Temporal trends in the incidence of adverse effects of medical treatment in BRICS countries from 1990 to 2021: an age-period cohort analysis

BackgroundSignificant disability-adjusted life year (DALY) losses are caused annually by adverse effects of medical treatment (AEMT), a serious public health concern worldwide that continuously strains nations’ socioeconomic progress. As they account for more than half of the world’s population and...

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Main Authors: Xingmin Wei, Lu Jiang, Zhidong Zhang, Longjian Shang, Kun Liu, Xiaoang Qin, Gaoheng Ding, Lu Liu, Jianjun Wu
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-06-01
Series:Frontiers in Public Health
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Online Access:https://www.frontiersin.org/articles/10.3389/fpubh.2025.1508272/full
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author Xingmin Wei
Xingmin Wei
Lu Jiang
Zhidong Zhang
Longjian Shang
Kun Liu
Xiaoang Qin
Gaoheng Ding
Lu Liu
Jianjun Wu
author_facet Xingmin Wei
Xingmin Wei
Lu Jiang
Zhidong Zhang
Longjian Shang
Kun Liu
Xiaoang Qin
Gaoheng Ding
Lu Liu
Jianjun Wu
author_sort Xingmin Wei
collection DOAJ
description BackgroundSignificant disability-adjusted life year (DALY) losses are caused annually by adverse effects of medical treatment (AEMT), a serious public health concern worldwide that continuously strains nations’ socioeconomic progress. As they account for more than half of the world’s population and exhibit notable variation in healthcare resource distribution, the BRICS nations—Brazil, Russia, India, China, and South Africa—have emerged as a crucial observational cohort for researching healthcare safety issues. This study evaluated trends in the incidence of AEMT across BRICS nations from 1990 to 2021.MethodsThis study evaluated trends in the incidence of AEMT in the BRICS nations between 1990 and 2021, utilizing data from the Global Burden of Disease (GBD) 2021 database. We employed Joinpoint regression to determine the average annual percentage change (AAPC) in incidence. Additionally, net drift, localized drift, age-specific curves, and period/cohort relative risk were estimated through an age-period-cohort (APC) model implementing the intrinsic estimator (IE) algorithm.ResultsBetween 1990 and 2021, the incidence of AEMT decreased in both South Africa and China. Notably, China exhibited a more pronounced decline, with an AAPC of −1.30% (from 36.94 per 100,000 to 24.65 per 100,000), compared to South Africa’s AAPC of −0.98% (from 117.82 per 100,000 to 86.57 per 100,000). In contrast, Brazil and Russia showed upward trends. Brazil experienced the most substantial increase, rising from 23.06 per 100,000 to 75.09 per 100,000 (AAPC +3.88%), while Russia’s incidence grew less markedly, from 153.97 to 188.67 cases per 100,000 (AAPC +0.65%). Notably, China exhibited a consistently lower incidence of AEMT compared to other BRICS nations. The burden of AEMT disproportionately affected the older adult population in Brazil, South Africa, India, and Russia, whereas in China, the highest incidence was observed among newborns and young children. Regarding cohort risk, all nations demonstrated a reduction over time, except for Brazil and Russia, where cohort relative risk increased significantly.ConclusionOver the past three decades, divergent trends in AEMT incidence have been observed across the BRICS nations. To strengthen AEMT prevention, these countries should prioritize optimizing existing healthcare resources, such as workforce training and surveillance systems. Additionally, targeted interventions—including enhanced care for vulnerable populations (e.g., young children, preschoolers, and the older adult)—are critical to further reducing AEMT incidence.
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spelling doaj-art-c0ec74eb1fdc4d4cbb3b63c1701d82002025-08-20T03:16:16ZengFrontiers Media S.A.Frontiers in Public Health2296-25652025-06-011310.3389/fpubh.2025.15082721508272Temporal trends in the incidence of adverse effects of medical treatment in BRICS countries from 1990 to 2021: an age-period cohort analysisXingmin Wei0Xingmin Wei1Lu Jiang2Zhidong Zhang3Longjian Shang4Kun Liu5Xiaoang Qin6Gaoheng Ding7Lu Liu8Jianjun Wu9School of Public Health, Gansu University of Chinese Medicine, Lanzhou, ChinaThe Collaborative Innovation Center for Prevention and Control by Chinese Medicine on Diseases Related Northwestern Environment and Nutrition, Lanzhou, ChinaSchool of Public Health, Gansu University of Chinese Medicine, Lanzhou, ChinaSchool of Public Health, Gansu University of Chinese Medicine, Lanzhou, ChinaSchool of Public Health, Gansu University of Chinese Medicine, Lanzhou, ChinaDepartment of Epidemiology, School of Public Health, Air Force Medical University, Xi’an, ChinaDepartment of Epidemiology, School of Public Health, Air Force Medical University, Xi’an, ChinaSchool of Public Health, Gansu University of Chinese Medicine, Lanzhou, ChinaSchool of Public Health, Gansu University of Chinese Medicine, Lanzhou, ChinaSchool of Public Health, Gansu University of Chinese Medicine, Lanzhou, ChinaBackgroundSignificant disability-adjusted life year (DALY) losses are caused annually by adverse effects of medical treatment (AEMT), a serious public health concern worldwide that continuously strains nations’ socioeconomic progress. As they account for more than half of the world’s population and exhibit notable variation in healthcare resource distribution, the BRICS nations—Brazil, Russia, India, China, and South Africa—have emerged as a crucial observational cohort for researching healthcare safety issues. This study evaluated trends in the incidence of AEMT across BRICS nations from 1990 to 2021.MethodsThis study evaluated trends in the incidence of AEMT in the BRICS nations between 1990 and 2021, utilizing data from the Global Burden of Disease (GBD) 2021 database. We employed Joinpoint regression to determine the average annual percentage change (AAPC) in incidence. Additionally, net drift, localized drift, age-specific curves, and period/cohort relative risk were estimated through an age-period-cohort (APC) model implementing the intrinsic estimator (IE) algorithm.ResultsBetween 1990 and 2021, the incidence of AEMT decreased in both South Africa and China. Notably, China exhibited a more pronounced decline, with an AAPC of −1.30% (from 36.94 per 100,000 to 24.65 per 100,000), compared to South Africa’s AAPC of −0.98% (from 117.82 per 100,000 to 86.57 per 100,000). In contrast, Brazil and Russia showed upward trends. Brazil experienced the most substantial increase, rising from 23.06 per 100,000 to 75.09 per 100,000 (AAPC +3.88%), while Russia’s incidence grew less markedly, from 153.97 to 188.67 cases per 100,000 (AAPC +0.65%). Notably, China exhibited a consistently lower incidence of AEMT compared to other BRICS nations. The burden of AEMT disproportionately affected the older adult population in Brazil, South Africa, India, and Russia, whereas in China, the highest incidence was observed among newborns and young children. Regarding cohort risk, all nations demonstrated a reduction over time, except for Brazil and Russia, where cohort relative risk increased significantly.ConclusionOver the past three decades, divergent trends in AEMT incidence have been observed across the BRICS nations. To strengthen AEMT prevention, these countries should prioritize optimizing existing healthcare resources, such as workforce training and surveillance systems. Additionally, targeted interventions—including enhanced care for vulnerable populations (e.g., young children, preschoolers, and the older adult)—are critical to further reducing AEMT incidence.https://www.frontiersin.org/articles/10.3389/fpubh.2025.1508272/fullincidenceage-period-cohorttrendAEMTBRICS
spellingShingle Xingmin Wei
Xingmin Wei
Lu Jiang
Zhidong Zhang
Longjian Shang
Kun Liu
Xiaoang Qin
Gaoheng Ding
Lu Liu
Jianjun Wu
Temporal trends in the incidence of adverse effects of medical treatment in BRICS countries from 1990 to 2021: an age-period cohort analysis
Frontiers in Public Health
incidence
age-period-cohort
trend
AEMT
BRICS
title Temporal trends in the incidence of adverse effects of medical treatment in BRICS countries from 1990 to 2021: an age-period cohort analysis
title_full Temporal trends in the incidence of adverse effects of medical treatment in BRICS countries from 1990 to 2021: an age-period cohort analysis
title_fullStr Temporal trends in the incidence of adverse effects of medical treatment in BRICS countries from 1990 to 2021: an age-period cohort analysis
title_full_unstemmed Temporal trends in the incidence of adverse effects of medical treatment in BRICS countries from 1990 to 2021: an age-period cohort analysis
title_short Temporal trends in the incidence of adverse effects of medical treatment in BRICS countries from 1990 to 2021: an age-period cohort analysis
title_sort temporal trends in the incidence of adverse effects of medical treatment in brics countries from 1990 to 2021 an age period cohort analysis
topic incidence
age-period-cohort
trend
AEMT
BRICS
url https://www.frontiersin.org/articles/10.3389/fpubh.2025.1508272/full
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