Analysis of malaria disease burden trends in HBHI countries based on GBD from 1990 to 2023

HU Xuefeng; LI Qiong; LI Zhongqi; TANG Xiaoyu; CHEN Feng; CHEN Lin; ZHANG Yi; GUO Ye; WU Hailei

doi:10.19821/j.1671-2781.2026.01.003

Abstract：Objective To analyze the trends in the burden of malaria from 1990 to 2023 in 12 to high burden to high impact(HBHI)countries based on the Global Burden of Disease(GBD)database,so as to provide a scientific basis for China's efforts to prevent the re-transmission of imported malaria.Methods Data on the burden of malaria,including the number of cases,deaths,and disability-adjusted life years(DALYs)from 1990 to 2023 in 12 HBHI countries,were collected from the GBD database.Descriptive analysis was conducted,and time trend analysis was performed using Joinpoint software version 5.4.0.0.Results Regarding the number of cases,all countries except India showed an increasing trend.The proportion of malaria cases in HBHI countries relative to the global total ranged between 64.883％and 71.342％.In terms of deaths,India,Mozambique,and Tanzania showed a significant decreasing trend.The proportion of malaria deaths in HBHI countries relative to the global total ranged between 69.057％and 73.776％.For DALYs,India and Tanzania showed a significant decreasing trend.The proportion of malaria DALYs in HBHI countries relative to the global total ranged between 69.698％and 74.494％.Compared with 1990,the age-standardized burden of malaria in HBHI countries overall showed a decreasing trend.Except for Niger,Sudan,and India,the correlation coefficients for the age-standardized burden of malaria in HBHI countries and globally were statistically significant(P＜0.05).Uganda showed a statistically significant increasing trend in the average annual percentage change(AAPC)for age-standardized incidence rate(P＜0.05),while the remaining HBHI countries showed a statistically significant decreasing trend in the AAPC for age-standardized incidence rate(P＜0.05).Except for Ghana,all other HBHI countries showed a statistically significant decreasing trend in the AAPC for age-standardized mortality rate(P＜0.05).All HBHI countries showed a statistically significant decreasing trend in the AAPC for age-standardized DALY rate(P＜0.05).Conclusion The burden of malaria in HBHI countries shows a declining trend,but continued resource investment is still required to further reduce the disease burden.China should strengthen the surveillance of overseas epidemic situations and implement multiple measures to consolidate and maintain the achievements of malaria elimination.