S1152 Comparative Global Burden of Diseases (GBD) Analysis of Diarrheal vs Gastrointestinal (GI) Non-Communicable Diseases (NCDs) Burden in Transitional Economies

Introduction: With socioeconomic development and lifestyle changes, gastrointestinal (GI) non-communicable diseases (NCDs) are now emerging as major contributors to the GI disease burden. Limited studies have investigated the burden of GI NCDs compared to diarrheal diseases in transitional economies and limited attention has been given to this burden on national economic capacity. Methods: We extracted age-standardized disability-adjusted life years (DALYs) per 100,000 from the Global Burden of Disease (GBD) Compare tool for diarrheal diseases and selected GI NCDs (colorectal cancer, cirrhosis, pancreatitis) in transitional economies (India, Brazil, Egypt, Philippines) from 1990 to 2020. DALY trends were identified in R software (v4.3.2) using ggplot2. The burden crossover year, the point where NCD DALYs surpassed diarrheal DALYs was identified. We also computed DALYs per $1,000 gross domestic product (GDP) to assess public health efficiency. Results: From 1990 to 2020, diarrheal disease DALYs declined by 73% (from 5500 to 1500/100,000), while GI NCD DALYs increased by 211% (from 1700 to 5300/100,000). The crossover occurred between 2005 and 2010. By 2020, GI NCDs accounted for most of the GI disease burden in all four countries. DALYs per $1,000 GDP remained disproportionately high for NCDs, indicating inadequate health system adaptation. Conclusion: Our analysis highlights the significant epidemiological shift in transitional economies wherein the burden of GI NCDs is now greater than that of diarrheal diseases. Significant public health measures like improved sanitation, access to clean water, and vaccination have decreased the burden of diarrheal diseases in these countries by 73%. However, urbanization, poor diet, alcohol consumption, sedentary lifestyles, and increased metabolic diseases have contributed to the burden of GI NCD-related DALYs on the rise by 211%. Using DALYs per $1,000 of GDP, we report that while these countries showed economic growth, there is an enormous GI NCD burden when compared with their financial capacities. This reflects a disconnect from current disease trends and healthcare investment, suggesting the need for policy reforms and strategies like early diagnosis programs (e.g., colorectal cancer screening), liver disease prevention, chronic care, provider training, and financing models.