Divisions of Epidemiology and Zoonoses, Department of Food Hygiene and Quality Control, Faculty of Veterinary Medicine, University of Tehran, Tehran, Iran.
Department of Avian Diseases, Faculty of Veterinary Medicine, University of Tehran, Tehran, Iran.
BMC Pulm Med. 2023 Jan 4;23(1):2. doi: 10.1186/s12890-022-02301-7.
Lower respiratory infections (LRIs) cause substantial mortality and morbidity. The present study reported and analysed the burden of LRIs in the Middle East and North Africa (MENA) region between 1990 and 2019, by age, sex, etiology, and socio-demographic index (SDI).
The data used in this study were sourced from the Global Burden of Disease (GBD) study 2019. The annual incidence, deaths, and disability-adjusted life-years (DALYs) due to LRIs were presented as counts and age-standardised rates per 100,000 population, along with their 95% uncertainty intervals (UIs). The average annual percent changes (AAPC) in the age-standardised incidence, death and DALYs rates were calculated using Joinpoint software and correlations (Pearson's correlation coefficient) between the AAPCs and SDIs were calculated using Stata software.
In 2019, there were 34.1 million (95% UI 31.7-36.8) incident cases of LRIs in MENA, with an age-standardised rate of 6510.2 (95% UI 6063.6-6997.8) per 100,000 population. The number of regional DALYs was 4.7 million (95% UI 3.9-5.4), with an age-standardised rate of 888.5 (95% UI 761.1-1019.9) per 100,000 population, which has decreased since 1990. Furthermore, Egypt [8150.8 (95% UI 7535.8-8783.5)] and Afghanistan [61.9 (95% UI 52.1-72.6)] had the highest age-standardised incidence and death rates, respectively. In 2019, the regional incidence and DALY rates were highest in the 1-4 age group, in both females and males. In terms of deaths, pneumococcus and H. influenza type B were the most and least common types of LRIs, respectively. From 1990 to 2019, the burden of LRIs generally decreased with increasing SDI. There were significant positive correlations between SDI and the AAPCs for the age-standardised incidence, death and DALY rates (p < 0.05). Over the 1990-2019 period, the regional incidence, deaths and DALYs attributable to LRIs decreased with AAPCs of - 1.19% (- 1.25 to - 1.13), - 2.47% (- 2.65 to - 2.28) and - 4.21% (- 4.43 to - 3.99), respectively.
The LRI-associated burden in the MENA region decreased between 1990 and 2019. SDI had a significant positive correlation with the AAPC and pneumococcus was the most common underlying cause of LRIs. Afghanistan, Yemen and Egypt had the largest burdens in 2019. Further studies are needed to investigate the effectiveness of healthcare interventions and programs to control LRIs and their risk factors.
下呼吸道感染（LRIs）会导致大量的死亡和发病。本研究报告并分析了 1990 年至 2019 年期间中东和北非（MENA）地区 LRIs 的负担，按年龄、性别、病因和社会人口指数（SDI）进行了分析。
本研究使用的数据来自 2019 年全球疾病负担（GBD）研究。以病例数和每 10 万人标准化发病率表示 LRIs 的年发病率、死亡人数和残疾调整生命年（DALYs），并附有 95%的不确定区间（UI）。使用 Joinpoint 软件计算年龄标准化发病率、死亡率和 DALYs 率的年均变化百分比（AAPC），使用 Stata 软件计算 AAPC 与 SDI 之间的相关性（Pearson 相关系数）。
2019 年，MENA 地区有 3410 万例（95%UI 3170-3680）LRIs 新发病例，年龄标准化发病率为 6510.2 例/10 万人（95%UI 6063.6-6997.8）。该地区的 DALY 数为 470 万（95%UI 390-540），年龄标准化发病率为 888.5 例/10 万人（95%UI 761.1-1019.9），自 1990 年以来一直在下降。此外，埃及[8150.8（95%UI 7535.8-8783.5）]和阿富汗[61.9（95%UI 52.1-72.6）]的年龄标准化发病率和死亡率最高。2019 年，1-4 岁年龄组在女性和男性中发病率和 DALY 率均最高。就死亡而言，肺炎球菌和乙型流感嗜血杆菌是最常见和最不常见的 LRI 类型。1990 年至 2019 年期间，LRIs 的负担一般随着 SDI 的增加而降低。SDI 与年龄标准化发病率、死亡率和 DALY 率的 AAPC 之间存在显著的正相关（p<0.05）。在 1990-2019 年期间，LRIs 导致的发病率、死亡和 DALY 归因于 AAPC 分别下降了-1.19%（-1.25 至-1.13）、-2.47%（-2.65 至-2.28）和-4.21%（-4.43 至-3.99）。
1990 年至 2019 年期间，MENA 地区与 LRI 相关的负担有所下降。SDI 与 AAPC 呈显著正相关，肺炎球菌是最常见的 LRI 病因。2019 年，阿富汗、也门和埃及的负担最大。需要进一步研究卫生保健干预措施和项目的有效性，以控制 LRIs 及其危险因素。
