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

Vos, T. and Kyu, H.H. and Pinho, C. and Wagner, J.A. and Brown, J.C. and Bertozzi-Villa, A. and Charlson, F.J. and Coffeng, L.E. and Dandona, L. and Erskine, H.E. and Ferrari, A.J. and Fitzmaurice, C. and Fleming, T.D. and Forouzanfar, M.H. and Graetz, N. and Guinovart, C. and Haagsma, J. and Higashi, H. and Kassebaum, N.J. and Larson, H.J. and Lim, S.S. and Mokdad, A.H. and Moradi-Lakeh, M. and Odell, S.V. and Roth, G.A. and Serina, P.T. and Stanaway, J.D. and Misganaw, A. and Whiteford, H.A. and Wolock, T.M. and Hanson, S.W. and Abd-Allah, F. and Abera, S.F. and Abu-Raddad, L.J. and Al Buhairan, F.S. and Amare, A.T. and Antonio, C.A.T. and Artaman, A. and Barker-Collo, S.L. and Barrero, L.H. and Benjet, C. and Bensenor, I.M. and Bhutta, Z.A. and Bikbov, B. and Brazinova, A. and Campos-Nonato, I. and Castañeda-Orjuela, C.A. and Catalá-López, F. and Chowdhury, R. and Cooper, C. and Crump, J.A. and Dandona, R. and Degenhardt, L. and Dellavalle, R.P. and Dharmaratne, S.D. and Faraon, E.J.A. and Feigin, V.L. and Fürst, T. and Geleijnse, J.M. and Gessner, B.D. and Gibney, K.B. and Goto, A. and Gunnell, D. and Hankey, G.J. and Hay, R.J. and Hornberger, J.C. and Hosgood, H.D. and Hu, G. and Jacobsen, K.H. and Jayaraman, S.P. and Jeemon, P. and Jonas, J.B. and Karch, A. and Kim, D. and Kim, S. and Kokubo, Y. and Defo, B.K. and Bicer, B.K. and Kumar, G.A. and Larsson, A. and Leasher, J.L. and Leung, R. and Li, Y. and Lipshultz, S.E. and Lopez, A.D. and Lotufo, P.A. and Lunevicius, R. and Lyons, R.A. and Majdan, M. and Malekzadeh, R. and Mashal, T. and Mason-Jones, A.J. and Melaku, Y.A. and Memish, Z.A. and Mendoza, W. and Miller, T.R. and Mock, C.N. and Murray, J. and Nolte, S. and Oh, I.-H. and Olusanya, B.O. and Ortblad, K.F. and Park, E.-K. and Caicedo, A.J.P. and Patten, S.B. and Patton, G.C. and Pereira, D.M. and Perico, N. and Piel, F.B. and Polinder, S. and Popova, S. and Pourmalek, F. and Quistberg, D.A. and Remuzzi, G. and Rodriguez, A. and Rojas-Rueda, D. and Rothenbacher, D. and Rothstein, D.H. and Sanabria, J. and Santos, I.S. and Schwebel, D.C. and Sepanlou, S.G. and Shaheen, A. and Shiri, R. and Shiue, I. and Skirbekk, V. and Sliwa, K. and Sreeramareddy, C.T. and Stein, D.J. and Steiner, T.J. and Stovner, L.J. and Sykes, B.L. and Tabb, K.M. and Terkawi, A.S. and Thomson, A.J. and Thorne-Lyman, A.L. and Towbin, J.A. and Ukwaja, K.N. and Vasankari, T. and Venketasubramanian, N. and Vlassov, V.V. and Vollset, S.E. and Weiderpass, E. and Weintraub, R.G. and Werdecker, A. and Wilkinson, J.D. and Woldeyohannes, S.M. and Wolfe, C.D.A. and Yano, Y. and Yip, P. and Yonemoto, N. and Yoon, S.-J. and Younis, M.Z. and Yu, C. and El Sayed Zaki, M. and Naghavi, M. and Murray, C.J.L. (2016) 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. JAMA Pediatrics, 170 (3). pp. 267-287.

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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. Copyright 2016 American Medical Association. All rights reserved.

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