Appendicitis burden in Africa, 2010–2023: temporal trends, pandemic-era deviations, and projections to 2030

INTRODUCTION: Appendicitis is a common abdominal surgical emergency, but continent-wide evidence on its burden and trends in Africa is limited. We assessed the burden, trends, geographic heterogeneity, demographic drivers, pandemic-era deviations, and future projections of appendicitis across Africa. METHODS: We conducted a population-level secondary analysis using Global Burden of Disease 2023 estimates for the African Union and 54 African countries from 2010 to 2023. We examined incidence, prevalence, deaths, and disability-adjusted life-years (DALYs) as absolute numbers and age-standardized rates (ASRs). Trends, drivers of change, pandemic-era deviations, and projections to 2030 were evaluated. RESULTS: From 2010 to 2023, appendicitis burden increased across Africa: incident cases rose from 2.45 to 3.73 million, prevalent cases from 92,805 to 141,711, deaths from 3,240 to 3,984, and DALYs from 182,086 to 226,592. Age-standardized incidence and prevalence increased modestly, whereas age-standardized death and DALY rates declined. Higher nonfatal burden was concentrated in parts of southern and western Africa, while fatal and disability burden remained highest in eastern Africa. Population growth was the main driver of increasing burden. During 2020-2023, incidence and prevalence exceeded expected levels, whereas deaths and DALYs were lower than expected. By 2030, incidence and prevalence are projected to increase in most countries, while death and DALY rates are projected to decline in most settings. CONCLUSIONS: Appendicitis burden in Africa increased substantially between 2010 and 2023, largely driven by demographic expansion. Persistent geographic inequalities highlight the need to strengthen timely diagnosis, referral, and emergency surgical care.