Temporal trends and global comparison of the burden of thalassemia in China: an analysis of the Global Burden Of Disease Study 2021

OBJECTIVE: This study aims to analyze the temporal trends, age‒sex patterns, and disease burden of thalassemia in China from 1990 to 2021 using the Global Burden of Disease (GBD) 2021 data, so as to optimize resource allocation and health strategy planning. METHODS: Data on incidence, prevalence, death, and disability-adjusted life years (DALYs) for thalassemia in China and worldwide are extracted from the GBD 2021 database. Trends are analyzed using Joinpoint regression, and the autoregressive integrated moving average (ARIMA) model is applied to forecast the burden over the next 15 years. RESULTS: Compared to the global average, China demonstrates a more pronounced decline in age-standardized mortality rate (ASMR) and age-standardized DALYs rate (ASDR). In contrast, the age-standardized incidence rate (ASIR) and age-standardized prevalence rate (ASPR) remained stable and significantly higher than the global level. The disease burden was higher in males and concentrated in children under five, with a visible shift toward older age groups. Projections indicate a potential rise in ASIR, stable ASPR with minor fluctuations, and continued decline in ASMR and ASDR over the next 15 years. CONCLUSION: China has made significant progress in reducing the disease burden associated with thalassemia. However, the disease burden remains higher than the global average, with persistent disparities by sex. These findings underscore the need for sustained and targeted public health strategies.