Trends of infective endocarditis in north africa and middle east from 1990 to 2021 and projections for the next 10 years: findings from the global burden of disease study 2021
M Shahin, A Al-Slaimieh, I Ghayada, R Al-Huneidy, H Taha, A Al-AniAbstract
Purpose
This study aims to provide an updated evaluation of the trends in infective endocarditis (IE) epidemiology at level of the North Africa and Middle East (NAME) region stratified by sex, age, and country. Moreover, this analysis provides projections of the burden of IE for the next 10 years.
Methods
Data on age-standardized incidence (ASIR), prevalence (ASPR), death (ASMR), and disability-adjusted life years (ASDR) were retrieved from the Global Burden of Disease study. Temporal trends between 1990 and 2021 were explored using estimated average percentage change (EAPC) and Jointpoint regression. ARIMA forecasting was applied to project future trends until 2031.
Results
Between 1990 and 2021, ASIR (EAPC: 0.87; 95%CI: 0.82 – 0.92) and ASPR (EAPC: 1.03; 95%CI: 0.93 – 1.12) demonstrated significant upward trends. Conversely, ASMR (EAPC: -1.32; 95%CI: -1.36 – -1.28) and ASDR (EAPC: -1.89; 95%CI: -1.92 – -1.86) demonstrated significant downward trends (Figure 1). Metrics of epidemiological burden demonstrated a bi-modal distribution across both infants and geriatric patients. SDI was positively correlated with ASIR, ASPR, but negatively with ASMR, and ASDR. Sex-based differences in trends were noted for ASPR (AAPC Difference: -0.53; 95%CI: -0.64 – -0.42), ASMR (AAPC Difference: -0.26; 95%CI: -0.44 – -0.07), and ASDR (AAPC Difference: 0.28; 95%CI: 0.09 – 0.47) but not ASIR. ARIMA projections indicate a downward trend for ASIR, ASMR, and ASDR but not ASPR from 2021 to 2031 (Figure 2).
Conclusion
In short, we have demonstrated a significant burden of IE across the NAME nations with a bi-modal distribution between infants and geriatrics. Nations with the highest recorded burden are yet to produce strong evidence regarding the clinical characteristics and outcomes of their affected patients. Our projections indicate reduced incidence, mortality, and DALYs over the next 10 years.Figure 1Figure 2