Tehran University of Medical Sciences

Science Communicator Platform

Stay connected! Follow us on X network (Twitter):
Share this content! By
Global, Regional, and National Burden of Upper Respiratory Infections and Otitis Media, 1990–2021: A Systematic Analysis From the Global Burden of Disease Study 2021 Publisher Pubmed



Sirota SB1 ; Doxey MC8 ; Dominguez RMV1 ; Bender RG1, 9 ; Vongpradith A1 ; Albertson SB1 ; Novotney A1 ; Burkart K1, 2 ; Carter A1 ; Abdi P13 ; Abdoun M14, 15 ; Abebe AM16 ; Abegaz KH18 ; Aboagye RG20 Show All Authors
Authors
  1. Sirota SB1
  2. Doxey MC8
  3. Dominguez RMV1
  4. Bender RG1, 9
  5. Vongpradith A1
  6. Albertson SB1
  7. Novotney A1
  8. Burkart K1, 2
  9. Carter A1
  10. Abdi P13
  11. Abdoun M14, 15
  12. Abebe AM16
  13. Abegaz KH18
  14. Aboagye RG20
  15. Abolhassani H25, 41
  16. Abreu LG42
  17. Abualruz H44
  18. Abugharbieh E45, 49
  19. Aburuz S55, 58
  20. Adane MM59
  21. Addo IY61, 63
  22. Adekanmbi V64
  23. Adnani QES66
  24. Adzigbli LA21
  25. Afzal MS69
  26. Afzal S70, 71
  27. Ahinkorah BO72
  28. Ahmad S75, 76
  29. Ahmed A77, 79, 81
  30. Ahmed H80
  31. Ahmed SA77, 79, 81
  32. Akinosoglou K84, 85
  33. Akkaif MA86
  34. Awaidy SA87, 88
  35. Alalalmeh SO89
  36. Albashtawy M91
  37. Albataineh MT92
  38. Algheethi AAS93, 94
  39. Alhalaiqa FN95, 98
  40. Alhassan RK22
  41. Ali A99
  42. Ali L100
  43. Ali MU102, 104
  44. Ali SS105
  45. Ali W106
  46. Almazan JU107
  47. Alqahtani JS108
  48. Alrawashdeh A109
  49. Alrifai RH56
  50. Alshahrani NZ111
  51. Altartoor K112
  52. Altawfiq JA114, 115
  53. Alvisguzman N116, 118
  54. Alworafi YM120, 121
  55. Aly H122
  56. Aly S125, 126
  57. Alzoubi KH50, 110
  58. Alzyoud WA130
  59. Amhare AF131, 132
  60. Amu H23
  61. Amusa GA134, 135
  62. Anil A136, 142
  63. Anvari S143
  64. Anyabolo EE145, 146
  65. Arabloo J147
  66. Arafat M155
  67. Areda D157, 158
  68. Aregawi BB159
  69. Aremu A162
  70. Athari SS164
  71. Aujayeb A166
  72. Aynalem ZB167
  73. Azadnajafabad S168
  74. Azzam AY169, 170
  75. Badar M171
  76. Taghanaki PB172
  77. Bahramian S179
  78. Baig AA184
  79. Bajcetic M185, 188
  80. Balakrishnan S189
  81. Banach M190, 191
  82. Bardhan M192
  83. Barqawi HJ49
  84. Bastan MM26, 148
  85. Batra K193
  86. Batra R194, 195
  87. Behnoush AH198
  88. Beiranvand M199
  89. Belete AG201
  90. Belete MA202
  91. Beloukas A204, 205
  92. Beran A206
  93. Bhardwaj P137, 138
  94. Bhargava A207
  95. Bhat AN208
  96. Bhuiyan MA211
  97. Bitra VR212
  98. Bodunrin AO82
  99. Bogale EK60
  100. Boppana SH213
  101. Borhany H217
  102. Bouaoud S222, 224
  103. Brown CS225, 226
  104. Buonsenso D229, 230
  105. Bustanji Y46, 51
  106. Camera LA231, 232
  107. Castanedaorjuela CA233, 234
  108. Cegolon L236, 237
  109. Cenderadewi M238, 239
  110. Chakraborty S240
  111. Chattu VK241, 242
  112. Cheng ETW243
  113. Chichagi F28
  114. Ching PR244
  115. Chopra H245
  116. Choudhari SG246
  117. Christopher DJ247
  118. Chu DT249
  119. Chukwu IS251
  120. Chung E1, 3
  121. Corlateanu A252
  122. Cruzmartins N253, 255
  123. Dadana S256
  124. Dadras O29, 257
  125. Dahiru T258
  126. Dai X1, 2
  127. Das JK259
  128. Dash NR49
  129. Dashti M260
  130. Dashtkoohi M30, 263
  131. De La Hoz FP235
  132. Debopadhaya S264
  133. Demessa BH265
  134. Demis AB266, 267
  135. Devanbu VGC269
  136. Devegowda D270
  137. Dhama K271
  138. Dhulipala VR272
  139. Diaz D274
  140. Diaz MJ200
  141. Do TC275
  142. Do THP276
  143. Dodangeh M277
  144. Dorostkar F149
  145. Dsouza AC278
  146. Dsouza HL279, 283
  147. Duraisamy S284
  148. Durojaiye OC285
  149. Dziedzic AM287
  150. Eddra A288
  151. Ekholuenetale M289
  152. Ekundayo TC290
  153. Sayed IE292
  154. Eldahiyat F156, 294
  155. Elhadi M295, 296
  156. Elshaer M297
  157. Eslami M300, 301
  158. Eze UA302, 303
  159. Fagbamigbe AF306, 310
  160. Faramarzi A312, 313
  161. Fasina FO315, 316
  162. Ferreira N317
  163. Fischer F318
  164. Fitriana I320
  165. Flor LS1, 2
  166. Gaihre S321
  167. Gajdacs M322
  168. Galehdar N323
  169. Ganiyani MA324, 325
  170. Gebregergis MW160
  171. Gebrehiwot M203
  172. Gebremeskel TG326, 327
  173. Getahun GK329
  174. Getie M330
  175. Ghadiri K331, 332
  176. Ghasemzadeh A260
  177. Ghorbani M173
  178. Goldust M10
  179. Golechha M334
  180. Goleij P333, 335
  181. Gorini G336
  182. Goyal A123
  183. Guan SY337
  184. Guarducci G338
  185. Gudeta MD339
  186. Gupta R139
  187. Gupta S340
  188. Gupta VB341
  189. Gupta VK342
  190. Hadei M31
  191. Hadi NR344
  192. Hajmirzaian A218, 345
  193. Halwani R49, 52
  194. Hamidi S348
  195. Hammoud A349
  196. Hanifi N165
  197. Hanna F350
  198. Haq ZA351
  199. Haque MR352
  200. Mahmudul Hasan SM353
  201. Hasani H150
  202. Hasnain MS354
  203. Hassankhani H261, 355
  204. Haubold J356, 357
  205. Hayat K133, 358
  206. Hegazi OE89
  207. Hezam K359, 360
  208. Holla R280
  209. Hoogar P361
  210. Horita N362, 363
  211. Hostiuc M364
  212. Huynh HH365
  213. Ibitoye SE307
  214. Ilesanmi OS368, 369
  215. Ilic IM186
  216. Ilic MD371
  217. Imam MT372
  218. Isa MA103, 374
  219. Islam MR375
  220. Islam SMS376, 377
  221. Ismail NE381, 382
  222. Iwagami M383, 384
  223. Vinothini J385
  224. Jafarzadeh A386, 388
  225. Jaggi K389, 390
  226. Jairoun AA391
  227. Jakovljevic M392, 393
  228. Jamshidi E216
  229. Jayaram S394
  230. Jeswani BM395
  231. Jha RP396, 397
  232. Jose J209
  233. Joseph N209
  234. Joshua CE398
  235. Jozwiak JJ399
  236. Vaishali K281
  237. Kabir Z400
  238. Kandel H378, 401
  239. Kanmodi KK402, 403
  240. Kant S404
  241. Kantar RS405, 406
  242. Karaye IM407, 408
  243. Behnagh AK151, 152
  244. Kaur N409
  245. Khajuria H411
  246. Khalaji A27, 196
  247. Khamesipour F153, 413
  248. Khan G57
  249. Nuruzzaman Khan M104, 379, 414, 415
  250. Khan M104, 379, 414, 415
  251. Khan MJ104, 379, 414, 415
  252. Kim MS347, 417
  253. Kimokoti RW418
  254. Kochhar S4, 419
  255. Korshunov VA420
  256. Kosen S421
  257. Krishan K422
  258. Krishna H139
  259. Krishnamoorthy V5, 423
  260. Defo BK424, 425
  261. Kuddus MA426, 428
  262. Kuddus M426, 428
  263. Kuitunen I430, 431
  264. Kulimbet M432, 433
  265. Kumar D434
  266. Kurmi OP311, 435
  267. Simhachalam Kutikuppala LV436
  268. Lahariya C437, 438
  269. Lal DK439
  270. Lasrado S440
  271. Latifinaibin K154
  272. Le HH441, 444
  273. Le NHH441, 444
  274. Le TTT443
  275. Le TDT443, 445
  276. Lee SW446
  277. Lee WC65
  278. Li MC447
  279. Li P448
  280. Lim SS1, 2
  281. Liu G73
  282. Liu R449
  283. Liu W451
  284. Liu X11, 124, 342, 452
  285. Liu X11, 124, 342, 452
  286. Lorenzovici L453, 454
  287. Luo L455
  288. Majeed A227
  289. Rad EM32
  290. Malhotra K457, 458, 459
  291. Malik I373
  292. Manilal A460
  293. Mehta B140
  294. Meto TM461
  295. Mekonnen MM462
  296. Meles HN161
  297. Memish ZA463, 464
  298. Mendezlopez MA465
  299. Meo SA466
  300. Merati M27
  301. Mestrovic T1, 468
  302. Mettananda S469, 470
  303. Minh LHN366, 367
  304. Mirrakhimov EM471, 472
  305. Misra AK473
  306. Mohamed AI268, 474
  307. Mohamed NS475, 476
  308. Mohammed M19, 96
  309. Mohammed M19, 96
  310. Mokdad AH1, 2
  311. Monasta L477
  312. Moni MA478, 480
  313. Moodi Ghalibaf A481
  314. Moore CE482
  315. Morawska L483
  316. Motappa R209
  317. Mougin V1
  318. Mousavi P26
  319. Mustafa G484, 486
  320. Naghavi P487
  321. Naik GR327, 488
  322. Nainu F489
  323. Najafi MS33, 34
  324. Najdaghi S180, 181
  325. Najmuldeen HHR490
  326. Nargus S491
  327. Davani DN180
  328. Naser M494
  329. Natto ZS127, 495
  330. Nayak BP411
  331. Nejadghaderi SA197, 387
  332. Nguyen DH346, 496
  333. Nguyen HTH497, 498
  334. Nguyen VT442
  335. Nikolouzakis TK499, 500
  336. Noman EA380, 501
  337. Nriezedi CA502
  338. Nunezsamudio V503, 504
  339. Nwatah VE505, 506
  340. Odetokun IA163
  341. Okekunle AP308, 507
  342. Okonji OC508
  343. Okwute PG509, 510
  344. Olanipekun TO128
  345. Olufadewa II309, 511
  346. Olusanya BO512
  347. Omer GL513, 514
  348. Onyedibe KI515
  349. Ordak M516
  350. Orish VN24, 518
  351. Ortizprado E519
  352. Otstavnov N521
  353. Ouyahia A223, 522
  354. Mahesh Padukudru PA523
  355. Padubidri JR210
  356. Pandey A524, 525
  357. Pantazopoulos I526, 527
  358. Pardhan S528
  359. Parija PP529
  360. Parikh RR530
  361. Park S531
  362. Parthasarathi A533, 534
  363. Pasovic M1
  364. Pathan AR485, 535
  365. Patil S536, 537
  366. Pawar S12
  367. Peprah P343
  368. Perianayagam A97
  369. Perumal D539
  370. Petcu IR540
  371. Pham HN541, 542, 543
  372. Pham HT541, 542, 543
  373. Philip AK544
  374. Pigott DM1, 2
  375. Piracha ZZ545
  376. Poddighe D107, 546
  377. Polibin RV420
  378. Postma MJ67, 548
  379. Pourbabaki R314
  380. Prates EJS43
  381. Puvvula J549
  382. Qazi AS100
  383. Qian G551
  384. Rafferty Q1
  385. Rahim F552, 553
  386. Rahimi M262
  387. Rahimimovaghar V35
  388. Rahman MO427, 554, 555, 556, 557
  389. Rahman M427, 554, 555, 556, 557
  390. Rahman MA427, 554, 555, 556, 557
  391. Rahmanian M219
  392. Rahmanian N144
  393. Rahmanian V558
  394. Rahmati M559
  395. Rajput P560
  396. Ramadan MM49, 298
  397. Ramasamy SK532
  398. Ramesh PS550
  399. Rao IR282
  400. Rao M280
  401. Rao SJ561
  402. Rashedi S197, 562
  403. Rashidi MM26, 220
  404. Rathish D563
  405. Ravikumar N565
  406. Rawaf S227, 566
  407. Redwan EMM567, 568
  408. Reyes LFF569, 571
  409. Rezaei N25, 26, 572
  410. Rezaei N25, 26, 572
  411. Rezahosseini O573
  412. Rizvi SMD429
  413. Rodriguez JAB574, 575
  414. Ronfani L477
  415. Roudashti S182, 183
  416. Roy P576
  417. De Andrade Ruela G577, 578
  418. Saddik BA52, 62
  419. Saeb MR580
  420. Saeed U581, 582
  421. Saeedi P174
  422. Safari M221
  423. Saheb Sharifaskari F53
  424. Saheb Sharifaskari N49
  425. Sahebkar A175, 176
  426. Sahu M583
  427. Sakshaug JW584, 585
  428. Salam N586
  429. Salami AA370, 402
  430. Saleh MA52, 299
  431. Sallam M47, 48
  432. Samodra YL587, 588
  433. Sanjeev RK589
  434. Santricmilicevic MM186, 187
  435. Saravanan A141, 590
  436. Sartorius B2, 479, 591
  437. Sathyanarayan A278
  438. Saulam J592, 593
  439. Saxena S228
  440. Saya GK594
  441. Schaarschmidt BM356
  442. Schumacher AE1
  443. Sedighi M595
  444. Sendekie AK596
  445. Senthilkumaran S597
  446. Sethi Y598
  447. Seyedalinaghi S36
  448. Shafie M37
  449. Shahid S492, 493
  450. Shaikh MA599
  451. Sham S600
  452. Shamshirgaran MA601
  453. Shanawaz M416
  454. Shannawaz M412
  455. Sharifan A38, 39
  456. Sharifirad J602
  457. Shastry RP603
  458. Sheikh A129, 304
  459. Shigematsu M604
  460. Shiri R605
  461. Shittu A606
  462. Shiue I607, 608
  463. Shorofi SA328, 609
  464. Siddig EE78, 610
  465. Simpson CR305, 611
  466. Singh JA612, 614
  467. Singh P616
  468. Singh S136
  469. Sinto R617, 618
  470. Solanki R619, 620
  471. Soliman SSM54
  472. Suleman M105, 621
  473. Suliankatchi Abdulkader RS622
  474. Swain CK623
  475. Szarpak L613, 624
  476. Tabatabaei SM177, 178
  477. Tabish M485
  478. Taha ZMA625
  479. Taiba J626, 627
  480. Talaat IM49, 293
  481. Tamuzi JL628, 629
  482. Taye BT17
  483. Tefera YM630
  484. Temsah MH467
  485. Terefa DR631, 632
  486. Thakur R633
  487. Thapar R209
  488. Thirunavukkarasu S113
  489. Tichopad A634
  490. Ticoalu JHV635
  491. Tovanipalone MR538, 637
  492. Tran NM639
  493. Tran NH74
  494. Duc NTM640
  495. Tsegay GM641
  496. Tumurkhuu M83
  497. Udoakang AJ291
  498. Upadhyay E642
  499. Vahabi SM40
  500. Vaithinathan AG643
  501. Valizadeh R644
  502. Vasankari TJ645, 646
  503. Vinayak M273
  504. Waqas M647, 648
  505. Weldetinsaa HL161
  506. Wickramasinghe ND564
  507. Yadollahpour A286
  508. Yaghoubi S649
  509. Yezli S638
  510. Yin D636
  511. Yon DK615
  512. Yonemoto N570, 579
  513. Yu Y450
  514. Zakham F520, 547
  515. Zandieh GGZ214
  516. Zare I410
  517. Zarimeidani F319
  518. Zastrozhin M250, 254
  519. Zhai C337
  520. Zhang H215, 248
  521. Zhang ZJ456
  522. Zhao Y119
  523. Zhou J117
  524. Zia H6, 101
  525. Zielinska M517
  526. Zoladl M68
  527. Zyoud SH90
  528. Aravkin AY1, 2, 7
  529. Kassebaum NJ1, 2, 5
  530. Naghavi M1, 2
  531. Vos T1, 2
  532. Hay SI1, 2
  533. Murray CJL1, 2
  534. Kyu HH1, 2

Source: The Lancet Infectious Diseases Published:2025


Abstract

Background: Upper respiratory infections (URIs) are the leading cause of acute disease incidence worldwide and contribute to a substantial health-care burden. Although acute otitis media is a common complication of URIs, the combined global burden of URIs and otitis media has not been studied comprehensively. We used results from the Global Burden of Diseases, Injuries, and Risk Factors Study 2021 to explore the fatal and non-fatal burden of the two diseases across all age groups, including a granular analysis of children younger than 5 years, in 204 countries and territories from 1990 to 2021. Methods: Mortality due to URIs and otitis media was estimated with use of vital registration and sample-based vital registration data, which are used as inputs to the Cause of Death Ensemble model to separately model URIs and otitis media mortality by age and sex. Morbidity was modelled with a Bayesian meta-regression tool using data from published studies identified via systematic reviews, population-based survey data, and cause-specific URI and otitis media mortality estimates. Additionally, we assessed and compared the burden of otitis media as it relates to URIs and examined the collective burden and contributing risk factors of both diseases. Findings: The global number of new episodes of URIs was 12·8 billion (95% uncertainty interval 11·4 to 14·5) for all ages across males and females in 2021. The global all-age incidence rate of URIs decreased by 10·1% (–12·0 to –8·1) from 1990 to 2019. From 2019 to 2021, the global all-age incidence rate fell by 0·5% (–0·8 to –0·1). Globally, the incidence rate of URIs was 162 484·8 per 100 000 population (144 834·0 to 183 289·4) in 2021, a decrease of 10·5% (–12·4 to –8·4) from 1990, when the incidence rate was 181 552·5 per 100 000 population (160 827·4 to 206 214·7). The highest incidence rates of URIs were seen in children younger than 2 years in 2021, and the largest number of episodes was in children aged 5–9 years. The number of new episodes of otitis media globally for all ages was 391 million (292 to 525) in 2021. The global incidence rate of otitis media was 4958·9 per 100 000 (3705·4 to 6658·6) in 2021, a decrease of 16·3% (–18·1 to –14·0) from 1990, when the incidence rate was 5925·5 per 100 000 (4371·8 to 8097·9). The incidence rate of otitis media in 2021 was highest in children younger than 2 years, and the largest number of episodes was in children aged 2–4 years. The mortality rate of URIs in 2021 was 0·2 per 100 000 (0·1 to 0·5), a decrease of 64·2% (–84·6 to –43·4) from 1990, when the mortality rate was 0·7 per 100 000 (0·2 to 1·1). In both 1990 and 2021, the mortality rate of otitis media was less than 0·1 per 100 000. Together, the combined burden accounted for by URIs and otitis media in 2021 was 6·86 million (4·24 to 10·4) years lived with disability and 8·16 million (4·99 to 12·0) disability-adjusted life-years (DALYs) for all ages across males and females. Globally, the all-age DALY rate of URIs and otitis media combined in 2021 was 103 per 100 000 (63 to 152). Infants aged 1–5 months had the highest combined DALY rate in 2021 (647 per 100 000 [189 to 1412]), followed by early neonates (aged 0–6 days; 582 per 100 000 [176 to 1297]) and late neonates (aged 7–24 days; 482 per 100 000 [161 to 1052]). Interpretation: The findings of this study highlight the widespread burden posed by URIs and otitis media across all age groups and both sexes. There is a continued need for surveillance, prevention, and management to better understand and reduce the burden associated with URIs and otitis media, and research is needed to assess their impacts on individuals, communities, economies, and health-care systems worldwide. Funding: Bill & Melinda Gates Foundation. © 2025 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license
Other Related Docs