Global burden of respiratory infections and tuberculosis attributable to risk factors, 1990-2021: demographic and SDI analysis.

INTRODUCTION Respiratory infections and tuberculosis are leading causes of global morbidity and mortality; yet comprehensive research on their associated risk factors remains limited, hindering the development of effective preventive strategies. METHODOLOGY The 2021 Global Burden of Disease data from 204 countries (1990-2021) was used to measure deaths, disability-adjusted life years (DALYs), and their age-standardized rates (ASMR and ASDR) tied to 9 risk factors. The trends were analyzed by age, gender, and socio-demographic index (SDI) regions, with annual and average annual percentage changes (APC, AAPC) used to track changes over time.

Results

Globally, mortality rates (ASMR) for respiratory infections and tuberculosis linked to traditional risks-malnutrition, air pollution, and alcohol use-declined significantly; annual decreases of 4.46%, 3.18%, and 3.35%, respectively. Deaths attributed to metabolic risks like high BMI and blood sugar increased, despite falling ASMR. Geographic disparities were notable: Lesotho saw the sharpest rise in BMI-related mortality (3.92%), while Hungary had the steepest decline (-7.4%). Men faced a higher burden from behavioral risks, with tobacco-related mortality 3.6 times higher than in women. Children under 5 years were especially vulnerable to environmental risks, with unsafe water and sanitation contributing to a 4.55% annual decline in mortality rates.

Conclusions

This study highlights the need for targeted actions, such as tobacco control in high-middle SDI regions, air quality improvements in South Asia, and nutrition programs in Sub-Saharan Africa. It offers a precise public health framework to reduce respiratory infections and tuberculosis, and promote global health equity by analyzing sociodemographic and time trends.