Global and National Burden of Diseases and Injuries Among Children and Adolescents Between 1990 and 2013: Findings From the Global Burden of Disease 2013 Study.
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Global Burden of Disease Pediatrics Collaboration, Kyu Hmwe H, Pinho Christine, Wagner Joseph A, Brown Jonathan C, Bertozzi-Villa Amelia, Charlson Fiona J, Coffeng Luc Edgar, Dandona Lalit, Erskine Holly E, Ferrari Alize J, Fitzmaurice Christina, Fleming Thomas D, Forouzanfar Mohammad H, Graetz Nicholas, Guinovart Caterina, Haagsma Juanita, Higashi Hideki, Kassebaum Nicholas J, Larson Heidi J, Lim Stephen S, Mokdad Ali H, Moradi-Lakeh Maziar, Odell Shaun V, Roth Gregory A, Serina Peter T, Stanaway Jeffrey D, Misganaw Awoke, Whiteford Harvey A, Wolock Timothy M, Wulf Hanson Sarah, Abd-Allah Foad, Abera Semaw Ferede, Abu-Raddad Laith J, AlBuhairan Fadia S, Amare Azmeraw T, Antonio Carl Abelardo T, Artaman Al, Barker-Collo Suzanne L, Barrero Lope H, Benjet Corina, Bensenor Isabela M, Bhutta Zulfiqar A, Bikbov Boris, Brazinova Alexandra, Campos-Nonato Ismael, Castañeda-Orjuela Carlos A, Catalá-López Ferrán, Chowdhury Rajiv, Cooper Cyrus, Crump John A, Dandona Rakhi, Degenhardt Louisa, Dellavalle Robert P, Dharmaratne Samath D, Faraon Emerito Jose A, Feigin Valery L, Fürst Thomas, Geleijnse Johanna M, Gessner Bradford D, Gibney Katherine B, Goto Atsushi, Gunnell David, Hankey Graeme J, Hay Roderick J, Hornberger John C, Hosgood H Dean, Hu Guoqing, Jacobsen Kathryn H, Jayaraman Sudha P, Jeemon Panniyammakal, Jonas Jost B, Karch André, Kim Daniel, Kim Sungroul, Kokubo Yoshihiro, Kuate Defo Barthelemy, Kucuk Bicer Burcu, Kumar G Anil, Larsson Anders, Leasher Janet L, Leung Ricky, Li Yongmei, Lipshultz Steven E, Lopez Alan D, Lotufo Paulo A, Lunevicius Raimundas, Lyons Ronan A, Majdan Marek, Malekzadeh Reza, Mashal Taufiq, Mason-Jones Amanda J, Melaku Yohannes Adama, Memish Ziad A, Mendoza Walter, Miller Ted R, Mock Charles N, Murray Joseph, Nolte Sandra, Oh In-Hwan, Olusanya Bolajoko Olubukunola, Ortblad Katrina F, Park Eun-Kee, Paternina Caicedo Angel J, Patten Scott B, Patton George C, Pereira David M, Perico Norberto, Piel Frédéric B, Polinder Suzanne, Popova Svetlana, Pourmalek Farshad, Quistberg D Alex, Remuzzi Giuseppe, Rodriguez Alina, Rojas-Rueda David, Rothenbacher Dietrich, Rothstein David H, Sanabria Juan, Santos Itamar S, Schwebel David C, Sepanlou Sadaf G, Shaheen Amira, Shiri Rahman, Shiue Ivy, Skirbekk Vegard, Sliwa Karen, Sreeramareddy Chandrashekhar T, Stein Dan J, Steiner Timothy J, Stovner Lars Jacob, Sykes Bryan L, Tabb Karen M, Terkawi Abdullah Sulieman, Thomson Alan J, Thorne-Lyman Andrew L, Towbin Jeffrey Allen, Ukwaja Kingsley Nnanna, Vasankari Tommi, Venketasubramanian Narayanaswamy, Vlassov Vasiliy Victorovich, Vollset Stein Emil, Weiderpass Elisabete, Weintraub Robert G, Werdecker Andrea, Wilkinson James D, Woldeyohannes Solomon Meseret, Wolfe Charles D A, Yano Yuichiro, Yip Paul, Yonemoto Naohiro, Yoon Seok-Jun, Younis Mustafa Z, Yu Chuanhua, El Sayed Zaki Maysaa, Naghavi Mohsen, Murray Christopher J L, Vos Theo
Аннотация
OBJECTIVE: To determine levels and trends in the fatal and nonfatal burden of diseases and injuries among younger children (aged <5 years), older children (aged 5-9 years), and adolescents (aged 10-19 years) between 1990 and 2013 in 188 countries from the Global Burden of Disease (GBD) 2013 study.
EVIDENCE REVIEW: Data from vital registration, verbal autopsy studies, maternal and child death surveillance, and other sources covering 14,244 site-years (ie, years of cause of death data by geography) from 1980 through 2013 were used to estimate cause-specific mortality. Data from 35,620 epidemiological sources were used to estimate the prevalence of the diseases and sequelae in the GBD 2013 study. Cause-specific mortality for most causes was estimated using the Cause of Death Ensemble Model strategy. For some infectious diseases (eg, HIV infection/AIDS, measles, hepatitis B) where the disease process is complex or the cause of death data were insufficient or unavailable, we used natural history models. For most nonfatal health outcomes, DisMod-MR 2.0, a Bayesian metaregression tool, was used to meta-analyze the epidemiological data to generate prevalence estimates.
FINDINGS: Of the 7.7 (95% uncertainty interval [UI], 7.4-8.1) million deaths among children and adolescents globally in 2013, 6.28 million occurred among younger children, 0.48 million among older children, and 0.97 million among adolescents. In 2013, the leading causes of death were lower respiratory tract infections among younger children (905.059 deaths; 95% UI, 810,304-998,125), diarrheal diseases among older children (38,325 deaths; 95% UI, 30,365-47,678), and road injuries among adolescents (115,186 deaths; 95% UI, 105,185-124,870). Iron deficiency anemia was the leading cause of years lived with disability among children and adolescents, affecting 619 (95% UI, 618-621) million in 2013. Large between-country variations exist in mortality from leading causes among children and adolescents. Countries with rapid declines in all-cause mortality between 1990 and 2013 also experienced large declines in most leading causes of death, whereas countries with the slowest declines had stagnant or increasing trends in the leading causes of death. In 2013, Nigeria had a 12% global share of deaths from lower respiratory tract infections and a 38% global share of deaths from malaria. India had 33% of the world's deaths from neonatal encephalopathy. Half of the world's diarrheal deaths among children and adolescents occurred in just 5 countries: India, Democratic Republic of the Congo, Pakistan, Nigeria, and Ethiopia.
CONCLUSIONS AND RELEVANCE: Understanding the levels and trends of the leading causes of death and disability among children and adolescents is critical to guide investment and inform policies. Monitoring these trends over time is also key to understanding where interventions are having an impact. Proven interventions exist to prevent or treat the leading causes of unnecessary death and disability among children and adolescents. The findings presented here show that these are underused and give guidance to policy makers in countries where more attention is needed.