Epidemiological Trends and Age–Period–Cohort Effects on Dengue Incidence Across High-Risk Regions from 1992 to 2021

Dengue, an acute infectious disease caused by the dengue virus, remains a major public health problem in the 21st century. This study investigated the global dengue burden, identified high-risk regions, evaluated the long-term incidence trends, and can inform evidence-based control strategies. Using GBD 2021 data, we analysed the dengue incidence from 1992 to 2021 using age-period-cohort models. We determined the net drift (overall annual percentage change), local drift (annual percentage change for each age group), longitudinal age curves (expected longitudinal age-specific rates), and periods' (cohorts') relative risks. In 2021, the global age-standardised incidence rate reached 752.04/100,000 (95% UI: 196.33-1363.35), a 47.26% increase since 1992. High-risk regions included eastern sub-Saharan Africa, Southeast Asia, South Asia, and Latin America and the Caribbean. Southeast Asia experienced the largest rise (65.43%), with a net drift of 2.47% (1992-2021). While individuals aged 5-39 years bore the highest burden, those over 80 faced an elevated risk. Dengue remains a critical public health threat, disproportionately affecting younger populations but increasingly endangering older adults. Targeted interventions in high-risk regions and age groups, coupled with precision public health strategies, are essential to enhance prevention and control efforts.