ORIGINAL RESEARCH article
Front. Public Health
Sec. Injury Prevention and Control
Volume 13 - 2025 | doi: 10.3389/fpubh.2025.1642367
Comparative Analysis and Forecast of Spinal Cord Injury Burden in BRICS Countries (1990-2021): Insights from the Global Burden of Disease Study 2021
Provisionally accepted
KONGJUN YUAN
Mengye OU
Shaohui ChenTian BaiHailong LINZhuqiang LUOYanli GAOXiaoqiang CHEN*Sixiong SHI*Dan ZHU*- The Sixth Affiliated Hospital of Jinan University (Dongguan East Center Hospital), 东莞市, China
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Background: As major emerging economies, the BRICS (Brazil, Russia, India, China, and South Africa) face a significant and distinct burden of spinal cord injury (SCI). We systematically assessed trends in the burden of SCI and its leading causes from 1990 to 2021 and forecasted trends to 2031, providing evidence to optimize prevention and control strategies. Methods: Based on the Global Burden of Disease Study 2021 (GBD 2021), we calculated the age-standardized incidence and prevalence rate (ASIR, ASPR) of SCI in the BRICS, along with the estimated annual percentage change (EAPC) and average annual percentage change (AAPC). Furthermore, we analyzed the etiological composition of the SCI burden and developed an autoregressive integrated moving average (ARIMA) model to forecast its trends from 2022 to 2031. Results: From 1990 to 2021, the absolute number of SCI cases rose in all BRICS countries except Russia; however, age-standardized rates (ASRs) fell consistently (EAPC range: –2.15 to –0.13). South Africa demonstrated the most substantial reductions (AAPC: ASIR –1.59, ASPR –1.93), while China showed the modest declines (–0.23 and –0.09, respectively). The burden of SCI varied substantially by age and sex. Males bore a consistently higher burden, with peak risks shifting from younger to older females. The peak number of cases occurred earlier (20–35 years) in Brazil, Russia, and South Africa, but was notably delayed in China and India (50–54 years). The leading causes of SCI across the BRICS included falls (70% of cases in India), road injuries, and self-harm and interpersonal violence (35% of cases in South Africa). Based on ARIMA modeling, a continued decline in ASRs is projected for all member countries over the coming decade. Conclusion: The burden of SCI in the BRICS countries is influenced by demographic, socioeconomic, and policy-related factors. Although ASRs have shown improvement, the absolute number of cases continues to grow. This trend necessitates tailored preventive strategies that address specific age, sex, and etiological factors, supported by enhanced international health cooperation, to mitigate the global burden of SCI.
Keywords: spinal cord injury, burden of disease, BRICS countries, ARIMA model, Etiology analysis
Received: 06 Jun 2025; Accepted: 26 Sep 2025.
Copyright: © 2025 YUAN, OU, Chen, Bai, LIN, LUO, GAO, CHEN, SHI and ZHU. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Xiaoqiang CHEN, 468432961@qq.com
Sixiong SHI, 1196422547@qq.com
Dan ZHU, jdzd2020@163.com
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