Trends in dengue incidence and disease burden in South Asia with special reference to India: Insights from the global burden of disease data, 1990–2021

BACKGROUND: Dengue fever has become a significant public health issue worldwide, especially in tropical and subtropical regions. In 2000, 505,430 cases of dengue were reported worldwide, and by 2023, the number of cases had increased to nearly 6.5 million. The present study aims to examine the temporal trends in dengue incidence and disability-adjusted life years from 1990 to 2021 using Global Burden of Disease 2021 data across South Asian countries while identifying geographic, gender, and age-related disparities with a specific focus on trends and spatial variations in India. METHODS: The GBD 2021 database was used to extract data on age-standardized incidence rates, DALYs, and ASDRs. Joinpoint regression was used to examine the trends and annual and average annual percentage changes. We also performed spatial and age-group analyses to explore the differences in disease burden across different geographical and demographic groups. FINDINGS: In 2021, 32.3 million cases of dengue were reported in South Asia, indicating a 152.9 % increase from 1990. With an estimated annual percentage change of 1.5 %, the ASIR increased from 1141.7 to 1704.9 per 100,000 people. At 944,761, DALYs almost doubled, whereas ASDRs increased at a rate of 1.87 % each year. A total of 28.2 million of these cases were in India, followed by Pakistan and Bangladesh. The increase in dengue cases in India has been reported as 11.2 million in 1990-28.2 million in 2021, with DALYs increasing by 2.86 % annually and an increase in the ASIR of 1.55 %. CONCLUSION: The findings highlight a substantial increase in dengue burden across South Asia. The rising burden of incidence and disability requires public health initiatives, such as robust surveillance, targeted vector control, and improved treatment strategies, to reduce its impact effectively.