Burden of six common sexually transmitted infections groups in North Africa and Middle East Region from 1990 to 2021: A systematic analysis of global burden of diseases
Amirhossein Shahsavand, Leonardo Oliveira Reis, Ali Golestani, Alireza Namazi Shabestari, Ziba Aghsaeifard, Ozra Tabatabaei‐Malazy, Iman Menbari Oskouie, Bagher Larijani, Seyed Mohammad Kazem Aghamir
Abstract
BACKGROUND: Sexually transmitted infections (STIs) are among the most widespread acute infections worldwide. The burden of STIs in North Africa and the Middle East (NAME) region, with its unique characteristics, has not been thoroughly investigated to date. In this study, we aim to provide an assessment of the burden of STIs in the NAME region. METHODS: Data from the GBD 2021 study were analyzed to assess health metrics including incidence, prevalence, mortality, and disability-adjusted life years (DALYs). Both age-standardized rates (ASRs) and total numbers were evaluated across 21 NAME countries, with breakdowns by sex, age, and sociodemographic index (SDI). Findings were reported along with 95 % uncertainty intervals (95 % UIs). RESULTS: From 1990-2021, the incidence of STIs increased from 26.7 million (95 % UI: 22.5-31.5 million) to 55.8 million (46.8-67.4 million), but the incidence ASR decreased by 5.4 % (-6.9 to -4.2). Same pattern was observed for prevalence. STIs DALYs decreased from 412,021.2 (160,004.8 to 824,494.5) to 330,050.9 (161,900.6 to 611,903.2), and DALYs ASR decreased by 33.9 % (-48.1 to -18.5). In 2021, the number of YLLs was 3.7 times the number of YLDs. STIs mostly affected reproductive age groups, with syphilis having the highest mortality and genital herpes the highest prevalence. Women were affected more than males. Lower SDI was associated with higher burden of STIs. CONCLUSION: The NAME region's STI burden reflect global trends, but considering social norms, underestimation is probable. Inadequate screening, low awareness, stigma, and limited access to healthcare exacerbate STIs' burden in the region, particularly for women. Declining population growth in NAME is worsened by STIs, especially in countries with lower SDI. Reducing the STI burden in NAME requires culturally sensitive approaches, robust surveillance, education, destigmatization, and improved healthcare access.