by SDI Levels. (A) Rate differences in ASIR of URIs by SDI Levels; (B) Rate differences in ASDR of URIs by SDI Levels; (C) Rate differences in ASIR of LRIs by SDI Levels; (D) Rate differences in ASDR of LRIs by SDI Levels; Supplementary Materials.
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