Global and Regional Impact of Pelvic Inflammatory Disease in Females Across All Age Groups (1990–2021) with Projections to 2046: Findings from the 2021 Global Burden of Disease Study

Yun Cheng,1,2,* Chen Yan,1,* Jing Feng,2,* Jie Chen,1 Ting Luan,1 Qianqian Lu,1 Xin Zeng1 1Department of Gynecology, Women’s Hospital of Nanjing Medical University, Nanjing Women and Children’s Healthcare Hospital, Nanjing Women and Children’s Healthcare Institute, Nanjing, Jiangsu, People’s Republic of China; 2Department of Gynecology, Nanjing First Hospital, Nanjing Medical University, Nanjing, Jiangsu, People’s Republic of China*These authors contributed equally to this workCorrespondence: Xin Zeng, Email [email protected]: Pelvic inflammatory disease (PID) is a common condition among women of childbearing age, referring to a group of infectious diseases of the upper female reproductive tract, tubo-ovarian abscess, and pelvic peritonitis, primarily caused by sexually transmitted infections (STIs). Delays in diagnosis and treatment can lead to sequelae associated with PID reproductive tract infections such as tubal factor infertility, ectopic pregnancy (EP), and chronic pelvic pain. This study assessed the global burden, trends, and cross-national disparities in PID among women, with projections extending to 2046.Methods: Estimates and the corresponding 95% uncertainty intervals (UI) for the prevalence and years lived with disability (YLDs) of PID were extracted from the GBD (the Global Burden of Disease) 2021 Study. We described the epidemiology of PID at the global, regional, and national levels; analyzed trends in its burden from 1990 to 2021 on overall, local, and multidimensional scales; evaluated time trends using estimated annual percentage changes (EAPCs); and predicted changes in PID burden over the next 25 years by using Bayesian age-period-cohort (BAPC) analysis.Results: From 1990 to 2021, an increase in the age-standardized prevalence rate (ASPR) (EAPC=− 0.02, 95% confidence interval (CI): − 0.07 to 0.02) was observed in PID. Although our findings show an EAPC of − 0.02 and stable incidence rates (ASR), the global burden continues to grow because of several factors. In 2021, the estimated number of PID cases was 1,089,544 (95% UI: 815,164 to 1,405,520), with a corresponding ASPR of 13.38 (95% UI: 10.02 to 17.28) per 100,000 population. The burden of PID varied widely across countries, with the highest ASR for prevalence and YLDs recorded in Guinea. Our predictions indicate that the prevalence and YLDs of PID will continue to rise over the next 25 years.Conclusion: PID remains a major global women’s public health concern, with its burden rising from 1990 to 2021. This study highlights the persistent challenges in managing PID, and its unequal distribution, offering insights for more effective resource allocation and age-inclusive care strategies.Keywords: Global Burden of Disease, pelvic inflammatory disease, inequality, sexually transmitted infections, women’s reproductive health, Bayesian age-period-cohort, BAPC