Trends and forecasting of cysticercosis burden in South Asia: Insights from global burden of disease data (1990-2021).

Cysticercosis, caused by Taenia solium larvae, is a neglected tropical disease endemic in more than 75 countries of the world. It significantly contributes to epilepsy in regions with poor sanitation and inadequate food safety practices. This study aims to examine the trends in cysticercosis burden in South Asia (SA) from 1990 to 2021 using prevalence and disability-adjusted life years (DALYs) rates, and to forecast the disease burden up to 2031. Data from Global Burden of Disease (GBD) (1990-2021) was utilized to estimate DALYs and prevalence rates. Trend analysis was done by Joinpoint regression to detect temporal changes in cysticercosis. Future burden projections used the Autoregressive Integrated Moving Average (ARIMA) model, forecasting through 2031. The highest prevalence rates of cysticercosis per 100,000 population in the SEA region were recorded in Nepal, followed by Bhutan, and India, however, the trends differed from country to country. There was marked reduction in the disease burden from 1990 to 2021 across SA region, with India and Nepal achieving the highest numerical reductions in prevalence (47.38 and 39.91 respectively). Forecasting suggests a consistent overall reduction in both prevalence (50.55 to 42.14), and DALYs (14.35 to 10.58) from 2022 to 2031 respectively in the SA region. Despite an overall reduction in prevalence and DALYs, disparities in the cysticercosis burden in the different SA countries were observed. The forecasting predicted that though cysticercosis burden is expected to reduce, but it is likely to remain a major public health problem. Thus, the control of the disease will need continued efforts to enhance sanitation, health education, and pig husbandry management, integrated into the national health systems of the countries.