Burden of lower respiratory infections in five East Asian countries from 1990 to 2021: observation, comparison, and forecast from the global burden of disease study 2021

作者：Shiwei Wang, Shuai Lin, Guodong Zhong, Zhihong Qi, Wei Wang, Wen Wen · 发表于：Frontiers in Public Health · 年份：2025 · DOI：10.3389/fpubh.2025.1679714 · 被引用次数：1 · 研究领域：Respiratory viral infections research、Pneumonia and Respiratory Infections、Pediatric health and respiratory diseases

Objective: Lower respiratory infections (LRIs) remain a major global health challenge. Although the overall burden has declined, cross-country differences in long-term trends, age-sex patterns, and risk factors in East Asia are not well characterized. This study provides the first systematic comparison of long-term LRI trends across five East Asian countries-China, Japan, Republic of Korea, Democratic People's Republic of Korea, and Mongolia-using Global Burden of Disease Study 2021 (GBD 2021) data. Methods: We analyzed LRI incidence, mortality, and disability-adjusted life years (DALYs) from 1990 to 2021. Temporal trends were quantified by estimated annual percentage change (EAPC). We combined decomposition analysis and autoregressive integrated moving average (ARIMA) forecasting to quantify the relative contributions of population growth, aging, and epidemiological changes, and to project future trajectories. Risk factor attribution was evaluated using population-attributable fractions, and age-sex patterns were compared across countries. Results: From 1990 to 2021, all five countries showed substantial reductions in age-standardized incidence and mortality, with Mongolia and China achieving the steepest declines. The burden shifted from children under five to older adults, particularly those aged ≥70 years, a novel epidemiological transition most evident in Japan and Korea. Decomposition indicated that epidemiological improvements were the primary drivers of mortality redu...