DOI: 10.4103/ajphp.ajphp_39_25 ISSN: 3050-6549

Trends in Osteoarthritis Burden across South Asia (1990-2021): A Global Burden of Disease Study in Bangladesh, Nepal, Pakistan, Bhutan, and India

Cameron J. Sabet, Noah Baca, Jad Lawand, Bara M. Hammadeh, Michael Kessler
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Abstract

Introduction:

Osteoarthritis (OA) poses a significant and growing public health challenge in South Asia. This study examines trends in OA-related disability-adjusted life years (DALYs), prevalence, and incidence across Bangladesh, Nepal, Pakistan, Bhutan, and India (1990-2021).

Methods:

Data on DALYs, prevalence, and incidence were sourced from the Institute for Health Metrics and Evaluation Global Burden of Disease database. Rates were age-standardized and stratified by country and sex. Analysis of variance (ANOVA) was used to test for intercountry differences, followed by Games-Howell post hoc tests. Pearson correlations assessed associations between the human development index (HDI) and OA outcomes, with confidence intervals from 1,000 bootstrap samples. Normality assumptions were confirmed using Kolmogorov–Smirnov and Shapiro–Wilk tests.

Results:

DALYs, prevalence, and incidence of OA increased significantly across all countries. By 2020, Bangladesh recorded the highest DALY rates, followed by India, Nepal, Pakistan, and Bhutan. ANOVA revealed significant country-level differences in DALYs ( P < 0.001), prevalence ( P < 0.001), and incidence ( P < 0.001). Eta-squared values indicated medium effect sizes (η 2 = 0.07 for DALYs, 0.067 for prevalence, and 0.076 for incidence). Post hoc tests highlighted significant differences, particularly between Nepal and Pakistan and Bangladesh and India. Strong positive correlations between HDI and OA outcomes were observed (DALYs: r = 0.792, P < 0.001; prevalence: r = 0.778, P < 0.001; incidence: r = 0.765, P < 0.001).

Conclusion:

This study establishes a robust link between HDI and OA burden in South Asia. Insights from this analysis can guide resource allocation and intervention strategies to address the rising OA burden, particularly in high-HDI countries.

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