目的 分析1990—2021年全球主要人体寄生虫病的疾病负担变化和分布特征，为寄生虫病防控提供科学依据。 方法 从全球疾病负担数据库中提取疟疾、美洲锥虫病、利什曼病、非洲锥虫病、血吸虫病、囊尾蚴病、细粒棘球蚴病、淋巴丝虫病、盘尾丝虫病、肠道线虫感染、食源性吸虫病及麦地那龙线虫病等12类主要人体寄生虫病的年龄标准化发病率、患病率、死亡率、伤残调整寿命年（DALY），从时间、人群（性别）及地区[含社会经济指数（SDI）分层]维度分析分布特征与趋势。采用R软件进行数据处理与可视化，结合Monte Carlo模拟估算不确定性区间。 结果 1990—2021年全球寄生虫病总DALY从7 403万人•年降至6 424万人•年，下降了13.22%。多数病种疾病负担下降，仅盘尾丝虫病、囊尾蚴病、食源性吸虫病和美洲锥虫病等4类有增加（增加1~5倍）。在病种排序上，疟疾始终为疾病负担最重的疾病（占比超3/4），利什曼病从第2位降至第8位，血吸虫病升至第2位。在时空分布中，疟疾疾病负担自2005年显著下降后近年略有反弹；肠道线虫感染、淋巴丝虫病等降幅超50%。撒哈拉以南非洲疾病负担最重，疟疾、血吸虫病等高度聚集；食源性吸虫病集中于东亚/东南亚；囊尾蚴病在欧美等发达地区亦高发。淋巴丝虫病男性疾病负担更重（死因排序第2位，女性中排序第7位）；疟疾、血吸虫分别为男性死因排序第1、第3位，为女性死因排序第1、第2位。低SDI地区疾病负担高于高SDI地区。 结论 全球寄生虫病负担整体下降但区域失衡突出，部分病种反弹风险犹存。需针对性调整防控策略，强化低SDI地区资源投入，关注性别差异，并警惕气候变化、全球化等新兴挑战。

Objective To investigate the trends in disease burden and distribution characteristics of major human parasitic diseases in the world from 1990 to 2021, so as to provide insights into parasitic disease control. Methods Age-standardized incidence, prevalence, mortality, and disability-adjusted life years (DALYs) of 12 major human parasitic diseases, including malaria, American trypanosomiasis, leishmaniasis, African trypanosomiasis, schistosomiasis, cysticercosis, cystic echinococcosis, lymphatic filariasis, onchocerciasis, intestinal nematode infections, food-borne trematodiases, and guinea worm disease, were extracted from the Global Burden of Disease database, and the temporal, population (gender) and regional [including socioeconomic index (SDI) stratification] distributions of and trends in disease burdens were analyzed. R software was used for data processing and visualization, and Monte Carlo simulation was employed to estimate uncertainty intervals (UI). Results The total global DALYs of parasitic diseases declined from 74.03 million to 64.24 million person-years from 1990 to 2021, with a reduction of 13.22%. The disease burdens due to most types of parasitic diseases declined, and the disease burdens due to onchocerciasis, cysticercosis, food-borne trematodiases and American trypanosomiasis increased by 1 to 5 folds. As to types of parasitic diseases, malaria always bore the highest disease burden (consisting of more than 3/4 of total burdens), and the disease burden due to leishmaniasis fell from the 2nd to the 8th place, while the burden of schistosomiasis rose to the 2nd place. The disease burden of malaria had remarkably reduced since 2005 and rebounded slightly in recent years, and the burdens due to intestinal nematode infections and lymphatic filariasis have declined by more than 50%. The highest burden of parasitic diseases was found in sub-Saharan Africa, with high clustering of disease burdens due to malaria and schistosomiasis, and the disease burden due to food-borne trematodiases was concentrated in east Asia and Southeast Asia, while cysticercosis was also highly prevalent in Europe and the United States. The disease burden due to lymphatic filariasis was higher among men (the second leading cause of death) than women (the seventh leading cause of death); malaria and schistosomiasis ranked 1st and 3rd respectively among the causes of death for males, and 1st and 2nd respectively among the causes of death for females. The disease burden due to parasitic diseases was significantly higher in low SDI regions than in high SDI areas. Conclusion The overall global burden of parasitic diseases has declined overall; however, regional disparities are prominent, and the risk of rebound for some parasitic diseases remains. It is necessary to adjust the parasitic disease control strategies, strengthen resources investment in low SDI regions, pay attention to gender differences, and be alert to emerging challenges such as climate change and globalization.