The burden of cystic echinococcosis in women of reproductive age globally, regionally, and nationally from 1990 to 2021: An analysis based on explainable machine learning

Background Cystic Echinococcosis (CE) is a zoonotic parasitic disease caused by the larvae of Echinococcus granulosus. Despite global efforts in prevention and control, systematic studies on women of childbearing age(WCBA) remain relatively scarce. Methods The data for this study were obtained from the Global Burden of Disease (GBD) 2021 database, covering the epidemiological burden of CE in women of childbearing age(WCBA) globally from 1990 to 2021.The study used Estimated Annual Percentage Change (EAPC) to perform a descriptive analysis of the trends in the disease burden of CE in WCBA from 1990 to 2021.The framework was constructed using the Extreme Gradient Boosting(XGBoost), with feature engineering and gradient boosting iteration to analyze the trends in incidence, prevalence, and Disability-Adjusted Life Years (DALYs).The trends in disease burden from 2022 to 2050 were predicted, and the Shapley Additive Explanations (SHAP) values were used to quantify the contribution of features, identifying high-risk populations and regions. Results The study found that between 1990 and 2021, the global prevalence of CE increased by about 0.84 times, the incidence rose by about 0.88 times, while DALYs decreased by about 0.22 times.In terms of age distribution, the highest increase in CE prevalence among WCBA was seen in the 45–49 age group, with an increase of nearly 1.44 times; while the highest increase in incidence was observed in the 30–34 age group, with an increase of about 1.04 times.Regionally, the CE disease burden is heaviest in Low SDI regions, while the number of cases in Middle SDI regions increased by 1.36 times.According to the model predictions, the prevalence and incidence of CE will show some fluctuation trends in the future. It is expected that by 2050, the global prevalence of CE in WCBA will reach 10.13 per 100,000, and the incidence will reach 2.34 per 100,000. Conclusions The global burden of CE in WCBA remains high, showing regional and age-related heterogeneity. There is a need to strengthen prevention and control measures in resource-poor areas, optimize dog management and hygiene intervention strategies, to reduce maternal and child health risks.