The global trends and regional differences in incidence and mortality of hepatitis A from 1990 to 2019 and implications for its prevention

Abstract

Background and purpose Despite decades of improved sanitation and hygiene measures and vaccine introduction, hepatitis A has been spread through numerous outbreaks globally. We used data from the Global Burden of Disease (GBD) study to quantify hepatitis A burden at the global, regional and national levels. Methods Annual incident cases, deaths, age-standardized incidence rates (ASIRs), and age-standardized mortality rates (ASMRs) of hepatitis A between 1990 and 2019 were derived from the GBD study 2019. Percentage changes of cases and deaths, and estimated annual percentage changes (EAPCs) of ASIRs and ASMRs were calculated to quantify their temporal trends. Results Global hepatitis A incident cases increased by 13.90% from 139.54 million in 1990 to 158.94 million in 2019. ASIR of hepatitis A remained stable (EAPC = 0.00, 95% CI −0.01 to 0.01), whereas ASMR decreased (EAPC = −4.63, 95% CI −4.94 to −4.32) between 1990 and 2019. ASIR increased in low (EAPC = 0.09, 95% CI 0.04 to 0.14) and low-middle (EAPC = 0.04, 95% CI 0.03 to 0.06) socio-demographic index (SDI) regions. For GBD regions, the most significant increases of ASIR were detected in high-income Asia Pacific (EAPC = 0.53, 95% CI 0.41 to 0.66), Oceania (EAPC = 0.31, 95% CI 0.25 to 0.36), and Australasia (EAPC = 0.28, 95% CI 0.13 to 0.44). EAPC of ASIR was positively associated with SDI value in countries and territories with SDI value ≥ 0.7 (ρ = −0.310, p < 0.001). Conclusion There is an unfavorable trend that hepatitis A is still pending in hyperendemic regions and is emerging in low endemic regions. These highlight the need of targeted and specific strategies to eliminate hepatitis A, such as sanitation measures and a comprehensive plan for surveillance and vaccination against hepatitis A.

Morbimortality Associated with Liver Cirrhosis in Peru: An Ecological Analysis for the Period of 2004–2016

“…The overall and percentage changes were calculated for the morbidity rates obtained for the years 2004 and 2016 in the three regions. We used the next formula: {[(n2 − n1)/n1] × 100}, where n2 means morbidity rate in 2016 and n1 means morbidity rate in 2004 [ 27 , 28 ]. The highest increase in the number of cases was found in the Coast (147.4%), and the minimum was found in the Jungle (58%) for the studied years.…”

Contribution of alcohol use to the global burden of cirrhosis and liver cancer from 1990 to 2019 and projections to 2044

“…This may partly explain why the alcoholrelated burden of cirrhosis was more severe in underdeveloped countries. In addition, low and low middle SDI regions often have a high burden of hepatitis virus due to poor health and medical systems (23). For example, sub-Saharan Africa region has relatively low per capita alcohol consumption (24), but bears a large share of the global burden of chronic hepatitis B and C viruses (25,26).…”

A Historical Review of Military Medical Strategies for Fighting Infectious Diseases: From Battlefields to Global Health

“…It was so largely widespread in the military, both in peacetime and mainly in wartime, that it was even known as “camp jaundice” [ 117 ]. In 2019, the global annual infections were estimated to be 158,944,000, an increase of nearly 14% compared with 1990, and the annual deaths were 39,280 [ 24 ] ( Table 1 ). Poor hygienic conditions and overcrowding as risk factors for the military were present in the literature up to 1990, whereas in more recent times, the major risk factor for the military has been the deployment to countries of high endemicity [ 118 ].…”