To analyze the changes in the disease burden of lower respiratory tract infections (LRIs) in China from 1990 to 2023 and predict future trends.
Based on the Global Burden of Disease Study 2023, the age-standardized incidence rate (ASIR), age-standardized mortality rate (ASMR), and age-standardized disability-adjusted life year (DALYs) rate (ASDR) of LRIs in China from 1990 to 2023 were described; the Joinpoint model was used to analyze the temporal trend; the age-period-cohort (APC) model was applied to decompose age, period and cohort effects; the R programming was performed to analyze the correlation with the Socio-demographic Index (SDI), the changing characteristics of pathogens, and the trend over the next 12 years.
From 1990 to 2023, the ASIR, ASMR and ASDR of LRIs in China decreased significantly (EAPC: -3.46%, -6.42%, and -9.29%, respectively,P<0.001). Joinpoint analysis indicated that affected by non-pharmaceutical interventions during the COVID-19 pandemic, ASIR reached a trough in 2020, while ASMR and ASDR bottomed out in 2021, followed by a rebound. APC results indicated that the net drift values for ASIR, ASMR, and ASDR of -2.16%, -4.94%, and -4.93%, respectively (P<0.05), driven by the combined effects of age, period, and cohort. The disease burden of all age groups decreased significantly, but the age group with the heaviest disease burden changed from <5 age group to ≥70 age group. The trend of ASDR attributed to various pathogens was consistent with the overall trend. Bacteria were the main pathogens, among which Streptococcus pneumoniae was dominant. Projections indicate that by 2035, the ASIR, ASMR, and ASDR of LRIs in China would decrease to 1 282.49, 6.30, and 91.24 per 100 000 population, respectively.
From 1990 to 2023, the disease burden of LRIs and pathogen-related burden in China decreased significantly. Although the burden will continue to decline over the next 12 years, bacterial infections and the elderly population remain the long-term priorities for prevention and control.
| 科 Family | 属数 Number of genus | 种数 Number of species | 占总种数比例 Percentage of total species (%) | 属 Genus | 种数 Number of species | 占总种数比例 Percentage of total species (%) |
|---|---|---|---|---|---|---|
| 鹅膏菌科Amanitaceae | 2 | 11 | 5.26 | 鹅膏菌属 Amanita | 10 | 4.78 |
| 小菇科 Mycenaceae | 2 | 12 | 5.74 | 丝盖伞属 Inocybe | 5 | 2.39 |
| 多孔菌科 Polyporaceae | 8 | 14 | 6.70 | 蜡蘑属 Laccaria | 5 | 2.39 |
| 红菇科 Russulaceae | 3 | 23 | 11.00 | 小皮伞属 Marasmius | 6 | 2.87 |
| 小菇属 Mycena | 11 | 5.26 | ||||
| 光柄菇属 Pluteus | 5 | 2.39 | ||||
| 红菇属 Russula | 17 | 8.13 | ||||
| 栓菌属 Trametes | 5 | 2.39 |