Trends of global and regional aetiologies, risk factors and mortality of lower respiratory infections from 1990 to 2019: An analysis for the Global Burden of Disease Study 2019
Liangyu Kang, Wenzhan Jing, Jue Liu, Min Liu
Abstract
BACKGROUND AND OBJECTIVE: Lower respiratory infections (LRIs) are a leading cause of death worldwide. We aimed to estimate the trends of global and regional aetiologies, risk factors and mortality of LRIs from 1990 to 2019. METHODS: From the Global Burden of Disease (GBD) Study 2019, we collected relevant data, including annual LRI deaths, mortality and deaths and mortality attributable to the four high-burden aetiologies and 14 risk factors during 1990-2019. To quantify the temporal trends, estimated annual percentage changes (EAPCs) were calculated by fitting linear regression model. RESULTS: Globally, the age-standardized mortality due to LRIs decreased by an average of 2.39% (95% CI 2.33%-2.45%) per year, from 66.67 deaths per 100,000 in 1990 to 35.72 deaths per 100,000 in 2019. Low Socio-demographic Index regions, South Asia and Sub-Saharan Africa had the heaviest burden of LRIs. The age-standardized mortality decreased in 18 GBD regions, whereas increased in Southern Latin America (EAPC = 1.20, 95% CI 1.03-1.37). LRIs led to considerable deaths among children under 5 years and adults older than 70 years. Streptococcus pneumoniae was the first leading aetiology, accounting for over 50% of LRI deaths. Household air pollution from solid fuels, child wasting and ambient particulate matter pollution were the three leading risk factors for LRI mortality in 2019. CONCLUSION: LRIs remain an important health problem globally, especially in some vulnerable areas and among children under 5 and adults over 70 years. Future researches focusing on the aetiologies and risk factors for LRIs are needed to provide targeted and updated prevention strategies.