Global burden of lower respiratory infections during the last three decades

Saeid Safiri; Ata Mahmoodpoor; Ali-Asghar Kolahi; Seyed Aria Nejadghaderi; Mark J M Sullman; Mohammad Ali Mansournia; Khalil Ansarin; Gary S Collins; Jay S Kaufman; Morteza Abdollahi

doi:10.3389/fpubh.2022.1028525

Global burden of lower respiratory infections during the last three decades

Front Public Health. 2023 Jan 9:10:1028525. doi: 10.3389/fpubh.2022.1028525. eCollection 2022.

Authors

Saeid Safiri^{1

2}, Ata Mahmoodpoor³, Ali-Asghar Kolahi⁴, Seyed Aria Nejadghaderi^{5

6}, Mark J M Sullman^{7

8}, Mohammad Ali Mansournia⁹, Khalil Ansarin¹⁰, Gary S Collins^{11

12}, Jay S Kaufman¹³, Morteza Abdollahi⁴

Affiliations

¹ Social Determinants of Health Research Center, Department of Community Medicine, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran.
² Tuberculosis and Lung Diseases Research Centre, Tabriz University of Medical Sciences, Tabriz, Iran.
³ Department of Anesthesiology, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran.
⁴ Social Determinants of Health Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
⁵ Research Centre for Integrative Medicine in Aging, Aging Research Institute, Tabriz University of Medical Sciences, Tabriz, Iran.
⁶ Systematic Review and Meta-analysis Expert Group (SRMEG), Universal Scientific Education and Research Network (USERN), Tehran, Iran.
⁷ Department of Life and Health Sciences, University of Nicosia, Nicosia, Cyprus.
⁸ Department of Social Sciences, University of Nicosia, Nicosia, Cyprus.
⁹ Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
¹⁰ Rahat Breath and Sleep Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
¹¹ NDORMS, Centre for Statistics in Medicine, Botnar Research Centre, University of Oxford, Oxford, United Kingdom.
¹² NIHR Oxford Biomedical Research Centre, Oxford University Hospitals NHS Foundation Trust, Oxford, United Kingdom.
¹³ Department of Epidemiology, Biostatistics and Occupational Health, Faculty of Medicine, McGill University, Montreal, QC, Canada.

Abstract

Background: Lower respiratory infections (LRIs) cause a substantial mortality, morbidity and economic burden. The present study reported the global, regional and national burden of LRIs and their attributable risk factors in 204 countries and territories, between 1990 and 2019, by age, sex, etiology, and Socio-demographic Index (SDI).

Methods: Using publicly available data from the Global Burden of Disease (GBD) study 2019, we reported the incidence, deaths and disability-adjusted life-years (DALYs), due to LRIs. Estimates were presented as counts and age-standardized rates per 100,000 population with their associated uncertainty intervals (UIs).

Results: Globally, in 2019 there were 488.9 million (95% UI: 457.6 to 522.6) incident cases and 2.4 million (2.3-2.7) deaths due to LRIs. The global age-standardized incidence and death rates for LRIs were 6,295 (5,887.4-6,737.3) and 34.3 (31.1-37.9) per 100,000 in 2019, which represents a 23.9% (22.5-25.4) and 48.5% (42.9-54.0) decrease, respectively since 1990. In 2019, Guinea [12,390.4 (11,495.5-13,332.8)], Chad [12,208.1 (11,289.3-13,202.5)] and India [11,862.1 (11,087.0-12,749.0)] had the three highest age-standardized incidence rates of LRI. Equatorial Guinea [-52.7% (95% UI: -55.8 to -49.3)], Chile [-50.2% (95% UI: -53.4 to -47.0)] and Albania [-48.6% (95% UI: -51.7 to -45.3)] showed the largest decreases from 1990 to 2019. In 2019, a decrease in the incidence rate of LRI was observed at the global level up to the 25-29 age group, then the incidence rates increased with age. The burden of LRIs decreased with increasing SDI at both the regional and national levels. Globally, child wasting (33.1%), household air pollution from solid fuels (24.9%) and a lack of access to handwashing facilities (14.4%) made the largest contributions to the LRI burden in 2019.

Conclusions: Although the burden of LRIs decreased over the period 1990-2019, LRIs still contribute to a large number of incident cases, deaths and DALYs. Preventative programs with a focus on reducing exposure to attributable risk factors should be implemented, especially in less developed countries.

Keywords: epidemiology; incidence; lower respiratory infection; mortality; respiratory infection; risk factor.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Air Pollution*
Child
Global Burden of Disease
Humans
Incidence
Respiratory Tract Infections* / epidemiology
Risk Factors

Grants and funding

The Bill and Melinda Gates Foundation, who were not involved in any way in the preparation of this manuscript, funded the GBD study. The Shahid Beheshti University of Medical Sciences, Tehran, Iran (Grant No. 24494) also supported the present report.