Global, regional, and national burden of neglected tropical diseases and malaria in the general population, 1990–2021: Systematic analysis of the global burden of disease study 2021

Neglected Tropical Diseases (NTDs) and malaria present considerable health obstacles, particularly impacting the socio-economic progress in at-risk areas. We aimed to estimate the burden, trends, and inequalities of NTDs and malaria globally, regionally, and nationally from 1990 to 2021. The study utilized data from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021, encompassing 204 countries and territories, spanning 21 global regions, including diverse populations across different Socio-Demographic Index (SDI) levels. Primary outcomes were the incidence and prevalence rates, Disability-Adjusted Life Years (DALYs), age-standardized rates, SDI, mortality rates, and 95% uncertainty intervals (UIs) for NTDs and malaria. In 2021, the global incidence of NTDs and malaria reached 4259.54 per 100,000 population (95% UI: 3188.38-5488.91), a 0.60% increase since 1990 (4235.42 per 100,000, 95% UI: 3347.35-5282.14). Conversely, the global prevalence saw a significant reduction of 42.00%, from 34451.84 per 100,000 in 1990 (95% UI: 32668.32-36407.73) to 14454.15 per 100,000 in 2021 (95% UI: 13659.74-15452.20). DALYs decreased by 18.00% from 87.42 million years (95% UI: 59.03-141.60 million) in 1990 to 71.63 million years (95% UI: 38.74-122.93 million) in 2021. Regional analysis revealed significant variances, with Western Sub-Saharan Africa reporting the highest incidence rates and Central Asia and East Asia showing substantial declines. The study also highlighted considerable disparities among different SDI regions, with lower SDI regions bearing a more significant disease burden. Age and gender disparities were prominent, particularly among children under five years, who showed the highest incidence and prevalence rates. The study demonstrates significant progress in reducing the burden of NTDs and malaria globally over the past three decades, particularly in terms of prevalence and DALYs. However, the increase in incidence rates emphasizes the ongoing challenges in fully controlling these diseases. Continued efforts to strengthen health systems, particularly in low SDI regions, are essential to sustain the gains made and address remaining challenges. The findings advocate for integrating economic development with public health strategies to achieve effective disease control and improved health outcomes.