Global, regional and national burden of human cystic echinococcosis from 1990 to 2019: a systematic analysis for the Global Burden of Disease Study 2019

Abstract

Abstract Background: Cystic echinococcosis (CE) is a neglected tropical parasitic disease that poses huge disease, social and economic burdens in the world. Although great strides have been achieved, multiple challenges remain to achieve the ambitious goal targeting CE set in the WHO roadmap for neglected tropical diseases 2021–2030. Estimates of the disease burden due to CE facilitate the progress towards eliminations; however, there is little knowledge on global morbidity, mortality and disability-adjusted life years (DALYs) of CE until now. This study aimed to present the most up-to-date data about the global, regional and national disease burden due to CE from 1990 to 2019 and to project trends in the next 10 years. Methods: We measured the global, regional and national morbidity, mortality and DALYs of CE from 1990 to 2019 based on the Global Burden of Disease Study 2019 (GBD 2019) data, and we examined the correlation between socioeconomic development levels and the disease burden of CE. In addition, the disease burden due to CE was projected using Bayesian age-period-cohort analysis with integrated nested Laplace approximations from 2020 to 2030. Results: The global number of CE cases increased from 134,980 [95% uncertainty interval (UI): (93,141 to 195,144)] in 1990 to 207,368 [95% UI: (6,347,183 to 8,769,520)] in 2019 [estimated annual percentage change (EAPC) = 0.54], and the age-standardized incidence rate (ASIR) of CE reduced from 2.65/105 [95% UI: (1.87/105 to 3.7/105)] in 1990 to 2.6/105 [95% UI: (1.72/105 to 3.79/105)] in 2019 (EAPC = ‒0.18). The number of deaths, DALYs, age-standardized mortality rate (ASMR) and age-standardized DALYs rate due to CE all appeared a tendency towards a decline from 1990 to 2019. A higher disease burden of CE was measured in women than in men in 2019. There was a significant difference in ASMR of CE in regions specified by socio-demographic index (SDI) and lower burdens of CE were estimated in high SDI regions. The global ASIR of CE was projected to appear a tendency towards a decline from 2020 to 2030; however, the ASMR and age-standardized DALY rate were projected to rise. Conclusions: Our data may provide data-based evidence for public health officials and policy-makers to formulate and implement cost-benefit interventions to tackle the disease burden attributable to CE. More health resources are recommended to be allocated to low SDI regions, women and the elderly at ages of 55 to 65 years to reduce the disease burden of CE.