Zhou Mingzhu, He Yong, Wu Liangmiao, Weng Kaiyuan
School of Pharmaceutical Business, Guangdong Pharmaceutical University, Guangzhou, Guangdong Province, China.
Jinan University First Affiliated Hospital, Guangzhou, Guangdong Province, China.
PLoS One. 2025 Jun 20;20(6):e0316694. doi: 10.1371/journal.pone.0316694. eCollection 2025.
The existing body of literature is deficient in the most recent data regarding the global perspective of dengue fever and its associated health inequities.Our aim is to assess the global burden of dengue fever and its health inequities from 1990 to 2021.
The Global Burden of Disease (GBD) database, organized by global health research institutions, is a comprehensive database and the largest-scale and most detailed scientific research to date. We utilized the GBD database for epidemiological trends, demographic analysis, epidemiological decomposition, cross-national inequality and predictive modeling for the global dengue burden up to 2051 were also performed.
Globally, dengue fever incidence, prevalence, Disability-Adjusted Life-Years (DALYs), and mortality have risen with marked international disparities. From 1990 to 2021, Age-Standardized Rates (ASRs) for incidence and prevalence rose by 1.83% (95% CI: 1.58%-2.08%), and for DALYs and mortality by 1.33% (95% CI: 1.10%-1.57%) and 1.70% (95% CI: 1.45%-1.94%), respectively. Age-Period-Cohort (APC) model analysis showed a positive link between dengue fever incidence and age, with mortality spiking in those over 80. DALYs burden decomposition highlighted population growth as the key driver of global burden, yet impacts differed across Socio-Demographic Index (SDI) quintiles. Dengue fever burden inequalities related to SDI have remained, with benefits shifting from poor to rich populations. Bayesian Age-Period-Cohort (BAPC) model projections indicate stable incidence and prevalence ASRs, but declining DALYs and mortality ASRs, especially for females.
This study elucidates the changes in the burden of dengue fever against the backdrop of a burgeoning global population, severe aging, and pronounced health inequities across nations, quantifying these alterations and forecasting the trends in the disease burden over the next three decades. Concurrently, the research proposes effective measures for various countries and regions to mitigate health inequities.
现有文献缺乏关于登革热全球视角及其相关健康不平等的最新数据。我们的目的是评估1990年至2021年登革热的全球负担及其健康不平等情况。
由全球卫生研究机构整理的全球疾病负担（GBD）数据库是一个综合数据库，也是迄今为止规模最大、最详细的科学研究。我们利用GBD数据库进行了流行病学趋势、人口分析、流行病学分解，还对全球登革热负担进行了跨国不平等和直至2051年的预测建模。
在全球范围内，登革热的发病率、患病率、伤残调整生命年（DALYs）和死亡率都有所上升，且存在显著的国际差异。1990年至2021年，发病率和患病率的年龄标准化率（ASRs）上升了1.83%（95%置信区间：1.58%-2.08%），DALYs和死亡率的年龄标准化率分别上升了1.33%（95%置信区间：1.10%-1.57%）和1.70%（95%置信区间：1.45%-1.94%）。年龄-时期-队列（APC）模型分析显示登革热发病率与年龄呈正相关，80岁以上人群的死亡率飙升。DALYs负担分解突出了人口增长是全球负担的关键驱动因素，但不同社会人口指数（SDI）五分位数的影响有所不同。与SDI相关的登革热负担不平等依然存在，益处从贫困人口转向了富裕人口。贝叶斯年龄-时期-队列（BAPC）模型预测表明发病率和患病率的ASRs将保持稳定，但DALYs和死亡率的ASRs将下降，尤其是女性。
本研究阐明了在全球人口迅速增长、老龄化严重以及各国健康不平等显著的背景下登革热负担的变化，量化了这些改变并预测了未来三十年疾病负担的趋势。同时，该研究为各国和各地区减轻健康不平等提出了有效措施。
