{"id":25967,"date":"2024-08-30T04:37:00","date_gmt":"2024-08-29T20:37:00","guid":{"rendered":"http:\/\/csccm.org.cn\/?p=25967"},"modified":"2024-09-02T10:11:19","modified_gmt":"2024-09-02T02:11:19","slug":"lancet-infect-dis%e5%8f%91%e8%a1%a8%e8%ae%ba%e6%96%87%ef%bc%9a1990%e5%b9%b4%e8%87%b32021%e5%b9%b4%e9%97%b4%e9%9d%9e%e6%96%b0%e5%86%a0%e7%97%85%e6%af%92%e4%b8%8b%e5%91%bc%e5%90%b8%e9%81%93%e6%84%9f","status":"publish","type":"post","link":"https:\/\/csccm.org.cn\/?p=25967","title":{"rendered":"[Lancet Infect Dis\u53d1\u8868\u8bba\u6587]\uff1a1990\u5e74\u81f32021\u5e74\u95f4\u975e\u65b0\u51a0\u75c5\u6bd2\u4e0b\u547c\u5438\u9053\u611f\u67d3\u53ca\u75c5\u56e0\u7684\u5168\u7403\u3001\u5730\u533a\u53ca\u56fd\u5bb6\u53d1\u75c5\u7387\u548c\u6b7b\u4ea1\u7387\u8d1f\u62c5"},"content":{"rendered":"\n

Articles<\/h4>\n\n\n\n

Global, regional, and national incidence and mortality burden of non-COVID-19 lower respiratory infections and aetiologies, 1990\u20132021: a systematic analysis from the Global Burden of Disease Study 2021<\/h1>\n\n\n\n

GBD 2021 Lower Respiratory Infections and Antimicrobial Resistance Collaborators<\/h3>\n\n\n\n

Lancet Infect Dis Published: April 15, 2024<\/h3>\n\n\n\n

DOI: https:\/\/doi.org\/10.1016\/S1473-3099(24)00176-2<\/a><\/h3>\n\n\n\n

Summary<\/h2>\n\n\n\n

Background<\/h3>\n\n\n\n

Lower respiratory infections (LRIs) are a major global contributor to morbidity and mortality. In 2020\u201321, non-pharmaceutical interventions associated with the COVID-19 pandemic reduced not only the transmission of SARS-CoV-2, but also the transmission of other LRI pathogens. Tracking LRI incidence and mortality, as well as the pathogens responsible, can guide health-system responses and funding priorities to reduce future burden. We present estimates from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 of the burden of non-COVID-19 LRIs and corresponding aetiologies from 1990 to 2021, inclusive of pandemic effects on the incidence and mortality of select respiratory viruses, globally, regionally, and for 204 countries and territories.<\/p>\n\n\n\n

Methods<\/h3>\n\n\n\n

We estimated mortality, incidence, and aetiology attribution for LRI, defined by the GBD as pneumonia or bronchiolitis, not inclusive of COVID-19. We analysed 26\u2009259 site-years of mortality data using the Cause of Death Ensemble model to estimate LRI mortality rates. We analysed all available age-specific and sex-specific data sources, including published literature identified by a systematic review, as well as household surveys, hospital admissions, health insurance claims, and LRI mortality estimates, to generate internally consistent estimates of incidence and prevalence using DisMod-MR 2.1. For aetiology estimation, we analysed multiple causes of death, vital registration, hospital discharge, microbial laboratory, and literature data using a network analysis model to produce the proportion of LRI deaths and episodes attributable to the following pathogens: Acinetobacter baumannii, Chlamydia<\/em>spp, Enterobacter<\/em> spp, Escherichia coli, fungi, group B streptococcus, Haemophilus influenzae, influenza viruses, Klebsiella pneumoniae, Legionella<\/em> spp, Mycoplasma spp, polymicrobial infections, Pseudomonas aeruginosa<\/em>, respiratory syncytial virus (RSV), Staphylococcus aureus, Streptococcus pneumoniae<\/em>, and other viruses (ie, the aggregate of all viruses studied except influenza and RSV), as well as a residual category of other bacterial pathogens.<\/p>\n\n\n\n

Findings<\/h3>\n\n\n\n

Globally, in 2021, we estimated 344 million (95% uncertainty interval [UI] 325\u2013364) incident episodes of LRI, or 4350 episodes (4120\u20134610) per 100\u2009000 population, and 2\u00b718 million deaths (1\u00b798\u20132\u00b736), or 27\u00b77 deaths (25\u00b71\u201329\u00b79) per 100\u2009000. 502\u2009000 deaths (406\u2009000\u2013611\u2009000) were in children younger than 5 years, among which 254\u2009000 deaths (197\u2009000\u2013320\u2009000) occurred in countries with a low Socio-demographic Index. Of the 18 modelled pathogen categories in 2021, S pneumoniae<\/em> was responsible for the highest proportions of LRI episodes and deaths, with an estimated 97\u00b79 million (92\u00b71\u2013104\u00b70) episodes and 505\u2009000 deaths (454\u2009000\u2013555\u2009000) globally. The pathogens responsible for the second and third highest episode counts globally were other viral aetiologies (46\u00b74 million [43\u00b76\u201349\u00b73] episodes) and Mycoplasma<\/em> spp (25\u00b73 million [23\u00b75\u201327\u00b72]), while those responsible for the second and third highest death counts were S aureus<\/em> (424\u2009000 [380\u2009000\u2013459\u2009000]) and K pneumoniae<\/em> (176\u2009000 [158\u2009000\u2013194\u2009000]). From 1990 to 2019, the global all-age non-COVID-19 LRI mortality rate declined by 41\u00b77% (35\u00b79\u201346\u00b79), from 56\u00b75 deaths (51\u00b73\u201361\u00b79) to 32\u00b79 deaths (29\u00b79\u201335\u00b74) per 100\u2009000. From 2019 to 2021, during the COVID-19 pandemic and implementation of associated non-pharmaceutical interventions, we estimated a 16\u00b70% (13\u00b71\u201318\u00b76) decline in the global all-age non-COVID-19 LRI mortality rate, largely accounted for by a 71\u00b78% (63\u00b78\u201378\u00b79) decline in the number of influenza deaths and a 66\u00b77% (56\u00b76\u201375\u00b73) decline in the number of RSV deaths.<\/p>\n\n\n\n

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Interpretation<\/h3>\n\n\n\n

Substantial progress has been made in reducing LRI mortality, but the burden remains high, especially in low-income and middle-income countries. During the COVID-19 pandemic, with its associated non-pharmaceutical interventions, global incident LRI cases and mortality attributable to influenza and RSV declined substantially. Expanding access to health-care services and vaccines, including S pneumoniae, H influenzae<\/em> type B, and novel RSV vaccines, along with new low-cost interventions against S aureus<\/em>, could mitigate the LRI burden and prevent transmission of LRI-causing pathogens.<\/p>\n\n\n\n

Funding<\/h3>\n\n\n\n

Bill & Melinda Gates Foundation, Wellcome Trust, and Department of Health and Social Care (UK).<\/p>\n","protected":false},"excerpt":{"rendered":"

Articles Global, regional, and national incidence and m […]<\/p>\n","protected":false},"author":3,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":[],"categories":[32,23],"tags":[],"_links":{"self":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/25967"}],"collection":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=25967"}],"version-history":[{"count":2,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/25967\/revisions"}],"predecessor-version":[{"id":26700,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/25967\/revisions\/26700"}],"wp:attachment":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=25967"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=25967"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=25967"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}