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

Authors

Shareli Caikai, Jing Jiang, Yi Shi, Hongli Zhang, Sicheng Xu

Published in

Journal of infection in developing countries. Volume 20. Issue 7. Pages 974-989. Jul 31, 2026. Epub Jul 31, 2026.

Abstract

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.
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.
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.
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.

PMID:
42566342
Bibliographic data and abstract were imported from PubMed on 08 Aug 2026.

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