Dataset Information

Child and Adolescent Health From 1990 to 2015: Findings From the Global Burden of Diseases, Injuries, and Risk Factors 2015 Study.

ABSTRACT:

Importance

Comprehensive and timely monitoring of disease burden in all age groups, including children and adolescents, is essential for improving population health.

Objective

To quantify and describe levels and trends of mortality and nonfatal health outcomes among children and adolescents from 1990 to 2015 to provide a framework for policy discussion.

Evidence review

Cause-specific mortality and nonfatal health outcomes were analyzed for 195 countries and territories by age group, sex, and year from 1990 to 2015 using standardized approaches for data processing and statistical modeling, with subsequent analysis of the findings to describe levels and trends across geography and time among children and adolescents 19 years or younger. A composite indicator of income, education, and fertility was developed (Socio-demographic Index [SDI]) for each geographic unit and year, which evaluates the historical association between SDI and health loss.

Findings

Global child and adolescent mortality decreased from 14.18 million (95% uncertainty interval [UI], 14.09 million to 14.28 million) deaths in 1990 to 7.26 million (95% UI, 7.14 million to 7.39 million) deaths in 2015, but progress has been unevenly distributed. Countries with a lower SDI had a larger proportion of mortality burden (75%) in 2015 than was the case in 1990 (61%). Most deaths in 2015 occurred in South Asia and sub-Saharan Africa. Global trends were driven by reductions in mortality owing to infectious, nutritional, and neonatal disorders, which in the aggregate led to a relative increase in the importance of noncommunicable diseases and injuries in explaining global disease burden. The absolute burden of disability in children and adolescents increased 4.3% (95% UI, 3.1%-5.6%) from 1990 to 2015, with much of the increase owing to population growth and improved survival for children and adolescents to older ages. Other than infectious conditions, many top causes of disability are associated with long-term sequelae of conditions present at birth (eg, neonatal disorders, congenital birth defects, and hemoglobinopathies) and complications of a variety of infections and nutritional deficiencies. Anemia, developmental intellectual disability, hearing loss, epilepsy, and vision loss are important contributors to childhood disability that can arise from multiple causes. Maternal and reproductive health remains a key cause of disease burden in adolescent females, especially in lower-SDI countries. In low-SDI countries, mortality is the primary driver of health loss for children and adolescents, whereas disability predominates in higher-SDI locations; the specific pattern of epidemiological transition varies across diseases and injuries.

Conclusions and relevance

Consistent international attention and investment have led to sustained improvements in causes of health loss among children and adolescents in many countries, although progress has been uneven. The persistence of infectious diseases in some countries, coupled with ongoing epidemiologic transition to injuries and noncommunicable diseases, require all countries to carefully evaluate and implement appropriate strategies to maximize the health of their children and adolescents and for the international community to carefully consider which elements of child and adolescent health should be monitored.

SUBMITTER: Global Burden of Disease Child and Adolescent Health Collaboration

PROVIDER: S-EPMC5540012 | biostudies-literature | 2017 Jun

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Child and Adolescent Health From 1990 to 2015: Findings From the Global Burden of Diseases, Injuries, and Risk Factors 2015 Study.

Kassebaum Nicholas N Kyu Hmwe Hmwe HH Zoeckler Leo L Olsen Helen Elizabeth HE Thomas Katie K Pinho Christine C Bhutta Zulfiqar A ZA Dandona Lalit L Ferrari Alize A Ghiwot Tsegaye Tewelde TT Hay Simon I SI Kinfu Yohannes Y Liang Xiaofeng X Lopez Alan A Malta Deborah Carvalho DC Mokdad Ali H AH Naghavi Mohsen M Patton George C GC Salomon Joshua J Sartorius Benn B Topor-Madry Roman R Vollset Stein Emil SE Werdecker Andrea A Whiteford Harvey A HA Abate Kalkidan Hasen KH Abbas Kaja K Damtew Solomon Abrha SA Ahmed Muktar Beshir MB Akseer Nadia N Al-Raddadi Rajaa R Al-Raddadi Rajaa R Alemayohu Mulubirhan Assefa MA Altirkawi Khalid K Abajobir Amanuel Alemu AA Amare Azmeraw T AT Antonio Carl A T CAT Arnlov Johan J Artaman Al A Asayesh Hamid H Avokpaho Euripide Frinel G Arthur EFGA Awasthi Ashish A Ayala Quintanilla Beatriz Paulina BP Bacha Umar U Betsu Balem Demtsu BD Barac Aleksandra A Bärnighausen Till Winfried TW Baye Estifanos E Bedi Neeraj N Bensenor Isabela M IM Berhane Adugnaw A Bernabe Eduardo E Bernal Oscar Alberto OA Beyene Addisu Shunu AS Biadgilign Sibhatu S Bikbov Boris B Boyce Cheryl Anne CA Brazinova Alexandra A Hailu Gessessew Bugssa GB Carter Austin A Castañeda-Orjuela Carlos A CA Catalá-López Ferrán F Charlson Fiona J FJ Chitheer Abdulaal A AA Choi Jee-Young Jasmine JJ Ciobanu Liliana G LG Crump John J Dandona Rakhi R Dellavalle Robert P RP Deribew Amare A deVeber Gabrielle G Dicker Daniel D Ding Eric L EL Dubey Manisha M Endries Amanuel Yesuf AY Erskine Holly E HE Faraon Emerito Jose Aquino EJA Faro Andre A Farzadfar Farshad F Fernandes Joao C JC Fijabi Daniel Obadare DO Fitzmaurice Christina C Fleming Thomas D TD Flor Luisa Sorio LS Foreman Kyle J KJ Franklin Richard C RC Fraser Maya S MS Frostad Joseph J JJ Fullman Nancy N Gebregergs Gebremedhin Berhe GB Gebru Alemseged Aregay AA Geleijnse Johanna M JM Gibney Katherine B KB Gidey Yihdego Mahari M Ginawi Ibrahim Abdelmageem Mohamed IAM Gishu Melkamu Dedefo MD Gizachew Tessema Assefa TA Glaser Elizabeth E Gold Audra L AL Goldberg Ellen E Gona Philimon P Goto Atsushi A Gugnani Harish Chander HC Jiang Guohong G Gupta Rajeev R Tesfay Fisaha Haile FH Hankey Graeme J GJ Havmoeller Rasmus R Hijar Martha M Horino Masako M Hosgood H Dean HD Hu Guoqing G Jacobsen Kathryn H KH Jakovljevic Mihajlo B MB Jakovljevic Mihajlo B MB Jayaraman Sudha P SP Jha Vivekanand V Jibat Tariku T Johnson Catherine O CO Jonas Jost J Kasaeian Amir A Kawakami Norito N Keiyoro Peter N PN Khalil Ibrahim I Khang Young-Ho YH Khubchandani Jagdish J Ahmad Kiadaliri Aliasghar A AA Kieling Christian C Kim Daniel D Kissoon Niranjan N Knibbs Luke D LD Koyanagi Ai A Krohn Kristopher J KJ Kuate Defo Barthelemy B Kucuk Bicer Burcu B Kulikoff Rachel R Kumar G Anil GA Lal Dharmesh Kumar DK Lam Hilton Y HY Larson Heidi J HJ Larsson Anders A Laryea Dennis Odai DO Leung Janni J Lim Stephen S SS Lo Loon-Tzian LT Lo Warren D WD Looker Katharine J KJ Lotufo Paulo A PA Magdy Abd El Razek Hassan H Malekzadeh Reza R Markos Shifti Desalegn D Mazidi Mohsen M Meaney Peter A PA Meles Kidanu Gebremariam KG Memiah Peter P Mendoza Walter W Abera Mengistie Mubarek M Mengistu Gebremichael Welday GW Mensah George A GA Miller Ted R TR Mock Charles C Mohammadi Alireza A Mohammed Shafiu S Monasta Lorenzo L Monasta Lorenzo L Mueller Ulrich U Nagata Chie C Naheed Aliya A Nguyen Grant G Nguyen Quyen Le QL Nsoesie Elaine E Oh In-Hwan IH Okoro Anselm A Olusanya Jacob Olusegun JO Olusanya Bolajoko O BO Ortiz Alberto A Paudel Deepak D Pereira David M DM Perico Norberto N Petzold Max M Phillips Michael Robert MR Polanczyk Guilherme V GV Pourmalek Farshad F Qorbani Mostafa M Rafay Anwar A Rahimi-Movaghar Vafa V Rahman Mahfuzar M Rai Rajesh Kumar RK Ram Usha U Rankin Zane Z Remuzzi Giuseppe G Renzaho Andre M N AMN Roba Hirbo Shore HS Rojas-Rueda David D Ronfani Luca L Sagar Rajesh R Sanabria Juan Ramon JR Kedir Mohammed Muktar Sano MS Santos Itamar S IS Satpathy Maheswar M Sawhney Monika M Schöttker Ben B Schwebel David C DC Scott James G JG Sepanlou Sadaf G SG Shaheen Amira A Shaikh Masood Ali MA She June J Shiri Rahman R Shiue Ivy I Sigfusdottir Inga Dora ID Singh Jasvinder J Silpakit Naris N Smith Alison A Sreeramareddy Chandrashekhar C Stanaway Jeffrey D JD Stein Dan J DJ Steiner Caitlyn C Sufiyan Muawiyyah Babale MB Swaminathan Soumya S Tabarés-Seisdedos Rafael R Tabb Karen M KM Tadese Fentaw F Tavakkoli Mohammad M Taye Bineyam B Teeple Stephanie S Tegegne Teketo Kassaw TK Temam Shifa Girma G Terkawi Abdullah Sulieman AS Thomas Bernadette B Thomson Alan J AJ Tobe-Gai Ruoyan R Tonelli Marcello M Tran Bach Xuan BX Troeger Christopher C Ukwaja Kingsley N KN Uthman Olalekan O Vasankari Tommi T Venketasubramanian Narayanaswamy N Vlassov Vasiliy Victorovich VV Weiderpass Elisabete E Weintraub Robert R Gebrehiwot Solomon Weldemariam SW Westerman Ronny R Williams Hywel C HC Wolfe Charles D A CDA Woodbrook Rachel R Yano Yuichiro Y Yonemoto Naohiro N Yoon Seok-Jun SJ Younis Mustafa Z MZ Yu Chuanhua C Zaki Maysaa El Sayed MES Zegeye Elias Asfaw EA Zuhlke Liesl Joanna LJ Murray Christopher J L CJL Vos Theo T

JAMA pediatrics 20170601 6

<h4>Importance</h4>Comprehensive and timely monitoring of disease burden in all age groups, including children and adolescents, is essential for improving population health.<h4>Objective</h4>To quantify and describe levels and trends of mortality and nonfatal health outcomes among children and adolescents from 1990 to 2015 to provide a framework for policy discussion.<h4>Evidence review</h4>Cause-specific mortality and nonfatal health outcomes were analyzed for 195 countries and territories by a ...[more]

PMID: 28384795

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Project description:ImportanceUnderstanding causes and correlates of health loss among children and adolescents can identify areas of success, stagnation, and emerging threats and thereby facilitate effective improvement strategies.ObjectiveTo estimate mortality and morbidity in children and adolescents from 1990 to 2017 by age and sex in 195 countries and territories.Design, setting, and participantsThis study examined levels, trends, and spatiotemporal patterns of cause-specific mortality and nonfatal health outcomes using standardized approaches to data processing and statistical analysis. It also describes epidemiologic transitions by evaluating historical associations between disease indicators and the Socio-Demographic Index (SDI), a composite indicator of income, educational attainment, and fertility. Data collected from 1990 to 2017 on children and adolescents from birth through 19 years of age in 195 countries and territories were assessed. Data analysis occurred from January 2018 to August 2018.ExposuresBeing under the age of 20 years between 1990 and 2017.Main outcomes and measuresDeath and disability. All-cause and cause-specific deaths, disability-adjusted life years, years of life lost, and years of life lived with disability.ResultsChild and adolescent deaths decreased 51.7% from 13.77 million (95% uncertainty interval [UI], 13.60-13.93 million) in 1990 to 6.64 million (95% UI, 6.44-6.87 million) in 2017, but in 2017, aggregate disability increased 4.7% to a total of 145 million (95% UI, 107-190 million) years lived with disability globally. Progress was uneven, and inequity increased, with low-SDI and low-middle-SDI locations experiencing 82.2% (95% UI, 81.6%-82.9%) of deaths, up from 70.9% (95% UI, 70.4%-71.4%) in 1990. The leading disaggregated causes of disability-adjusted life years in 2017 in the low-SDI quintile were neonatal disorders, lower respiratory infections, diarrhea, malaria, and congenital birth defects, whereas neonatal disorders, congenital birth defects, headache, dermatitis, and anxiety were highest-ranked in the high-SDI quintile.Conclusions and relevanceMortality reductions over this 27-year period mean that children are more likely than ever to reach their 20th birthdays. The concomitant expansion of nonfatal health loss and epidemiological transition in children and adolescents, especially in low-SDI and middle-SDI countries, has the potential to increase already overburdened health systems, will affect the human capital potential of societies, and may influence the trajectory of socioeconomic development. Continued monitoring of child and adolescent health loss is crucial to sustain the progress of the past 27 years.

Project description:BackgroundAlthough a preventable and treatable disease, tuberculosis causes more than a million deaths each year. As countries work towards achieving the Sustainable Development Goal (SDG) target to end the tuberculosis epidemic by 2030, robust assessments of the levels and trends of the burden of tuberculosis are crucial to inform policy and programme decision making. We assessed the levels and trends in the fatal and non-fatal burden of tuberculosis by drug resistance and HIV status for 195 countries and territories from 1990 to 2016.MethodsWe analysed 15 943 site-years of vital registration data, 1710 site-years of verbal autopsy data, 764 site-years of sample-based vital registration data, and 361 site-years of mortality surveillance data to estimate mortality due to tuberculosis using the Cause of Death Ensemble model. We analysed all available data sources, including annual case notifications, prevalence surveys, population-based tuberculin surveys, and estimated tuberculosis cause-specific mortality to generate internally consistent estimates of incidence, prevalence, and mortality using DisMod-MR 2.1, a Bayesian meta-regression tool. We assessed how the burden of tuberculosis differed from the burden predicted by the Socio-demographic Index (SDI), a composite indicator of income per capita, average years of schooling, and total fertility rate.FindingsGlobally in 2016, among HIV-negative individuals, the number of incident cases of tuberculosis was 9·02 million (95% uncertainty interval [UI] 8·05-10·16) and the number of tuberculosis deaths was 1·21 million (1·16-1·27). Among HIV-positive individuals, the number of incident cases was 1·40 million (1·01-1·89) and the number of tuberculosis deaths was 0·24 million (0·16-0·31). Globally, among HIV-negative individuals the age-standardised incidence of tuberculosis decreased annually at a slower rate (-1·3% [-1·5 to -1·2]) than mortality did (-4·5% [-5·0 to -4·1]) from 2006 to 2016. Among HIV-positive individuals during the same period, the rate of change in annualised age-standardised incidence was -4·0% (-4·5 to -3·7) and mortality was -8·9% (-9·5 to -8·4). Several regions had higher rates of age-standardised incidence and mortality than expected on the basis of their SDI levels in 2016. For drug-susceptible tuberculosis, the highest observed-to-expected ratios were in southern sub-Saharan Africa (13·7 for incidence and 14·9 for mortality), and the lowest ratios were in high-income North America (0·4 for incidence) and Oceania (0·3 for mortality). For multidrug-resistant tuberculosis, eastern Europe had the highest observed-to-expected ratios (67·3 for incidence and 73·0 for mortality), and high-income North America had the lowest ratios (0·4 for incidence and 0·5 for mortality).InterpretationIf current trends in tuberculosis incidence continue, few countries are likely to meet the SDG target to end the tuberculosis epidemic by 2030. Progress needs to be accelerated by improving the quality of and access to tuberculosis diagnosis and care, by developing new tools, scaling up interventions to prevent risk factors for tuberculosis, and integrating control programmes for tuberculosis and HIV.FundingBill & Melinda Gates Foundation.

Project description:ImportanceThe literature focuses on mortality among children younger than 5 years. Comparable information on nonfatal health outcomes among these children and the fatal and nonfatal burden of diseases and injuries among older children and adolescents is scarce.ObjectiveTo 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 reviewData 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.FindingsOf 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 relevanceUnderstanding 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.

Project description:BackgroundIschaemic heart disease (IHD) is a major barrier to sustainable human development, but its health burden and geographic distribution among provinces of China remain unclear. This study aimed to estimate IHD burden in provinces of China, and attributable to risk factors from 1990 to 2015.MethodsData were collected from the Global Burden of Disease 2015 Study, which evaluated IHD burden and attributable risk factors using deaths and disability-adjusted life years (DALYs). Statistical models including cause of death ensemble modelling, Bayesian meta-regression analysis, and comparative risk assessment approaches were applied to reduce bias and produce comprehensive results of IHD deaths, DALYs and attributable risks. The 95% uncertainty intervals (UIs) were calculated and reported for mortality and DALYs.ResultsThe age-standardised death rate per 100,000 people increased by 13.3% from 101.3 (95%UI: 95.3-107.5) to 114.8 (95%UI: 109.8-120.1) from 1990 to 2015 in China, whereas the age-standardised DALY rate declined 3.9% to 1760.2 per 100,000 people (95%UI: 1671.6-1864.3). In 2015, the age-standardised death rate per 100,000 people was the highest in Heilongjiang (187.4, 95%UI: 161.6-217.5) and the lowest in Shanghai (44.2, 95%UI: 37.0-53.1), and the age-standardised DALY rate per 100,000 people was the highest in Xinjiang (3040.8, 95%UI: 2488.8-3735.4) and the lowest in Shanghai (524.4, 95%UI: 434.7-638.4). Geographically, the age-standardised death and DALY rates for southern provinces were lower than northern provinces, especially in southeastern coastal provinces. 95.3% of the IHD burden in China was attributable to environmental, behavioural and metabolic risk factors. The five leading IHD risks in 2015 were high systolic blood pressure, high total cholesterol, diet high in sodium, diet low in whole grains, and smoking.ConclusionsPopulation growth and ageing has led to a steady increase in the IHD burden. Regional disparities in IHD burden were observed in provinces of China. The distribution characteristics of IHD burden provide guidance for decision makers to formulate targeted preventive policies and interventions.

Dataset Information

Child and Adolescent Health From 1990 to 2015: Findings From the Global Burden of Diseases, Injuries, and Risk Factors 2015 Study.

Importance

Objective

Evidence review

Findings

Conclusions and relevance

Publications

Child and Adolescent Health From 1990 to 2015: Findings From the Global Burden of Diseases, Injuries, and Risk Factors 2015 Study.

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