# Epidemiology and Burden of Gallbladder and Biliary Diseases and the Socioeconomic Factors in the Region of Middle East and North Africa, 1990–2021: Estimates From the Global Burden of Disease 2021 Study

## TL;DR

This study examines the health impact of gallbladder and biliary diseases in the Middle East and North Africa from 1990 to 2021, showing how these conditions affect women, older adults, and lower-income countries more.

## Contribution

The study provides updated, region-specific insights into gallbladder and biliary disease burden and its socioeconomic determinants in the MENA region using GBD 2021 data.

## Key findings

- In 2021, the MENA region had 4.8 million new gallbladder and biliary disease cases, with a 5.0% decline in incidence since 1990.
- Females experienced a higher disease burden across all age groups, and lower Socio-Demographic Index (SDI) countries had higher disease rates.
- Afghanistan had the highest DALY rates, while Oman had the lowest, highlighting regional disparities in disease burden.

## Abstract

As common disorders affecting the digestive system, gallbladder and biliary diseases present a significant health issue. This research aimed to assess the burden of these conditions in the Middle East and North Africa (MENA) region over the period of 1990 to 2021. Furthermore, we investigated the epidemiological characteristics of these diseases in relation to age, sex, and the Socio‐demographic Index (SDI).

Drawing from the Global Burden of Disease (GBD) study 2021, we extracted data on the prevalence, incidence, and disability‐adjusted life years (DALYs) linked with gallbladder and biliary disease for 21 countries in the MENA region from 1990 to 2021. The results were presented as both absolute numbers and rates per 100,000 people, accompanied by their corresponding 95% uncertainty intervals (UIs). The association between disease burden and SDI was evaluated using smoothing spline models.

In 2021, the MENA region documented 4.8 million new cases of gallbladder and biliary diseases, with an age‐standardized incidence rate of 808.9 per 100,000 population, which represents a 5.0% reduction since 1990. The prevalence increased to 15.4 million cases, with an age‐standardized rate of 2807.5 per 100,000, marking a 7.9% decrease. The overall disease burden, quantified in DALYs, reached 437.1 thousand, with an age‐standardized rate of 85.7 per 100,000, signifying a 16.6% decline. Afghanistan estimated the highest DALY rates, while Oman had the lowest. A more pronounced burden was observed in females across all age brackets. An inverse correlation was identified between disease burden and SDI.

Gallbladder and biliary diseases continue to be a public health challenge, particularly affecting women, the elderly, and nations with lower SDI levels. It is imperative for each country to develop healthcare systems and preventive measures that are tailored to its specific context.