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

Theo Vos, Hmwe H. Kyu, Christine Pinho, Joseph A. Wagner, Jonathan C. Brown, Amelia Bertozzi-Villa, Fiona J. Charlson, Luc Edgar Coffeng, Lalit Dandona, Holly E. Erskine, Alize J. Ferrari, Christina Fitzmaurice, Thomas D. Fleming, Mohammad H. Forouzanfar, Nicholas Graetz, Caterina Guinovart, Juanita Haagsma, Hideki Higashi, Nicholas J. Kassebaum, Heidi J. LarsonStephen S. Lim, Ali H. Mokdad, Maziar Moradi-Lakeh, Shaun V. Odell, Gregory A. Roth, Peter T. Serina, Jeffrey D. Stanaway, Awoke Misganaw, Harvey A. Whiteford, Timothy M. Wolock, Sarah Wulf Hanson, Foad Abd-Allah, Semaw Ferede Abera, Laith J. Abu-Raddad, Fadia S. Al Buhairan, Azmeraw T. Amare, Carl Abelardo T. Antonio, Al Artaman, Suzanne L. Barker-Collo, Lope H. Barrero, Corina Benjet, Isabela M. Bensenor, Zulfiqar A. Bhutta, Boris Bikbov, Alexandra Brazinova, Ismael Campos-Nonato, Carlos A. Castañeda-Orjuela, Ferrán Catalá-López, Rajiv Chowdhury, Cyrus Cooper, John A. Crump, Rakhi Dandona, Louisa Degenhardt, Robert P. Dellavalle, Samath D. Dharmaratne, Emerito Jose A. Faraon, Valery L. Feigin, Thomas Fürst, Johanna M. Geleijnse, Bradford D. Gessner, Katherine B. Gibney, Atsushi Goto, David Gunnell, Graeme J. Hankey, Roderick J. Hay, John C. Hornberger, H. Dean Hosgood, Guoqing Hu, Kathryn H. Jacobsen, Sudha P. Jayaraman, Panniyammakal Jeemon, Jost B. Jonas, André Karch, Daniel Kim, Sungroul Kim, Yoshihiro Kokubo, Barthelemy Kuate Defo, Burcu Kucuk Bicer, G. Anil Kumar, Anders Larsson, Janet L. Leasher, Ricky Leung, Yongmei Li, Steven E. Lipshultz, Alan D. Lopez, Paulo A. Lotufo, Raimundas Lunevicius, Ronan A. Lyons, Marek Majdan, Reza Malekzadeh, Taufiq Mashal, Amanda J. Mason-Jones, Yohannes Adama Melaku, Ziad A. Memish, Walter Mendoza, Ted R. Miller, Charles N. Mock, Joseph Murray, Sandra Nolte, In Hwan Oh, Bolajoko Olubukunola Olusanya, Katrina F. Ortblad, Eun Kee Park, Angel J.Paternina Caicedo, Scott B. Patten, George C. Patton, David M. Pereira, Norberto Perico, Frédéric B. Piel, Suzanne Polinder, Svetlana Popova, Farshad Pourmalek, D. Alex Quistberg, Giuseppe Remuzzi, Alina Rodriguez, David Rojas-Rueda, Dietrich Rothenbacher, David H. Rothstein, Juan Sanabria, Itamar S. Santos, David C. Schwebel, Sadaf G. Sepanlou, Amira Shaheen, Rahman Shiri, Ivy Shiue, Vegard Skirbekk, Karen Sliwa, Chandrashekhar T. Sreeramareddy, Dan J. Stein, Timothy J. Steiner, Lars Jacob Stovner, Bryan L. Sykes, Karen M. Tabb, Abdullah Sulieman Terkawi, Alan J. Thomson, Andrew L. Thorne-Lyman, Jeffrey Allen Towbin, Kingsley Nnanna Ukwaja, Tommi Vasankari, Narayanaswamy Venketasubramanian, Vasiliy Victorovich Vlassov, Stein Emil Vollset, Elisabete Weiderpass, Robert G. Weintraub, Andrea Werdecker, James D. Wilkinson, Solomon Meseret Woldeyohannes, Charles D.A. Wolfe, Yuichiro Yano, Paul Yip, Naohiro Yonemoto, Seok Jun Yoon, Mustafa Z. Younis, Chuanhua Yu, Maysaa El Sayed Zaki, Mohsen Naghavi, Christopher J.L. Murray

Research output: Contribution to journalReview articlepeer-review

490 Citations (Scopus)

Abstract

IMPORTANCE: The 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. 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, HIVinfection/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-MR2.0, 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 amongyounger 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 amongyounger children (905 059 deaths; 95% UI, 810 304-998125), diarrheal diseases among older children (38 325 deaths; 95% UI, 30 365-47 678), and road injuries among adolescents (115186 deaths; 95% UI, 105185-124 870). 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 injust 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.

Original languageEnglish
Pages (from-to)267-287
Number of pages21
JournalJAMA Pediatrics
Volume170
Issue number3
DOIs
Publication statusPublished - Mar 2016

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