Global burden of dengue from 1990 to 2021: a systematic analysis from the Global Burden of Disease study 2021

Dengue fever remains a major global public health challenge, with increasing incidence and burden over recent decades. Global warming, urbanization, and increased international travel have fueled the global spread of dengue. Despite escalating global concern, recent and consistent estimates of the global dengue burden remain limited. This study aimed to quantify the shifting trends of dengue fever.

We analyzed the 2021 Global Burden of Disease (GBD) dataset to assess dengue fever's incidence, prevalence, mortality, and disability-adjusted life years (DALYs) from 1990 to 2021 across 204 countries/regions. Data were stratified by age, sex, and socio-demographic index (SDI) using age-standardized rates, and time-trend analysis was conducted with general linear regression. Correlations between SDI and disease burden metrics were evaluated using Spearman's rank correlation.

From 1990 to 2021, the global burden of dengue increased, with age-standardized incidence rate (ASIR) rising by 0.56% (95% UI: 0.23-2.38), age-standardized prevalence rate (ASPR) by 0.56% (95% UI: 0.23-2.36), and age-standardized DALYs rate (ASDR) by 0.28% (95% UI: -0.38-0.92). In 2021, there were an estimated 58.96 million cases. Regionally, Tropical Latin America reported the highest ASIR (5774.82; 95% UI: 1774.73-11,624.76). At the national level, variations in the change of the ASIR were observed across countries with Tonga reporting the highest ASIR in 2021. From 1990 to 2021, males exhibited a higher ASDR compared to females, particularly in the 0-14 age group. Dengue burden trends varied across SDI regions, with high-middle and middle SDI regions showing increased ASIR, while low SDI regions experienced a decline.

The analysis highlights the increase in dengue burden globally, with demographic and geographic disparities. The findings underscore the need for targeted prevention, control, and treatment strategies to mitigate the growing burden of dengue fever worldwide.