Abstract
BACKGROUND: This study analyzed global rabies burden and trends from 1990 to 2021, offering epidemiological insights worldwide by using the Global Burden of Diseases (GBD), Injuries, and Risk Factors Study 2021 database. METHODS: We obtained all relevant data on rabies worldwide from the GBD database from 1990 to 2021, including incidence, mortality, and disability-adjusted life years (DALYs), were analyzed by gender, age, sociodemographic index (SDI), and region using the GBD 2021 data. Trends were assessed with average annual percentage change (AAPC), and future trends were predicted using a Bayesian age-period-cohort (BAPC) model. RESULTS: From 1990 to 2021, global rabies incidence and age-standardised incidence rates (ASIR) decreased by 53.8% and 69.4%, respectively. Mortality and DALYs also declined by 50.2% and 54.5%. The most significant declines were observed between 2007 and 2010, particularly in low SDI regions, with AAPC for incidence, mortality, and DALYs ASRs at - 3.983%, - 3.929%, and - 3.97%, respectively. South Asia had the highest incidence in 2021, while Central Latin America saw a 99.9% decrease in ASIR. Nepal had the highest ASIR in both 1990 and 2021, though it significantly declined over time. In China, significant reductions in rabies burden occurred post-2005, with consistently higher rates in men. CONCLUSIONS: The study emphasizes the importance of targeted interventions and addressing regional disparities to reduce the global rabies burden.