Global, regional and national burden of echinococcosis in 204 countries and territories from 1990 to 2021: a systematic analysis based on the Global Burden of Disease Study 2021

Echinococcosis, a neglected zoonotic helminthic disease, poses a significant health and economic burden globally. The study aimed to systematically analyze the burden of echinococcosis from 1990 to 2021. This study described incidence, prevalence, deaths, and disability-adjusted life years (DALYs) lost due to echinococcosis, explored trends in disease burden over time, identified high-burden regions and countries, and evaluated the contribution of various age and sex groups to the overall burden. First, numbers and age-standardized rates of incidence, prevalence, deaths, and DALYs were assessed globally and by sub-types in 2021. Furthermore, the temporal trend of the disease burden was explored by the linear regression model from 1990 to 2021. Moreover, the age-period-cohort (APC) model and Bayesian age-period-cohort (BAPC) model were used to predict the future disease burden from 2022 to 2046. The Autoregressive Integrated Moving Average (ARIMA) model and the Exponential smoothing (ES) model were used for sensitivity analysis. To further delve into the factors driving changes in the disease burden between 1990 and 2021, decomposition analyses were conducted. Finally, frontier analysis was employed to assess the correlation between disease burden and sociodemographic development. Exposure to Echinococcosis contributed to 148521 incidence, 633404 prevalence, 1364 deaths, and 105072 DALYs globally in 2021. Younger and middle-aged adults were high-risk populations. Lower socio-demographic index (SDI) regions were high-risk areas. The disease burden varied considerably across the GBD regions and the countries. From 1990-2021, the number of incidence and prevalence cases increased. The predicted results showed that the incidence and prevalence for both genders would still increase from 2022 to 2046. Countries or regions with a higher SDI have greater burden improvement potential. In conclusion, Echinococcosis has threatened public health globally. More proactive and effective strategic measures should be developed after considering global-specific circumstances.