Trends in the burden of fire, heat, and hot substances in North Africa and the Middle East, 1990-2023: an analysis of the 2023 Global Burden of Disease Study.

BACKGROUND

Thermal injuries from fire, heat, and hot substances (FHHS) pose a significant public health challenge in North Africa and the Middle East (NAME). Comprehensive, long-term regional analyses, particularly those including the post-pandemic period, are limited. This study leverages Global Burden of Disease (GBD) 2023 data to provide a comprehensive assessment of the FHHS burden in the NAME region from 1990 to 2023, analyzing the distinct effects of age, period, and cohort to inform targeted interventions.

METHODS

This study utilized FHHS data from the GBD 2023 for the 21 countries and territories of the NAME region. We analyzed trends in prevalence, incidence, mortality, and disability-adjusted life years (DALYs). The analysis employed joinpoint regression to identify temporal trend changes, decomposition analysis to isolate the effects of population growth, aging, and epidemiology, and an age-period-cohort model to delineate generational and age-specific risks.

RESULTS

From 1990 to 2023, the age-standardized DALY rate for FHHS in NAME declined significantly (EAPC, - 2.6). Absolute prevalence increased in most countries, with increases exceeding 300% in Qatar and the United Arab Emirates. Joinpoint analysis identified an increase in ASIR during 2020-2023 (APC, 0.61%). Decomposition showed that population growth and ageing exerted upward pressure on absolute counts. For deaths, however, these positive demographic contributions were more than offset by favorable changes in age-specific epidemiological rates, resulting in a small net regional decline.

CONCLUSION

From 1990 to 2023, NAME achieved substantial reductions in age-standardized DALY and death rates from FHHS. Population growth and ageing increased pressure on absolute prevalence and incidence, whereas improved age-specific epidemiological rates outweighed these pressures for deaths. The recent change in ASIR and the increasing burden in older age groups warrant continued surveillance and targeted prevention.