{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T16:25:24Z","timestamp":1788279924658,"version":"build-2803163510"},"reference-count":67,"publisher":"Public Library of Science (PLoS)","issue":"11","license":[{"start":{"date-parts":[[2025,11,5]],"date-time":"2025-11-05T00:00:00Z","timestamp":1762300800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"<jats:sec id=\"sec001\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Gastroesophageal reflux disease (GERD) represents a major global health challenge with varied regional epidemiological patterns. This study aimed to comprehensively analyze temporal trends, health inequalities, and driving factors of GERD.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec002\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Using Global Burden of Disease 2021 data, we extracted GERD prevalence across 204 territories. Age-standardized prevalence rate (ASPR) was calculated and analyzed using age-period-cohort framework. An autoregressive integrated moving average model was employed to project future trends to 2036. Health inequalities were assessed using slope index and concentration index.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec003\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Global GERD prevalence surged from 450,765,455 cases in 1990\u2013825,603,654 in 2021, with an annual percentage change of 0.04% in ASPR. Significant regional disparities were observed across Socio-demographic Index (SDI) quintiles: middle SDI regions exhibited the steepest ASPR increase (0.22% annually), contrasting with declining trends in high-middle (\u22120.26%) and high SDI regions (\u22120.18%). Latin American countries demonstrated the highest burden, with Paraguay, Brazil, and El Salvador leading globally. The United States and China revealed notable post-2010 prevalence rebounds. Notably, populations aged 25\u201334 years showed the most rapid prevalence growth (&gt;0.3% annually), challenging traditional age-risk paradigms. The slope index increased from \u22121978.5 to \u22122053.4, signifying worsening absolute health disparities, with low SDI nations bearing a disproportionate GERD burden.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec004\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The increasing prevalence of GERD has resulted in major health burdens over the past three decades. Future strategies should prioritize targeted interventions for high-risk populations and modifiable risk factors, enhanced healthcare accessibility, and integration of GERD management within non-communicable disease frameworks to address this emerging public health challenge.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1371\/journal.pone.0334396","type":"journal-article","created":{"date-parts":[[2025,11,5]],"date-time":"2025-11-05T18:42:42Z","timestamp":1762368162000},"page":"e0334396","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":5,"title":["Global temporal trends and projections of gastroesophageal reflux disease prevalence: Age-period-cohort analysis 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