Global burden of viral infectious diseases of poverty based on Global Burden of Diseases Study 2021

Abstract

Background: Viral infectious diseases of poverty (vIDPs) remain a significant global health challenge. Despite their profound impact, the burden of these diseases is not comprehensively quantified. This study aims to analyze the global burden of six major vIDPs, including coronavirus disease 2019 (COVID-19), HIV/AIDS, acute hepatitis, dengue, rabies, and Ebola virus disease (EVD), using data from the Global Burden of Diseases, Injuries, and Risk Factors Study 2021 (GBD 2021).

Methods: Following the GBD 2021 framework, we analyzed the incidence, mortality, and disability-adjusted life years (DALYs) of the six vIDPs across 204 countries and territories from 1990 to 2021. We examined the association between the Socio-Demographic Index (SDI) and the burden of vIDPs. All estimates were reported as numbers and rates per 100,000 population, calculated using the Bayesian statistical model employed by GBD 2021, with 95% uncertainty intervals (UI).

Results: In 2021, vIDPs caused approximately 8.7 million deaths and 259.2 million DALYs, accounting for 12.8% and 9.0% of the global all-cause totals, respectively. Globally, the burden of vIDPs varied significantly: COVID-19 caused around 7.9 million (95% UI: 7.5, 8.4) deaths and 212.0 million (95% UI 197.9, 234.7) DALYs in 2021. Acute hepatitis had the second-highest age-standardized incidence rate, with 3411.5 (95% UI: 3201.8, 3631.3) per 100,000 population, while HIV/AIDS had a high age-standardized prevalence rate, with 483.1 (95% UI: 459.0, 511.4) per 100,000 population. Dengue incidence cases rose from 26.5 million (95% UI: 3.9, 51.9) in 1990 to 59.0 million (95% UI: 15.5, 106.9) in 2021. Rabies, although reduced in prevalence, continued to pose a significant mortality risk. EVD had the lowest overall burden but significant outbreak impacts. Age-standardized DALY rates for vIDPs were significantly negatively correlated with SDI: acute hepatitis (r = -0.8, P < 0.0001), rabies (r = -0.7, P < 0.0001), HIV/AIDS (r = -0.6, P < 0.0001), COVID-19 (r = -0.5, P < 0.0001), dengue (r = -0.4, P < 0.0001), and EVD (r = -0.2, P < 0.005).

Conclusions: VIDPs pose major public health challenges worldwide, with significant regional, age, and gender disparities. The results underscore the need for targeted interventions and international cooperation to mitigate the burden of these diseases. Policymakers can use these findings to implement cost-effective interventions and improve health outcomes, particularly in regions with high or increasing burdens.

Keywords: Disability-adjusted life years; Global Burden of Disease 2021; Socio-Demographic Index; Viral infectious diseases of poverty.

Fig. 1

Global distribution of age-standardized DALY rates for six viral infectious diseases of poverty for all ages and both sexes in 2021 (a rabies, b dengue, c acute hepatitis, d HIV/AIDS, e EVD, and f COVID-19). *The rate is per 100,000 population. DALY disability-adjusted life year. Map approval number: GS(2024)3052

Fig. 2

Trends in age-standardized DALY rates of six viral infectious diseases of poverty globally and by different SDI levels, 1990–2021. *The rate is per 100,000 population. DALY disability-adjusted life year; SDI Socio-Demographic Index

Fig. 3

Age and gender differences in incidence rates and number of cases of six viral infectious diseases of poverty in 2021 (a: rabies, b: dengue, c: acute hepatitis, d HIV/AIDS, e: EVD, and f: COVID-19)

Fig. 4

Heatmap of age-standardized DALY rates for six viral infectious diseases of poverty by 21 regions in 2021. *The rate is per 100,000 population. DALY disability-adjusted life year

Fig. 5

Relationship between SDI and age-standardized DALY rates for six viral infectious diseases of poverty in 2021 (a: rabies, b: dengue, c: acute hepatitis, d: HIV/AIDS, e: EVD, and f: COVID-19). *SDI: Socio-Demographic Index; DALY: disability-adjusted life year