Burden of Neglected Tropical Diseases in Ethiopia: Analysis from the Global Burden of Disease Estimates 2023

Abstract Introduction Neglected Tropical Diseases (NTDs) comprises over 20 preventable infectious illness that disproportionately affecting low- and middle-income countries, including Ethiopia. Although national control initiatives have expanded since 2013, evidence on recent national and subnational burden trends remains limited. This study aimed to assess trends in mortality and disability-adjusted life years attributable to neglected tropical diseases in Ethiopia at national and subnational level from 1990 to 2023. Methods We used data from the Global Burden of Disease 2023 study to estimate age-standardized and age-specific mortality and Disability-Adjusted Life Years (DALYs) attributable to neglected tropical diseases. Results are presented as absolute numbers and age-standardized rates (per 100,000 population), disaggregated by disease, sex, region, and year from 1990 to 2023, with 95% uncertainty intervals. Result In 2023, the national age-standardized DALY rate for all NTDs was 708.3 where, schistosomiasis accounted the largest share ( 228.7; 95% UI: 145.4–375.0 ) , followed by other NTDs ( 104.4; 95% UI: 59.7–171.4), trachoma (100.0; 95% UI: 67.4–144.9), and rabies (78.3; 95% UI: 9.5–257.9), together contributed to over three-quarters DALYs due to NTDs. The national age-standardized mortality rate was 5.98 mostly contributed by schistosomiasis (2.01; 95% UI: 1.72–2.38) and rabies (1.40; 95% UI: 0.18–4.58). Substantial regional variation was observed, with Addis Ababa recording the lowest (200.5 and 1.2) and Afar the highest (860.3 and 8.9) DALYs and mortality rate due to all NTDs respectively. Between 1990 and 2023, DALYs and mortality rate declined by 87.5% and 91.6%, respectively, although declines slowed after 2010. During 2010–2023, increases in DALYs and mortality due to schistosomiasis were observed in Addis Ababa (+25%) and Harari (+13%), while trachoma increased in Oromia (+9%). Conclusion NTDs continue to impose a substantial burden of disability and mortality in Ethiopia, with pronounced regional disparities and a slowing pace of progress in recent years. The observed stagnation or increases in specific NTDs at the subnational level highlight the need for sustained monitoring and targeted control strategies.