# National trends in burden of enteric infections in China: Shifts from 1990 to 2021

## TL;DR

This study examines how the burden of enteric infections in China changed from 1990 to 2021, finding significant declines in cases and deaths.

## Contribution

The study provides updated national trends and age-specific patterns of enteric infection burden in China using the Global Burden of Disease Study 2021 data.

## Key findings

- China saw a 74.12% decrease in enteric infection cases from 1990 to 2021.
- Diarrheal diseases were the main cause of the enteric infection burden in China.
- A dual age pattern was observed with higher incidence and DALY rates in specific age groups.

## Abstract

•China had 75.15 million new cases and 5590 deaths from enteric infections in 2021•Substantial decreases showed in number and rates of enteric infections, 1990–2021•Diarrheal diseases were the main contributor of enteric infections burden in China•A dual age pattern was identified from higher incidence rates and DALY rates

China had 75.15 million new cases and 5590 deaths from enteric infections in 2021

Substantial decreases showed in number and rates of enteric infections, 1990–2021

Diarrheal diseases were the main contributor of enteric infections burden in China

A dual age pattern was identified from higher incidence rates and DALY rates

Enteric infections impose a substantial global health burden annually, especially in countries with inadequate sanitation. This study aims to assess the trends in the burden of enteric infections in China.

Prevalence, incidence, deaths, and disability-adjusted life years (DALYs) attributed to enteric infections by etiology in China were leveraged from the Global Burden of Disease Study 2021. Temporal trends in the burden of enteric infections from 1990 to 2021 were determined by percent changes and average annual percent change (AAPC). Decomposition analysis for percent changes was conducted to understand the contributions of demographic and epidemiological changes.

In 2021, China bore 75.15 million incidence cases and 5,590 deaths from enteric infections, with age-standardized incidence and mortality rates of 59.04 per 100,000 and 0.44 per 100,000, respectively. Substantial decreases, mainly driven by epidemiological changes, were observed in incidence cases (−74.12%), deaths (−94.09%), and DALYs (−95.60%) from 1990 to 2021. Simultaneously, age-standardized incidence, mortality, and DALY rates showed decreasing trends for enteric infections and the subtypes in China. Diarrheal diseases were consistently the main constituent of the burden of enteric infections in China.

From 1990 to 2021, China has made significant strides in the control of enteric infections. This study underscores the need for continued efforts for the improvement of the health system, and enhanced interventions and health promotion strategies for both young and older populations.

Image, graphical abstract