Global, Regional and National Burden of Pelvic Inflammatory Disease: Trend Projections and Health Inequality Analysis, 1990–2021

Qingyu Song,1,* Zhaoyi Jing,2,* Zheng Shen,3 Shuo Li,3 Rui Li,3 Dianhui Yang,3,4 Mengmeng Wang3,4 1The Seventh Clinical College, Shanghai University of Traditional Chinese Medicine, Shanghai, 200137, People’s Republic of China; 2The First Clinical College, Shandong University of Traditional Chinese Medicine, Jinan, 250011, People’s Republic of China; 3College of Acupuncture and Massage, Shandong University of Traditional Chinese Medicine, Jinan, 250011, People’s Republic of China; 4Acupuncture Department, Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, 250011, People’s Republic of China*These authors contributed equally to this workCorrespondence: Dianhui Yang; Mengmeng Wang, Email [email protected]; [email protected]: Pelvic inflammatory disease (PID), a global health challenge, poses a major challenge to women’s health and economic development, but has received relatively little research investment and attention. We aimed to assess the global, regional, and national burdens and trends of PID in women from 1990 to 2021.Methods: The Global Burden of Disease (GBD) 2021 standardized methodology was used to analyze the burden of PID at global, regional, and national levels, with attention to the age factor; Join-point regression was applied to identify turning points in the change in the burden of disease, and in addition, Spearman correlation analyses were used to assess the association between ASR and SDI; the study also involved a cross-countryinequality analysis with decomposition. Finally, Bayesian age-period-cohort modeling was used to predict the disease burden of pelvic inflammatory disease in 2035.Results: PID prevalence and YLDs increased over 32 years, whereas ASPR and ASYR remained relatively stable; the PID burden of disease is concentrated in the 30– 39 year age group; countries with lower SDI bear a greater burden of PID, and health inequalities have declined but persist, the Inequality Slope indices of ASPR and ASYR were − 22.12 (95% CI: − 27.15 to − 17.08) and − 0.16 (95% CI: − 0.20 to − 0.11), respectively; population growth and aging are driving the burden of PID, with epidemiological changes driving the increase in PID but slowing the rise in YLDs; projections based on the BAPC model suggest that the burden of PID will continue to rise through 2035.Conclusion: The global burden of PID has risen and will continue to do so, with significant differences between regions and countries. Therefore, global investment in research on the epidemiology of PID should be strengthened, targeted health policies should be formulated to enhance disease management in low-income countries, female sexual health education should be strengthened, and safe and hygienic sexual lifestyles should be promoted.Keywords: global burden of disease, pelvic inflammatory disease, socio-demographic index, inequality analysis, decomposition analysis