Yang G, He A, Li Y, Lü S, Chen M, Tian L, Liu Q, Duan L, Lu Y, Yang J, Li S, Zhou X, Wang J, Zhang S
Gansu Provincial Center for Disease Control and Prevention, Lanzhou, Gansu 730000, China.
National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention (Chinese Center for Tropical Diseases Research), National Health Commission Key Laboratory of Parasite and Vector Biology, WHO Collaborating Centre for Tropical Diseases, National Center for International Research on Tropical Diseases, Ministry of Science and Technology, China.
Zhongguo Xue Xi Chong Bing Fang Zhi Za Zhi. 2025 Feb 5;37(1):35-43. doi: 10.16250/j.32.1915.2024251.
To investigate the global burden of visceral leishmaniasis (VL) from 1990 to 2021 and predict the trends in the burden of VL from 2022 to 2035, so as to provide insights into global VL prevention and control.
The global age-standardized incidence, prevalence, mortality and disability-adjusted life years (DALYs) rates of VL and their 95% uncertainty intervals () were captured from the Global Burden of Disease Study 2021 (GBD 2021) data resources. The trends in the global burden of VL were evaluated with average annual percent change (AAPC) and 95% confidence interval () from 1990 to 2021, and gender-, age-, country-, geographical area- and socio-demographic index (SDI)-stratified burdens of VL were analyzed. The trends in the global burden of VL were projected with a Bayesian age-period-cohort (BAPC) model from 2022 to 2035, and the associations of age-standardized incidence, prevalence, mortality, and DALYs rates of VL with SDI levels were examined with a smoothing spline model.
The global age-standardized incidence [AAPC = -0.25%, 95% : (-0.25%, -0.24%)], prevalence [AAPC = -0.06%, 95% : (-0.06%, -0.06%)], mortality [AAPC = -0.25%, 95% : (-0.25%, -0.24%)] and DALYs rates of VL [AAPC = -2.38%, 95% : (-2.44%, -2.33%)] all appeared a tendency towards a decline from 1990 to 2021, and the highest age-standardized incidence [2.55/10, 95% : (1.49/10, 4.07/10)], prevalence [0.64/10, 95% : (0.37/10, 1.02/10)], mortality [0.51/10, 95% : (0, 1.80/10)] and DALYs rates of VL [33.81/10, 95% : (0.06/10, 124.09/10)] were seen in tropical Latin America in 2021. The global age-standardized incidence and prevalence of VL were both higher among men [0.57/10, 95% : (0.45/10, 0.72/10); 0.14/10, 95% : (0.11/10, 0.18/10)] than among women [0.27/10, 95% : (0.21/10, 0.33/10); 0.06/10, 95% : (0.05/10, 0.08/10)], and the highest mortality of VL was found among children under 5 years of age [0.24/10, 95% : (0.08/10, 0.66/10)]. The age-standardized incidence ( = -0.483, < 0.001), prevalence ( = -0.483, < 0.001), mortality ( = -0.511, < 0.001) and DALYs rates of VL ( = -0.514, < 0.001) correlated negatively with SDI levels from 1990 to 2021. In addition, the global burden of VL was projected with the BAPC model to appear a tendency towards a decline from 2022 to 2035, and the age-standardized incidence, prevalence, mortality and DALYs rates were projected to be reduced to 0.11/10, 0.03/10, 0.02/10 and 1.44/10 in 2035, respectively.
Although the global burden of VL appeared an overall tendency towards a decline from 1990 to 2021, the burden of VL showed a tendency towards a rise in Central Asia and western sub-Saharan African areas. The age-standardized incidence and prevalence rates of VL were relatively higher among men, and the age-standardized mortality of VL was relatively higher among children under 5 years of age. The global burden of VL was projected to continue to decline from 2022 to 2035.
调查1990年至2021年内脏利什曼病（VL）的全球负担，并预测2022年至2035年VL负担的趋势，以便为全球VL的预防和控制提供见解。
从《2021年全球疾病负担研究》（GBD 2021）数据资源中获取全球VL的年龄标准化发病率、患病率、死亡率和伤残调整生命年（DALYs）率及其95%不确定性区间（）。采用年均变化率（AAPC）和95%置信区间（）评估1990年至2021年全球VL负担的趋势，并分析VL按性别、年龄、国家、地理区域和社会人口指数（SDI）分层的负担。使用贝叶斯年龄-时期-队列（BAPC）模型预测2022年至2035年全球VL负担的趋势，并使用平滑样条模型检验VL的年龄标准化发病率、患病率、死亡率和DALYs率与SDI水平的关联。
1990年至2021年，全球VL的年龄标准化发病率[AAPC = -0.25%，95% ：（-0.25%，-0.24%）]、患病率[AAPC = -0.06%，95% ：（-0.06%，-0.06%）]、死亡率[AAPC = -0.25%，95% ：（-0.25%，-0.24%）]和DALYs率[AAPC = -2.38%，95% ：（-2.44%，-2.33%）]均呈下降趋势，2021年热带拉丁美洲的年龄标准化发病率最高[2.55/10，95% ：（1.49/10，4.07/10）]、患病率[0.64/10，95% ：（0.37/10，1.02/10）]、死亡率[0.51/10，95% ：（0，1.80/10）]和DALYs率[33.81/10，95% ：（0.06/10，124.09/10）]。2021年，全球VL的年龄标准化发病率和患病率在男性中均高于女性[0.57/10，95% ：（0.45/10，0.72/10）；0.14/10，95% ：（0.11/10，0.18/10）]，分别为[0.27/10，95% ：（0.21/10，0.33/10）；0.06/10，95% ：（0.05/10，0.08/10）]，VL死亡率最高的是5岁以下儿童[0.24/10，95% ：（0.08/10，0.66/10）]。1990年至2021年，VL的年龄标准化发病率（ = -0.483， < 0.001）、患病率（ = -0.483， < 0.001）、死亡率（ = -0.511， < 0.001）和DALYs率（ = -0.514， < 0.001）与SDI水平呈负相关。此外，BAPC模型预测2022年至2035年全球VL负担呈下降趋势，预计到2035年，年龄标准化发病率、患病率、死亡率和DALYs率将分别降至0.11/10、0.03/10、0.02/10和1.44/10。
尽管1990年至2021年全球VL负担总体呈下降趋势，但中亚和撒哈拉以南非洲西部地区的VL负担呈上升趋势。VL的年龄标准化发病率和患病率在男性中相对较高，VL的年龄标准化死亡率在5岁以下儿童中相对较高。预计2022年至2035年全球VL负担将继续下降。
