Global burden of reported lower respiratory system fungal infection

Abstract

Background: The epidemiological trend of lower respiratory tract fungal infections remains unclear. This study aims to quantify the global burden of these infections from 1990 to 2021 using data from the Global Burden of Disease Study 2021.

Methods: Data were analyzed at global, regional, and national levels, considering factors such as age, gender, region, and socio-demographic index (SDI). Key indicators included age-standardized disability-adjusted life-year (ASDR) and age-standardized mortality rates (ASMR).

Results: On a global scale, the burden of lower respiratory fungal infections decreased significantly from 1990 to 2021, with a decline in mortality rates. Regionally, substantial disparities were observed among the 21 geographic super-regions. Nationally, Argentina experienced the greatest increase in ASDR and ASMR, while Finland showed the largest decrease, with average annual percentage changes (AAPC) below -5 for both indicators. Sex-based analysis revealed a notably higher burden in males compared to females. ASDR and ASMR were negatively correlated with SDI in most regions.

Conclusion: Although the global burden of lower respiratory tract fungal infections has decreased, it remains a substantial public health issue, particularly in low-SDI regions. There is an urgent need to implement targeted preventive measures to address this ongoing challenge.

Keywords: age-standardized disability-adjusted life-year rates; age-standardized mortality rates; global health; join-point regression analysis; lower respiratory tract fungal infections.

Figure 1

The burdens of lower respiratory tract fungal infection among 204 countries and territories in 2021. (A) Regional distribution of the ASDR of lower respiratory tract fungal infection in 2021. (B) Regional distribution of trends in ASDR from 1990 to 2021. (C) Regional distribution of the ASMR of lower respiratory tract fungal infection in 2021. (D) Regional distribution of trends in ASMR from 1990 to 2021. (ASDR, age-standardized disability-adjusted life year; ASMR, age-standardized mortality rate; AAPC, average annual percentage changes; Blue, from light to dark indicates an increase in values; Red: decrease, Purple: increase, the gradient from light to dark represents the intensity of the change).

Figure 2

The burdens of lower respiratory tract fungal infection of different age groups from 1990 to 2021. The DALYs (A), ASDR (B), Death (C), Mortality rate (D) of different age groups from 1990 to 2021. (ASDR, age-standardized disability-adjusted life year; DALYs, disability-adjusted life years.).

Figure 3

The correlation between SDI and ASR in 19 regions and 204 countries. The correlation between SDI and ASDR in 19 regions (A) and 204 countries (B). The correlation between SDI and ASMR in 19 regions (C) and 204 countries (D). (ASDR, age-standardized disability-adjusted life year; ASMR, age-standardized mortality rate; SDI, Socio-demographic Index; The black curve represents the fitted curve).

Figure 4

The join-point analysis of ASR change by sex and SDI, 1990 to 2021. The join-point analysis for lower respiratory tract fungal infection in ASDR by SDI of male (A), female (B). The join-point analysis for lower respiratory tract fungal infection in ASMR by SDI of male (C), female (D). (ASDR, age-standardized disability-adjusted life year; ASMR, age-standardized mortality rate; SDI, Socio-demographic Index; Each color represents a different level of SDI, and each point represents a year; For specific join-point years, refer to Supplementary Table 2 ).