Pediatric surgery international · 2026
Childhood Inguinal, Femoral, and Abdominal Hernias in Low-Income Countries: Trends, Inequalities, and Projections to 2050.
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Gu Xinjia, Zheng Zhihui, Zhu Jihua, Lv Wenwen, Liu Taixiang
Аннотация
PURPOSE: To examine trends, Socio-demographic Index (SDI) associations, inequalities, and future burden of childhood inguinal, femoral, and abdominal hernia (IFAH) in low-income countries (LICs).
METHODS: GBD 2023 estimates for children aged 0-14 years in 25 LICs were analyzed for 1990-2023. Counts, crude rates, estimated annual percentage changes (EAPCs), age- and sex-specific patterns, SDI associations, concentration indices, population-rate decomposition, lower-quantile benchmarking, and projections to 2050 were assessed.
RESULTS: In 2023, IFAH accounted for 253,424 incident cases, 377 deaths, and 67,970 disability-adjusted life years (DALYs). From 1990 to 2023, incident cases increased by 64.38% and DALYs by 22.18%, whereas deaths decreased by 6.60%. Incidence, mortality, and DALY rates declined, with EAPCs of -0.62%, -2.54%, and -1.75%, respectively. Infants accounted for 64.12% of deaths and 46.72% of DALYs. Mortality and DALY rates were inversely associated with SDI and became increasingly concentrated in relatively lower-SDI countries. Population growth offset gains associated with declining rates. By 2050, incident cases, deaths, and DALYs were projected to reach 305,947, 422, and 77,279.
CONCLUSION: Childhood IFAH rates declined, but absolute burden remained substantial and may increase with population growth. Planning should prioritize infant care and LICs with high fatal and disabling burden.
METHODS: GBD 2023 estimates for children aged 0-14 years in 25 LICs were analyzed for 1990-2023. Counts, crude rates, estimated annual percentage changes (EAPCs), age- and sex-specific patterns, SDI associations, concentration indices, population-rate decomposition, lower-quantile benchmarking, and projections to 2050 were assessed.
RESULTS: In 2023, IFAH accounted for 253,424 incident cases, 377 deaths, and 67,970 disability-adjusted life years (DALYs). From 1990 to 2023, incident cases increased by 64.38% and DALYs by 22.18%, whereas deaths decreased by 6.60%. Incidence, mortality, and DALY rates declined, with EAPCs of -0.62%, -2.54%, and -1.75%, respectively. Infants accounted for 64.12% of deaths and 46.72% of DALYs. Mortality and DALY rates were inversely associated with SDI and became increasingly concentrated in relatively lower-SDI countries. Population growth offset gains associated with declining rates. By 2050, incident cases, deaths, and DALYs were projected to reach 305,947, 422, and 77,279.
CONCLUSION: Childhood IFAH rates declined, but absolute burden remained substantial and may increase with population growth. Planning should prioritize infant care and LICs with high fatal and disabling burden.