Global magnitude of encephalitis burden and its evolving pattern over the past 30 years. Issue 6 (June 2022)

• Record Type: Journal Article
• Authors: Wang, Hao; Zhao, Shaohua; Wang, Shengjun; Zheng, Yue; Wang, Shaohua; Chen, Hui; Pang, Jiaojiao; Ma, Juan; Yang, Xiaorong; Chen, Yuguo
• Is Part Of: Journal of infection. Volume 84:Issue 6(2022)
• Page Start: 777
• Page End: 787
• Publication Date: 2022-06
• Subjects: Encephalitis -- Global burden -- Temporal trend -- Risk factors -- Systematic analysis; ASDR age-standardized DALY rate -- ASIR age-standardized incidence rate -- ASMR age-standardized mortality rate -- ASR age-standardized rate -- CI confidence interval -- DALY disability-adjusted life-year -- EAPC estimated annual percentage change -- GBD Global Burden of Disease Study -- HAP household air pollution from solid fuels -- HSE herpes simplex encephalitis -- HSV herpes simplex virus -- ICD International Classification of Diseases -- JE Japanese encephalitis -- PCR polymerase chain reaction -- SDI socio-demographic index -- TBE tick-borne encephalitis -- UI uncertainty interval; Infection -- Periodicals; Bacterial Infections -- Periodicals; Communicable Diseases -- Periodicals; Electronic journals; 616.905
• DOI: 10.1016/j.jinf.2022.04.026
• Languages: English
• ISSNs: 0163-4453

Abstract

Highlights: Global spatiotemporal pattern in the encephalitis burden was estimated. The burden of encephalitis has shown a downward trend over the past 30 years. Lower SDI regions in Asia and Africa had the highest burden of encephalitis in 2019. The increased burden in some developed countries with higher SDI deserves attention. Children and older adults are high-risk groups for encephalitis. Summary: Objective: We aimed to estimate the spatiotemporal patterns of the encephalitis burden along with its attributable risk factors at the national, regional, and global levels, which may be helpful in guiding targeted prevention and treatment programs. Methods: Based on available data sources, the incidence, mortality, and disability-adjusted life years (DALYs) of encephalitis in 204 countries and regions from 1990 to 2019 were reconstructed by the Global Burden of Disease Study 2019 using the Cause of Death Ensemble model, spatiotemporal Gaussian process regression, and DisMod-MR 2.1. We conducted a systematic analysis on the epidemiological characteristics of encephalitis in detail by gender, region, and age over the past three decades. Results: Globally, 1, 444, 720 incident cases, 89, 900 deaths, and 4.80 million DALYs related to encephalitis were estimated in 2019. The age-standardized incidence rate and age-standardized mortality rate (ASMR) decreased from 23.17 and 2.18 to 19.33 and 1.19 per 100, 000 person-years over the past 30 years, respectively. However, beginning in 2011–2013, the burden of encephalitis has shown an inflection point, with a further decline of the ASRs ceasing. Lower socio-demographic index (SDI) regions in South Asia, Western and Eastern Sub-Saharan Africa had the highest burden of encephalitis in 2019. During the past three decades, most countries of South Asia achieved significant control of the burden. In contrast, developed countries with a higher SDI have shown a notable increase in ASMR and age-standardized DALYs rate. Children and older adults have always been high-risk groups for encephalitis. Conclusion: Although the global burden of encephalitis has decreased in the past 30 years, a further decline stopped from 2011 to 2013. The diverse burden in different regions calls for differentiated management, and the persistent high burden in some low-SDI regions and the increased burden in developed countries with higher SDIs deserve more attention.