The burden of diseases from human-animal contact in 2021: a spatiotemporal analysis using the...

Animal contact (AC) is a major global public health concern, carrying a substantial and unevenly distributed disease burden. This study aims to illuminate the spatiotemporal trends and spatial patterns of the AC burden across global, regional, and national scales by analyzing data from the Global Burden of Disease Study 2021 (GBD 2021). Grounded in the "Production-Living-Ecological" spatial (PLES) framework, it further explores the spatial heterogeneity of factors influencing AC incidence to inform targeted health policies.

We extracted GBD 2021 data on AC cases, deaths, age-standardized incidence rate (ASIR), age-standardized mortality rate (ASMR), age-standardized disability-adjusted life-years rate (ASDR), and age-standardized prevalence rate (ASPR) across 204 countries/territories (1990-2021), and calculated indicator percentage changes. Six influencing factors (agricultural employment, agricultural land, urban population, non-working age population [0-14, 65 +], average annual temperature, forest area) were selected, and a geographically weighted regression (GWR) model analyzed their spatially varying relationships with ASIR.

In 2021, an estimated 50.5 million AC cases and 88,531 deaths occurred globally. Although the ASIR and ASMR declined by 28.5% and 45.3%, respectively, from 1990 to 2021, the absolute number of cases increased by 1.2%. South Asia bore the highest burden, accounting for 40.7% of global cases and 68.9% of deaths. Low and low-middle socio-demographic index (SDI) regions were disproportionately affected, contributing to over 80% of global deaths. Venomous animal encounters constituted 89.7% of fatalities, with males and individuals over 40 years old at elevated risk. GWR revealed clear spatial heterogeneity in risk factors: production and ecological variables were more influential in low- and middle-income countries, whereas living environmental factors had a stronger impact in middle- and high-income regions.

The burden of AC is marked by significant multidimensional spatiotemporal inequalities, reflecting broader disparities in socioeconomic development, healthcare access, and ecological pressures. The persistent increase in case numbers and sustained mortality in resource-limited settings highlight critical systemic gaps. The regional variation in key drivers underscores the necessity for context-specific interventions, tailored to local PLES conditions, to effectively mitigate zoonotic risks and promote harmonious human-animal coexistence.