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Background <p>Lower respiratory tract fungal infections (LRTFIs) contribute significantly to global disease burden, yet systematic research is limited. This study analyzes their disability-adjusted life year (DALY) burden, exploring trends, geographic patterns, demographic differences, driving factors, and inequalities.</p> Methods <p>Using Global Burden of Disease Study 2021 data, we analyzed global, regional, and national DALYs trends from 1990 to 2021 and forecasted burden to 2050. Decomposition analysis evaluated impacts of population growth, ageing, and epidemiological changes. We analyzed national burden inequalities using the Slope Index of Inequality and the Concentration Index.</p> Results <p>Global DALYs from LRTFIs decreased slightly from 1.32 to 1.30 million (1990–2021), with an age-standardized DALY rate (ASDR) decline from 25.86 to 16.37 per 100,000 (EAPC = − 1.52). The highest ASDRs were in low-SDI regions, particularly Central Sub-Saharan Africa (71.86 per 100,000). Zimbabwe, Lesotho, and the Central African Republic had the highest national burdens. Males and individuals over 50 had higher DALY rates. Population growth increased DALYs, while ageing and epidemiological shifts reduced then. Absolute inequality declined, but relative inequality increased. By 2050, DALYs are projected to rise to 1.78 million, though ASDR will decline to 10.37 per 100,000.</p> Conclusions <p>Despite progress, LRTFIs burden remains high in underdeveloped regions, particularly Africa. Population growth and ageing will drive future challenges, and significant global inequalities in disease burden persist.</p>

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Global, Regional, and National Disability-Adjusted Life Years Burdens of Lower Respiratory Tract Fungal Infections, 1990–2021: A Systematic Analysis of the Global Burden of Disease Study 2021

  • 期刊论文

  • 发表日期：

    2025年10月8日

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  • Zhiwei Long,
  • Longzhen Lu,
  • Guisheng Xian,
  • Zhengtu Li,
  • Mingkai Guo,
  • Aguo Li,
  • Zhenlin Guan,
  • Feng Ye,
  • Yan Wang

摘要

Background

Lower respiratory tract fungal infections (LRTFIs) contribute significantly to global disease burden, yet systematic research is limited. This study analyzes their disability-adjusted life year (DALY) burden, exploring trends, geographic patterns, demographic differences, driving factors, and inequalities.

Methods

Using Global Burden of Disease Study 2021 data, we analyzed global, regional, and national DALYs trends from 1990 to 2021 and forecasted burden to 2050. Decomposition analysis evaluated impacts of population growth, ageing, and epidemiological changes. We analyzed national burden inequalities using the Slope Index of Inequality and the Concentration Index.

Results

Global DALYs from LRTFIs decreased slightly from 1.32 to 1.30 million (1990–2021), with an age-standardized DALY rate (ASDR) decline from 25.86 to 16.37 per 100,000 (EAPC = − 1.52). The highest ASDRs were in low-SDI regions, particularly Central Sub-Saharan Africa (71.86 per 100,000). Zimbabwe, Lesotho, and the Central African Republic had the highest national burdens. Males and individuals over 50 had higher DALY rates. Population growth increased DALYs, while ageing and epidemiological shifts reduced then. Absolute inequality declined, but relative inequality increased. By 2050, DALYs are projected to rise to 1.78 million, though ASDR will decline to 10.37 per 100,000.

Conclusions

Despite progress, LRTFIs burden remains high in underdeveloped regions, particularly Africa. Population growth and ageing will drive future challenges, and significant global inequalities in disease burden persist.