Changing Trends in the Cysticercosis–Related Disease Burden from 1990 to 2021 and its Predicted Level in 2022–2050 Years

Abstract

Background

A major worldwide health concern is cysticercosis, a zoonotic parasitic illness brought on by human parasites. This study aims to examine the current worldwide cysticercosis burden in order to serve as a resource for developing successful global control initiatives.

Methods

Five layers of data about cysticercosis were analyzed: gender, age, year, and the regional and national social and economic development index (SDI). The various groups were compared using age-standardized rates, and patterns in the burden of disease were examined and evaluated. Furthermore, from 2022 to 2050, disease patterns were predicted using the ARIMA and ES models.

Results

It was discovered that compared with 1990, the number of deaths decreased by 362 in 2021, the prevalence number increased by 1,318,963, the DALYs decreased by 151,192, and the age-standardized Mortality rate (ASMR) decreased by 0.02 per 100,000 people (EAPC − 2.39, 95% CI − 2.46 to − 2.32), the age-standardized DALY rate (ASDR) decreased by 9.14 per 100,000 people (EAPC − 1.84, 95% CI − 1.93 to − 1.75), and the age-standardized prevalence rate (ASPR) decreased by 17.18 per 100,000 people (EAPC − 1.2, 95% CI − 1.3 to − 1.1).

Conclusions

To sum up, although the prevalence of cysticercosis has dramatically declined globally over the last 30 years, it is still high in many low-SDI nations and regions. Therefore, in order to further optimize prevention and control methods and lower the burden of disease in high-burden regions and countries, it is imperative that international cooperation be strengthened.

Supplementary Information

The online version contains supplementary material available at 10.1007/s11686-025-01058-3.

Introduction

Cysticercosis is exclusively caused by Taenia solium (pork tapeworm). The infection occurs when humans ingest T. solium eggs via the fecal–oral route (e.g., contaminated water/food or poor hygiene). These eggs develop into larvae (cysticerci) that migrate to tissues like the brain, muscles, or eyes, causing symptoms such as seizures, subcutaneous nodules, or vision loss [1]. Cysticercosis is a chronic parasitic disease that seriously endangers human health and livestock production, which is becoming more and more serious and has a worldwide distribution [2, 3]. It is estimated that millions of people worldwide suffer from cysticercosis, mainly in Latin America, sub-Saharan Africa, China, India, and some regions of Asia, where the incidence is high [1, 4–10]. Not only does it pose a serious threat to the health and lives of people, but it also causes huge economic losses to livestock production, particularly in the pork industry. Infection with cysticercosis will lead to the decline of the labor ability of farmers and herdsmen, and their productivity will be lost. This situation directly results in a significant reduction in family income, which further aggravates the insufficiency of investment in children's nutrition and education [11, 12]. This situation greatly hindering the development of the endemic areas and is an important public health problem [13]. The symptoms of cysticercosis are various. For the subcutaneous and muscular types, there are subcutaneous nodules and muscle discomfort. The brain type has a variety of symptoms, such as epilepsy and high intracranial pressure. The eye type is more common among adolescent females and can lead to vision loss, periorbital redness and swelling, etc. Different parts present different symptoms [3, 13–19]. There are very few reports on the burden of cysticercosis [10, 20], and it is impossible to comprehensively and scientifically evaluate the harm of cysticercosis to human health. This study aims to analyze the global burden of cysticercosis disease, including morbidity, mortality, and DALYs, using the latest data released by the Global Burden of Disease Study (GBD) from 1990 to 2021. The study also aims to provide scientific evidence for understanding the global trend of cysticercosis and formulating strategies for the prevention and control of cysticercosis.

Materials and Methods

Data Sources

The study used number of deaths, DALYs, prevalence number, ASMR, ASPR, and ASDR as indicators to evaluate the burden of cysticercosis. All data sources were from the GBD website in 2021 (https://vizhub.healthdata.org/gbd-results/). The GBD study is a global research involving 204 countries and 370 disease-related injuries and risk factors that affect health [21]. The study period was from 1990 to 2021, and the study area was global, divided into 20 age groups from < 5 years to > 95 years. Five SDI regions, 54 GBD regions, and 204 countries and administrative regions were included.

ARIMA and ES Model Predictions

The study used the ARIMA model to predict the trend of cysticercosis-related number of deaths, DALYs, prevalence number and age-standardized rates from 2022 to 2050 [22]. The model captures the characteristics of different types of time series by adjusting the parameters (p, d, q), where p represents the autoregressive term; q represents the number of moving averages; and d represents the number of times the time series is differenced to become stationary. After the ARIMA analysis, the parameter values for males were: ASMR (0,1,1), ASDR (0,1,1), ASPR (2,2,0); number of deaths (0,1,0), DALYs (1,0,0), prevalence number (2,2,0). For females, the parameter values were: ASMR (0,1,2), ASDR (0,1,1), ASPR (1,1,1), number of deaths (0,1,1), DALYs (0,1,1), prevalence number (1,1,1). The study also used the Exponential Smoothing (ES) model for predictive analysis. The ES model estimates the future burden of cysticercosis by calculating the exponential smoothing value and combining it with a certain time series prediction [23]. Using both prediction methods together can provide a more stable and accurate prediction of the future trend of cysticercosis.

Statistical Analysis

The study examined the trends in global cysticercosis burden from 1990 to 2021, using linear regression models to estimate the annual percentage change (EAPC) for disease trends. The EAPC was calculated as 100 × [exp(β) − 1], with a 95% confidence interval (CI). When the EAPC value is positive, it is defined as an increasing trend. Conversely, it is defined as a decreasing trend. All studies used R (version 4.3.0) software for data construction, cleaning, analysis, and graphing, with p-values < 0.05 considered statistically significant.

Results

Disease Burden Caused by Cysticercosis in 2021

In 2021, 1643 deaths (95% UI 1141–2287) and an ASMR of 0.02 per 100,000 (95% UI 0.01–0.03) were caused by cysticercosis (Table 1 and Fig. 1). It produced an ASDR of 14.62 per 100,000 (95% UI 9.33–21.34) and 1,235,939 DALYs (95% UI 787,769–1,808,363) (Table 2 and Fig. 1). An ASPR of 51.27 per 100,000 (95% UI 37.17–67.28) and 4,357,190 prevalence cases (95% UI 3,150,316–5,716,430) were the outcomes (Table 3 and Fig. 1). From 1990 to 2021 the number of deaths caused by cysticercosis declined by 362, the ASMR dropped by 0.02 per 100,000, and the EAPC result was − 2.39 (95% CI − 2.46 to − 2.32) (Table 1 and Fig. 1). The DALYs rose by 151,192, the ASDR fell by 9.14/100,000 and the EAPC result was − 1.84 (95% CI − 1.93 to − 1.75) (Table 2 and Fig. 1). The prevalence number increased by 1,318,963, the ASPR reduced by 17.18/100,000, and the EAPC result was − 1.2 (95% CI − 1.3 to − 1.1) (Table 3 and Fig. 1).

Table 1.

The number of deaths cases and the age-standardized deaths rate attributable to cysticercosis in 1990 and 2021, and its trends from 1990 to 2021 globally

Characteristics	Number of deaths cases (95% UI) in 1990	The age-standardized deaths rate/100000 (95% UI) in 1990	Number of deaths cases (95% UI) in 2021	The age-standardized deaths rate/100000 (95% UI) in 2021	EAPC (95% CI)
Global	2005 (1405–2738)	0.04 (0.03–0.06)	1643 (1114–2287)	0.02 (0.01–0.03)	− 2.39 (− 2.46–2.32)
Sex
Female	979 (633–1387)	0.04 (0.03–0.06)	780 (465–1122)	0.02 (0.01–0.03)	− 2.5 (− 2.58–2.43)
Male	1026 (617–1488)	0.04 (0.03–0.06)	863 (491–1290)	0.02 (0.01–0.03)	− 2.3 (− 2.37–2.22)
Age
< 5 years	190 (63–371)	0.03 (0.01–0.06)	62 (5–145)	0.01 (0–0.02)	− 3.71 (− 3.93–3.5)
5–9 years	94 (19–196)	0.02 (0–0.03)	55 (4–121)	0.01 (0–0.02)	− 1.82 (− 2.07–1.58)
10–14 years	89 (16–195)	0.02 (0–0.04)	63 (9–137)	0.01 (0–0.02)	− 1.6 (− 1.73–1.47)
15–19 years	99 (20–216)	0.02 (0–0.04)	82 (14–188)	0.01 (0–0.03)	− 1.38 (− 1.49–1.26)
20–24 years	125 (28–251)	0.03 (0.01–0.05)	111 (25–231)	0.02 (0–0.04)	− 1.33 (− 1.51–1.15)
25–29 years	158 (37–309)	0.04 (0.01–0.07)	138 (34–265)	0.02 (0.01–0.05)	− 1.5 (− 1.69–1.31)
30–34 years	165 (45–316)	0.04 (0.01–0.08)	147 (39–288)	0.02 (0.01–0.05)	− 1.75 (− 1.88–1.62)
35–39 years	158 (38–303)	0.04 (0.01–0.09)	140 (32–288)	0.02 (0.01–0.05)	− 1.93 (− 1.98–1.87)
40–44 years	154 (39–292)	0.05 (0.01–0.1)	144 (33–285)	0.03 (0.01–0.06)	− 2.28 (− 2.41–2.15)
45–49 years	144 (33–301)	0.06 (0.01–0.13)	132 (30–278)	0.03 (0.01–0.06)	− 2.77 (− 2.87–2.68)
50–54 years	142 (29–287)	0.07 (0.01–0.14)	124 (26–261)	0.03 (0.01–0.06)	− 3.08 (− 3.19–2.97)
55–59 years	133 (26–273)	0.07 (0.01–0.15)	115 (22–251)	0.03 (0.01–0.06)	− 3.07 (− 3.21–2.93)
60–64 years	118 (22–251)	0.07 (0.01–0.16)	101 (14–220)	0.03 (0–0.07)	− 3.06 (− 3.22–2.89)
65–69 years	98 (17–219)	0.08 (0.01–0.18)	86 (12–192)	0.03 (0–0.07)	− 3.02 (− 3.2–2.84)
70–74 years	47 (3–107)	0.06 (0–0.13)	41 (1–112)	0.02 (0–0.05)	− 3.03 (− 3.12–2.94)
75–79 years	48 (2–119)	0.08 (0–0.19)	46 (2–119)	0.04 (0–0.09)	− 2.88 (− 3–2.76)
80–84 years	27 (1–70)	0.08 (0–0.2)	31 (1–88)	0.04 (0–0.1)	− 2.58 (− 2.76–2.39)
85–89 years	11 (0–33)	0.08 (0–0.22)	15 (0–41)	0.03 (0–0.09)	− 2.6 (− 2.78–2.43)
90–94 years	3 (0–9)	0.07 (0–0.21)	6 (0–17)	0.03 (0–0.09)	− 2.48 (− 2.68–2.29)
95 + years	1 (0–3)	0.08 (0–0.25)	2 (0–6)	0.04 (0–0.11)	− 2.31 (− 2.52–2.1)
SDI region
High-middle SDI	61 (39–86)	0.01 (0–0.01)	16 (10–24)	0 (0–0)	− 6.1 (− 6.24–5.95)
High SDI	10 (6–15)	0 (0–0)	4 (2–6)	0 (0–0)	− 4.13 (− 4.29–3.96)
Low-middle SDI	468 (316–628)	0.05 (0.04–0.07)	394 (262–537)	0.02 (0.01–0.03)	− 2.65 (− 2.82–2.47)
Low SDI	1038 (664–1611)	0.28 (0.17–0.42)	993 (648–1512)	0.12 (0.08–0.18)	− 2.85 (− 2.97–2.72)
Middle SDI	426 (302–567)	0.03 (0.02–0.04)	233 (149–328)	0.01 (0.01–0.01)	− 4.18 (− 4.27–4.09)
GBD region
Advanced Health System	15 (8–24)	0 (0–0)	7 (3–10)	0 (0–0)	− 3.96 (− 4.12–3.8)
Africa	1223 (799–1819)	0.26 (0.17–0.39)	1222 (807–1802)	0.12 (0.08–0.17)	− 2.69 (− 2.84–2.55)
African Region	1198 (788–1762)	0.33 (0.21–0.47)	1183 (792–1699)	0.14 (0.1–0.2)	− 2.76 (− 2.91–2.6)
America	436 (298–594)	0.06 (0.04–0.09)	304 (195–421)	0.03 (0.02–0.04)	− 2.88 (− 2.93–2.82)
Andean Latin America	49 (36–65)	0.17 (0.12–0.23)	27 (17–39)	0.04 (0.03–0.06)	− 4.73 (− 4.87–4.58)
Asia	335 (240–431)	0.01 (0.01–0.02)	112 (79–152)	0 (0–0)	− 5.62 (− 5.7–5.54)
Basic Health System	558 (394–738)	0.03 (0.02–0.04)	324 (212–451)	0.01 (0.01–0.01)	− 3.74 (− 3.82–3.66)
Caribbean	48 (36–62)	0.15 (0.11–0.2)	42 (29–57)	0.08 (0.06–0.11)	− 1.84 (− 1.96–1.72)
Central Africa	157 (113–204)	0.35 (0.25–0.46)	218 (158–289)	0.2 (0.15–0.27)	− 1.78 (− 2.13–1.43)
Central Asia	1 (0–1)	0 (0–0)	0 (0–1)	0 (0–0)	− 4.51 (− 4.85–4.17)
Central Europe	1 (1–2)	0 (0–0)	0 (0–1)	0 (0–0)	− 4.45 (− 5.11–3.8)
Central Latin America	180 (121–245)	0.15 (0.1–0.2)	122 (77–171)	0.05 (0.03–0.07)	− 3.78 (− 3.94–3.62)
Central Sub-Saharan Africa	148 (110–194)	0.4 (0.3–0.53)	166 (124–218)	0.19 (0.14–0.25)	− 2.36 (− 2.73–1.99)
Commonwealth High Income	1 (1–2)	0 (0–0)	1 (0–1)	0 (0–0)	− 4.32 (− 4.59–4.05)
Commonwealth Low Income	192 (126–262)	0.13 (0.08–0.18)	233 (155–331)	0.07 (0.05–0.1)	− 1.89 (− 2.04–1.73)
Commonwealth Middle Income	410 (268–580)	0.04 (0.03–0.06)	314 (190–444)	0.02 (0.01–0.02)	− 3.29 (− 3.51–3.08)
East Asia	138 (85–199)	0.01 (0.01–0.02)	31 (16–48)	0 (0–0)	− 7.05 (− 7.2–6.9)
East Asia & Pacific—WB	169 (113–233)	0.01 (0.01–0.01)	46 (29–64)	0 (0–0)	− 6.38 (− 6.51–6.24)
Eastern Africa	540 (331–830)	0.46 (0.28–0.71)	479 (304–721)	0.18 (0.12–0.26)	− 3.34 (− 3.47–3.22)
Eastern Europe	3 (2–5)	0 (0–0)	2 (1–3)	0 (0–0)	− 2.98 (− 3.65–2.31)
Eastern Mediterranean Region	33 (14–78)	0.01 (0–0.03)	46 (17–127)	0.01 (0–0.02)	− 1.93 (− 2.05–1.81)
Eastern Sub-Saharan Africa	660 (418–981)	0.52 (0.32–0.77)	619 (406–887)	0.22 (0.14–0.31)	− 3.05 (− 3.17–2.94)
Europe	7 (4–11)	0 (0–0)	3 (1–4)	0 (0–0)	− 3.96 (− 4.37–3.55)
Europe & Central Asia—WB	7 (4–11)	0 (0–0)	3 (2–5)	0 (0–0)	− 4.02 (− 4.41–3.62)
European Region	7 (4–12)	0 (0–0)	3 (2–5)	0 (0–0)	− 4.03 (− 4.42–3.64)
High-income Asia Pacific	1 (1–2)	0 (0–0)	0 (0–0)	0 (0–0)	− 7.08 (− 7.64–6.51)
High-income North America	5 (3–8)	0 (0–0)	3 (2–4)	0 (0–0)	− 3.22 (− 3.33–3.12)
Latin America & Caribbean—WB	432 (295–586)	0.12 (0.08–0.16)	301 (194–418)	0.04 (0.03–0.06)	− 3.34 (− 3.4–3.28)
Limited Health System	1074 (722–1511)	0.09 (0.06–0.12)	866 (579–1175)	0.03 (0.02–0.05)	− 3.31 (− 3.42–3.2)
Middle East & North Africa—WB	2 (1–3)	0 (0–0)	1 (0–1)	0 (0–0)	− 6.03 (− 6.07–5.99)
Minimal Health System	355 (217–613)	0.36 (0.23–0.59)	445 (277–765)	0.21 (0.13–0.34)	− 1.69 (− 1.89–1.5)
North Africa and Middle East	5 (3–8)	0 (0–0)	2 (1–4)	0 (0–0)	− 5.73 (− 5.83–5.63)
North America	5 (3–8)	0 (0–0)	3 (2–4)	0 (0–0)	− 3.23 (− 3.34–3.13)
Northern Africa	2 (1–3)	0 (0–0)	1 (0–1)	0 (0–0)	− 5.57 (− 5.63–5.51)
Oceania	1 (1–2)	0.03 (0.01–0.04)	2 (1–2)	0.01 (0.01–0.02)	− 1.89 (− 1.99–1.79)
Region of the Americas	436 (298–594)	0.06 (0.04–0.09)	304 (195–421)	0.03 (0.02–0.04)	− 2.88 (− 2.93–2.82)
South-East Asia Region	175 (110–246)	0.02 (0.01–0.02)	67 (40–97)	0 (0–0)	− 5.24 (− 5.4–5.07)
South Asia	163 (103–227)	0.02 (0.01–0.03)	66 (39–94)	0 (0–0.01)	− 5.13 (− 5.32–4.95)
South Asia—WB	165 (105–230)	0.02 (0.01–0.03)	67 (40–95)	0 (0–0.01)	− 5.13 (− 5.31–4.95)
Southeast Asia	31 (18–44)	0.01 (0–0.01)	13 (7–20)	0 (0–0)	− 5.05 (− 5.13–4.97)
Southern Africa	208 (145–279)	0.29 (0.2–0.39)	225 (156–303)	0.16 (0.11–0.21)	− 1.83 (− 2.15–1.5)
Southern Latin America	5 (3–7)	0.01 (0.01–0.01)	1 (1–1)	0 (0–0)	− 6.74 (− 6.94–6.54)
Southern Sub-Saharan Africa	61 (36–88)	0.15 (0.09–0.22)	76 (48–109)	0.1 (0.06–0.14)	− 0.86 (− 1.51–0.2)
Sub-Saharan Africa—WB	1222 (797–1817)	0.33 (0.21–0.49)	1221 (807–1801)	0.15 (0.1–0.21)	− 2.69 (− 2.85–2.54)
Tropical Latin America	153 (99–211)	0.13 (0.08–0.17)	111 (69–153)	0.04 (0.03–0.06)	− 3.16 (− 3.28–3.04)
Western Africa	317 (171–562)	0.24 (0.13–0.4)	300 (158–549)	0.1 (0.06–0.17)	− 2.87 (− 3.05–2.68)
Western Europe	1 (1–2)	0 (0–0)	0 (0–0)	0 (0–0)	− 4.88 (− 5.77–3.98)
Western Pacific Region	151 (98–213)	0.01 (0.01–0.02)	38 (23–56)	0 (0–0)	− 6.57 (− 6.71–6.42)
Western Sub-Saharan Africa	353 (191–623)	0.24 (0.13–0.4)	359 (190–650)	0.11 (0.06–0.18)	− 2.7 (− 2.89–2.5)
World Bank High Income	14 (8–22)	0 (0–0)	7 (4–10)	0 (0–0)	− 3.44 (− 3.57–3.31)
World Bank Low Income	828 (527–1294)	0.34 (0.21–0.52)	812 (538–1228)	0.16 (0.1–0.23)	− 2.77 (− 2.88–2.65)
World Bank Lower Middle Income	612 (402–854)	0.04 (0.03–0.06)	503 (325–701)	0.02 (0.01–0.02)	− 2.87 (− 3.03–2.72)
World Bank Upper Middle Income	549 (388–722)	0.03 (0.02–0.04)	320 (210–443)	0.01 (0.01–0.01)	− 3.39 (− 3.48–3.31)
Country
American Samoa	0 (0–0)	0 (0–0)	0 (0–0)	0 (0–0)	− 1.78 (− 2.02–1.54)
Arab Republic of Egypt	1 (1–2)	0 (0–0)	0 (0–1)	0 (0–0)	− 5.95 (− 6.1–5.81)
Argentine Republic	3 (2–5)	0.01 (0.01–0.02)	1 (0–1)	0 (0–0)	− 6.76 (− 6.96–6.55)
Barbados	0 (0–0)	0.06 (0.03–0.09)	0 (0–0)	0.02 (0.01–0.03)	− 3.44 (− 3.59–3.29)
Belize	0 (0–0)	0.15 (0.08–0.22)	0 (0–0)	0.04 (0.02–0.06)	− 4.42 (− 4.83–4.02)
Bermuda	0 (0–0)	0.04 (0.02–0.07)	0 (0–0)	0.01 (0–0.01)	− 6 (− 6.29–5.71)
Bolivarian Republic of Venezuela	14 (10–19)	0.1 (0.07–0.14)	17 (12–25)	0.06 (0.04–0.09)	− 1.69 (− 1.96–1.41)
Bosnia and Herzegovina	0 (0–0)	0 (0–0)	0 (0–0)	0 (0–0)	− 4.94 (− 5.52–4.35)
Brunei Darussalam	0 (0–0)	0 (0–0)	0 (0–0)	0 (0–0)	− 4.93 (− 5.46–4.41)
Burkina Faso	30 (13–66)	0.44 (0.2–0.91)	28 (12–60)	0.18 (0.08–0.38)	− 2.87 (− 3–2.74)
Central African Republic	10 (6–15)	0.55 (0.33–0.81)	15 (9–23)	0.4 (0.24–0.61)	− 0.99 (− 1.08–0.9)
Commonwealth of Dominica	0 (0–0)	0.15 (0.08–0.23)	0 (0–0)	0.04 (0.02–0.06)	− 4.37 (− 4.65–4.09)
Commonwealth of the Bahamas	0 (0–0)	0.06 (0.03–0.09)	0 (0–0)	0.02 (0.01–0.03)	− 4.21 (− 4.49–3.92)
Cook Islands	0 (0–0)	0 (0–0.01)	0 (0–0)	0 (0–0)	− 4.99 (− 5.4–4.58)
Democratic People's Republic of Korea	1 (0–1)	0 (0–0.01)	1 (0–1)	0 (0–0)	− 2.31 (− 2.39–2.22)
Democratic Republic of Sao Tome and Principe	0 (0–0)	0.2 (0.11–0.3)	0 (0–0)	0.07 (0.04–0.1)	− 3.88 (− 4.38–3.36)
Democratic Republic of the Congo	84 (63–109)	0.33 (0.25–0.43)	115 (84–150)	0.2 (0.14–0.26)	− 1.5 (− 1.98–1.01)
Democratic Republic of Timor-Leste	0 (0–0)	0.02 (0.01–0.03)	0 (0–0)	0.01 (0–0.01)	− 4.34 (− 4.7–3.98)
Democratic Socialist Republic of Sri Lanka	1 (1–2)	0.01 (0–0.01)	0 (0–0)	0 (0–0)	− 6.97 (− 7.2–6.75)
Dominican Republic	8 (5–12)	0.16 (0.1–0.22)	7 (4–10)	0.06 (0.04–0.09)	− 2.51 (− 2.69–2.32)
Eastern Republic of Uruguay	0 (0–0)	0 (0–0)	0 (0–0)	0 (0–0)	− 5.56 (− 6.08–5.04)
Federal Democratic Republic of Ethiopia	342 (200–558)	1.03 (0.6–1.67)	196 (117–308)	0.27 (0.17–0.43)	− 4.82 (− 5.03–4.61)
Federal Democratic Republic of Nepal	4 (2–6)	0.03 (0.02–0.04)	1 (1–2)	0.01 (0–0.01)	− 5.57 (− 5.8–5.35)
Federal Republic of Nigeria	134 (76–207)	0.19 (0.11–0.29)	120 (60–196)	0.07 (0.04–0.11)	− 3.31 (− 3.5–3.11)
Federal Republic of Somalia	22 (7–65)	0.45 (0.15–1.24)	38 (11–115)	0.31 (0.1–0.91)	− 1.4 (− 1.52–1.29)
Federated States of Micronesia	0 (0–0)	0.02 (0.01–0.03)	0 (0–0)	0.01 (0–0.01)	− 2.67 (− 2.97–2.37)
Federative Republic of Brazil	149 (97–206)	0.13 (0.08–0.17)	108 (68–149)	0.04 (0.03–0.06)	− 3.17 (− 3.29–3.04)
Gabonese Republic	2 (1–4)	0.34 (0.18–0.54)	2 (1–3)	0.11 (0.06–0.18)	− 3.69 (− 3.93–3.46)
Georgia	0 (0–0)	0 (0–0)	0 (0–0)	0 (0–0)	− 1.88 (− 2.32–1.43)
Grenada	0 (0–0)	0.19 (0.1–0.29)	0 (0–0)	0.04 (0.02–0.06)	− 4.75 (− 5.05–4.45)
Guam	0 (0–0)	0 (0–0)	0 (0–0)	0 (0–0)	− 2.99 (− 3.69–2.3)
Hellenic Republic	0 (0–0)	0 (0–0)	0 (0–0)	0 (0–0)	− 4.86 (− 5.24–4.48)
Hungary	0 (0–0)	0 (0–0)	0 (0–0)	0 (0–0)	− 6.5 (− 7.03–5.97)
Independent State of Papua New Guinea	1 (0–2)	0.03 (0.02–0.05)	1 (1–2)	0.02 (0.01–0.03)	− 2.13 (− 2.21–2.04)
Independent State of Samoa	0 (0–0)	0 (0–0.01)	0 (0–0)	0 (0–0)	− 4.43 (− 4.98–3.87)
Islamic Republic of Afghanistan	1 (1–2)	0.02 (0.01–0.03)	1 (0–1)	0 (0–0.01)	− 4.79 (− 5.14–4.44)
Islamic Republic of Pakistan	6 (3–10)	0.01 (0–0.01)	7 (4–10)	0 (0–0.01)	− 2.82 (− 3.17–2.46)
Jamaica	2 (1–3)	0.09 (0.05–0.14)	1 (1–2)	0.04 (0.02–0.07)	− 2.78 (− 3.14–2.41)
Kingdom of Bhutan	0 (0–0)	0.03 (0.02–0.04)	0 (0–0)	0.01 (0–0.01)	− 4.99 (− 5.15–4.82)
Kingdom of Cambodia	3 (2–4)	0.04 (0.02–0.06)	1 (1–2)	0.01 (0–0.01)	− 5.46 (− 5.64–5.29)
Kingdom of Eswatini	2 (1–3)	0.35 (0.18–0.55)	2 (1–3)	0.21 (0.11–0.35)	− 1.3 (− 2.14–0.46)
Kingdom of Lesotho	4 (2–5)	0.33 (0.17–0.51)	5 (3–8)	0.34 (0.19–0.53)	0.94 (0.29–1.6)
Kingdom of Morocco	0 (0–1)	0 (0–0)	0 (0–0)	0 (0–0)	− 3.92 (− 4.12–3.72)
Kingdom of Spain	1 (0–1)	0 (0–0)	0 (0–0)	0 (0–0)	− 5.85 (− 6.02–5.69)
Kingdom of Thailand	2 (1–2)	0 (0–0.01)	0 (0–1)	0 (0–0)	− 7.2 (− 7.61–6.8)
Kingdom of Tonga	0 (0–0)	0.01 (0–0.01)	0 (0–0)	0 (0–0)	− 2.52 (− 2.7–2.33)
Kyrgyz Republic	0 (0–0)	0 (0–0)	0 (0–0)	0 (0–0)	− 5.15 (− 5.7–4.6)
Lao People's Democratic Republic	1 (1–2)	0.03 (0.02–0.05)	0 (0–1)	0.01 (0–0.01)	− 5.84 (− 6.03–5.65)
Lebanese Republic	0 (0–0)	0 (0–0)	0 (0–0)	0 (0–0)	− 9.03 (− 9.47–8.6)
Malaysia	0 (0–0)	0 (0–0)	0 (0–0)	0 (0–0)	− 4.08 (− 4.36–3.8)
Mongolia	0 (0–0)	0.01 (0–0.01)	0 (0–0)	0 (0–0)	− 4.24 (− 4.61–3.86)
Montenegro	0 (0–0)	0 (0–0)	0 (0–0)	0 (0–0)	− 2.94 (− 3.31–2.56)
North Macedonia	0 (0–0)	0 (0–0)	0 (0–0)	0 (0–0)	− 4.11 (− 4.38–3.84)
Northern Mariana Islands	0 (0–0)	0 (0–0)	0 (0–0)	0 (0–0)	− 1.55 (− 2.11–1)
Palestine	0 (0–0)	0 (0–0)	0 (0–0)	0 (0–0)	− 8.61 (− 8.92–8.29)
People's Democratic Republic of Algeria	0 (0–0)	0 (0–0)	0 (0–0)	0 (0–0)	− 6.27 (− 6.4–6.14)
People's Republic of Bangladesh	7 (4–13)	0.01 (0–0.02)	3 (2–5)	0 (0–0)	− 4.72 (− 4.91–4.52)
People's Republic of China	136 (83–198)	0.01 (0.01–0.02)	30 (15–47)	0 (0–0)	− 7.11 (− 7.26–6.96)
Plurinational State of Bolivia	12 (8–18)	0.27 (0.17–0.38)	8 (5–13)	0.08 (0.05–0.12)	− 3.9 (− 3.96–3.84)
Principality of Monaco	0 (0–0)	0 (0–0)	0 (0–0)	0 (0–0)	− 3.51 (− 3.61–3.41)
Puerto Rico	0 (0–1)	0.01 (0.01–0.02)	0 (0–0)	0.01 (0–0.01)	− 3.06 (− 3.38–2.73)
Republic of Albania	0 (0–0)	0 (0–0)	0 (0–0)	0 (0–0)	− 4.65 (− 4.87–4.42)
Republic of Angola	43 (29–62)	0.6 (0.41–0.86)	26 (17–36)	0.13 (0.08–0.18)	− 5.19 (− 5.51–4.88)
Republic of Armenia	0 (0–0)	0 (0–0)	0 (0–0)	0 (0–0)	− 3.06 (− 3.33–2.78)
Republic of Austria	0 (0–0)	0 (0–0)	0 (0–0)	0 (0–0)	− 5.15 (− 5.37–4.94)
Republic of Azerbaijan	0 (0–0)	0 (0–0)	0 (0–0)	0 (0–0)	− 4.69 (− 5.13–4.24)
Republic of Belarus	0 (0–0)	0 (0–0)	0 (0–0)	0 (0–0)	− 4.31 (− 4.8–3.82)
Republic of Benin	13 (8–19)	0.38 (0.23–0.55)	15 (9–22)	0.17 (0.1–0.24)	− 2.72 (− 2.87–2.57)
Republic of Botswana	3 (1–4)	0.31 (0.16–0.52)	2 (1–4)	0.11 (0.06–0.17)	− 3.08 (− 3.34–2.82)
Republic of Burundi	16 (10–23)	0.42 (0.26–0.61)	18 (12–25)	0.21 (0.13–0.3)	− 2.78 (− 2.98–2.58)
Republic of Cabo Verde	0 (0–1)	0.17 (0.09–0.27)	0 (0–1)	0.09 (0.04–0.14)	− 2.35 (− 2.45–2.25)
Republic of Cameroon	17 (11–25)	0.24 (0.15–0.36)	26 (16–40)	0.12 (0.07–0.19)	− 2.23 (− 2.62–1.85)
Republic of Chad	18 (9–34)	0.41 (0.21–0.76)	33 (15–67)	0.3 (0.14–0.6)	− 1.13 (− 1.42–0.84)
Republic of Chile	1 (1–2)	0.01 (0.01–0.01)	0 (0–0)	0 (0–0)	− 6.84 (− 7.15–6.53)
Republic of Colombia	31 (25–37)	0.12 (0.09–0.14)	17 (11–22)	0.03 (0.02–0.04)	− 4.53 (− 4.71–4.34)
Republic of Costa Rica	1 (1–2)	0.06 (0.03–0.08)	1 (0–1)	0.01 (0.01–0.02)	− 4.66 (− 4.91–4.41)
Republic of Saint Helena	17 (9–27)	0.21 (0.11–0.33)	22 (11–36)	0.11 (0.06–0.19)	− 1.97 (− 2.3–1.64)
Republic of Croatia	0 (0–0)	0 (0–0)	0 (0–0)	0 (0–0)	− 4.85 (− 4.99–4.71)
Republic of Ecuador	10 (7–14)	0.13 (0.09–0.18)	6 (4–9)	0.03 (0.02–0.05)	− 4.48 (− 4.85–4.11)
Republic of El Salvador	9 (6–13)	0.23 (0.15–0.32)	4 (2–6)	0.07 (0.04–0.1)	− 4.15 (− 4.38–3.92)
Republic of Equatorial Guinea	2 (1–3)	0.61 (0.33–1)	1 (0–1)	0.06 (0.03–0.1)	− 8.25 (− 8.63–7.88)
Republic of Estonia	0 (0–0)	0 (0–0)	0 (0–0)	0 (0–0)	− 6.07 (− 6.32–5.83)
Republic of Fiji	0 (0–0)	0.01 (0–0.01)	0 (0–0)	0 (0–0.01)	− 2.95 (− 3.05–2.85)
Republic of Ghana	25 (16–34)	0.23 (0.15–0.32)	23 (15–33)	0.09 (0.06–0.13)	− 2.79 (− 3.09–2.5)
Republic of Guatemala	21 (15–26)	0.37 (0.27–0.48)	10 (6–14)	0.07 (0.05–0.1)	− 5.34 (− 5.61–5.06)
Republic of Guinea	14 (6–33)	0.28 (0.13–0.62)	12 (5–26)	0.13 (0.06–0.28)	− 2.21 (− 2.47–1.96)
Republic of Guinea-Bissau	4 (2–6)	0.57 (0.31–0.88)	3 (2–5)	0.23 (0.13–0.36)	− 2.89 (− 3.15–2.64)
Republic of Guyana	1 (1–2)	0.18 (0.1–0.28)	0 (0–1)	0.06 (0.03–0.09)	− 3.23 (− 3.39–3.08)
Republic of Haiti	32 (25–42)	0.67 (0.5–0.88)	31 (21–42)	0.29 (0.2–0.4)	− 2.6 (− 2.67–2.52)
Republic of Honduras	12 (8–17)	0.36 (0.24–0.52)	10 (6–15)	0.13 (0.08–0.19)	− 3.43 (− 3.51–3.35)
Republic of India	145 (92–204)	0.02 (0.01–0.03)	55 (33–78)	0 (0–0.01)	− 5.31 (− 5.5–5.11)
Republic of Indonesia	9 (5–13)	0.01 (0–0.01)	4 (2–6)	0 (0–0)	− 4.8 (− 4.88–4.71)
Republic of Kazakhstan	0 (0–0)	0 (0–0)	0 (0–0)	0 (0–0)	− 7.12 (− 7.73–6.5)
Republic of Kenya	24 (14–36)	0.17 (0.09–0.27)	40 (21–61)	0.12 (0.06–0.18)	− 0.72 (− 1.08–0.37)
Republic of Kiribati	0 (0–0)	0.02 (0.01–0.03)	0 (0–0)	0.01 (0.01–0.02)	− 1.71 (− 1.81–1.62)
Republic of Korea	1 (1–2)	0 (0–0.01)	0 (0–0)	0 (0–0)	− 8.11 (− 8.62–7.59)
Republic of Latvia	0 (0–0)	0 (0–0)	0 (0–0)	0 (0–0)	− 5.85 (− 6.21–5.49)
Republic of Liberia	7 (4–10)	0.35 (0.21–0.52)	7 (4–11)	0.18 (0.1–0.28)	− 2.52 (− 2.74–2.3)
Republic of Lithuania	0 (0–0)	0 (0–0)	0 (0–0)	0 (0–0)	− 5.33 (− 5.69–4.96)
Republic of Madagascar	41 (29–55)	0.48 (0.34–0.65)	69 (50–93)	0.35 (0.24–0.47)	− 0.87 (− 1–0.74)
Republic of Malawi	25 (17–33)	0.35 (0.23–0.48)	26 (17–37)	0.2 (0.13–0.28)	− 2.09 (− 2.44–1.74)
Republic of Mali	20 (8–51)	0.3 (0.13–0.74)	20 (8–50)	0.13 (0.06–0.31)	− 2.5 (− 2.58–2.43)
Republic of Mauritius	0 (0–0)	0 (0–0)	0 (0–0)	0 (0–0)	− 5.44 (− 5.93–4.94)
Republic of Moldova	0 (0–0)	0 (0–0.01)	0 (0–0)	0 (0–0)	− 3.26 (− 3.66–2.85)
Republic of Mozambique	54 (34–81)	0.53 (0.34–0.77)	69 (42–102)	0.36 (0.21–0.52)	− 0.78 (− 0.98–0.58)
Republic of Namibia	3 (2–5)	0.34 (0.18–0.52)	3 (2–5)	0.16 (0.09–0.26)	− 2.66 (− 3.12–2.19)
Republic of Nauru	0 (0–0)	0.01 (0.01–0.02)	0 (0–0)	0.01 (0–0.01)	− 2.28 (− 2.73–1.82)
Republic of Nicaragua	5 (3–8)	0.2 (0.13–0.3)	5 (3–7)	0.08 (0.05–0.11)	− 2.82 (− 3.01–2.63)
Republic of Niue	0 (0–0)	0.01 (0–0.01)	0 (0–0)	0 (0–0.01)	− 3.67 (− 4.03–3.3)
Republic of Palau	0 (0–0)	0 (0–0.01)	0 (0–0)	0 (0–0)	− 1.31 (− 1.76–0.86)
Republic of Panama	2 (1–3)	0.11 (0.06–0.16)	2 (1–3)	0.04 (0.02–0.06)	− 2.85 (− 3.07–2.63)
Republic of Paraguay	3 (2–5)	0.11 (0.06–0.17)	3 (2–4)	0.04 (0.03–0.07)	− 2.84 (− 2.99–2.7)
Republic of Peru	27 (20–35)	0.16 (0.12–0.21)	13 (8–18)	0.04 (0.02–0.05)	− 5.34 (− 5.64–5.04)
Republic of Poland	0 (0–1)	0 (0–0)	0 (0–0)	0 (0–0)	− 5.15 (− 5.52–4.78)
Republic of Rwanda	13 (8–18)	0.27 (0.17–0.39)	9 (5–13)	0.09 (0.05–0.14)	− 4.74 (− 5.21–4.27)
Republic of San Marino	0 (0–0)	0 (0–0)	0 (0–0)	0 (0–0)	− 4.79 (− 5.13–4.45)
Republic of Senegal	10 (5–22)	0.19 (0.09–0.39)	6 (3–11)	0.06 (0.03–0.1)	− 3.85 (− 4.06–3.63)
Republic of Serbia	0 (0–0)	0 (0–0)	0 (0–0)	0 (0–0)	− 4.09 (− 4.32–3.85)
Republic of Sierra Leone	7 (3–13)	0.21 (0.11–0.36)	7 (4–14)	0.12 (0.06–0.21)	− 1.74 (− 2.02–1.46)
Republic of South Africa	41 (24–60)	0.13 (0.07–0.19)	39 (22–55)	0.07 (0.04–0.1)	− 1.89 (− 2.6–1.18)
Republic of South Sudan	21 (13–31)	0.51 (0.31–0.78)	33 (20–51)	0.5 (0.31–0.77)	− 0.29 (− 0.54–0.03)
Republic of Sudan	1 (1–2)	0.01 (0.01–0.01)	1 (0–1)	0 (0–0)	− 4.72 (− 4.81–4.63)
Republic of Suriname	0 (0–1)	0.11 (0.06–0.17)	0 (0–0)	0.04 (0.02–0.05)	− 3.95 (− 4.2–3.71)
Republic of Tajikistan	0 (0–0)	0 (0–0)	0 (0–0)	0 (0–0)	− 4.47 (− 4.92–4.02)
Republic of the Congo	7 (4–10)	0.45 (0.25–0.69)	8 (5–13)	0.2 (0.11–0.3)	− 2.77 (− 2.96–2.57)
Republic of the Gambia	1 (1–2)	0.17 (0.09–0.26)	1 (1–2)	0.09 (0.05–0.15)	− 2.13 (− 2.32–1.94)
Republic of the Marshall Islands	0 (0–0)	0.02 (0.01–0.03)	0 (0–0)	0.01 (0–0.01)	− 2.09 (− 2.15–2.03)
Republic of the Niger	27 (9–75)	0.41 (0.16–1.06)	25 (8–71)	0.16 (0.06–0.47)	− 3.17 (− 3.35–2.98)
Republic of the Philippines	3 (1–4)	0.01 (0–0.01)	2 (1–3)	0 (0–0)	− 3.66 (− 3.8–3.52)
Republic of the Union of Myanmar	7 (4–10)	0.02 (0.01–0.03)	2 (1–4)	0 (0–0.01)	− 5.22 (− 5.38–5.06)
Republic of Trinidad and Tobago	1 (0–1)	0.08 (0.04–0.12)	0 (0–1)	0.02 (0.01–0.03)	− 5.22 (− 5.58–4.84)
Republic of Tunisia	0 (0–0)	0 (0–0)	0 (0–0)	0 (0–0)	− 6.25 (− 6.34–6.17)
Republic of Turkey	1 (0–1)	0 (0–0)	0 (0–0)	0 (0–0)	− 7.41 (− 7.57–7.24)
Republic of Uganda	23 (15–31)	0.21 (0.14–0.31)	34 (24–47)	0.13 (0.09–0.18)	− 2.25 (− 2.54–1.95)
Republic of Uzbekistan	0 (0–0)	0 (0–0)	0 (0–0)	0 (0–0)	− 4.39 (− 4.64–4.15)
Republic of Vanuatu	0 (0–0)	0.02 (0.01–0.03)	0 (0–0)	0.01 (0.01–0.01)	− 2.35 (− 2.52–2.18)
Republic of Zambia	25 (17–35)	0.48 (0.32–0.67)	28 (17–42)	0.22 (0.13–0.32)	− 3.01 (− 3.41–2.6)
Republic of Zimbabwe	9 (5–13)	0.15 (0.09–0.22)	25 (16–37)	0.23 (0.14–0.33)	2.34 (1.45–3.24)
Romania	1 (0–1)	0 (0–0)	0 (0–0)	0 (0–0)	− 4.3 (− 4.49–4.1)
Russian Federation	2 (1–4)	0 (0–0)	1 (1–2)	0 (0–0)	− 2.79 (− 3.53–2.04)
Saint Kitts and Nevis	0 (0–0)	0.16 (0.09–0.25)	0 (0–0)	0.02 (0.01–0.04)	− 6.3 (− 6.65–5.96)
Saint Lucia	0 (0–0)	0.2 (0.1–0.3)	0 (0–0)	0.03 (0.01–0.04)	− 6.65 (− 7.02–6.28)
Saint Vincent and the Grenadines	0 (0–0)	0.19 (0.1–0.28)	0 (0–0)	0.05 (0.03–0.08)	− 4.11 (− 4.33–3.89)
Slovak Republic	0 (0–0)	0 (0–0)	0 (0–0)	0 (0–0)	− 4.93 (− 5.34–4.53)
Socialist Republic of Viet Nam	6 (3–9)	0.01 (0.01–0.02)	3 (1–5)	0 (0–0)	− 4.72 (− 4.78–4.66)
Solomon Islands	0 (0–0)	0.03 (0.02–0.06)	0 (0–0)	0.02 (0.01–0.03)	− 1.9 (− 2–1.8)
State of Eritrea	14 (7–22)	0.62 (0.36–0.97)	13 (7–21)	0.27 (0.16–0.44)	− 2.79 (− 2.85–2.73)
State of Israel	0 (0–0)	0 (0–0)	0 (0–0)	0 (0–0)	− 5.62 (− 5.78–5.46)
Taiwan (Province of China)	0 (0–1)	0 (0–0)	0 (0–0)	0 (0–0)	− 7.29 (− 7.64–6.95)
Togolese Republic	8 (5–12)	0.33 (0.2–0.48)	10 (6–16)	0.17 (0.1–0.25)	− 2.02 (− 2.29–1.76)
Tokelau	0 (0–0)	0.02 (0.01–0.03)	0 (0–0)	0.01 (0–0.01)	− 4.39 (− 4.67–4.11)
Turkmenistan	0 (0–0)	0 (0–0)	0 (0–0)	0 (0–0)	− 4.37 (− 4.81–3.94)
Tuvalu	0 (0–0)	0.02 (0.01–0.03)	0 (0–0)	0.01 (0–0.01)	− 3.54 (− 3.84–3.25)
Ukraine	1 (0–1)	0 (0–0)	0 (0–1)	0 (0–0)	− 3.44 (− 4.05–2.82)
Union of the Comoros	0 (0–1)	0.16 (0.08–0.25)	1 (0–1)	0.09 (0.05–0.14)	− 2.1 (− 2.33–1.87)
United Mexican States	84 (49–124)	0.14 (0.08–0.2)	57 (33–82)	0.04 (0.02–0.06)	− 3.87 (− 4.12–3.63)
United Republic of Tanzania	39 (21–62)	0.22 (0.12–0.35)	46 (26–75)	0.11 (0.06–0.19)	− 2.17 (− 2.29–2.06)
United States of America	5 (3–8)	0 (0–0)	3 (2–4)	0 (0–0)	− 3.2 (− 3.3–3.09)
United States Virgin Islands	0 (0–0)	0.06 (0.03–0.09)	0 (0–0)	0.01 (0.01–0.02)	− 4.51 (− 4.77–4.26)

Fig. 1.

Global trends in the disease burden of cysticercosis from 1990 to 2021. (A) Trends in deaths cases and ASMR. (B) Trends in DALYs and ASDR. (C) Trends in prevalence cases and ASPR

Table 2.

The number of DALYs cases and the age-standardized DALYs rate attributable to cysticercosis in 1990 and 2021, and its trends from 1990 to 2021 globally

Characteristics	Number of DALYs cases (95% UI) in 1990	The age-standardized DALYs rate/100000 (95% UI) in 1990	Number of DALYs cases (95% UI) in 2021	The age-standardized DALYs rate/100000 (95% UI) in 2021	EAPC (95% CI)
Global	1,084,747 (703,279–1493750)	23.76 (15.36–33.12)	1,235,939 (787,769–1,808,363)	14.62 (9.33–21.34)	− 1.84 (− 1.93–1.75)
Sex
Female	585,142 (381,753–804,750)	24.87 (16.2–34.14)	679,825 (433,128–980,159)	15.6 (9.92–22.47)	− 1.8 (− 1.9–1.71)
Male	499,604 (316,843–704,580)	22.82 (14.75–32.13)	556,114 (357,195–820,470)	13.64 (8.81–20.01)	− 1.91 (− 2.01–1.81)
Age
< 5 years	16,503 (5470–32224)	2.66 (0.88–5.2)	5408 (441–12,521)	0.82 (0.07–1.9)	− 3.72 (− 3.93–3.51)
5–9 years	7961 (1772–16,409)	1.36 (0.3–2.81)	4640 (383–10,186)	0.68 (0.06–1.48)	− 1.83 (− 2.07–1.58)
10–14 years	9427 (2821–17,887)	1.76 (0.53–3.34)	6630 (1667–12,907)	0.99 (0.25–1.94)	− 1.71 (− 1.83–1.58)
15–19 years	26,373 (9056–50450)	5.08 (1.74–9.71)	19,728 (7988–36,823)	3.16 (1.28–5.9)	− 1.8 (− 1.93–1.66)
20–24 years	60,551 (28,267–108,222)	12.3 (5.74–21.99)	45,864 (21,614–78,990)	7.68 (3.62–13.23)	− 1.91 (− 2.08–1.75)
25–29 years	90,702 (41,499–164,254)	20.49 (9.38–37.11)	70,101 (33,051–124499)	11.92 (5.62–21.16)	− 2.12 (− 2.26–1.98)
30–34 years	98,919 (45,595–171,611)	25.67 (11.83–44.53)	81,762 (39,336–143,585)	13.53 (6.51–23.75)	− 2.36 (− 2.45–2.28)
35–39 years	107,129 (44,161–181,239)	30.41 (12.54–51.45)	88,689 (39,137–153,811)	15.81 (6.98–27.42)	− 2.47 (− 2.58–2.36)
40–44 years	97,303 (43,043–169710)	33.96 (15.02–59.24)	90,658 (38,954–160,789)	18.12 (7.79–32.14)	− 2.5 (− 2.64–2.35)
45–49 years	84,743 (40,278–149017)	36.5 (17.35–64.18)	90,761 (41,509–157401)	19.17 (8.77–33.24)	− 2.51 (− 2.64–2.37)
50–54 years	84,425 (42,106–140909)	39.72 (19.81–66.29)	94,497 (47,722–158,734)	21.24 (10.73–35.68)	− 2.36 (− 2.48–2.24)
55–59 years	87,993 (49,678–149,211)	47.51 (26.82–80.57)	108,293 (56,771–187,125)	27.37 (14.35–47.29)	− 2.02 (− 2.11–1.92)
60–64 years	91,505 (49,566–151,264)	56.97 (30.86–94.18)	118,899 (62,551–206,017)	37.15 (19.54–64.37)	− 1.63 (− 1.72–1.54)
65–69 years	76,768 (40,343–129233)	62.11 (32.64–104.55)	121,953 (58,947–225,620)	44.21 (21.37–81.79)	− 1.25 (− 1.33–1.17)
70–74 years	58,778 (27,749–95,359)	69.43 (32.78–112.64)	105,734 (49,978–184,671)	51.37 (24.28–89.72)	− 0.98 (− 1.03–0.92)
75–79 years	44,232 (21,649–73,504)	71.86 (35.17–119.41)	79,859 (38,084–138442)	60.55 (28.88–104.97)	− 0.78 (− 0.86–0.71)
80–84 years	25,999 (13,960–42545)	73.49 (39.46–120.26)	55,627 (27,780–93749)	63.51 (31.72–107.04)	− 0.62 (− 0.77–0.46)
85–89 years	11,041 (6004–18232)	73.06 (39.73–120.65)	29,444 (14,757–49,871)	64.4 (32.28–109.08)	− 0.54 (− 0.73–0.35)
90–94 years	3344 (1765–5625)	78.03 (41.2–131.27)	12,541 (6181–22,023)	70.1 (34.55–123.11)	− 0.4 (− 0.62–0.18)
95 + years	1050 (463–1809)	103.11 (45.45–177.66)	4852 (1983–8938)	89.02 (36.38–163.99)	− 0.35 (− 0.5–0.19)
SDI region
High-middle SDI	183,050 (112,853–270,216)	17.55 (10.89–25.99)	163,688 (93,476–270,379)	8.91 (5.13–14.47)	− 2.73 (− 2.89–2.58)
High SDI	89,490 (51,133–135,150)	8.68 (4.99–13.25)	132,161 (75,590–216564)	7.77 (4.29–12.48)	− 0.45 (− 0.82–0.08)
Low-middle SDI	273,298 (174,094–389906)	34.62 (22.29–49.12)	306,048 (200,801–434348)	19.38 (12.78–27.35)	− 1.96 (− 2.02–1.89)
Low SDI	186,780 (125,547–258,436)	56.44 (38.67–78.23)	205,653 (141,360–283695)	29.22 (20.42–40.54)	− 2.24 (− 2.34–2.15)
Middle SDI	350,799 (218,438–497,922)	27.27 (17.63–38.7)	427,044 (263,383–630,914)	15.94 (9.98–23.3)	− 2.12 (− 2.22–2.01)
GBD region
Advanced Health System	185,983 (111,913–277,612)	12.17 (7.32–18.25)	206,069 (118,070–326390)	8.81 (4.92–13.96)	− 1.16 (− 1.35–0.96)
Africa	217,106 (151,681–295,929)	51.38 (35.72–70.41)	280,174 (190,892–389463)	30.1 (21.02–41.64)	− 1.82 (− 1.95–1.69)
African Region	215,257 (150,671–292733)	64.56 (44.78–88.7)	277,633 (189,266–386,104)	37.6 (26.37–52.04)	− 1.84 (− 1.97–1.7)
America	280,294 (175,969–392,122)	42.16 (26.83–58.48)	401,258 (252,167–592,253)	32.88 (20.59–48.65)	− 0.91 (− 1.01–0.82)
Andean Latin America	28,109 (17,170–41528)	102.33 (63.03–151.8)	32,596 (18,315–53,054)	51.12 (29.13–82.35)	− 2.67 (− 2.8–2.54)
Asia	465,185 (291,634–678,661)	19.2 (12.13–27.85)	458,583 (278,721–695,803)	9.09 (5.58–13.69)	− 2.85 (− 2.98–2.72)
Basic Health System	436,554 (273,636–622,375)	24.22 (15.58–34.26)	518,875 (321,394–787,027)	14.21 (8.83–21.16)	− 2.19 (− 2.31–2.06)
Caribbean	14,422 (9650–20140)	47.41 (31.99–66.06)	18,373 (11,746–26,399)	35.82 (22.78–51.6)	− 0.93 (− 1.04–0.82)
Central Africa	39,795 (25,993–55,756)	96.25 (63.72–135.78)	58,109 (38,412–82,283)	57.87 (37.7–81.86)	− 1.54 (− 1.65–1.42)
Central Asia	6663 (3800–10570)	12.92 (7.36–20.7)	6624 (3555–11,164)	7.39 (4.01–12.56)	− 1.93 (− 1.99–1.86)
Central Europe	40,295 (24,336–60,549)	27.97 (16.94–42.33)	32,832 (17,876–52,854)	18.45 (10–29.95)	− 1.44 (− 1.5–1.39)
Central Latin America	106,159 (65,315–149,808)	90.36 (56.97–125.9)	157,382 (98,523–228,880)	60.29 (37.93–87.26)	− 1.33 (− 1.47–1.19)
Central Sub-Saharan Africa	40,273 (26,142–56,979)	118.56 (78.26–166.72)	58,930 (37,879–85,786)	71.99 (46.4–103.65)	− 1.38 (− 1.5–1.26)
Commonwealth High Income	981 (586–1487)	0.76 (0.44–1.15)	1141 (625–1893)	0.57 (0.3–0.94)	− 1.07 (− 1.14–1)
Commonwealth Low Income	36,852 (25,080–50231)	28.02 (19.18–39.51)	49,321 (33,185–69,799)	16.25 (11.06–23.33)	− 1.86 (− 2.02–1.71)
Commonwealth Middle Income	293,685 (183,116–423,164)	36.93 (23.65–52.76)	302,362 (194,044–430257)	18.23 (12.05–26.14)	− 2.46 (− 2.56–2.36)
East Asia	186,402 (114,792–276,401)	18.64 (11.84–27.56)	176,228 (101,465–284693)	8.53 (4.97–13.69)	− 3.47 (− 3.75–3.19)
East Asia & Pacific—WB	225,047 (138,234–333,703)	14.53 (9.23–21.56)	229,129 (134,038–369820)	7.27 (4.23–11.55)	− 3 (− 3.22–2.78)
Eastern Africa	65,901 (45,471–89,230)	59.14 (41.31–80.65)	70,673 (48,187–95,428)	29.05 (20.33–40.62)	− 2.5 (− 2.58–2.42)
Eastern Europe	64,335 (38,673–96,312)	24.23 (14.54–36.42)	44,322 (24,819–69,985)	14.29 (7.86–22.82)	− 2.05 (− 2.17–1.93)
Eastern Mediterranean Region	3166 (1775–5441)	1.2 (0.71–1.95)	3944 (1977–8178)	0.6 (0.32–1.15)	− 2.3 (− 2.35–2.24)
Eastern Sub-Saharan Africa	84,997 (58,634–115,876)	71.07 (50.12–97.19)	94,863 (64,603–129428)	36.36 (25.53–50.94)	− 2.36 (− 2.47–2.26)
Europe	118,797 (72,287–178,346)	12.5 (7.63–18.7)	92,950 (51,926–147,970)	7.19 (3.97–11.4)	− 1.97 (− 2.02–1.92)
Europe & Central Asia—WB	121,383 (73,672–181,806)	12.32 (7.52–18.37)	95,874 (53,925–152,236)	7.03 (3.88–11.2)	− 1.99 (− 2.04–1.93)
European Region	122,567 (74,518–183,728)	12.35 (7.55–18.42)	97,787 (54,940–155748)	7.1 (3.93–11.32)	− 1.97 (− 2.02–1.91)
High-income Asia Pacific	9205 (4423–16,853)	4.67 (2.23–8.47)	10,898 (4130–22406)	3.36 (1.23–7.17)	− 1.2 (− 1.35–1.05)
High-income North America	52,193 (28,518–83,632)	15.91 (8.71–25.4)	92,483 (52,610–150158)	16.82 (9.27–26.86)	0.17 (− 0.4–0.75)
Latin America & Caribbean—WB	230,085 (143,232–320,005)	67.21 (43.56–93.43)	310,352 (199,006–448322)	43.63 (28.02–62.88)	− 1.5 (− 1.64–1.36)
Limited Health System	406,031 (265,145–579,174)	38.63 (25.33–54.3)	434,691 (289,753–606,928)	19.62 (13.17–27.61)	− 2.34 (− 2.42–2.26)
Middle East & North Africa—WB	1187 (672–1978)	0.85 (0.47–1.48)	1921 (865–3707)	0.55 (0.25–1.06)	− 1.49 (− 1.55–1.42)
Minimal Health System	54,849 (36,148–75,422)	60.24 (40.65–82.64)	74,958 (50,491–107003)	37.66 (26.02–53.39)	− 1.44 (− 1.56–1.32)
North Africa and Middle East	1028 (652–1673)	0.47 (0.3–0.8)	892 (514–1469)	0.17 (0.1–0.28)	− 3.41 (− 3.47–3.35)
North America	52,224 (28,539–83,670)	15.92 (8.72–25.41)	92,508 (52,629–150,197)	16.83 (9.28–26.87)	0.17 (− 0.41–0.75)
Northern Africa	406 (244–691)	0.51 (0.31–0.86)	368 (192–630)	0.21 (0.11–0.34)	− 2.87 (− 3–2.73)
Oceania	1221 (685–1882)	30.13 (17.14–46.58)	1917 (1075–3110)	19.01 (11.11–30.17)	− 1.51 (− 1.54–1.48)
Region of the Americas	280,294 (175,969–392,122)	42.16 (26.83–58.48)	401,258 (252,167–592,253)	32.88 (20.59–48.65)	− 0.91 (− 1.01–0.82)
South-East Asia Region	251,274 (152,723–367,026)	28.58 (17.9–41.34)	243,183 (154,409–352733)	13.34 (8.66–19.47)	− 2.59 (− 2.69–2.49)
South Asia	233,452 (141,170–342534)	32.42 (20.3–46.89)	221,269 (139,958–320,733)	14.76 (9.49–21.41)	− 2.7 (− 2.81–2.59)
South Asia—WB	236,290 (142,623–345,838)	31.89 (19.96–46.07)	224,542 (141,722–325,709)	14.6 (9.43–21.19)	− 2.68 (− 2.79–2.57)
Southeast Asia	30,604 (19,089–46592)	9.91 (6.24–15.13)	42,442 (24,323–67,083)	6.23 (3.63–9.93)	− 1.43 (− 1.5–1.35)
Southern Africa	60,057 (40,292–83023)	93.88 (62.97–129.7)	84,765 (53,879–119,363)	65.57 (43.21–92.8)	− 1.23 (− 1.44–1.03)
Southern Latin America	13,486 (7858–20,953)	28.67 (16.81–44.45)	15,617 (7989–26,608)	19.27 (9.68–32.76)	− 1.16 (− 1.25–1.07)
Southern Sub-Saharan Africa	33,413 (21,135–47,061)	89.28 (58.09–123.48)	47,525 (29,208–67824)	66.81 (42.67–94.28)	− 1.08 (− 1.31–0.85)
Sub-Saharan Africa—WB	216,699 (151,418–295,419)	64.81 (45.03–88.94)	279,806 (190,673–388830)	38.18 (26.81–53.03)	− 1.8 (− 1.93–1.66)
Tropical Latin America	68,431 (43,256–97,633)	58.39 (38.01–82.87)	87,033 (55,080–132764)	33.92 (21.63–51.47)	− 1.91 (− 2.14–1.67)
Western Africa	50,947 (33,902–72343)	43.02 (28.97–61.37)	66,259 (41,761–95,293)	25.43 (16.4–37.64)	− 1.83 (− 2.01–1.64)
Western Europe	12,410 (6221–22,179)	2.47 (1.24–4.45)	15,607 (6958–29,522)	2.11 (0.91–3.97)	− 0.01 (− 0.22–0.2)
Western Pacific Region	206,596 (127,200–305459)	15.67 (9.94–23.11)	206,200 (118,032–333843)	7.79 (4.47–12.5)	− 3.1 (− 3.35–2.86)
Western Sub− Saharan Africa	57,648 (38,634–81,497)	44.3 (29.76–62.93)	78,105 (50,136–112896)	26.71 (17.83–39.02)	− 1.77 (− 1.96–1.58)
World Bank High Income	120,223 (70,448–184309)	10.19 (5.97–15.64)	161,207 (91,293–258,292)	8.58 (4.64–13.74)	− 0.55 (− 0.81–0.29)
World Bank Low Income	121,436 (82,009–166269)	54.08 (37.45–74.62)	138,843 (94,211–189,476)	28.82 (20.22–40.02)	− 2.13 (− 2.21–2.05)
World Bank Lower Middle Income	364,075 (231,394–517,469)	27.55 (17.69–38.75)	393,354 (257,135–556,805)	14.53 (9.66–20.77)	− 2.19 (− 2.27–2.11)
World Bank Upper Middle Income	484,253 (302,372–687596)	27.55 (17.68–38.78)	548,706 (340,038–825997)	16.84 (10.39–24.95)	− 2.08 (− 2.21–1.95)
Country
American Samoa	5 (2–8)	16.29 (8.13–27.49)	6 (3–9)	11.4 (6.05–18.62)	− 0.96 (− 1.08–0.83)
Arab Republic of Egypt	300 (169–532)	0.85 (0.48–1.5)	267 (125–488)	0.35 (0.17–0.63)	− 2.67 (− 2.85–2.48)
Argentine Republic	7114 (3575–12,116)	22.3 (11.32–37.97)	7898 (3534–14,970)	14.97 (6.62–28.35)	− 1.21 (− 1.3–1.12)
Barbados	150 (81–245)	56.08 (29.83–92.42)	150 (72–276)	34.8 (16.95–64.17)	− 1.66 (− 1.74–1.59)
Belize	77 (43–119)	62.79 (35.06–95.49)	163 (79–274)	43.73 (21.7–73.75)	− 1.51 (− 1.68–1.34)
Bermuda	33 (17–57)	49.78 (25.17–85.9)	26 (11–52)	24.11 (9.53–47.28)	− 2.43 (− 2.54–2.32)
Bolivarian Republic of Venezuela	11,763 (6168–19,286)	86.67 (46.79–140.65)	16,530 (8045–28675)	56.4 (27.46–95.75)	− 1.33 (− 1.43–1.22)
Bosnia and Herzegovina	975 (494–1813)	21.49 (11.03–39.24)	845 (364–1635)	15.95 (6.89–30.86)	− 1.51 (− 1.66–1.35)
Brunei Darussalam	5 (2–9)	3.27 (1.57–5.88)	7 (3–13)	1.52 (0.68–2.89)	− 2.2 (− 2.39–2.01)
Burkina Faso	2960 (1735–5133)	45.84 (27.61–71.68)	3217 (1870–4956)	23.18 (14–36.36)	− 2.29 (− 2.43–2.16)
Central African Republic	2547 (1581–3664)	140.75 (88.34–194.71)	3534 (2176–5131)	97.38 (60.77–139.52)	− 1.13 (− 1.23–1.03)
Commonwealth of Dominica	52 (29–81)	86.16 (48.63–137.85)	46 (24–76)	57.97 (29.82–96.85)	− 1.51 (− 1.62–1.4)
Commonwealth of the Bahamas	123 (60–213)	61.69 (32.02–104.11)	154 (74–288)	36.04 (17.2–66.35)	− 1.93 (− 2.03–1.83)
Cook Islands	2 (1–3)	14.32 (7.67–25.28)	2 (1–4)	8.44 (3.72–15.29)	− 1.6 (− 1.66–1.54)
Democratic People's Republic of Korea	3387 (1726–5867)	18.5 (9.68–31.67)	2420 (1169–4291)	7.44 (3.58–13.15)	− 3.07 (− 3.14–3)
Democratic Republic of Sao Tome and Principe	65 (40–98)	83.5 (51.68–122.58)	87 (45–138)	58.61 (31.7–93.49)	− 1.39 (− 1.59–1.19)
Democratic Republic of the Congo	24,149 (15,289–34,727)	104.19 (65.65–151.69)	34,541 (20,870–51110)	62.77 (38.1–93.29)	− 1.32 (− 1.46–1.17)
Democratic Republic of Timor-Leste	135 (74–216)	32.11 (17.85–50.31)	135 (71–236)	14.43 (7.78–25.21)	− 2.6 (− 2.69–2.52)
Democratic Socialist Republic of Sri Lanka	2747 (1401–4539)	21.22 (11.4–35.19)	3197 (1495–5589)	12.3 (5.78–21.27)	− 1.89 (− 1.96–1.81)
Dominican Republic	2933 (1774–4418)	56.98 (34.42–86.18)	5176 (2766–8589)	48.24 (25.85–80.39)	−0.39 (−0.48–0.3)
Eastern Republic of Uruguay	1057 (510–1831)	30.67 (14.65–53.95)	1250 (570–2319)	27.17 (12.34–50.96)	−0.15 (−0.27–0.04)
Federal Democratic Republic of Ethiopia	32,098 (21,493–44,645)	94.89 (64.3–131.23)	23,045 (15,445–31,212)	34.05 (23.31–46.8)	−3.71 (−3.84–3.58)
Federal Democratic Republic of Nepal	8591 (4725–13,716)	69.89 (39.38–108.68)	11,364 (5905–18828)	44.19 (23.62–73.05)	−1.24 (−1.45–1.03)
Federal Republic of Nigeria	21,100 (13,870–31229)	34.52 (22.77–52.05)	23,046 (14,560–34360)	16.95 (10.66–25.95)	−2.42 (−2.69–2.14)
Federal Republic of Somalia	1231 (361–3680)	19.5 (6.35–56.24)	2009 (551–6069)	12.91 (3.94–38.93)	−1.53 (−1.65–1.42)
Federated States of Micronesia	17 (9–27)	27.75 (14.58–45.08)	14 (7–24)	16.51 (8.94–27.07)	−1.74 (−1.76–1.72)
Federative Republic of Brazil	66,936 (42,410–95446)	58.53 (37.96–83.04)	84,937 (53,722–129,709)	33.96 (21.63–51.57)	−1.91 (−2.15–1.67)
Gabonese Republic	989 (541–1526)	147.08 (81.16–227.8)	1002 (532–1657)	77.46 (41.15–126.31)	−2.14 (−2.26–2.02)
Georgia	2040 (992–3561)	33.13 (16.1–57.68)	1328 (645–2334)	25.55 (12.47–45.29)	−0.51 (−0.79–0.22)
Grenada	58 (33–90)	82.93 (47.88–129.28)	53 (27–87)	46.9 (23.32–77.19)	−1.75 (−1.93–1.57)
Guam	11 (6–19)	11.52 (6.02–20.07)	16 (8–30)	8.2 (3.82–15.24)	−1.03 (−1.17–0.88)
Hellenic Republic	2120 (905–4213)	15.82 (6.56–30.94)	1915 (713–3862)	10.46 (4.08–20.91)	−1.23 (−1.35–1.12)
Hungary	4589 (2025–7847)	34.82 (15.6–60.44)	2927 (1207–5882)	18.98 (7.77–38.14)	−2.12 (−2.2–2.05)
Independent State of Papua New Guinea	828 (439–1340)	33.04 (17.41–52.53)	1452 (780–2457)	20.25 (11.2–33.43)	−1.62 (−1.65–1.58)
Independent State of Samoa	39 (20–65)	38.66 (20.93–63.58)	37 (19–62)	22.62 (11.87–38.16)	−1.64 (−1.7–1.58)
Islamic Republic of Afghanistan	91 (56–137)	1.2 (0.72–1.8)	76 (45–119)	0.41 (0.25–0.66)	−3.67 (−3.87–− 3.47)
Islamic Republic of Pakistan	1132 (689–1861)	1.6 (0.96–2.66)	1229 (732–1945)	0.76 (0.44–1.26)	− 2.46 (− 2.62–2.3)
Jamaica	1031 (578–1699)	54.49 (30.46–89.35)	1162 (552–2115)	37.27 (17.73–67.78)	− 1.32 (− 1.53–1.11)
Kingdom of Bhutan	188 (103–299)	51.36 (30.31–76.76)	218 (111–367)	31.99 (16.42–53.5)	− 1.85 (− 1.99–1.71)
Kingdom of Cambodia	1498 (829–2340)	25.73 (14.5–39.99)	1844 (968–3057)	13.27 (7.05–21.77)	− 2.27 (− 2.31–2.24)
Kingdom of Eswatini	484 (295–700)	104.3 (63.51–149.99)	745 (431–1168)	89.25 (52.66–138.7)	− 0.51 (− 0.91–0.1)
Kingdom of Lesotho	822 (501–1149)	76.94 (47–109.41)	1337 (810–1964)	91.21 (55.03–133.5)	0.81 (0.52–1.11)
Kingdom of Morocco	44 (27–68)	0.24 (0.15–0.39)	39 (21–69)	0.11 (0.06–0.19)	− 2.69 (− 2.78–2.6)
Kingdom of Spain	7865 (3421–15,285)	16.33 (7.19–31.89)	10,457 (3747–22,107)	13.01 (4.68–26.92)	− 0.06 (− 0.34–0.21)
Kingdom of Thailand	4070 (2065–7099)	9.78 (5.1–17.41)	8692 (3710–16343)	8.72 (3.77–16.04)	− 0.37 (− 0.42–0.33)
Kingdom of Tonga	14 (7–23)	22.25 (11.68–36.64)	12 (6–21)	14.24 (6.99–25.18)	− 1.53 (− 1.6–1.46)
Kyrgyz Republic	64 (30–117)	1.92 (0.87–3.5)	76 (32–140)	1.3 (0.57–2.33)	− 1.5 (− 1.72–1.29)
Lao People's Democratic Republic	951 (524–1470)	37.38 (20.79–57.91)	932 (471–1498)	16.89 (9.26–27.79)	− 2.63 (− 2.69–2.58)
Lebanese Republic	90 (43–167)	3.8 (1.87–7.11)	93 (37–186)	1.52 (0.61–3.07)	− 3.04 (− 3.12–2.95)
Malaysia	154 (81–265)	1.33 (0.69–2.31)	254 (120–452)	0.83 (0.39–1.46)	− 1.64 (− 1.74–1.54)
Mongolia	653 (350–1082)	48.69 (26.64–80.17)	1237 (601–2065)	41.05 (20.39–68)	− 0.79 (− 0.96–0.63)
Montenegro	122 (51–243)	18.84 (7.89–37.58)	117 (49–225)	13.37 (5.49–25.8)	− 1.38 (− 1.49–1.26)
North Macedonia	498 (228–898)	24.77 (11.45–43.71)	458 (186–887)	14.38 (5.84–27.74)	− 2.22 (− 2.38–2.06)
Northern Mariana Islands	4 (2–7)	12.78 (6.11–22.1)	4 (2–8)	8.11 (3.77–15.05)	− 1.3 (− 1.37–1.22)
Palestine	5 (3–9)	0.47 (0.26–0.89)	6 (3–11)	0.17 (0.08–0.32)	− 3.44 (− 3.5–3.37)
People's Democratic Republic of Algeria	54 (30–89)	0.35 (0.19–0.59)	54 (24–102)	0.13 (0.06–0.26)	− 3.14 (− 3.32–2.97)
People's Republic of Bangladesh	937 (568–1470)	1.4 (0.8–2.25)	687 (365–1267)	0.48 (0.25–0.91)	− 3.61 (− 3.68–3.54)
People's Republic of China	180,788 (111,398–267,668)	18.75 (11.94–27.67)	170,848 (98,670–275981)	8.56 (4.99–13.71)	− 3.51 (− 3.8–3.22)
Plurinational State of Bolivia	4487 (2658–6574)	102.42 (61.7–151.44)	4916 (2857–7997)	47.57 (27.17–77.77)	− 2.6 (− 2.82–2.39)
Principality of Monaco	9 (4–17)	15.91 (6.81–32.3)	10 (4–21)	13.75 (5.44–29.17)	− 0.4 (− 0.44–0.36)
Puerto Rico	1935 (915–3269)	53.75 (25.21–90.21)	1529 (644–2723)	27.81 (11.16–50.93)	− 2.63 (− 2.79–2.47)
Republic of Albania	62 (27–114)	2.45 (1.1–4.54)	57 (22–118)	1.53 (0.61–3.08)	− 1.87 (− 1.97–1.77)
Republic of Angola	10,197 (6405–14578)	157.04 (96.7–223.08)	16,287 (9324–24,874)	93.09 (54.13–144.68)	− 1.55 (− 1.64–1.45)
Republic of Armenia	859 (402–1460)	28.2 (13.7–47.91)	641 (274–1202)	15.79 (6.7–29.27)	− 2.35 (− 2.54–2.15)
Republic of Austria	1717 (770–3384)	16.78 (7.72–33.5)	1750 (679–4007)	11.66 (4.42–25.1)	− 1.38 (− 1.47–1.28)
Republic of Azerbaijan	27 (15–48)	0.46 (0.25–0.85)	36 (17–68)	0.32 (0.16–0.59)	− 1.43 (− 1.63–1.23)
Republic of Belarus	3538 (1601–6376)	29.31 (13.22–52.33)	1951 (813–3870)	13.93 (5.66–27.36)	− 2.58 (− 2.88–2.28)
Republic of Benin	3297 (1972–4715)	108.49 (64.91–155.56)	5659 (3350–8625)	72.08 (43.19–111.23)	− 1.62 (− 1.81–1.43)
Republic of Botswana	814 (490–1233)	99.29 (60.58–150.8)	1607 (866–2584)	79.71 (42.95–128.83)	− 0.95 (− 1.18–0.73)
Republic of Burundi	3019 (1892–4363)	87.2 (53.83–127.63)	3621 (2289–5383)	45.92 (29.34–68.47)	− 2.7 (− 2.92–2.47)
Republic of Cabo Verde	271 (153–410)	107.74 (62.32–161.88)	408 (216–663)	78.93 (41.83–128.22)	− 1.3 (− 1.47–1.14)
Republic of Cameroon	4969 (3171–7179)	79.53 (49.98–114.93)	8737 (5272–13,276)	47.67 (28.68–71.21)	− 1.85 (− 2.07–1.63)
Republic of Chad	1664 (983–2717)	38.32 (23.3–60.04)	3021 (1715–5159)	28.48 (17.07–45.53)	− 1.03 (− 1.26–0.8)
Republic of Chile	5314 (2548–9262)	45.66 (22.39–79.05)	6469 (2826–12,427)	27.26 (11.74–52.38)	− 1.49 (− 1.61–1.36)
Republic of Colombia	11,596 (7066–17465)	46.43 (28.41–71.22)	12,303 (5931–22,350)	22.44 (10.86–40.88)	− 2.34 (− 2.42–2.27)
Republic of Costa Rica	1303 (674–2182)	57.92 (30.55–94.66)	2090 (975–3823)	38.52 (17.97–70.7)	− 1.29 (− 1.41–1.18)
Republic of Saint Helena	6388 (3577–9760)	94.22 (53.81–139.09)	11,237 (5933–17,736)	67.8 (37.59–105)	− 1.29 (− 1.42–1.15)
Republic of Croatia	2723 (1304–5259)	45.14 (21.69–86.97)	1671 (667–3211)	24.48 (9.94–48.49)	− 2.04 (− 2.29–1.8)
Republic of Ecuador	5641 (3369–8618)	81.82 (49–125.48)	7755 (3998–13,531)	44.98 (23.36–78.81)	− 2.11 (− 2.18–2.05)
Republic of El Salvador	2748 (1634–4131)	70.63 (41.83–105.72)	2699 (1409–4749)	42.61 (22.26–76.16)	− 1.75 (− 1.86–1.65)
Republic of Equatorial Guinea	361 (223–523)	132.68 (83.83–188.92)	569 (293–965)	72.84 (38.69–120.88)	− 1.74 (− 1.94–1.54)
Republic of Estonia	569 (252–1036)	30.06 (13.48–55.29)	475 (198–948)	23.76 (10.02–47.73)	− 0.68 (− 0.97–0.39)
Republic of Fiji	108 (52–187)	21.38 (11.22–36.66)	119 (59–202)	13.98 (7.07–23.19)	− 1.39 (− 1.41–1.37)
Republic of Ghana	6185 (3904–9083)	66.38 (41.66–97.7)	11,111 (6268–17,529)	49.66 (27.92–79.61)	− 0.94 (− 1.1–0.78)
Republic of Guatemala	7459 (4445–11,339)	132.32 (81.16–194.53)	10,057 (5461–16,618)	73.8 (40.33–122.59)	− 1.95 (− 2.1–1.81)
Republic of Guinea	1111 (575–2264)	21.49 (12.54–38.39)	985 (552–1748)	10.69 (6.36–18.16)	− 2.17 (− 2.33–2.01)
Republic of Guinea-Bissau	427 (261–616)	66.27 (42.47–97.19)	354 (217–528)	28.99 (17.9–43.49)	− 2.82 (− 2.99–2.64)
Republic of Guyana	434 (251–667)	80.54 (47.42–123.3)	415 (211–675)	57.82 (30.33–93.22)	− 1.25 (− 1.31–1.18)
Republic of Haiti	5959 (3918–8309)	126.63 (80.86–174.51)	7473 (4654–11,067)	70.8 (43.49–104.47)	− 1.84 (− 1.93–1.75)
Republic of Honduras	3800 (2335–5735)	117.37 (72.45–176.81)	5728 (3196–9113)	70.77 (39.23–110.01)	− 1.79 (− 1.88–1.7)
Republic of India	222,605 (134,724–327,497)	38.92 (24.27–56.07)	207,770 (130,390–300775)	17.32 (11.02–25.13)	− 2.79 (− 2.91–2.67)
Republic of Indonesia	1063 (690–1504)	0.79 (0.52–1.13)	1002 (588–1592)	0.38 (0.23–0.61)	− 2.45 (− 2.51–2.39)
Republic of Kazakhstan	2888 (1205–5489)	20.68 (8.94–39.36)	3080 (1301–6103)	15.85 (6.93–31.21)	− 1.21 (− 1.39–1.02)
Republic of Kenya	7256 (4684–10,335)	60.66 (39.43–85.79)	11,689 (7397–17,022)	37.59 (24.28–54.93)	− 1.39 (− 1.53–1.25)
Republic of Kiribati	15 (8–26)	30.9 (16.08–51.1)	18 (9–30)	19.27 (10.11–31.83)	− 1.55 (− 1.58–1.52)
Republic of Korea	9200 (4418–16,846)	24.93 (12.27–44.71)	10,892 (4126–22,398)	12.82 (4.82–26.85)	− 2.28 (− 2.38–2.18)
Republic of Latvia	867 (371–1560)	26.69 (11.31–48.23)	614 (251–1210)	21.28 (8.44–41.96)	− 1.01 (− 1.2–0.81)
Republic of Liberia	1961 (1188–2945)	117.89 (70.76–174.82)	2377 (1367–3722)	67.66 (39.45–103.79)	− 1.79 (− 1.84–1.74)
Republic of Lithuania	1383 (634–2681)	32.72 (15.01–63.12)	996 (437–1890)	23.45 (10.21–45.12)	− 1.13 (− 1.25–1)
Republic of Madagascar	5873 (3920–8262)	74.82 (47.13–106.45)	8564 (5970–12114)	45.59 (30.97–65.75)	− 1.59 (− 1.68–1.5)
Republic of Malawi	4457 (2930–6342)	72.5 (45.85–105.49)	4614 (2929–6843)	39.57 (25.24–59.78)	− 2.16 (− 2.38–1.95)
Republic of Mali	1235 (503–3061)	15.99 (7.4–37.2)	1282 (531–3037)	7.42 (3.6–15.79)	− 2.52 (− 2.62–2.42)
Republic of Mauritius	166 (84–296)	19.19 (10.1–33.55)	249 (119–459)	14.51 (7.17–26.27)	− 0.8 (− 0.87–0.73)
Republic of Moldova	1601 (824–2868)	35.06 (18.03–62.36)	856 (372–1544)	16.32 (7.1–29.29)	− 2.85 (− 3.04–2.66)
Republic of Mozambique	7648 (5147–10,618)	83.38 (53.43–116.7)	10,685 (6837–15,812)	60.27 (38.63–89.61)	− 0.95 (− 1.16–0.73)
Republic of Namibia	862 (541–1291)	95.64 (59.82–139.62)	1266 (695–1941)	69.54 (38.15–107.86)	− 1.2 (− 1.43–0.96)
Republic of Nauru	2 (1–3)	28.6 (14.93–47.11)	1 (1–2)	15.05 (8.19–25.03)	− 2.04 (− 2.08–2.01)
Republic of Nicaragua	2012 (1188–3148)	83.21 (50.2–126.76)	2680 (1414–4675)	45.65 (23.83–77.53)	− 2.05 (− 2.12–1.98)
Republic of Niue	1 (0–1)	27 (14.97–42.99)	0 (0–1)	17.37 (9.29–29.3)	− 1.35 (− 1.46–1.25)
Republic of Palau	2 (1–4)	17.88 (9.54–30.97)	3 (1–5)	11.09 (5.8–19.34)	− 1.4 (− 1.47–1.34)
Republic of Panama	1056 (576–1713)	56.82 (30.61–92.3)	2079 (1047–3621)	47.1 (23.65–82.24)	− 0.47 (− 0.53–0.42)
Republic of Paraguay	1495 (828–2303)	52.48 (29.4–79.7)	2096 (1036–3475)	31.97 (15.79–52.53)	− 1.75 (− 1.8–1.7)
Republic of Peru	17,980 (10,284–27646)	111.61 (65.15–169.47)	19,925 (9615–35,955)	55.22 (26.93–99.34)	− 2.86 (− 3.06–2.66)
Republic of Poland	14,339 (8640–21780)	33.61 (20.07–50.89)	14,462 (7900–23769)	25.08 (13.7–40.73)	− 0.93 (− 1.02–0.83)
Republic of Rwanda	3288 (2062–4811)	77.09 (46.1–114.34)	3046 (1718–4812)	35.14 (21.18–54.05)	− 3.08 (− 3.24–2.91)
Republic of San Marino	4 (2–8)	12.73 (5.11–25.13)	5 (2–11)	9.73 (4.02–19.87)	− 0.98 (− 1.08–0.88)
Republic of Senegal	658 (307–1447)	10.14 (5.48–19.63)	396 (231–635)	3.35 (1.99–5.34)	− 3.63 (− 3.84–3.41)
Republic of Serbia	4202 (2019–7627)	36.94 (17.83–65.71)	3274 (1409–6322)	23.55 (10.05–45.8)	− 1.58 (− 1.64–1.51)
Republic of Sierra Leone	618 (346–1055)	18.96 (11.63–29.44)	653 (372–1045)	10.59 (6.2–16.71)	− 1.93 (− 2.13–1.73)
Republic of South Africa	24,397 (15,000–35521)	86 (53.74–123.09)	32,364 (19,271–46,591)	59.38 (35.88–85.46)	− 1.42 (− 1.66–1.17)
Republic of South Sudan	1567 (1017–2203)	35.68 (23.56–49.23)	2182 (1406–3218)	29.26 (19.47–41.93)	− 0.78 (− 0.96–0.6)
Republic of Sudan	265 (157–422)	2.11 (1.22–3.6)	218 (113–388)	0.79 (0.4–1.4)	− 3.29 (− 3.34–3.24)
Republic of Suriname	241 (135–387)	78.61 (43.91–125.37)	348 (179–612)	55.25 (28.7–96.27)	− 1.1 (− 1.22–0.98)
Republic of Tajikistan	28 (14–50)	0.85 (0.42–1.57)	41 (20–79)	0.55 (0.27–1.03)	− 1.66 (− 1.77–1.55)
Republic of the Congo	2031 (1214–3046)	137.19 (81.32–202.87)	2997 (1734–4638)	80.32 (48.42–125.35)	− 1.82 (− 1.89–1.74)
Republic of the Gambia	70 (37–113)	9.24 (5.68–13.4)	86 (49–128)	4.83 (2.84–7.16)	− 2.29 (− 2.47–2.11)
Republic of the Marshall Islands	5 (3–9)	23.39 (12.61–38.76)	7 (3–12)	14.77 (7.74–24.23)	− 1.5 (− 1.6–1.4)
Republic of the Niger	1803 (540–5019)	21.4 (8.04–55.79)	1444 (477–4140)	7.58 (2.87–20.75)	− 3.55 (− 3.73–3.38)
Republic of the Philippines	6473 (3956–9910)	17.59 (10.97–26.7)	9628 (5664–14,834)	10.79 (6.63–16.67)	− 1.52 (− 1.57–1.48)
Republic of the Union of Myanmar	7552 (4123–12,250)	26.56 (15.25–43.32)	7696 (3964–12,930)	14.62 (7.72–24.62)	− 1.98 (− 2.03–1.92)
Republic of Trinidad and Tobago	665 (372–1045)	67.74 (38.12–107.65)	795 (377–1395)	44.49 (21.31–77.8)	− 1.48 (− 1.55–1.41)
Republic of Tunisia	8 (5–13)	0.14 (0.08–0.21)	7 (3–13)	0.05 (0.03–0.1)	− 3.19 (− 3.3–3.09)
Republic of Turkey	170 (98–265)	0.4 (0.23–0.64)	131 (59–263)	0.14 (0.06–0.28)	− 3.35 (− 3.45–3.25)
Republic of Uganda	6137 (3599–9182)	64.12 (37.62–97)	8812 (5100–13257)	38.38 (22.77–59.01)	− 2 (− 2.19–1.81)
Republic of Uzbekistan	83 (44–141)	0.6 (0.31–1.05)	149 (69–289)	0.47 (0.22–0.92)	− 1.34 (− 1.59–1.1)
Republic of Vanuatu	27 (14–45)	31.64 (17–51.19)	40 (21–66)	17.84 (9.46–29.5)	− 1.83 (− 1.86–1.79)
Republic of Zambia	4343 (2852–6300)	93.71 (60.37–139.93)	5655 (3372–8659)	49.13 (28.76–78.06)	− 2.33 (− 2.56–2.1)
Republic of Zimbabwe	6035 (3675–9135)	104.25 (62.17–161.49)	10,206 (6150–15246)	98.66 (60.17–146.45)	− 0.07 (− 0.29–0.16)
Romania	10,019 (5271–17,052)	37.58 (19.8–63.87)	6442 (2640–12484)	21.76 (9.2–41.48)	− 2 (− 2.15–1.86)
Russian Federation	38,196 (22,929–56,472)	21.74 (13.08–32.24)	27,164 (15,511–43,295)	12.39 (6.89–19.57)	− 2.16 (− 2.28–2.05)
Saint Kitts and Nevis	38 (20–59)	108.17 (57.79–170.01)	34 (15–62)	47.78 (22.95–84.15)	− 2.84 (− 3.06–2.63)
Saint Lucia	94 (55–149)	94.17 (54.46–147.29)	106 (53–186)	46.79 (23.82–82.13)	− 2.48 (− 2.71–2.25)
Saint Vincent and the Grenadines	65 (37–104)	79.97 (45.83–125)	72 (37–126)	54.04 (27.92–93.25)	− 1.43 (− 1.53–1.32)
Slovak Republic	2123 (1004–3648)	36.76 (17.42–63.29)	2100 (847–4190)	25.82 (10.36–51.25)	− 1.07 (− 1.15–0.99)
Socialist Republic of Viet Nam	5751 (3129–9444)	12.65 (6.91–20.77)	8754 (4048–15731)	8.52 (4.08–15.18)	− 1.04 (− 1.29–0.8)
Solomon Islands	61 (33–100)	33 (18.24–53.5)	98 (50–171)	20.5 (10.82–34.82)	− 1.56 (− 1.6–1.53)
State of Eritrea	1480 (967–2124)	72.25 (47.25–103.42)	1696 (1053–2557)	38.17 (23.97–58.44)	− 2.27 (− 2.39–2.15)
State of Israel	685 (309–1248)	14.48 (6.47–26.23)	1455 (558–3045)	13.09 (5.08–27.62)	− 0.31 (− 0.39–0.22)
Taiwan (Province of China)	2227 (1028–4023)	12.82 (6.09–22.56)	2960 (1137–5738)	7.73 (3.01–14.89)	− 1.52 (− 1.71–1.33)
Togolese Republic	2861 (1704–4278)	130.23 (78.38–193.97)	4006 (2255–6215)	71.99 (41.99–111.53)	− 2.04 (− 2.18–1.9)
Tokelau	0 (0–0)	20.04 (10.53–33.21)	0 (0–0)	9.17 (4.91–15.73)	− 2.49 (− 2.53–2.45)
Turkmenistan	22 (11–37)	0.94 (0.49–1.61)	34 (15–62)	0.73 (0.33–1.29)	− 1.03 (− 1.1–0.96)
Tuvalu	2 (1–3)	21.13 (11.45–34.86)	1 (1–2)	11.73 (6.15–19.96)	− 1.9 (− 1.93–1.87)
Ukraine	18,182 (9147–30,922)	28.81 (14.39–49.14)	12,265 (5779–22,637)	19.24 (8.87–35.09)	− 1.69 (− 1.82–1.57)
Union of the Comoros	27 (13–44)	7.17 (3.6–11.55)	27 (15–41)	3.8 (2.14–5.82)	− 2.3 (− 2.61–1.99)
United Mexican States	64,422 (39,854–94,145)	108.72 (68.35–157.34)	103,216 (63,787–151,247)	77.25 (48.05–113.06)	− 1.14 (− 1.31–0.98)
United Republic of Tanzania	6512 (4008–9334)	40.81 (24.58–60.05)	9135 (5883–13,808)	24.56 (15.62–37.37)	− 1.64 (− 1.8–1.48)
United States of America	52,192 (28,517–83,630)	17.63 (9.65–28.14)	92,481 (52,609–150156)	18.83 (10.39–30.06)	0.2 (− 0.37–0.78)
United States Virgin Islands	47 (25–78)	48.39 (26.11–79.9)	47 (23–85)	32.85 (16.3–59.25)	− 1.34 (− 1.41–1.26)

Table 3.

The number of prevalence cases and the age-standardized prevalence rate attributable to cysticercosis in 1990 and 2021, and its trends from 1990 to 2021 globally

Characteristics	Number of prevalence cases (95% UI) in 1990	The age-standardized prevalence rate/100000 (95% UI) in 1990	Number of prevalence cases (95% UI) in 2021	The age-standardized prevalence rate/100000 (95% UI) in 2021	EAPC (95% CI)
Global	3,038,227 (2,125,499–3,980,434)	68.45 (48.91–88.57)	4,357,190 (3,150,316–5716430)	51.27 (37.17–67.28)	− 1.2 (− 1.3–1.1)
sex
Female	1,671,128 (1,194,734–2,186,012)	72.43 (52.77–92.77)	2,449,939 (1,796,822–3,162,527)	55.51 (40.32–71.86)	− 1.14 (− 1.25–1.04)
Male	1,367,100 (936,893–1,823,486)	64.89 (46.02–84.58)	1,907,251 (1,358,890–2561228)	46.91 (33.7–63.14)	− 1.29 (− 1.4–1.19)
Age
5–9 years	335 (87–939)	0.06 (0.01–0.16)	261 (65–744)	0.04 (0.01–0.11)	− 1.48 (− 1.6–1.36)
10–14 years	6530 (1950–15255)	1.22 (0.36–2.85)	5146 (1472–12,154)	0.77 (0.22–1.82)	− 1.58 (− 1.7–1.45)
15–19 years	51,745 (18,986–112,789)	9.96 (3.66–21.71)	42,024 (14,984–90,326)	6.73 (2.4–14.48)	− 1.56 (− 1.7–1.41)
20–24 years	143,877 (65,688–268,365)	29.24 (13.35–54.54)	121,214 (54,687–229,473)	20.3 (9.16–38.43)	− 1.59 (− 1.75–1.43)
25–29 years	230,454 (102,797–427862)	52.07 (23.22–96.67)	201,521 (88,943–372,136)	34.25 (15.12–63.25)	− 1.73 (− 1.87–1.6)
30–34 years	263,280 (125,156–473,127)	68.31 (32.47–122.76)	249,834 (119,811–455,883)	41.33 (19.82–75.42)	− 1.95 (− 2.04–1.86)
35–39 years	295,985 (123,749–480,595)	84.03 (35.13–136.44)	284,584 (120,081–464276)	50.74 (21.41–82.78)	− 2.02 (− 2.14–1.9)
40–44 years	274,550 (119,687–473,484)	95.84 (41.78–165.28)	299,596 (127,677–531,565)	59.89 (25.52–106.26)	− 1.99 (− 2.14–1.84)
45–49 years	240,365 (112,159–392,103)	103.52 (48.3–168.87)	310,549 (143,814–530,941)	65.59 (30.37–112.13)	− 1.9 (− 2.06–1.74)
50–54 years	245,391 (136,302–389765)	115.44 (64.12–183.36)	334,518 (182,503–544315)	75.19 (41.02–122.34)	− 1.69 (− 1.83–1.55)
55–59 years	261,774 (143,298–397,803)	141.35 (77.37–214.8)	396,330 (216,939–630,018)	100.15 (54.82–159.2)	− 1.31 (− 1.41–1.21)
60–64 years	282,715 (160,365–424033)	176.03 (99.85–264.02)	446,641 (245,792–695,265)	139.55 (76.8–217.24)	− 0.95 (− 1.03–0.87)
65–69 years	243,747 (133,750–383248)	197.19 (108.2–310.05)	470,963 (255,401–804446)	170.74 (92.59–291.63)	− 0.61 (− 0.69–0.54)
70–74 years	193,995 (97,893–299,996)	229.14 (115.63–354.35)	422,916 (206,656–675637)	205.46 (100.4–328.24)	− 0.38 (− 0.45–0.31)
75–79 years	151,902 (77,628–228,953)	246.77 (126.11–371.95)	325,646 (161,367–516,995)	246.92 (122.35–392.01)	− 0.21 (− 0.31–0.12)
80–84 years	92,840 (51,894–138,555)	262.44 (146.69–391.67)	235,210 (127,972–357,817)	268.56 (146.11–408.55)	− 0.07 (− 0.25–0.12)
85–89 years	41,261 (22,991–62,242)	273.05 (152.15–411.9)	129,716 (70,461–200578)	283.71 (154.11–438.69)	0.01 (− 0.21–0.23)
90–94 years	13,121 (7270–20454)	306.19 (169.66–477.32)	57,483 (31,079–93008)	321.32 (173.73–519.9)	0.12 (− 0.12–0.37)
95 + years	4362 (2097–7275)	428.43 (205.94–714.54)	23,039 (10,517–39812)	422.72 (192.96–730.46)	0.06 (− 0.11–0.23)
sex
Female	62,486,337 (50,400,556–75171103)	2284.05 (1841.1–2755)	70,079,922 (49,689,738–93,022,715)	1795.23 (1269.64–2372.76)	− 0.58 (− 0.9–0.27)
Male	74,048,147 (60,698,477–87372607)	2662.98 (2186.16–3142.23)	81,296,823 (59,293,551–105,565,420)	2030.97 (1485.87–2643.59)	− 0.67 (− 1.01–0.34)
SDI region
High-middle SDI	639,470 (446,136–855,406)	61.68 (43.68–81.98)	711,508 (495,374–966,074)	38.51 (27.22–52.35)	− 1.96 (− 2.09–1.84)
High SDI	369,711 (259,159–484,516)	35.73 (24.81–47.31)	638,844 (454,787–853,712)	36.98 (26.46–49.62)	0.01 (− 0.41–0.43)
Low-middle SDI	691,167 (490,772–898172)	91.57 (68.62–115.29)	952,149 (697,384–1,224,726)	62.06 (46.59–78.07)	− 1.34 (− 1.41–1.27)
Low SDI	337,289 (232,686–444,046)	116.95 (85.35–148.01)	458,729 (320,588–605616)	73.55 (54.89–93.47)	− 1.59 (− 1.66–1.53)
Middle SDI	996,556 (679,957–1,331,136)	79.85 (58.59–102.58)	1,591,281 (1,143,957–2,091,592)	59.62 (43.88–77.93)	− 1.31 (− 1.4–1.21)
GBD region
Advanced Health System	737,877 (517,821–958,034)	48.15 (33.56–63.24)	970,862 (694,716–1,285,259)	40.9 (29.3–54.3)	− 0.61 (− 0.84–0.38)
Africa	404,703 (274,641–536,202)	109.16 (80.91–137.9)	657,851 (454,434–873,144)	77.54 (56.85–98.45)	− 1.2 (− 1.3–1.09)
African Region	403,464 (273,820–534378)	138.11 (102.42–174.22)	656,338 (453,467–870,672)	97.9 (71.98–124.26)	− 1.2 (− 1.32–1.09)
America	868,048 (610,782–1150894)	132.21 (94.87–173.08)	1,561,906 (1,147,974–1,988,138)	126.35 (91.96–161.93)	− 0.28 (− 0.44–0.12)
Andean Latin America	74,536 (56,709–93110)	279.83 (218.65–344.63)	118,801 (89,038–150771)	187.42 (142.28–235.29)	− 1.74 (− 1.87–1.61)
Asia	1,303,156 (894,194–1,729,759)	55.18 (39.84–71.4)	1,708,704 (1,224,577–2,253,971)	33.94 (24.45–44.79)	− 1.99 (− 2.11–1.87)
Basic Health System	1,256,582 (854,529–1,683,883)	71.65 (51.71–93.39)	1,954,402 (1,389,732–2,605,420)	53.43 (38.44–70.48)	− 1.4 (− 1.52–1.28)
Caribbean	35,403 (25,075–44468)	120.28 (86.75–150.01)	54,588 (39,869–69,310)	105.26 (76.08–134.15)	− 0.52 (− 0.58–0.45)
Central Africa	82,257 (58,923–105,506)	217.91 (165.39–268.55)	136,187 (97,834–174,094)	147.65 (112.93–180.43)	− 1.15 (− 1.21–1.09)
Central Asia	22,538 (14,881–31,705)	44.11 (29–62.22)	25,167 (16,535–36,634)	28.38 (19.26–40.76)	− 1.43 (− 1.48–1.38)
Central Europe	147,491 (102,758–193076)	102.2 (70.58–134.65)	147,111 (103,948–195430)	81.76 (56.28–110.1)	− 0.82 (− 0.86–0.77)
Central Latin America	295,933 (198,692–394,358)	261.05 (188.31–335.01)	562,969 (410,577–708799)	216.42 (160.27–271.4)	− 0.65 (− 0.74–0.55)
Central Sub-Saharan Africa	83,491 (58,525–106,781)	268.23 (205.41–329.89)	147,075 (104,657–189855)	191.35 (144.1–234.99)	− 0.85 (− 0.95–0.75)
Commonwealth High Income	3003 (2075–3978)	2.29 (1.56–3.07)	4217 (3004–5552)	2.06 (1.42–2.75)	− 0.41 (− 0.49–0.34)
Commonwealth Low Income	70,282 (48,441–95,312)	61.17 (44.98–80.17)	111,612 (76,502–152299)	39.48 (28.96–52.57)	− 1.6 (− 1.75–1.44)
Commonwealth Middle Income	757,938 (534,190–996031)	100.01 (75.01–126.1)	976,194 (710,661–1260417)	60.9 (45.63–77.28)	− 1.76 (− 1.85–1.67)
East Asia	546,981 (367,924–751,496)	55.85 (39.35–75.22)	725,883 (494,719–1,018,980)	35.01 (24.21–48.69)	− 2.4 (− 2.66–2.14)
East Asia & Pacific—WB	659,633 (442,743–908,549)	43.38 (30.33–58.48)	920,408 (626,043–1279291)	29.06 (20.03–40.4)	− 2.02 (− 2.23–1.81)
Eastern Africa	95,410 (62,833–130,586)	104.21 (74.66–135.57)	138,207 (95,077–188700)	66.5 (48.81–87.58)	− 1.62 (− 1.69–1.54)
Eastern Europe	242,704 (172,243–320,915)	91.26 (64.34–120.99)	191,119 (136,087–254707)	61.03 (43.69–80.57)	− 1.55 (− 1.62–1.48)
Eastern Mediterranean Region	3769 (2273–6253)	1.8 (1.13–2.99)	4541 (2861–7015)	0.84 (0.56–1.36)	− 2.45 (− 2.49–2.41)
Eastern Sub-Saharan Africa	127,050 (83,659–173,855)	129.21 (92.51–167.34)	186,229 (126,441–256,036)	83.32 (61.14–110.27)	− 1.61 (− 1.71–1.5)
Europe	450,715 (316,264–592,274)	47.23 (32.95–62.48)	416,813 (299,773–543,797)	31.78 (22.53–42.09)	− 1.4 (− 1.43–1.36)
Europe & Central Asia—WB	459,214 (321,399–602,904)	46.42 (32.27–61.34)	427,873 (306,176–561049)	30.98 (22.02–41.08)	− 1.42 (− 1.46–1.38)
European Region	463,877 (324,556–609,276)	46.55 (32.35–61.5)	436,729 (312,433–573,125)	31.28 (22.24–41.5)	− 1.4 (− 1.43–1.36)
High-income Asia Pacific	32,664 (22,152–43,932)	16.55 (11.11–22.5)	53,394 (37,527–73,170)	16.11 (10.89–22.91)	− 0.23 (− 0.28–0.18)
High-income North America	233,396 (167,077–306345)	70.85 (50.57–93.87)	455,787 (325,721–606,980)	81.85 (57.54–108.68)	0.43 (− 0.17–1.04)
Latin America & Caribbean—WB	642,043 (439,357–851,419)	193.2 (140.46–249.66)	1,113,144 (821,864–1,412,347)	156.55 (116.45–198.06)	− 0.81 (− 0.93–0.69)
Limited Health System	948,996 (669,707–1241291)	96.96 (72.32–122.01)	1,279,996 (935,684–1,662,247)	60.77 (45.84–76.94)	− 1.64 (− 1.71–1.57)
Middle East & North Africa—WB	4054 (2787–5786)	3.1 (2.18–4.35)	8427 (5788–11,748)	2.47 (1.73–3.49)	− 0.78 (− 0.88–0.68)
Minimal Health System	90,738 (63,818–118,654)	116.95 (87.48–146.98)	147,252 (103,345–191781)	84.63 (63.85–105.63)	− 1 (− 1.07–0.93)
North Africa and Middle East	2101 (1280–3302)	1.05 (0.67–1.66)	2621 (1656–3956)	0.5 (0.34–0.75)	− 2.41 (− 2.48–2.34)
North America	233,511 (167,156–306,506)	70.88 (50.59–93.91)	455,904 (325,807–607131)	81.86 (57.55–108.7)	0.43 (− 0.17–1.04)
Northern Africa	842 (506–1325)	1.13 (0.7–1.78)	1109 (692–1738)	0.63 (0.4–0.94)	− 1.91 (− 2.05–1.78)
Oceania	3242 (2070–4497)	82.84 (57.46–111.72)	5369 (3392–7765)	54.96 (37.61–76.66)	− 1.39 (− 1.42–1.37)
Region of the Americas	868,048 (610,782–1150894)	132.21 (94.87–173.08)	1,561,906 (1,147,974–1,988,138)	126.35 (91.96–161.93)	− 0.28 (− 0.44–0.12)
South-East Asia Region	671,537 (480,259–882383)	79.24 (59.7–99.75)	833,949 (607,321–1079211)	46.64 (34.79–59.6)	− 1.81 (− 1.92–1.71)
South Asia	621,656 (447,803–812895)	89.54 (67.74–112.41)	755,683 (551,993–972,079)	51.57 (38.06–65.69)	− 1.92 (− 2.03–1.81)
South Asia—WB	630,106 (453,194–824,687)	88.18 (66.79–110.74)	768,058 (560,565–989300)	51.08 (37.8–64.96)	− 1.9 (− 2–1.79)
Southeast Asia	84,188 (57,804–118186)	28.3 (20.15–38.73)	145,177 (99,878–206,135)	21.67 (15.27–30.21)	− 0.77 (− 0.84–0.69)
Southern Africa	137,313 (92,432–178,914)	231.7 (167.42–290.18)	230,475 (160,117–296068)	188.36 (140.86–235.93)	− 0.78 (− 0.94–0.62)
Southern Latin America	45,968 (32,016–60334)	97.95 (68.72–127.8)	65,461 (46,768–85,880)	80.41 (56.76–106.69)	− 0.53 (− 0.59–0.48)
Southern Sub-Saharan Africa	90,696 (61,400–117986)	250.78 (181.36–314.16)	144,431 (101,226–183711)	208.32 (155.27–258.39)	− 0.76 (− 0.93–0.59)
Sub-Saharan Africa—WB	403,861 (274,066–535078)	138.14 (102.51–174.32)	656,742 (453,703–871325)	99.21 (73.06–125.8)	− 1.16 (− 1.27–1.05)
Tropical Latin America	191,525 (130,042–259401)	169.01 (122.49–223.34)	313,300 (225,480–409454)	122.02 (88.69–159.66)	− 1.26 (− 1.51–1.01)
Western Africa	88,882 (58,798–124,070)	89.67 (64.59–118.19)	151,874 (101,166–208562)	66.02 (47.51–87.67)	− 1.13 (− 1.31–0.95)
Western Europe	54,984 (39,285–72,996)	10.84 (7.66–14.71)	79,324 (58,303–105209)	10.51 (7.5–14.21)	0.37 (0.17–0.57)
Western Pacific Region	607,742 (408,849–834590)	46.84 (32.69–63.27)	838,801 (571,517–1,167,020)	31.46 (21.7–43.94)	− 2.09 (− 2.32–1.85)
Western Sub-Saharan Africa	101,682 (69,230–139848)	92.94 (68.14–120.92)	177,701 (121,380–240539)	68.98 (50.14–91.17)	− 1.11 (− 1.29–0.93)
World Bank High Income	499,746 (348,960–650017)	41.16 (28.43–54.24)	787,889 (563,412–1,045,250)	40.47 (29.1–53.97)	− 0.07 (− 0.38–0.25)
World Bank Low Income	183,181 (123,094–246143)	102.25 (73.78–130.32)	262,181 (180,702–353963)	66 (48.38–84.99)	− 1.47 (− 1.52–1.42)
World Bank Lower Middle Income	965,070 (683,289–1,261,216)	74.25 (55.52–93.71)	1,277,048 (937,728–1,672,505)	47.14 (35.35–59.99)	− 1.58 (− 1.65–1.52)
World Bank Upper Middle Income	1,386,187 (949,890–1847544)	83.43 (60.06–108.82)	2,025,383 (1,443,957–2,693,815)	63.68 (45.86–84.21)	− 1.34 (− 1.46–1.22)
Country
American Samoa	15 (9–22)	51.09 (34.84–74.93)	19 (12–27)	38.17 (25.95–53.09)	− 0.76 (− 0.9–0.62)
Arab Republic of Egypt	636 (379–1010)	1.92 (1.21–2.99)	809 (494–1273)	1.08 (0.7–1.62)	− 1.8 (− 1.97–1.63)
Argentine Republic	23,823 (17,259–31,112)	74.75 (54.28–97.67)	31,250 (22,318–41,341)	58.99 (42.03–79.17)	− 0.71 (− 0.76–0.66)
Barbados	506 (364–672)	187.58 (134.25–251.43)	590 (428–773)	134.94 (97.13–177.79)	− 1.21 (− 1.28–1.13)
Belize	212 (151–272)	178.71 (132.21–223.73)	545 (384–701)	148.49 (108.53–187.72)	− 0.92 (− 1.07–0.76)
Bermuda	120 (83–159)	182.16 (128.28–238.51)	125 (89–168)	111.76 (77.86–148.39)	− 1.74 (− 1.81–1.67)
Bolivarian Republic of Venezuela	34,467 (22,601–48177)	260.62 (183.71–350.29)	57,938 (40,016–75819)	196.99 (138.52–257.73)	− 0.81 (− 0.88–0.73)
Bosnia and Herzegovina	3524 (2289–4880)	78.16 (52.01–107.32)	3771 (2491–5346)	70.46 (46.72–98.92)	− 0.73 (− 0.86–0.6)
Brunei Darussalam	16 (10–25)	10.73 (7.1–15.97)	24 (15–35)	5.81 (3.83–8.53)	− 1.76 (− 1.92–1.6)
Burkina Faso	3442 (2441–4780)	73.4 (51.16–103.99)	5007 (3635–7047)	46.1 (33.05–66.94)	− 1.66 (− 1.87–1.45)
Central African Republic	4915 (3533–6222)	290.94 (221.57–348.37)	6954 (4984–8819)	207 (161.82–249.86)	− 1.02 (− 1.12–0.92)
Commonwealth of Dominica	153 (109–200)	256.86 (179.69–334.43)	152 (107–201)	193.08 (134.61–254.83)	− 1.13 (− 1.2–1.05)
Commonwealth of the Bahamas	380 (248–525)	194.1 (133.37–256.92)	547 (378–748)	128.34 (90.57–174.55)	− 1.45 (− 1.52–1.39)
Cook Islands	7 (4–9)	47.3 (31.95–67.05)	8 (5–11)	33.91 (22.98–48.42)	− 1.03 (− 1.07–1)
Democratic People's Republic of Korea	10,070 (6753–14,121)	55.64 (38.08–76.78)	8298 (5729–11,493)	25.55 (17.58–35.28)	− 2.65 (− 2.71–2.58)
Democratic Republic of Sao Tome and Principe	158 (114–200)	214.16 (160.77–262.84)	270 (188–350)	188.29 (142.64–232.1)	− 0.63 (− 0.78–0.47)
Democratic Republic of the Congo	51,674 (36,641–67,192)	242.2 (184.18–300.41)	83,244 (60,072–106785)	161.66 (123.12–197.68)	− 0.98 (− 1.13–0.84)
Democratic Republic of Timor-Leste	339 (227–469)	84.48 (62.16–108.72)	404 (277–583)	43.98 (30.92–61.89)	− 2.1 (− 2.19–2.01)
Democratic Socialist Republic of Sri Lanka	8372 (5541–11,956)	66.17 (45.96–93.82)	12,279 (8259–17,902)	47.26 (32.7–67.3)	− 1.15 (− 1.23–1.08)
Dominican Republic	7266 (5002–9355)	147.69 (108.72–184.42)	16,876 (12,330–21610)	158.44 (115.39–201)	0.27 (0.25–0.29)
Eastern Republic of Uruguay	3807 (2697–4932)	109.87 (76.5–144.08)	5361 (3963–7083)	115.28 (81.66–156.33)	0.37 (0.29–0.45)
Federal Democratic Republic of Ethiopia	33,094 (20,398–45692)	125.45 (85.29–165.82)	39,260 (26,635–54,030)	71.54 (51.07–94.41)	− 2.1 (− 2.21–2)
Federal Democratic Republic of Nepal	22,456 (16,442–28,765)	187.68 (142.71–232.18)	37,551 (27,406–47473)	147.77 (110.65–183.76)	− 0.53 (− 0.73–0.32)
Federal Republic of Nigeria	36,609 (23,268–53,364)	72.45 (47.97–105.82)	49,953 (31,879–73,575)	43.75 (29.36–63.79)	− 1.73 (− 2.01–1.45)
Federal Republic of Somalia	15 (9–21)	0.42 (0.29–0.64)	32 (19–49)	0.35 (0.24–0.52)	− 0.71 (− 0.73–0.69)
Federated States of Micronesia	44 (28–65)	74.55 (50.78–103.89)	42 (27–60)	49.35 (33.77–69.47)	− 1.34 (− 1.37–1.32)
Federative Republic of Brazil	187,319 (127,061–253721)	169.43 (122.64–223.86)	306,109 (220,350–399587)	122.23 (88.93–159.76)	− 1.26 (− 1.51–1.01)
Gabonese Republic	2438 (1703–3184)	372.91 (267.46–477.49)	3075 (2145–4183)	245.1 (173.31–326.93)	− 1.44 (− 1.51–1.36)
Georgia	7429 (5051–10169)	120.66 (82.51–164.65)	5173 (3637–6937)	98.51 (68.72–131.78)	− 0.37 (− 0.65–0.08)
Grenada	163 (119–210)	234.61 (170.27–296.15)	188 (136–246)	166 (121.31–215.28)	− 1.12 (− 1.25–1)
Guam	38 (24–57)	39.66 (26.73–57.9)	60 (40–89)	30.37 (20.51–44.28)	− 0.86 (− 0.94–0.77)
Hellenic Republic	9772 (7017–13217)	72.52 (51.16–98.63)	9557 (7098–12851)	51.13 (36.68–69.02)	− 1.03 (− 1.12–0.94)
Hungary	17,342 (11,946–23,028)	130.78 (89.22–173.96)	13,329 (9337–17,440)	85.31 (59.28–113.08)	− 1.65 (− 1.73–1.57)
Independent State of Papua New Guinea	2157 (1382–2986)	89.41 (61.96–119.21)	3992 (2519–5778)	57.65 (39.44–80.68)	− 1.51 (− 1.54–1.47)
Independent State of Samoa	115 (79–154)	116.06 (82.02–152.62)	119 (79–164)	74.55 (51.4–101.03)	− 1.41 (− 1.46–1.35)
Islamic Republic of Afghanistan	79 (45–135)	1.14 (0.66–1.92)	97 (54–154)	0.63 (0.38–1.01)	− 1.96 (− 1.99–1.94)
Islamic Republic of Pakistan	2140 (1308–3564)	3.37 (2.07–5.62)	2525 (1589–3989)	1.75 (1.1–2.94)	− 2.05 (− 2.14–1.96)
Jamaica	3248 (2379–4096)	172.78 (126.84–214.81)	4177 (3089–5315)	133.62 (98.26–170.52)	− 0.86 (− 1.01–0.72)
Kingdom of Bhutan	480 (346–656)	136.74 (104.72–169.96)	737 (543–954)	109.47 (83.08–138.09)	− 0.96 (− 1.07–0.85)
Kingdom of Cambodia	3535 (2330–4981)	64.21 (45.42–87.28)	5578 (3735–8203)	41.07 (28.69–58.45)	− 1.54 (− 1.59–1.49)
Kingdom of Eswatini	1101 (764–1423)	254.55 (190.57–312.25)	1980 (1297–2614)	248.6 (179.83–310.31)	− 0.16 (− 0.45–0.14)
Kingdom of Lesotho	1805 (1345–2243)	176.4 (136.76–215.13)	3112 (2218–3948)	221.95 (166.29–274.65)	0.85 (0.66–1.04)
Kingdom of Morocco	69 (42–111)	0.43 (0.26–0.7)	99 (62–157)	0.27 (0.17–0.43)	− 1.52 (− 1.56–1.48)
Kingdom of Spain	34,514 (24,537–46,275)	71.18 (50.38–95.8)	53,816 (39,216–71,864)	65.74 (47.11–89.36)	0.38 (0.13–0.63)
Kingdom of Thailand	12,825 (8387–18,723)	31.55 (21.5–44.73)	33,882 (22,981–48,676)	33.79 (23.66–47.92)	0.27 (0.22–0.33)
Kingdom of Tonga	42 (27–58)	68.83 (46.9–93.95)	40 (27–55)	47.12 (32.2–65.61)	− 1.3 (− 1.37–1.22)
Kyrgyz Republic	192 (119–298)	5.84 (3.66–8.86)	265 (164–402)	4.58 (2.98–6.82)	− 1.03 (− 1.21–0.84)
Lao People's Democratic Republic	2222 (1502–3026)	90.35 (65.38–118.69)	2723 (1844–3911)	50.58 (35.3–69.69)	− 1.96 (− 1.99–1.93)
Lebanese Republic	300 (196–458)	12.9 (8.64–19.52)	387 (261–573)	6.36 (4.27–9.45)	− 2.35 (− 2.39–2.31)
Malaysia	421 (269–636)	3.81 (2.54–5.58)	837 (541–1242)	2.78 (1.88–4.1)	− 1.1 (− 1.17–1.03)
Mongolia	1800 (1205–2377)	135.99 (93.92–178.17)	4237 (2810–5774)	142.01 (97.99–186.58)	0.04 (− 0.07–0.14)
Montenegro	507 (346–693)	78.56 (53.61–106.87)	540 (366–748)	61.15 (42.1–84.61)	− 0.9 (− 0.96–0.84)
North Macedonia	1763 (1141–2440)	88.08 (58.09–121.67)	1945 (1272–2766)	60.96 (41.16–86.03)	− 1.54 (− 1.64–1.45)
Northern Mariana Islands	13 (7–19)	43.61 (29.59–62.84)	16 (10–24)	29.62 (20.08–42.74)	− 1.23 (− 1.29–1.18)
Palestine	12 (7–19)	1.17 (0.74–1.88)	19 (12–29)	0.58 (0.38–0.85)	− 2.47 (− 2.53–2.41)
People's Democratic Republic of Algeria	121 (73–189)	0.84 (0.53–1.3)	178 (112–266)	0.44 (0.29–0.65)	− 2.09 (− 2.24–1.95)
People's Republic of Bangladesh	1416 (898–2275)	2.68 (1.66–4.52)	1836 (1165–3114)	1.36 (0.88–2.25)	− 2.41 (− 2.47–2.35)
People's Republic of China	528,727 (355,785–727,094)	56 (39.43–75.54)	704,575 (480,310–990299)	35.19 (24.27–49)	− 2.42 (− 2.7–2.15)
Plurinational State of Bolivia	10,216 (7691–12,928)	244.02 (185.51–300.27)	14,952 (11,184–19,267)	147.19 (111.59–191.25)	− 1.77 (− 2.01–1.53)
Principality of Monaco	40 (28–54)	72.6 (50.64–99.35)	51 (36–73)	68.67 (47.96–97.9)	− 0.16 (− 0.2–0.13)
Puerto Rico	7235 (5125–9565)	200.98 (142.91–266.97)	6831 (5007–8897)	121.28 (87.48–159.33)	− 2.05 (− 2.2–1.91)
Republic of Albania	203 (125–300)	8.19 (5.23–12.33)	242 (156–371)	6.35 (4.09–9.25)	− 1.06 (− 1.2–0.93)
Republic of Angola	19,370 (13,121–24,806)	333.96 (253.31–409.1)	44,075 (30,306–58296)	265.08 (193.93–336.79)	− 0.59 (− 0.67–0.5)
Republic of Armenia	2983 (2175–3895)	98.69 (71.97–128.69)	2637 (1784–3588)	64.62 (43.84–87.52)	− 1.78 (− 1.94–1.61)
Republic of Austria	7693 (5411–10,177)	74.6 (52.5–99.39)	8890 (6427–12,106)	58.22 (40.85–77.66)	− 1.03 (− 1.1–0.95)
Republic of Azerbaijan	65 (41–98)	1.16 (0.76–1.77)	116 (73–186)	1.02 (0.66–1.58)	− 0.48 (− 0.62–0.33)
Republic of Belarus	13,313 (9243–17,776)	109.96 (74.69–145.91)	8717 (6124–11,759)	61.74 (43.01–81.72)	− 2 (− 2.24–1.75)
Republic of Benin	6692 (4681–8753)	247 (181.29–306.1)	14,258 (9676–18,538)	195.78 (144.31–244.49)	− 1.11 (− 1.32–0.9)
Republic of Botswana	1895 (1348–2423)	244.83 (185.41–297.71)	4776 (3293–6018)	243.9 (177.39–302.06)	− 0.28 (− 0.48–0.07)
Republic of Burundi	5339 (3547–7461)	175.6 (123.36–232.55)	7362 (4852–10,009)	104.91 (75.62–136.35)	− 2.32 (− 2.56–2.08)
Republic of Cabo Verde	759 (568–940)	305.28 (235.07–365.09)	1434 (1070–1792)	280.64 (216.48–343.1)	− 0.5 (− 0.65–0.35)
Republic of Cameroon	10,981 (8406–13754)	193.03 (149.15–234.39)	22,367 (16,700–28816)	132.76 (101.82–165.78)	− 1.43 (− 1.61–1.26)
Republic of Chad	1659 (1089–2415)	53.77 (36.01–78.41)	3189 (2096–4673)	44.53 (30.47–65.37)	− 0.68 (− 0.84–0.52)
Republic of Chile	18,336 (12,278–24,362)	158.8 (109.07–209.38)	28,847 (20,295–38350)	121.09 (84.4–162.48)	− 0.71 (− 0.79–0.63)
Republic of Colombia	31,582 (24,263–39,798)	132.42 (103.76–167.34)	46,480 (36,224–59,171)	84.51 (65.67–107.58)	− 1.42 (− 1.49–1.36)
Republic of Costa Rica	4467 (3023–6139)	202.16 (142.96–269.49)	8658 (6258–11,597)	159.35 (114.93–213)	− 0.76 (− 0.85–0.66)
Republic of Saint Helena	14,872 (9520–20454)	239.21 (169.75–304.97)	30,248 (19,424–40,718)	193.64 (135.16–246.53)	− 0.87 (− 0.96–0.78)
Republic of Croatia	11,215 (7783–14,784)	185.86 (128.05–245.16)	7991 (5694–10,708)	115.41 (80.22–158.24)	− 1.56 (− 1.77–1.35)
Republic of Ecuador	15,280 (12,038–19243)	229.57 (185.25–288.38)	28,020 (21,020–36453)	163.53 (122.84–211.88)	− 1.35 (− 1.42–1.28)
Republic of El Salvador	6629 (4506–8784)	177.68 (125.64–229.84)	9701 (7054–12648)	153.24 (110.02–198.78)	− 0.67 (− 0.72–0.61)
Republic of Equatorial Guinea	675 (463–862)	270.3 (198.25–331.63)	1813 (1162–2553)	243.26 (173.95–331.32)	0.04 (− 0.32–0.39)
Republic of Estonia	2180 (1528–2873)	114.76 (80.2–151.9)	2205 (1524–3067)	108.85 (75.03–151.58)	− 0.01 (− 0.29–0.26)
Republic of Fiji	308 (184–467)	62.85 (42.21–90.39)	370 (241–539)	43.97 (30.17–62.03)	− 1.22 (− 1.24–1.2)
Republic of Ghana	13,435 (9074–17614)	158.86 (114.41–197.81)	31,029 (21,157–41,036)	145.6 (105.79–186.81)	− 0.35 (− 0.48–0.23)
Republic of Guatemala	17,061 (12,085–22483)	316.47 (234.5–393.66)	31,812 (23,345–41,063)	236.8 (176.22–297.94)	− 0.98 (− 1.04–0.92)
Republic of Guinea	762 (490–1273)	22.09 (14.3–36.71)	951 (607–1403)	14.45 (9.57–22.3)	− 1.5 (− 1.57–1.43)
Republic of Guinea-Bissau	495 (308–723)	102.79 (69.02–145.2)	523 (329–769)	53.87 (36.79–77.97)	− 2.32 (− 2.43–2.2)
Republic of Guyana	1080 (737–1406)	207.61 (148.1–262.14)	1264 (862–1691)	178.02 (124.93–237.36)	− 0.78 (− 0.86–0.7)
Republic of Haiti	10,475 (7175–13,124)	240.5 (177.77–292.6)	16,417 (11,052–21366)	162.69 (117.02–204.08)	− 1.25 (− 1.32–1.18)
Republic of Honduras	8695 (6272–11,526)	281.93 (213.74–350.53)	17,009 (12,962–21,661)	214.57 (166.46–266.84)	− 1.05 (− 1.15–0.94)
Republic of India	595,163 (427,500–778493)	108.11 (81.64–135.62)	713,035 (519,805–922491)	60.73 (44.59–77.58)	− 2.02 (− 2.14–1.89)
Republic of Indonesia	1586 (989–2471)	1.35 (0.88–2)	2421 (1555–3753)	0.93 (0.63–1.42)	− 1.28 (− 1.34–1.21)
Republic of Kazakhstan	9728 (5954–14,947)	70.17 (43.27–107.16)	12,065 (7279–19,239)	62.44 (39.06–97.07)	− 0.52 (− 0.59–0.45)
Republic of Kenya	17,133 (11,366–23,885)	157.65 (111.47–206.36)	30,384 (20,172–42715)	105.45 (74.92–142.98)	− 1.33 (− 1.4–1.26)
Republic of Kiribati	38 (24–54)	77.82 (52.05–109.9)	49 (31–70)	52.43 (35.77–74.09)	− 1.32 (− 1.35–1.29)
Republic of Korea	32,648 (22,142–43,908)	90.16 (64.88–119.74)	53,370 (37,510–73140)	62.36 (43.93–87.61)	− 1.34 (− 1.39–1.29)
Republic of Latvia	3290 (2315–4332)	100.77 (69.38–134.01)	2640 (1831–3533)	89.97 (60.21–123.51)	− 0.62 (− 0.82–0.42)
Republic of Liberia	4217 (2957–5485)	277.36 (201.51–343.12)	6248 (4263–8079)	190.88 (142.3–234.79)	− 1.13 (− 1.19–1.06)
Republic of Lithuania	5422 (3762–7308)	127.96 (87.46–171.99)	4263 (2989–5823)	99.05 (68.35–138.61)	− 0.87 (− 0.98–0.76)
Republic of Madagascar	9551 (6313–13,510)	143.06 (101.27–193.39)	13,909 (9138–19,489)	89.32 (65.65–120.02)	− 1.62 (− 1.71–1.53)
Republic of Malawi	7821 (5160–10827)	149.59 (106.11–197.32)	9443 (6331–13,465)	92.23 (67.67–123.6)	− 1.75 (− 1.91–1.59)
Republic of Mali	258 (157–423)	6.33 (3.92–10.75)	537 (340–832)	5.26 (3.41–8.53)	− 1.23 (− 1.5–0.96)
Republic of Mauritius	533 (347–783)	62.63 (41.82–88.79)	920 (614–1323)	53.47 (35.97–75.04)	− 0.46 (− 0.54–0.37)
Republic of Moldova	5563 (3855–7425)	122.07 (85.06–161.93)	3482 (2446–4603)	65.89 (46.27–87.4)	− 2.4 (− 2.56–2.24)
Republic of Mozambique	11,746 (7806–15839)	156.33 (111.15–203.08)	20,092 (13,063–28341)	131.69 (92.34–178.25)	− 0.66 (− 0.96–0.36)
Republic of Namibia	1966 (1412–2498)	230.52 (173.56–281.36)	3617 (2599–4588)	206.39 (157.29–254.52)	− 0.48 (− 0.64–0.31)
Republic of Nauru	5 (3–7)	79.89 (52.2–115.84)	4 (2–5)	45.97 (29.92–63.85)	− 1.78 (− 1.84–1.72)
Republic of Nicaragua	5280 (3678–7023)	230.88 (169.46–290.8)	9045 (6438–11,717)	157.08 (117.3–197.26)	− 1.32 (− 1.4–1.23)
Republic of Niue	2 (1–2)	83.11 (56.86–115.88)	1 (1–2)	59.69 (42.2–83.91)	− 0.94 (− 1.07–0.81)
Republic of Palau	7 (4–10)	55.6 (36.91–78.89)	9 (6–13)	37.68 (25.67–54.76)	− 1.17 (− 1.21–1.13)
Republic of Panama	3188 (2165–4360)	176.3 (126.15–233.43)	7975 (5853–10,585)	180.53 (132.08–240.36)	0.13 (0.1–0.16)
Republic of Paraguay	4206 (2955–5670)	152.05 (112.62–198.45)	7191 (5032–9724)	111.07 (80.44–149.2)	− 1.19 (− 1.25–1.13)
Republic of Peru	49,039 (35,869–61,759)	312.5 (235.11–385.18)	75,828 (57,253–95,885)	210.97 (161.16–265.3)	− 1.83 (− 2.04–1.63)
Republic of Poland	52,278 (35,846–69,932)	122.43 (82.79–162.83)	64,792 (45,243–86,479)	111.23 (75.46–150.09)	− 0.3 (− 0.43–0.17)
Republic of Rwanda	6298 (4235–8756)	163.58 (117.27–218.58)	7776 (5251–10,898)	95.71 (69.25–127.68)	− 2.06 (− 2.15–1.97)
Republic of San Marino	19 (13–26)	60.41 (42.37–83.35)	28 (20–38)	48.55 (33.37–67.91)	− 0.74 (− 0.84–0.65)
Republic of Senegal	165 (107–286)	4.77 (3.05–8.32)	277 (179–430)	3.24 (2.12–5.3)	− 1.62 (− 1.91–1.33)
Republic of Serbia	15,338 (10,694–20639)	134.91 (94.2–179.49)	14,726 (10,290–19964)	104.67 (73.91–141.43)	− 0.88 (− 0.93–0.84)
Republic of Sierra Leone	579 (371–902)	25.62 (16.63–41.16)	766 (508–1119)	16.7 (11.14–25.74)	− 1.58 (− 1.72–1.43)
Republic of South Africa	67,637 (45,224–89,418)	246.25 (174.12–313)	105,423 (73,596–135,005)	196.84 (145.93–245.1)	− 0.91 (− 1.09–0.72)
Republic of South Sudan	1129 (730–1630)	36.37 (25.02–51.48)	1137 (719–1619)	22.82 (16.39–32.24)	− 1.58 (− 1.73–1.42)
Republic of Sudan	503 (302–825)	4.54 (2.87–7.38)	550 (334–845)	2.1 (1.38–3.17)	− 2.62 (− − 2.66–2.58)
Republic of Suriname	665 (453–880)	221.03 (154.39–286.96)	1159 (797–1563)	184.2 (127.05–246.53)	− 0.59 (− 0.69–0.5)
Republic of Tajikistan	70 (44–110)	2.2 (1.39–3.41)	117 (71–184)	1.58 (1.01–2.44)	− 1.32 (− 1.4–1.24)
Republic of the Congo	4418 (2991–5861)	315.07 (226.58–398.62)	7914 (5426–10,602)	223.72 (163.6–289.12)	− 1.11 (− 1.14–1.07)
Republic of the Gambia	22 (14–36)	5.49 (3.5–9.49)	38 (25–58)	3.32 (2.19–5.41)	− 1.76 (− 1.93–1.58)
Republic of the Marshall Islands	14 (9–20)	63.73 (43.8–90.05)	19 (12–29)	43.28 (28.78–62.34)	− 1.25 (− 1.32–1.18)
Republic of the Niger	89 (51–152)	2.92 (1.7–5.28)	181 (113–324)	1.98 (1.23–3.6)	− 1.38 (− 1.48–1.28)
Republic of the Philippines	18,935 (12,354–26,598)	53.08 (36.85–73.14)	30,761 (21,159–44,239)	35.13 (24.31–48.68)	− 1.32 (− 1.37–1.27)
Republic of the Union of Myanmar	18,830 (12,674–26,965)	68.2 (47.52–94.85)	23,507 (15,737–34,040)	45.2 (31–63.07)	− 1.33 (− 1.38–1.28)
Republic of Trinidad and Tobago	1996 (1379–2653)	206.27 (146.88–266.33)	2933 (2110–3867)	163.02 (115.9–214.65)	− 0.8 (− 0.84–0.75)
Republic of Tunisia	15 (10–25)	0.28 (0.18–0.44)	23 (15–36)	0.17 (0.12–0.26)	− 1.71 (− 1.77–1.65)
Republic of Turkey	364 (224–555)	0.89 (0.57–1.37)	456 (300–669)	0.48 (0.33–0.7)	− 1.82 (− 1.96–1.68)
Republic of Uganda	13,396 (9270–18090)	154.27 (111.47–201.12)	20,809 (14,253–28,721)	101.07 (73.59–134.8)	− 1.58 (− 1.72–1.45)
Republic of Uzbekistan	212 (133–320)	1.58 (1–2.43)	450 (273–689)	1.43 (0.91–2.15)	− 0.71 (− 0.93–0.5)
Republic of Vanuatu	73 (46–103)	86.14 (59.6–117.52)	111 (73–161)	51.25 (35.48–71.1)	− 1.69 (− 1.72–1.66)
Republic of Zambia	7679 (5101–10654)	194.25 (138.59–263.01)	12,434 (8209–17994)	121.62 (85.59–169.24)	− 1.63 (− 1.75–1.51)
Republic of Zimbabwe	16,292 (11,782–20,308)	291.13 (219.86–351.06)	25,522 (18,397–31,589)	259.22 (198.41–310.36)	− 0.46 (− 0.62–0.3)
Romania	34,809 (24,799–46,383)	130.24 (92.79–172.95)	28,167 (19,933–37,069)	94.11 (66.6–125.25)	− 1.27 (− 1.39–1.15)
Russian Federation	142,799 (98,997–190,762)	81.21 (55.96–108.92)	119,402 (84,790–162144)	54.07 (38.09–72.84)	− 1.56 (− 1.62–1.5)
Saint Kitts and Nevis	105 (74–140)	301.25 (211.21–397.22)	124 (85–167)	172.5 (126.15–227.49)	− 2.02 (− 2.15–1.88)
Saint Lucia	270 (189–344)	274.39 (196.64–346.06)	383 (287–496)	168.49 (126.52–217.51)	− 1.81 (− 1.98–1.64)
Saint Vincent and the Grenadines	179 (127–234)	225.76 (162.58–288.12)	244 (176–312)	182.07 (130.53–234.6)	− 0.83 (− 0.89–0.77)
Slovak Republic	8153 (5599–10,827)	141.03 (96.36–187.74)	9467 (6467–12,875)	115.41 (77.19–157.41)	− 0.59 (− 0.67–0.52)
Socialist Republic of Viet Nam	16,470 (11,628–22,460)	37.07 (26.49–50.11)	31,664 (21,533–44,933)	31.15 (21.91–43.95)	− 0.34 (− 0.59–0.1)
Solomon Islands	153 (100–216)	84.98 (58.47–116.98)	266 (171–384)	57.04 (38.72–80.61)	− 1.33 (− 1.36–1.3)
State of Eritrea	1866 (1170–2731)	117.66 (81.32–164.59)	2922 (1785–4216)	77.05 (52.32–109.41)	− 1.67 (− 1.85–1.5)
State of Israel	2901 (2010–3960)	61.24 (43.25–82.98)	6912 (4804–9489)	61.64 (42.63–85.35)	0.08 (− 0.01–0.17)
Taiwan (Province of China)	8183 (5480–12023)	47.82 (33.61–68.33)	13,010 (9091–19183)	33.65 (23.72–48.22)	− 1.03 (− 1.2–0.87)
Togolese Republic	6484 (4323–8604)	319.46 (229.07–397.77)	10,423 (7233–13,617)	197.54 (144.7–245.87)	− 1.72 (− 1.87–1.57)
Tokelau	1 (0–1)	56.53 (37.92–80.13)	0 (0–1)	30.4 (20.03–43.29)	− 1.98 (− 2.02–1.95)
Turkmenistan	58 (37–89)	2.52 (1.67–3.84)	106 (68–161)	2.27 (1.49–3.39)	− 0.46 (− 0.5–0.41)
Tuvalu	4 (3–6)	55.74 (37.86–78.6)	4 (3–6)	36.24 (24.53–50.88)	− 1.47 (− 1.52–1.42)
Ukraine	70,137 (50,155–92594)	110.71 (77–147.92)	50,410 (36,677–66,045)	78.34 (55.88–102.68)	− 1.42 (− 1.51–1.34)
Union of the Comoros	2 (1–2)	0.67 (0.46–0.97)	2 (1–3)	0.35 (0.24–0.51)	− 2.2 (− 2.25–2.16)
United Mexican States	184,563 (120,609–249345)	321.3 (227.23–423.87)	374,349 (268,191–470,014)	281.37 (206.29–351.98)	− 0.5 (− 0.62–0.38)
United Republic of Tanzania	11,893 (8834–15,731)	87.03 (65.79–114.85)	20,506 (15,568–26,425)	61.52 (47.83–79.66)	− 1.22 (− 1.4–1.05)
United States of America	233,391 (167,073–306338)	78.47 (55.94–103.98)	455,779 (325,715–606,971)	91.64 (64.44–121.55)	0.47 (− 0.14–1.07)
United States Virgin Islands	151 (104–206)	157.12 (113.4–208.85)	187 (134–255)	126.55 (90.76–173.36)	− 0.84 (− 0.94–0.74)

Analysis of the Cysticercosis Burden by Subgroup in 2021

The number of deaths increased with age group, reaching a peak in the 30–34 age group before thereafter falling. The Disease indicator ASMR was notably elevated among the age groups of 75–79 years, 80–84 years, and 95 years and older. As people age, both the prevalence number and DALYs rise, peaking between 60 and 65 years of age before declining. As one ages, ASPR and ASDR both rise and peak in the oldest age group (95 +) (Supplementary Fig. 1). In terms of gender, male deaths due to cysticercosis were higher than those of females, but the ASMR was similar for both. However, in terms of DALYs, prevalence number, ASDR, and ASPR, female figures were higher than those of males (Supplementary Fig. 2).

Fig. 2.

The trend of cysticercosis in age subgroups from 1990 to 2021. (A) ASMR, ASDR, ASPR. (B) the numbers of prevalence, deaths, DALYs

In the SDI group, the highest number of deaths (993, 95% UI 648–1,512), ASMR (0.12/100,000, 95% UI 0.08–0.18), ASDR (29.22/100,000, 95% UI 20.42–40.54) and ASPR (73.55/100,000, 95% UI 54.89–93.47) were found in the low SDI region, while the highest DALYs (427,044, 95% UI 263,383–630,914) and prevalence number (1,591,281, 95% UI 1,143,957–2,091,592) were found in the middle SDI region (Supplementary Fig. 3 and Table 1, 2, 3). From the GBD region, the highest ASMR due to cysticercosis was found in Eastern Sub-Saharan Africa at 0.22/100,000 (95% UI 0.14–0.31), the highest ASDR was found in Central Sub-Saharan Africa at 71.99/100,000 (95% UI 46.4–103.65), and the highest ASPR was found in Central Latin America at 216.42/100,000 (95% UI 160.27–271.4). However, the highest number of deaths was found in Africa at 1,222 people (95% UI: 807–1,802), the highest number of DALYs was found in the World Bank Upper Middle Income at 548,706 (95% UI 340,038–825,997), and the highest prevalence number was found in the World Bank Upper Middle Income at 2,025,383 people (95% UI 1,443,957–2,693,815) (Supplementary Fig. 4).

Fig. 3.

The trend of cysticercosis sex subgroups from 1990 to 2021. (A) ASPR, ASMR, ASDR. (B) the numbers of prevalence, deaths, DALYs

Fig. 4.

The trend of cysticercosis SDI subgroups from 1990 to 2021. (A) ASPR, ASMR, ASDR. (B) the numbers of prevalence, deaths, DALYs

At the national level, in 2021, the highest ASMR due to cysticercosis was found in the Republic of South Sudan at 0.5/100,000 (95% UI 0.31–0.77) (Table 1 and Supplementary Fig. 5), the highest ASDR was found in the Republic of Zimbabwe at 98.66/100,000 (95% UI 60.17–146.45) (Table 2 and Supplementary Fig. 5), and the highest ASPR was found in United Mexican States at 281.37/100,000 (95% UI 206.29–351.98) (Table 3 and Supplementary Fig. 5). However, the highest number of deaths caused by cysticercosis was 196 in the Federal Democratic Republic of Ethiopia (95% UI: 117–308) (Table 1 and Supplementary Fig. 5), the highest number of DALYs was 207,770 in the Republic of India (95% UI 130,390–300,775) (Table 2 and Supplementary Fig. 5), and the highest prevalence number was 713,035 in the Republic of India (95% UI 519,805–922,491) (Table 3 and Supplementary Fig. 5).

Fig. 5.

Results of cluster analysis based on the EAPC values of the cysticercosis-related age-standardized rates for deaths, DALYs, prevalence from 1990 to 2021

Trends in Subgroups Analysis

From 1990 to 2021, the incidence of cysticercosis-related ASMR has shown a downward trend in all age groups. In the mortality indicator, there was an upward trend in four age groups (80–84, 85–89, 90–94, and 95 +), while the other age groups showed a downward trend. In the DALYs indicator, the 0–44 age groups showed a downward trend, while the 45–95 + age groups showed an upward trend. All age groups showed a downward trend in the ASDR indicator. The prevalence number indicator showed a downward trend in the 0–39 age groups, while the other age groups showed an upward trend. The ASPR indicator showed an upward trend in the 85–89, 90–94, and 95 + age groups, while the other age groups showed a downward trend (Fig. 2). In the gender subgroups, both male and female showed a downward trend in number of deaths, ASMR, ASDR, and ASPR indicators, while showing a significant upward trend in DALYs and prevalence number indicators (Fig. 3). In the SDI subgroups, all SDI regions showed a significant downward trend in number of deaths, ASMR, and ASDR indicators, while showing an upward trend in DALYs and prevalence number indicators (Fig. 4). Additionally, 54 GBD were divided into four categories: significant growth, slight growth, stability or slight decline, and significant reduction, and were compared through cluster analysis based on the disease burden (Fig. 5). In the analysis of all countries and territories, the ASMR, ASPR, and ASDR of most countries showed a downward trend from 1990 to 2021, and the change in disease burden was shown through changes in the world map (Fig. 6).

Fig. 6.

The trend of cysticercosis in national and territories from 1990 to 2021. (A) Age-standardized prevalence rate. (B) Age-standardized mortality rate. (C) Age-standardized DALYs rates. (D) Prevalence cases. (E) Deaths cases. (F) DALYs

Estimating the Burden of Cysticercosis Disease

The disease burden due to cysticercosis was estimated using the ES model and the ARIMA model for the years 2022–2050. Both models employed 30-year data on the disease burden associated with cysticercosis to objectively forecast the disease's future trajectory. Over the 2022–2050 timeframe, the ARIMA model predicts a continuous drop in both mortality and ASMR for male and female, with ASMR for female remaining stable and number of deaths for males slightly rising. While DALYs marginally increased, ASDR in both male and female kept declining. Both the frequency and ASPR indices for male and females are gradually increasing (Fig. 7A, B, C). The prediction results of ES model are basically consistent with those of ARIMA model (Fig. 7D, E, F).

Fig. 7.

Predicted trends of global cysticercosis. (A) Deaths cases and ASMR (ARIMA). (B) DALYs and ASDR (ARIMA). (C) Prevalence cases and ASPR (ARIMA). (D) Deaths cases and ASMR (ES). (E) DALYs and ASDR (ES). (F) Prevalence cases and ASPR (ES)

Discussion

Given that there has been no comprehensive report on the global or regional burden of cysticercosis in the past, people are unclear about the past and future trends of the disease at the global or regional level [24]. It is crucial to have a comprehensive understanding of the biological characteristics, infection mechanisms, and pathological changes of parasites in the human body to build a comprehensive disease burden assessment model. Based on the 2021 Global Burden of Disease (GBD) data, this study systematically examined the transmission dynamics and control advancements of cysticercosis. It further explored the risk heterogeneity of cysticercosis, including disparities across Socio-Demographic Index (SDI) regions and gender differences from 1990 to 2021. Additionally, the study projected the disease burden up to 2050 using advanced modeling techniques, emphasizing the critical surveillance challenges in endemic areas. The study hopes that the research results will raise the awareness of cysticercosis among high-risk populations in endemic areas and encourage local residents to actively participate in the prevention and treatment of the disease, thereby improving public health awareness of the disease.

The study results show that global cysticercosis control has made significant progress from 1990 to 2021. Compared with the indicators in 1990, the four disease burden indicators (number of deaths, ASMR, ASDR, and ASPR) have shown a downward trend overall in 2021. Only the prevalence number and DALYs indicators showed an upward trend. Among the two subpopulation variables of age and sex, most indicators showed a downward trend in general. Overall, the significant progress in global cysticercosis control over the past 30 years is attributed to the following factors: firstly, the continuous attention and advocacy of WHO on the importance of diseases such as cysticercosis[2]; secondly, the active prevention and control measures taken by most disease burden regions; and thirdly, the active intervention of effective treatment drugs, which jointly contributed to a significant reduction in the global burden of cysticercosis[24].

In the SDI sub-variable group, the 5 SDI areas showed an upward trend in both DALYs and prevalence number indicators. Among all SDI regions, the disease burden in low SDI areas was relatively the heaviest, which may be related to the economic challenges of these areas. Cysticercosis treatment costs are high, and it is a heavy social and economic burden for the poor. It is estimated that the annual medical costs of cysticercosis worldwide are considerable, occupying a large amount of medical resources [25]. Because neurocysticercosis often leads to patients losing their ability to work or study, it causes serious impacts on social and economic life. This not only affects the quality of life of patients, but also increases the economic burden on families and society [25–27]. The DALYs lost due to cysticercosis worldwide are quite serious, especially in developing countries such as China [20]. These DALYs losses not only reflect the direct impact of cysticercosis on patients'health, but also reflect its indirect impact on social and economic life.

It is noteworthy that the disease burden indicator for females was generally higher than that for males from 1990 to 2021. The reasons for this result may include socioeconomic status, education level and cultural awareness. In many societies, female's socioeconomic status is relatively lower, which may limit their access to medical resources and healthcare services. Therefore, when women suffer from cysticercosis, they may not be able to receive effective diagnosis and treatment in time, leading to an increase in the disease burden [28–30]. In some areas, due to differences in education level and cultural awareness, women may have insufficient knowledge of cysticercosis prevention and treatment methods, and ignore symptoms or take inappropriate self-treatment in the early stage of infection, thereby aggravating the condition and increasing the disease burden [31].

In the national and territories sub-group variables, only 170 of the 204 countries recorded a burden of cysticercosis, and in these countries with a burden of disease, most of the ASMR, ASPR, and ASDR indicators showed a downward trend, but the number of deaths, DALYs, and prevalence number indicators showed an upward trend. The general decline in the standardized burden of cysticercosis globally may reflect the effectiveness of control measures and advances in diagnostic technology[32], but the rise in number of deaths, DALYs, and prevalence number may be related to population growth and mobility, environmental and ecological changes, social and economic factors, lack of awareness and behavioral habits, and other factors [2, 30, 33]. To effectively control the transmission and prevalence of cysticercosis, sustained efforts are required to reinforce the implementation of control measures, enhance diagnostic technologies, improve environmental and ecological conditions, strengthen health education and personal hygiene, provide socio-economic support, and promote improvements in animal husbandry practices and sanitation standards.

There are also limitations in this study, such as the difference between the data in the GBD database and the actual situation, the lack of data from marginal areas, and the fact that the burden of cysticercosis needs to be evaluated from multiple dimensions, including economic burden (treatment costs, productivity losses, etc.), social and psychological impacts. These dimensions need to be coordinated to ensure the comprehensiveness and accuracy of the evaluation results [34]. Due to huge economic disparities globally, many poor resource countries and regions (including some high-income regions) have never conducted comprehensive and detailed data collection on the disease, which makes the overall burden analysis of cysticercosis less accurate [7, 25]. Some countries and regions have taken measures to control cysticercosis, control measures for cysticercosis encompass the following approaches: (1) Regulatory health oversight: Government authorities enforce comprehensive food safety protocols through systematic monitoring of meat production and processing chains, implement rigorous animal disease surveillance systems to identify potential infection reservoirs in livestock, and conduct environmental sampling to detect contamination risks in water sources and agricultural lands; (2) Community health promotion: Public health campaigns should disseminate evidence-based information about disease transmission mechanisms and clinical manifestations through multi-channel community outreach. Behavioral interventions should emphasize cultivating proper hygiene practices including preprandial handwashing protocols [35]. Additionally, strengthening international medical collaboration and knowledge exchange is essential [36]. In terms of global control, cysticercosis prevention and control still face many challenges, such as global warming, the lack of an effective vaccine, an imperfect disease monitoring system, and insufficient monitoring data [37]. Diagnostic techniques also need to be improved, unhealthy eating habits persist, and global economic development is highly uneven, with insufficient funding for public health in economically challenged regions. Therefore, a comprehensive understanding of the global epidemiological situation of cysticercosis and the clarification of the characteristics of the disease are the basis for exploring comprehensive prevention and control strategies.

Conclusion

Based on GBD data, global cysticercosis prevalence and DALYs still increased, with the highest burden in low-SDI regions. Females faced elevated risks due to socioeconomic status, education level and cultural awareness. While WHO-led interventions reduced standardized rates, population growth, environmental shifts, and insufficient health investments exacerbated absolute case numbers. Future strategies require multidimensional approaches: advancing vaccine development, enhancing surveillance, integrating health-economic measures, implementing gender-sensitive interventions, and fostering international collaboration to reduce healthcare disparities, ultimately alleviating the global cysticercosis burden.

Supplementary Information

Below is the link to the electronic supplementary material.

Abbreviations

ASR

Age-standardized rates

EAPC

Estimated annual percent changes

ASMR

Age-standardized mortality rate

ASDR

Age-standardized DALY rate

ASPR

Age-standardized prevalence rate

SDI

Socio-demographic Index

UI

Uncertainty interval

ARIMA

Autoregressive integrated moving average

ES

Exponential smoothing

UI

Uncertainty intervals

CI

Confidence interval

Author Contributions

Zhangzhou Shen Wrote the main manuscript text and Houqiang Luo prepared figures and tables. All authors reviewed this paper.

Data Availability

No datasets were generated or analysed during the current study.

Declarations

Conflict of Interest

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.