Non-HIV sexually transmitted infections among women of childbearing age: A population-based analysis of GBD 2021 trends, inequalities, and projections.

چکیده اصلی

Non-HIV sexually transmitted infections (STIs) among women of childbearing age (WCBA) are a major cause of severe long-term reproductive health sequelae. However, a comprehensive analysis of the spatiotemporal trends, health inequalities, and future predictions of the disease burden specific to this population, based on global data, is still lacking. This study conducted a secondary analysis based on the Global Burden of Disease 2021 data to systematically estimate the burden of non-HIV STIs among WCBA globally from 1990 to 2021. We integrated multiple analytical approaches, including Joinpoint regression analysis, health inequality assessment (involving Sociodemographic Index [SDI] correlation and concentration index analysis), and predictive modeling, to comprehensively reveal the spatiotemporal evolution, inequalities, and future trends of the disease burden. Globally, the incidence and prevalence of non-HIV STIs showed fluctuating, nonlinear temporal patterns over the past 3 decades, while disability-adjusted life years (DALYs) displayed no sustained long-term decline. Trichomoniasis and chlamydial infection were the most significant contributors to the overall burden. The distribution of the disease burden revealed substantial geographical inequalities, with DALYs showing a strong negative correlation with SDI (R = -0.59, P < .001). Low-SDI regions, such as Western sub-Saharan Africa, bore the highest burden, whereas Western Europe had the lowest. Health inequality assessment indicated that although inequalities related to DALYs modestly improved, incidence-based inequalities intensified. Under a projection scenario based on historical age-period-cohort patterns, global incidence and DALY rates are projected to increase, exceeding 14,000 cases and 40 DALYs per 100,000 population by 2050, respectively. The burden of non-HIV STIs among WCBA remains persistent and unequally distributed globally. Model-based projections suggest that this burden may increase if historical patterns continue. New infections are increasingly concentrated among socioeconomically disadvantaged groups. These findings support targeted and equity-oriented prevention strategies to reduce disease burden and promote health equity.

ترجمه فارسی چکیده

عفونت‌های آمیزش جنسی (STI) غیر HIV در زنان در سنین باروری (WCBA) علت اصلی پیامدهای طولانی‌مدت و شدید سلامت باروری هستند. این مطالعه یک تحلیل ثانویه بر اساس داده‌های GBD 2021 انجام داد تا بار بیماری عفونی STI غیر HIV در این جمعیت را از 1990 تا 2021 برآورد کند. نتایج نشان داد که شیوع و مقدمات عفونت‌ها الگوهای غیرخطی و نوسانی داشته‌اند، در حالی که سال‌های زندگی اصلاح‌شده (DALY) کاهش پایداری نداشتند. عفونت‌های تریکوموناس و کلامیدیا بیشترین سهم را در بار بیماری داشتند. نابرابری‌های جغرافیایی قابل توجهی وجود داشت و DALYها با شاخص جمعیت‌شناختی-اجتماعی (SDI) همبستگی منفی قوی داشتند (R = -0.59، P < .001). بر اساس سناریوی پیش‌بینی، شیوع و نرخ DALY جهانی تا سال 2050 افزایش خواهد یافت. این یافته‌ها از استراتژی‌های پیشگیری متمرکز و مبتنی بر عدالت حمایت می‌کنند.

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