Global, regional, and subnational trends in typhoid fever burden from 1990 to 2021: an analysis of global burden of disease data

Q3 Medicine

Vacunas Pub Date : 2026-01-01 Epub Date: 2025-09-30 DOI:10.1016/j.vacun.2025.500503

Z. Ahsan , H. Mehmood , H. Ali , M. Ahsan

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引用次数: 0

Abstract

Introduction

Typhoid fever remains a significant global health concern, particularly in low- and middle-income countries (LMICs). The study aimed to assess temporal trends in typhoid fever burden at the global, South Asian, and provincial levels in Pakistan from 1990 to 2021 using data from the Global Burden of Disease (GBD) study.

Methods

An ecological analysis was conducted using GBD data to examine trends in age-standardized mortality rates (ASMRs) and disability-adjusted life years (DALYs) attributable to typhoid fever. Temporal changes were analyzed globally, across South Asia, and within Pakistan's provinces using average percent change (APC) calculations and Joinpoint regression.

Results

Globally and in South Asia, typhoid-related age-standardized mortality rates (ASMRs) and disability-adjusted life years (DALYs) declined substantially from 1990 to 2021. The global ASMR decreased from 3.22 to 1.31 per 100,000, while DALYs dropped from 247.95 to 101.09 per 100,000. In South Asia, ASMR fell from 9.80 to 3.42, and DALYs from 728.56 to 260.27 per 100,000. Within Pakistan, national ASMR declined from 6.42 to 3.08, and DALYs from 483.43 to 238.58 per 100,000. Provincial trends revealed marked disparities: Punjab and Khyber Pakhtunkhwa exhibited the greatest reductions, whereas Sindh showed slower progress, with the smallest decline in both mortality and DALYs.

Conclusion

Despite encouraging global progress, persistent subnational disparities in Pakistan highlight the need for targeted public health interventions. Expanding vaccine coverage, enhancing antimicrobial resistance surveillance, and improving water, sanitation, and hygiene (WASH) infrastructure are essential to further reducing typhoid burden and addressing regional inequities.

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1990年至2021年伤寒负担的全球、区域和次国家趋势：对全球疾病负担数据的分析

伤寒仍然是一个重大的全球卫生问题，特别是在低收入和中等收入国家。该研究旨在利用全球疾病负担（GBD）研究的数据，评估1990年至2021年巴基斯坦全球、南亚和省级伤寒负担的时间趋势。方法采用GBD数据进行生态分析，探讨伤寒导致的年龄标准化死亡率（ASMRs）和残疾调整生命年（DALYs）的变化趋势。使用平均百分比变化（APC）计算和Joinpoint回归分析了南亚和巴基斯坦各省的全球时间变化。在全球和南亚，从1990年到2021年，伤寒相关的年龄标准化死亡率（ASMRs）和残疾调整生命年（DALYs）大幅下降。全球ASMR从3.22 / 10万下降到1.31 / 10万，DALYs从247.95 / 10万下降到101.09 / 10万。在南亚，ASMR从9.80下降到3.42，DALYs从每10万人728.56下降到260.27。在巴基斯坦，全国ASMR从6.42下降到3.08，DALYs从每10万人483.43下降到238.58。各省的趋势显示出明显的差异：旁遮普省和开伯尔-普赫图赫瓦省的下降幅度最大，而信德省的进展较慢，死亡率和伤残津贴年的下降幅度最小。结论：尽管全球进展令人鼓舞，但巴基斯坦持续存在的地方差距突出了有针对性的公共卫生干预措施的必要性。扩大疫苗覆盖面、加强抗微生物药物耐药性监测以及改善水、环境卫生和个人卫生基础设施对于进一步减轻伤寒负担和解决区域不平等问题至关重要。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Vacunas Medicine-Infectious Diseases

CiteScore

3.90

自引率

0.00%

发文量

138

审稿时长

62 days

期刊介绍： Sin duda una de las mejores publicaciones para conocer los avances en el campo de las vacunaciones preventivas, tanto en el ámbito de la investigación básica como aplicada y en la evaluación de programas de vacunaciones. Su alta calidad y utilidad la ha llevado a estar indexada en los prestigiosos índices IME y SCOPUS.