Age–sex differences in the global burden of lower respiratory infections and risk factors, 1990–2019: results from the Global Burden of Disease Study 2019. Issue 11 (November 2022)

• Record Type: Journal Article
• Authors: Kyu, Hmwe Hmwe; Vongpradith, Avina; Sirota, Sarah Brooke; Novotney, Amanda; Troeger, Christopher E; Doxey, Matthew C; Bender, Rose G; Ledesma, Jorge R; Biehl, Molly H; Albertson, Samuel B; Frostad, Joseph Jon; Burkart, Katrin; Bennitt, Fiona B; Zhao, Jeff T; Gardner, William M; Hagins, Hailey; Bryazka, Dana; Dominguez, Regina-Mae Villanueva; Abate, Semagn Mekonnen; Abdelmasseh, Michael; Abdoli, Amir; Abdoli, Gholamreza; Abedi, Aidin; Abedi, Vida; Abegaz, Tadesse M; Abidi, Hassan; Aboagye, Richard Gyan; Abolhassani, Hassan; Abtew, Yonas Derso; Abubaker Ali, Hiwa; Abu-Gharbieh, Eman; Abu-Zaid, Ahmed; Adamu, Kidist; Addo, Isaac Yeboah; Adegboye, Oyelola A; Adnan, Mohammad; Adnani, Qorinah Estiningtyas Sakilah; Afzal, Muhammad Sohail; Afzal, Saira; Ahinkorah, Bright Opoku; Ahmad, Aqeel; Ahmad, Araz Ramazan; Ahmad, Sajjad; Ahmadi, Ali; Ahmadi, Sepideh; Ahmed, Haroon; Ahmed, Jivan Qasim; Ahmed Rashid, Tarik; Akbarzadeh-Khiavi, Mostafa; Al Hamad, Hanadi; Albano, Luciana; Aldeyab, Mamoon A; Alemu, Bezatu Mengistie; Alene, Kefyalew Addis; Algammal, Abdelazeem M; Alhalaiqa, Fadwa Alhalaiqa Naji; Alhassan, Robert Kaba; Ali, Beriwan Abdulqadir; Ali, Liaqat; Ali, Musa Mohammed; Ali, Syed Shujait; Alimohamadi, Yousef; Alipour, Vahid; Al-Jumaily, Adel; Aljunid, Syed Mohamed; Almustanyir, Sami; Al-Raddadi, Rajaa M; Al-Rifai, Rami H Hani; AlRyalat, Saif Aldeen S; Alvis-Guzman, Nelson; Alvis-Zakzuk, Nelson J; Ameyaw, Edward Kwabena; Aminian Dehkordi, Javad Javad; Amuasi, John H; Amugsi, Dickson A; Anbesu, Etsay Woldu; Ansar, Adnan; Anyasodor, Anayochukwu Edward; Arabloo, Jalal; Areda, Demelash; Argaw, Ayele Mamo; Argaw, Zeleke Gebru; Arulappan, Judie; Aruleba, Raphael Taiwo; Asemahagn, Mulusew A; Athari, Seyyed Shamsadin; Atlaw, Daniel; Attia, Engi F; Attia, Sameh; Aujayeb, Avinash; Awoke, Tewachew; Ayana, Tegegn Mulatu; Ayanore, Martin Amogre; Azadnajafabad, Sina; Azangou-Khyavy, Mohammadreza; Azari, Samad; Azari Jafari, Amirhossein; Badar, Muhammad; Badiye, Ashish D; Baghcheghi, Nayereh; Bagherieh, Sara; Baig, Atif Amin; Banach, Maciej; Banerjee, Indrajit; Bardhan, Mainak; Barone-Adesi, Francesco; Barqawi, Hiba Jawdat; Barrow, Amadou; Bashiri, Azadeh; Bassat, Quique; Batiha, Abdul-Monim Mohammad; Belachew, Abate Bekele; Belete, Melaku Ashagrie; Belgaumi, Uzma Iqbal; Bhagavathula, Akshaya Srikanth; Bhardwaj, Nikha; Bhardwaj, Pankaj; Bhatt, Parth; Bhojaraja, Vijayalakshmi S; Bhutta, Zulfiqar A; Bhuyan, Soumitra S; Bijani, Ali; Bitaraf, Saeid; Bodicha, Belay Boda Abule; Briko, Nikolay Ivanovich; Buonsenso, Danilo; Butt, Muhammad Hammad; Cai, Jiao; Camargos, Paulo; Cámera, Luis Alberto; Chakraborty, Promit Ananyo; Chanie, Muluken Genetu; Charan, Jaykaran; Chattu, Vijay Kumar; Ching, Patrick R; Choi, Sungchul; Chong, Yuen Yu; Choudhari, Sonali Gajanan; Chowdhury, Enayet Karim; Christopher, Devasahayam J; Chu, Dinh-Toi; Cobb, Natalie L; Cohen, Aaron J; Cruz-Martins, Natália; Dadras, Omid; Dagnaw, Fentaw Teshome; Dai, Xiaochen; Dandona, Lalit; Dandona, Rakhi; Dao, An Thi Minh; Debela, Sisay Abebe; Demisse, Biniyam; Demisse, Fitsum Wolde; Demissie, Solomon; Dereje, Diriba; Desai, Hardik Dineshbhai; Desta, Abebaw Alemayehu; Desye, Belay; Dhingra, Sameer; Diao, Nancy; Diaz, Daniel; Digesa, Lankamo Ena; Doan, Linh Phuong; Dodangeh, Milad; Dongarwar, Deepa; Dorostkar, Fariba; dos Santos, Wendel Mombaque; Dsouza, Haneil Larson; Dubljanin, Eleonora; Durojaiye, Oyewole Christopher; Edinur, Hisham Atan; Ehsani-Chimeh, Elham; Eini, Ebrahim; Ekholuenetale, Michael; Ekundayo, Temitope Cyrus; El Desouky, Eman D; El Sayed, Iman; El Sayed Zaki, Maysaa; Elhadi, Muhammed; Elkhapery, Ahmed Mahmoud Rabie; Emami, Amir; Engelbert Bain, Luchuo; Erkhembayar, Ryenchindorj; Etaee, Farshid; Ezati Asar, Mohamad; Fagbamigbe, Adeniyi Francis; Falahi, Shahab; Fallahzadeh, Aida; Faraj, Anwar; Faraon, Emerito Jose A; Fatehizadeh, Ali; Ferrara, Pietro; Ferrari, Allegra Allegra; Fetensa, Getahun; Fischer, Florian; Flavel, Joanne; Foroutan, Masoud; Gaal, Peter Andras; Gaidhane, Abhay Motiramji; Gaihre, Santosh; Galehdar, Nasrin; Garcia-Basteiro, Alberto L; Garg, Tushar; Gebrehiwot, Mesfin Damtew; Gebremichael, Mathewos Alemu; Gela, Yibeltal Yismaw; Gemeda, Belete Negese Belete; Gessner, Bradford D; Getachew, Melaku; Getie, Asmare; Ghamari, Seyyed-Hadi; Ghasemi Nour, Mohammad; Ghashghaee, Ahmad; Gholamrezanezhad, Ali; Gholizadeh, Abdolmajid; Ghosh, Rakesh; Ghozy, Sherief; Goleij, Pouya; Golitaleb, Mohamad; Gorini, Giuseppe; Goulart, Alessandra C; Goyomsa, Girma Garedew; Guadie, Habtamu Alganeh; Gudisa, Zewdie; Guled, Rashid Abdi; Gupta, Sapna; Gupta, Veer Bala; Gupta, Vivek Kumar; Guta, Alemu; Habibzadeh, Parham; Haj-Mirzaian, Arvin; Halwani, Rabih; Hamidi, Samer; Hannan, Md Abdul; Harorani, Mehdi; Hasaballah, Ahmed I; Hasani, Hamidreza; Hassan, Abbas M; Hassani, Shokoufeh; Hassanian-Moghaddam, Hossein; Hassankhani, Hadi; Hayat, Khezar; Heibati, Behzad; Heidari, Mohammad; Heyi, Demisu Zenbaba; Hezam, Kamal; Holla, Ramesh; Hong, Sung Hwi; Horita, Nobuyuki; Hosseini, Mohammad-Salar; Hosseinzadeh, Mehdi; Hostiuc, Mihaela; Househ, Mowafa; Hoveidamanesh, Soodabeh; Huang, Junjie; Hussein, Nawfal R; Iavicoli, Ivo; Ibitoye, Segun Emmanuel; Ikuta, Kevin S; Ilesanmi, Olayinka Stephen; Ilic, Irena M; Ilic, Milena D; Immurana, Mustapha; Ismail, Nahlah Elkudssiah; Iwagami, Masao; Jaafari, Jalil; Jamshidi, Elham; Jang, Sung-In; Javadi Mamaghani, Amirreza; Javaheri, Tahereh; Javanmardi, Fatemeh; Javidnia, Javad; Jayapal, Sathish Kumar; Jayarajah, Umesh; Jayaram, Shubha; Jema, Alelign Tasew; Jeong, Wonjeong; Jonas, Jost B; Joseph, Nitin; Joukar, Farahnaz; Jozwiak, Jacek Jerzy; K, Vaishali; Kabir, Zubair; Kacimi, Salah Eddine Oussama; Kadashetti, Vidya; Kalankesh, Laleh R; Kalhor, Rohollah; Kamath, Ashwin; Kamble, Bhushan Dattatray; Kandel, Himal; Kanko, Tesfaye K; Karaye, Ibraheem M; Karch, André; Karkhah, Samad; Kassa, Bekalu Getnet; Katoto, Patrick DMC; Kaur, Harkiran; Kaur, Rimple Jeet; Keikavoosi-Arani, Leila; Keykhaei, Mohammad; Khader, Yousef Saleh; Khajuria, Himanshu; Khan, Ejaz Ahmad; Khan, Gulfaraz; Khan, Imteyaz A; Khan, Maseer; Khan, Md Nuruzzaman; Khan, Moien AB; Khan, Yusra H; Khatatbeh, Moawiah Mohammad; Khosravifar, Mina; Khubchandani, Jagdish; Kim, Min Seo; Kimokoti, Ruth W; Kisa, Adnan; Kisa, Sezer; Kissoon, Niranjan; Knibbs, Luke D; Kochhar, Sonali; Kompani, Farzad; Koohestani, Hamid Reza; Korshunov, Vladimir Andreevich; Kosen, Soewarta; Koul, Parvaiz A; Koyanagi, Ai; Krishan, Kewal; Kuate Defo, Barthelemy; Kumar, G Anil; Kurmi, Om P; Kuttikkattu, Ambily; Lal, Dharmesh Kumar; Lám, Judit; Landires, Iván; Ledda, Caterina; Lee, Sang-woong; Levi, Miriam; Lewycka, Sonia; Liu, Gang; Liu, Wei; Lodha, Rakesh; Lorenzovici, László; Lotfi, Mojgan; Loureiro, Joana A; Madadizadeh, Farzan; Mahmoodpoor, Ata; Mahmoudi, Razzagh; Mahmoudimanesh, Marzieh; Majidpoor, Jamal; Makki, Alaa; Malakan Rad, Elaheh; Malik, Ahmad Azam; Mallhi, Tauqeer Hussain; Manla, Yosef; Matei, Clara N; Mathioudakis, Alexander G; Maude, Richard James; Mehrabi Nasab, Entezar; Melese, Addisu; Memish, Ziad A; Mendoza-Cano, Oliver; Mentis, Alexios-Fotios A; Meretoja, Tuomo J; Merid, Mehari Woldemariam; Mestrovic, Tomislav; Micheletti Gomide Nogueira de Sá, Ana Carolina; Mijena, Gelana Fekadu Worku; Minh, Le Huu Nhat; Mir, Shabir Ahmad; Mirfakhraie, Reza; Mirmoeeni, Seyyedmohammadsadeq; Mirza, Agha Zeeshan; Mirza, Moonis; Mirza-Aghazadeh-Attari, Mohammad; Misganaw, Abay Sisay; Misganaw, Awoke Temesgen; Mohammadi, Esmaeil; Mohammadi, Mokhtar; Mohammed, Arif; Mohammed, Shafiu; Mohan, Syam; Mohseni, Mohammad; Moka, Nagabhishek; Mokdad, Ali H; Momtazmanesh, Sara; Monasta, Lorenzo; Moniruzzaman, Md; Montazeri, Fateme; Moore, Catrin E; Moradi, Abdolvahab; Morawska, Lidia; Mosser, Jonathan F; Mostafavi, Ebrahim; Motaghinejad, Majid; Mousavi Isfahani, Haleh; Mousavi-Aghdas, Seyed Ali; Mubarik, Sumaira; Murillo-Zamora, Efrén; Mustafa, Ghulam; Nair, Sanjeev; Nair, Tapas Sadasivan; Najafi, Houshang; Naqvi, Atta Abbas; Narasimha Swamy, Sreenivas; Natto, Zuhair S; Nayak, Biswa Prakash; Nejadghaderi, Seyed Aria; Nguyen, Huy Van Nguyen; Niazi, Robina Khan; Nogueira de Sá, Antonio Tolentino; Nouraei, Hasti; Nowroozi, Ali; Nuñez-Samudio, Virginia; Nzoputam, Chimezie Igwegbe; Nzoputam, Ogochukwu Janet; Oancea, Bogdan; Ochir, Chimedsuren; Odukoya, Oluwakemi Ololade; Okati-Aliabad, Hassan; Okekunle, Akinkunmi Paul; Okonji, Osaretin Christabel; Olagunju, Andrew T; Olufadewa, Isaac Iyinoluwa; Omar Bali, Ahmed; Omer, Emad; Oren, Eyal; Ota, Erika; Otstavnov, Nikita; Oulhaj, Abderrahim; P A, Mahesh; Padubidri, Jagadish Rao; Pakshir, Keyvan; Pakzad, Reza; Palicz, Tamás; Pandey, Anamika; Pant, Suman; Pardhan, Shahina; Park, Eun-Cheol; Park, Eun-Kee; Pashazadeh Kan, Fatemeh; Paudel, Rajan; Pawar, Shrikant; Peng, Minjin; Pereira, Gavin; Perna, Simone; Perumalsamy, Navaraj; Petcu, Ionela-Roxana; Pigott, David M; Piracha, Zahra Zahid; Podder, Vivek; Polibin, Roman V; Postma, Maarten J; Pourasghari, Hamid; Pourtaheri, Naeimeh; Qadir, Mirza Muhammad Fahd; Raad, Mathieu; Rabiee, Mohammad; Rabiee, Navid; Raeghi, Saber; Rafiei, Alireza; Rahim, Fakher; Rahimi, Mehran; Rahimi-Movaghar, Vafa; Rahman, Azizur; Rahman, Md Obaidur; Rahman, Mosiur; Rahman, Muhammad Aziz; Rahmani, Amir Masoud; Rahmanian, Vahid; Ram, Pradhum; Ramezanzadeh, Kiana; Rana, Juwel; Ranasinghe, Priyanga; Rani, Usha; Rao, Sowmya J; Rashedi, Sina; Rashidi, Mohammad-Mahdi; Rasul, Azad; Ratan, Zubair Ahmed; Rawaf, David Laith; Rawaf, Salman; Rawassizadeh, Reza; Razeghinia, Mohammad Sadegh; Redwan, Elrashdy Moustafa Mohamed; Reitsma, Marissa B; Renzaho, Andre M N; Rezaeian, Mohsen; Riad, Abanoub; Rikhtegar, Reza; Rodriguez, Jefferson Antonio Buendia; Rogowski, Emma L B; Ronfani, Luca; Rudd, Kristina E; Saddik, Basema; Sadeghi, Erfan; Saeed, Umar; Safary, Azam; Safi, Sher Zaman; Sahebazzamani, Maryam; Sahebkar, Amirhossein; Sakhamuri, Sateesh; Salehi, Sana; Salman, Muhammad; Samadi Kafil, Hossein; Samy, Abdallah M; Santric-Milicevic, Milena M; Sao Jose, Bruno Piassi; Sarkhosh, Maryam; Sathian, Brijesh; Sawhney, Monika; Saya, Ganesh Kumar; Seidu, Abdul-Aziz; Seylani, Allen; Shaheen, Amira A; Shaikh, Masood Ali; Shaker, Elaheh; Shamshad, Hina; Sharew, Mequannent Melaku; Sharhani, Asaad; Sharifi, Azam; Sharma, Purva; Sheidaei, Ali; Shenoy, Suchitra M; Shetty, Jeevan K; Shiferaw, Damtew Solomon; Shigematsu, Mika; Shin, Jae Il; Shirzad-Aski, Hesamaddin; Shivakumar, K M; Shivalli, Siddharudha; Shobeiri, Parnian; Simegn, Wudneh; Simpson, Colin R; Singh, Harpreet; Singh, Jasvinder A; Singh, Paramdeep; Siwal, Samarjeet Singh; Skryabin, Valentin Yurievich; Skryabina, Anna Aleksandrovna; Soltani-Zangbar, Mohammad Sadegh; Song, Suhang; Song, Yimeng; Sood, Prashant; Sreeramareddy, Chandrashekhar T; Steiropoulos, Paschalis; Suleman, Muhammad; Tabatabaeizadeh, Seyed-Amir; Tahamtan, Alireza; Taheri, Majid; Taheri Soodejani, Moslem; Taki, Elahe; Talaat, Iman M; Tampa, Mircea; Tandukar, Sarmila; Tat, Nathan Y; Tat, Vivian Y; Tefera, Yibekal Manaye; Temesgen, Gebremaryam; Temsah, Mohamad-Hani; Tesfaye, Azene; Tesfaye, Degefa Gomora; Tessema, Belay; Thapar, Rekha; Ticoalu, Jansje Henny Vera; Tiyuri, Amir; Tleyjeh, Imad I; Togtmol, Munkhsaikhan; Tovani-Palone, Marcos Roberto; Tufa, Derara Girma; Ullah, Irfan; Upadhyay, Era; Valadan Tahbaz, Sahel; Valdez, Pascual R; Valizadeh, Rohollah; Vardavas, Constantine; Vasankari, Tommi Juhani; Vo, Bay; Vu, Linh Gia; Wagaye, Birhanu; Waheed, Yasir; Wang, Yu; Waris, Abdul; West, T Eoin; Wickramasinghe, Nuwan Darshana; Xu, Xiaoyue; Yaghoubi, Sajad; Yahya, Gahin Abdulraheem Tayib; Yahyazadeh Jabbari, Seyed Hossein; Yon, Dong Keon; Yonemoto, Naohiro; Zaman, Burhan Abdullah; Zandifar, Alireza; Zangiabadian, Moein; Zar, Heather J; Zare, Iman; Zareshahrabadi, Zahra; Zarrintan, Armin; Zastrozhin, Mikhail Sergeevich; Zeng, Wu; Zhang, Mengxi; Zhang, Zhi-Jiang; Zhong, Chenwen; Zoladl, Mohammad; Zumla, Alimuddin; Lim, Stephen S; Vos, Theo; Naghavi, Mohsen; Brauer, Michael; Hay, Simon I; Murray, Christopher J L;
• Is Part Of: Lancet infectious diseases. Volume 22:Issue 11(2022)
• Page Start: 1626
• Page End: 1647
• Publication Date: 2022-11
• Subjects: Communicable diseases -- Periodicals; Infection -- Periodicals; Communicable Diseases -- Periodicals; Infection -- Periodicals; Maladies infectieuses -- Périodiques; Infection -- Périodiques; Communicable diseases; Infection; Periodicals; 616.905
• DOI: 10.1016/S1473-3099(22)00510-2
• Languages: English
• ISSNs: 1473-3099

Abstract

Summary: Background: The global burden of lower respiratory infections (LRIs) and corresponding risk factors in children older than 5 years and adults has not been studied as comprehensively as it has been in children younger than 5 years. We assessed the burden and trends of LRIs and risk factors across all age groups by sex, for 204 countries and territories. Methods: In this analysis of data for the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019, we used clinician-diagnosed pneumonia or bronchiolitis as our case definition for LRIs. We included International Classification of Diseases 9th edition codes 079.6, 466–469, 470.0, 480–482.8, 483.0–483.9, 484.1–484.2, 484.6–484.7, and 487–489 and International Classification of Diseases 10th edition codes A48.1, A70, B97.4–B97.6, J09–J15.8, J16–J16.9, J20–J21.9, J91.0, P23.0–P23.4, and U04–U04.9. We used the Cause of Death Ensemble modelling strategy to analyse 23 109 site-years of vital registration data, 825 site-years of sample vital registration data, 1766 site-years of verbal autopsy data, and 681 site-years of mortality surveillance data. We used DisMod-MR 2.1, a Bayesian meta-regression tool, to analyse age–sex-specific incidence and prevalence data identified via systematic reviews of the literature, population-based survey data, and claims and inpatient data. Additionally, we estimated age–sex-specific LRI mortality that is attributable to the independent effects of 14 risk factors. Findings: Globally, in 2019, we estimated that there were 257 million (95% uncertainty interval [UI] 240–275) LRI incident episodes in males and 232 million (217–248) in females. In the same year, LRIs accounted for 1·30 million (95% UI 1·18–1·42) male deaths and 1·20 million (1·07–1·33) female deaths. Age-standardised incidence and mortality rates were 1·17 times (95% UI 1·16–1·18) and 1·31 times (95% UI 1·23–1·41) greater in males than in females in 2019. Between 1990 and 2019, LRI incidence and mortality rates declined at different rates across age groups and an increase in LRI episodes and deaths was estimated among all adult age groups, with males aged 70 years and older having the highest increase in LRI episodes (126·0% [95% UI 121·4–131·1]) and deaths (100·0% [83·4–115·9]). During the same period, LRI episodes and deaths in children younger than 15 years were estimated to have decreased, and the greatest decline was observed for LRI deaths in males younger than 5 years (–70·7% [–77·2 to –61·8]). The leading risk factors for LRI mortality varied across age groups and sex. More than half of global LRI deaths in children younger than 5 years were attributable to child wasting (population attributable fraction [PAF] 53·0% [95% UI 37·7–61·8] in males and 56·4% [40·7–65·1] in females), and more than a quarter of LRI deaths among those aged 5–14 years were attributable to household air pollution (PAF 26·0% [95% UI 16·6–35·5] for males and PAF 25·8% [16·3–35·4] for females). PAFs of male LRI deaths attributed to smoking were 20·4% (95% UI 15·4–25·2) in those aged 15–49 years, 30·5% (24·1–36·9) in those aged 50–69 years, and 21·9% (16·8–27·3) in those aged 70 years and older. PAFs of female LRI deaths attributed to household air pollution were 21·1% (95% UI 14·5–27·9) in those aged 15–49 years and 18·2% (12·5–24·5) in those aged 50–69 years. For females aged 70 years and older, the leading risk factor, ambient particulate matter, was responsible for 11·7% (95% UI 8·2–15·8) of LRI deaths. Interpretation: The patterns and progress in reducing the burden of LRIs and key risk factors for mortality varied across age groups and sexes. The progress seen in children younger than 5 years was clearly a result of targeted interventions, such as vaccination and reduction of exposure to risk factors. Similar interventions for other age groups could contribute to the achievement of multiple Sustainable Development Goals targets, including promoting wellbeing at all ages and reducing health inequalities. Interventions, including addressing risk factors such as child wasting, smoking, ambient particulate matter pollution, and household air pollution, would prevent deaths and reduce health disparities. Funding: Bill & Melinda Gates Foundation.