Global trends of schistosomiasis burden from 1990 to 2021 across 204 countries and territories: Findings from GBD 2021 study

Introduction: The WHO aims to eliminate schistosomiasis as a public health problem by 2030. Based on the Global Burden of Disease 2021 (GBD 2021), this study assesses the global distribution of schistosomiasis burden to guide policy and resource allocation.

Methods: Schistosomiasis burden and social-demographic indexes (SDIs) data were extracted from GBD 2021 study. Smoothing spline models were used to examine the relationship between age-standardized prevalence rates (ASPR), DALY rates, mortality rates (ASMR), and SDI. Future burden predictions till 2030 were made using a Bayesian age-period-cohort model. Predictions and their 95 % certainty intervals were used to determine whether the region can meet the target by 2030.

Results: Globally, the burden of schistosomiasis was substantial (prevalence: 151.38 million; DALYs: 1,746,333.31; deaths: 12,857.57) in 2021. Africa accounted for most burden (Prevalence: 84.25 %; DALYs: 87.92 %; Deaths: 87.28 %). Among all age groups, individuals aged 15 to 24 years old bear the heaviest burden in 2021. The ASPR, Age-standardized DALY rate and ASMR were inversely correlated to the SDIs across different super regions (r = -0.72, P < 0.00; r = -0.71, P < 0.00; r = -0.71, P < 0.00) and countries and territories (r = 0.02, P = 0.85; r = -0.48, P < 0.00; r = -0.72, P < 0.00). According to model results, the burden of schistosomiasis in most regions will continue to decline in the future, while it in regions with high-income presented slightly rising.

Conclusions: Despite significant progress, further effects are needed to achieve the 2030 goal across the world. Additionally, the rising ASR of DALY of schistosomiasis in regions with high-income warrants attentions.