[Analysis and comparison of otitis media disease burden trends across Chinese provinces 1990-2021]

Objective: To describe, analyze, and compare the disease burden and trends of otitis media across provinces in China from 1990 to 2021, providing evidence for precise prevention and control strategies at the provincial level. Methods: Utilizing data from the Global Burden of Disease (GBD) database (1990-2021), this study analyzed the characteristics of the otitis media burden in Chinese provinces, including prevalence, Years Lived with Disability (YLD), and their age-standardized rates. The Joinpoint regression model was employed to analyze temporal trends, calculating the Annual Percent Change (APC) and Average Annual Percent Change (AAPC). Statistical analyses were performed using R software. Results: From 1990 to 2021, the number of prevalent otitis media cases in China decreased from 19.764 million to 14.303 million, a cumulative decline of 27.63%. The Age-Standardized Prevalence Rate (ASPR) dropped from 1 631.81 to 1 097.04 per 100 000, a reduction of 32.77%. The number of YLD decreased from 362.6 thousand person-years to 263.8 thousand person-years, a decline of 27.25%. The Age-Standardized YLD Rate (ASYR) fell from 64.35 to 37.81 per 100 000, a decrease of 41.24%. The disease burden was generally higher in males than in females. Children and adolescents remained the primary affected population; however, the burden showed a trend of shifting from a concentration in younger ages towards a more uniform distribution across all age groups. Geographically, a pattern of "higher burden in the southwest, lower burden in the northeast and coastal areas" was observed. Provinces like Guizhou, Gansu, and Xizang exhibited higher burdens, whereas, Macao, Hong Kong, Beijing, Tianjin, and Shanghai had lower burdens. Joinpoint analysis revealed that the AAPC for ASPR and ASYR were -1.277% and -1.266%, respectively, indicating a faster decline in earlier years that had slowed down recently. Conclusion: The burden of otitis media in China and its provinces decreases significantly from 1990 to 2021, reflecting the effectiveness of national public health interventions. However, substantial geographical heterogeneity and shifts in population distribution of the disease burden persist. Future efforts should strengthen targeted interventions in high-burden regions and promote whole-life-cycle health management to further reduce the disease burden.