The shift in Mosquito-borne diseases incidence across Asia-Pacific region (1992-2021): insights from an Age-Period-Cohort analysis using the global burden of disease study 2021

亚太地区蚊媒疾病发病率的变化(1992-2021年):基于2021年全球疾病负担研究的年龄-时期-队列分析的启示

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Abstract

PURPOSE: Mosquito-borne diseases (MBDs) pose a significant threat in the Asia-Pacific region, encompassing both the Western Pacific and South-East Asia. This study is aimed at improving the understanding of the evolution of incidence patterns of MBDs within the Asia-Pacific region and supporting the development of effective health policies. METHODS: Case numbers, incidence, and age-standardized incidence rate (ASIR) of MBDs were obtained from the Global Burden of Disease Study 2021. Furthermore, an Age-Period-Cohort model was applied to characterize overall temporal trends in MBDs incidence and to assess the independent effects of age, period, and birth cohort. Decomposition analysis was used to quantify the extent to epidemiological changes, population growth, and aging contributed to the observed trends. Additional stratified analyses were performed by regions and country. RESULTS: From 1992 to 2021, the ASIR of MBDs in the Asia-Pacific region displayed regional heterogeneity. Overall, the net drift of ASIR indicated an annual increase of 1.07% per year in the Western Pacific region, rising from 292.26 to 380.84 per 100,000 population. In contrast, the South-East Asia region experienced an annual decrease of 1.88% per year, with ASIR declining from 3,779.81 to 1,856.84 per 100,000 population. Meanwhile, driven by population growth and epidemiological changes, dengue gradually replaced malaria as the predominant MBD in both regions. Dengue cases increased from 1,082,887 to 3,839,091 in the Western Pacific region and from 14,326,313 to 32,627,815 in the South-East Asia region, far exceeding the corresponding malaria cases (2,387,112 and 5,784,641). Age-Period-Cohort analysis further revealed distinct epidemiological patterns: South-East Asia exhibited favorable period and cohort effects, while the Western Pacific showed an unfavorable trend. CONCLUSION: The intensifying threat of MBDs in the Western Pacific region underscores the need for highly responsive and adaptive public health strategies, supported by ongoing regional collaboration.

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