Zoonotic diseases in China: epidemiological trends, incidence forecasting, and comparative analysis between real-world surveillance data and Global Burden of Disease 2021 estimates

Abstract

BACKGROUND: Zoonotic diseases remain a significant public health challenge in China. This study examines the temporal trends, disease burden, and demographic patterns of major zoonoses from 2010 to 2023. METHODS: This study analyzed data from China's National Notifiable Infectious Disease Reporting System (NNIDRS, 2010-2023) on nine major zoonoses, including echinococcosis, brucellosis, leptospirosis, anthrax, leishmaniasis, encephalitis (Japanese encephalitis), hemorrhagic fever, rabies, and schistosomiasis. Joinpoint regression was applied to assess annual trends in incidence rates, while autoregressive integrated moving average (ARIMA) and exponential smoothing models were used to forecast incidence trends from 2024 to 2035. To assess the performance of the Global Burden of Disease (GBD) 2021 model in China, disease-specific multipliers-defined as the ratio of GBD estimates to national surveillance data-along with their corresponding 95% confidence intervals (CIs) were calculated to quantify discrepancies and evaluate the consistency between modeled estimates and empirical observations. RESULTS: From 2010 to 2023, the incidence rates of leptospirosis [average annual percent change (AAPC) = - 5.527%, 95% CI: - 11.054, - 0.485], encephalitis (AAPC = - 16.934%, 95% CI: - 23.690, - 11.245), hemorrhagic fever (AAPC = - 5.384%, 95% CI: - 7.754, - 2.924), rabies (AAPC = - 20.428%, 95% CI: - 21.076, - 19.841), and schistosomiasis (AAPC = - 28.378%, 95% CI: - 40.688, - 15.656) showed a declining trend in China. In contrast, brucellosis exhibited a modest but statistically significant increase (AAPC = 0.151%, 95% CI: 0.031, 0.272). For most diseases, incidence rates were consistently higher in males than females. Children aged 0-5 years accounted for a substantial proportion of encephalitis and leishmaniasis cases, while adults aged 14-65 years represented the primary affected group across the majority of diseases. Occupationally, farmers and herders were the most affected populations. Compared to national surveillance data, the GBD 2021 model substantially overestimated the burden of zoonotic diseases in China, particularly for echinococcosis (by 3.611-7.409 times) and leishmaniasis (by 3.054-10.500 times). CONCLUSION: The study revealed significant decline in several major zoonoses in China, while brucellosis showed a continued upward trend. These findings highlight the urgent need for a One Health-based prevention and control system to interrupt cross-species transmission and reduce long-term public health risks.