Global patterns of the burden of zoonotic infectious diseases of poverty based on GBD 2021

Background The zoonotic infectious diseases of poverty (zIDPs) continue to be a significant factor contributing to global poverty, with a broad distribution and a significant impact on a substantial population. We aimed to assess the global, regional, and national burden and trends of zIDPs utilizing Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021, providing scientific support for policy making and resource allocating. Methods We retrieved data from GBD 2021 on the prevalence, disability-adjusted life-years (DALYs) of zIDPs (schistosomiasis, cystic echinococcosis [CE], cysticercosis, foodborne trematodiases particularly referring to opisthochiais, clonorchiasis, paragonimiasis, fascioliasis, fasciolopsis) in 204 countries and territories from 1990 to 2021. Estimated annual percentage changes in the age-standardized prevalence and DALY rates of zIDPs by age, sex, and Socio-demographic Index (SDI), were calculated to quantify the temporal trends. Spearman correlation analysis was used to examine the relationship between age-standardized rates and SDI. Results Globally, there are an estimated 151 376 744 schistosomiasis cases (95% Uncertainty Interval (UI) 109 062 891 to 198 666 395), 633 404 CE cases (95% UI 517 477 to 782 468), 4 357 190 cysticercosis cases (95% UI 3 150 315 to 5 716 430), and 44 466 329 (95% UI 40 017 218 to 50 034 921) foodborne trematodiases cases, respectively. The number of DALYs due to schistosomiasis, CE, cysticercosis and foodborne trematodiases worldwide in 2021 was 1 746 333 (95% UI 1038122 to 2984204), 105 072 (95% UI 78 967 to 133 309), 1 235 939 (95% UI 787 769 to 1 808 363) and 998 029 (95% UI 569 766-1 638 112), respectively. The age-standardized prevalence rate and DALYs of schistosomiasis, cysticercosis and foodborne trematodiases decreased year by year significantly globally during 1990 to 2019. The highest number of cases and DALYs occurred in: Sub-Saharan Africa for schistosomiasis; South Asia, East Asia (only cases), North Africa and Middle East, Eastern Sub-Saharan Africa (only DALYs) for CE; South Asia (only cases), East Asia and Central Latin America for cysticercosis; East Asia, Southeast Asia (only cases), High-income Asia Pacific (only cases) for foodborne trematodiases. The age-standardized prevalence rates of the zIDPs exhibited three different patterns with the increases of SDI, whereas the age-standardized DALY of the zIDPs (excluding foodborne trematodiases) decreased with the rise of SDI. Conclusion The prevalence and DALYs of zIDPs presented decrease trends in most endemic regions globally by year. The regions and countries with low SDI should prioritize reducing the burden of zIDPs in light of the WHO's aim to control or eliminate NTDs.