The Triple Burden of Disease in Khyber Pakhtunkhwa, Pakistan (2021–2025): A Provincial Analysis of Epidemiological Shifts and Healthcare Challenges
1
Pathology, Peshawar Institute of Cardiology-MTI, Peshawar, Pakistan
Popul. Med. 2026;8(Supplement Supplement 1):
ABSTRACT
BACKGROUND:
Over the last decade, Khyber Pakhtunkhwa has faced a unique "Triple Burden" of disease, the resurgence of infectious outbreaks (exacerbated by climate-driven floods), rising prevalence of non-communicable diseases, and a significant increase in injuries and disabilities. This study aims to analyze the 30-year disease burden trends in the adult population of KP, with a specific focus on the critical shifts observed during the 2021–2025 period.
METHODS:
Data for the period 1990 to 2025 was extracted from the Global Burden of Disease (GBD) for Pakistan, provincial surveillance reports, and recent Integrated Population and Health Surveys (IPHS). Trends were analyzed through prevalence, death rates, and disability-adjusted life years (DALYs). Poisson regression analysis was utilized to evaluate the incidence rate ratio (IRR) across three categories: Communicable Diseases (CDs), Non-Communicable Diseases (NCDs), and Injuries.
RESULTS:
While traditional CDs showed relative decrease in prevalence (approx. 21% decrease since 1990), there was significant resurgence in 2024–2025. Diphtheria cases spiked (n=309) with a 24.6% mortality rate, and waterborne diseases increased by over 80% in flood-affected districts. Hypertension prevalence reached 29.2%, and Diabetes affected 7.4% of the adult population. Cardiovascular diseases now account for the highest NCD mortality in the province. A relative increase of 58.4% was recorded in prevalence rate of injuries since 1990. Road traffic accidents and firearm-related trauma predominated in urban Peshawar, while congenital and post-injury disabilities were significantly higher in rural settings (3.5%). The prevalence rate ratio for injuries increased significantly to 1.011 [95% CI: 1.008–1.014].
CONCLUSIONS:
Khyber Pakhtunkhwa is currently at tipping point where the "triple burden" is straining the UHC-Benefit Package. The findings highlight policy shifts toward NCD management are necessary, the province must rebuild climate-resilient systems to manage resurgence of infectious diseases and the growing toll of trauma. Integrated, multi-sectoral strategies are essential to improve provincial health outcomes by 2030.
Over the last decade, Khyber Pakhtunkhwa has faced a unique "Triple Burden" of disease, the resurgence of infectious outbreaks (exacerbated by climate-driven floods), rising prevalence of non-communicable diseases, and a significant increase in injuries and disabilities. This study aims to analyze the 30-year disease burden trends in the adult population of KP, with a specific focus on the critical shifts observed during the 2021–2025 period.
METHODS:
Data for the period 1990 to 2025 was extracted from the Global Burden of Disease (GBD) for Pakistan, provincial surveillance reports, and recent Integrated Population and Health Surveys (IPHS). Trends were analyzed through prevalence, death rates, and disability-adjusted life years (DALYs). Poisson regression analysis was utilized to evaluate the incidence rate ratio (IRR) across three categories: Communicable Diseases (CDs), Non-Communicable Diseases (NCDs), and Injuries.
RESULTS:
While traditional CDs showed relative decrease in prevalence (approx. 21% decrease since 1990), there was significant resurgence in 2024–2025. Diphtheria cases spiked (n=309) with a 24.6% mortality rate, and waterborne diseases increased by over 80% in flood-affected districts. Hypertension prevalence reached 29.2%, and Diabetes affected 7.4% of the adult population. Cardiovascular diseases now account for the highest NCD mortality in the province. A relative increase of 58.4% was recorded in prevalence rate of injuries since 1990. Road traffic accidents and firearm-related trauma predominated in urban Peshawar, while congenital and post-injury disabilities were significantly higher in rural settings (3.5%). The prevalence rate ratio for injuries increased significantly to 1.011 [95% CI: 1.008–1.014].
CONCLUSIONS:
Khyber Pakhtunkhwa is currently at tipping point where the "triple burden" is straining the UHC-Benefit Package. The findings highlight policy shifts toward NCD management are necessary, the province must rebuild climate-resilient systems to manage resurgence of infectious diseases and the growing toll of trauma. Integrated, multi-sectoral strategies are essential to improve provincial health outcomes by 2030.
| eISSN: | 2654-1459 |
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