Trend analysis and cross nations inequality analysis of infectious skin diseases from 1990 to 2021

Abstract

The skin serves as a crucial barrier against microbial invasion, but breaches in this barrier can lead to infectious skin diseases (ISD). ISD, including bacterial (BSD), fungal (FSD) and viral Skin Disease (VSD), pose significant global health challenges. Age-standardized and age specific incidence, prevalence, and lived with disability (YLDs) data for ISD were sourced from the Global Burden of Disease Study 2021 (GBD 2021) and demographic data from the United Nations. We utilized linear regression to analyze the prevalence trends and the Average Annual Percentage Change (AAPC) for BSD, FSD and VSD. Log transformation of prevalence rates addressed heteroscedasticity. Cross-national inequality was assessed using concentration and slope indices based on SDI. From the prevalence perspective, FSD continues to rank first, with a prevalence rate of 7789.55 (95% CI 7059.28 to 8583.54) in 2021. Interestingly, VSD overtakes BSD, with a prevalence rate of 1781.31 (95% CI 1733.08 to 1835.16), while BSD has a prevalence rate of 473.98 (95% CI 463.37 to 484.64). Next, looking at YLDs, VSD rises to the first position in 2021, with YLDs rate of 54.77 (95% CI 34.83 to 81.77). FSD comes next, with YLDs rate of 43.39 (95% CI 17.79 to 89.10). Lastly, BSD has YLDs rate of 4.21 (95% CI 2.36 to 7.20). The rate of YLDs for FSD is primarily concentrated among the elderly, while VSD are concentrated among children. There is no significant difference for BSD. The burden is greater for males than females. The prevalence of BSD and FSD is negatively correlated with the Socio-demographic Index (SDI), with the burden primarily concentrated in low SDI countries. VSD shows a positive correlation, mainly concentrated in high SDI countries. We discovered that the global impact of ISD remains significant. Both BSD and FSD are increasing, while VSD are decreasing. FSD is more common among the elderly, whereas VSD predominantly affects children. BSD and FSD are primarily found in less developed areas such as Africa, whereas VSD is more prevalent in developed regions like Europe and North America. ISD cases are also increasing in the Middle East and South America. To reduce the burden of ISD, it is crucial to improve global hygiene standards, boost vaccination rates against viruses, and strictly regulate the use of antimicrobial drugs.

Keywords: Average annual percent change; Bacterial skin disease (BSD); Cross nations inequality analysis; Fungal skin disease (FSD); Infectious skin disease (ISD); Socio-demographic index; Trend analysis; Viral skin disease (VSD).