Wenhua Zhao, Hui Li, Maoling Hu, Tiansheng Bu
GBD-estimated CDI-related burden in China increased substantially, and age-specific DALY rates were highest among older adults. These model-based findings support strengthened CDI surveillance, diagnostic capacity, antimicrobial stewardship, infection control, and prevention among high-risk older populations.
PURPOSE: National evidence on the long-term burden of Clostridioides difficile infection (CDI) in China remains limited. We assessed CDI-related burden from 1990 to 2021 and projected rates to 2030.
METHODS: China-specific estimates of deaths, disability-adjusted life years (DALYs), years of life lost (YLLs), and years lived with disability (YLDs) were obtained from the Global Burden of Disease Study 2021 (GBD 2021). Temporal trends were evaluated using joinpoint regression, decomposition analysis, and autoregressive integrated moving average models.
RESULTS: From 1990 to 2021, CDI-related DALYs increased from 6,645.59 to 15,759.24, and GBD-estimated CDI-attributable deaths increased from 215 to 721. YLLs accounted for more than 99% of DALYs within the GBD estimation framework. In 2021, DALY rates were higher in males than females and increased markedly with age. The death rate had the highest average annual percentage change. Population aging contributed 57.1% of the increase in DALYs, exceeding the contributions of population growth and epidemiological change. Historical-trend-based projections suggested that all-age burden rates may continue to rise through 2030; YLD projections require additional caution because of possible residual autocorrelation.
CONCLUSION: GBD-estimated CDI-related burden in China increased substantially, and age-specific DALY rates were highest among older adults. These model-based findings support strengthened CDI surveillance, diagnostic capacity, antimicrobial stewardship, infection control, and prevention among high-risk older populations.