The unfinished agenda of communicable diseases among children and adolescents before the COVID-19 pandemic, 1990-2019: a systematic analysis of the Global Burden of Disease Study 2019

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AZZOPARDI Peter S KERR Jessica A FRANCIS Kate L SAWYER Susan M KENNEDY Elissa Clare STEER Andrew C GRAHAM Stephen Michael VINER Russell M WARD Joseph L HENNEGAN Julie PHAM Minh HABITO Christine Marie D KURJI Jaameeta CINI Karly I BEESON James G BROWN Alex MURRAY Christopher J L ABBASI-KANGEVARI Mohsen ABOLHASSANI Hassan ADEKANMBI Victor AGAMPODI Suneth Buddhika AHMED Muktar Beshir AJAMI Marjan AKBARIALIABAD Hossein AKBARZADEH-KHIAVI Mostafa AL-AHDAL Tareq Mohammed Ali ALI Musa Mohammed SAMAKKHAH Shohreh Alian ALIMOHAMADI Yousef ALIPOUR Vahid AL-JUMAILY Adel AMIRI Sohrab AMIRZADE-IRANAQ Mohammad Hosein ANOUSHIRAVANI Amir ANVARI Davood ARABLOO Jalal ARAB-ZOZANI Morteza ARKEW Mesay ARMOCIDA Benedetta ASADI-POOYA Ali A ASEMI Zatollah ASGARY Saeed ATHARI Seyyed Shamsadin AZAMI Hiva AZANGOU-KHYAVY Mohammadreza AZIZI Hosein BAGHERI Nader BAGHERIEH Sara BARONE-ADESI Francesco BARTEIT Sandra BASU Sanjay BELETE Melaku Ashagrie BELO Luis BERHIE Alemshet Yirga BIJANI Ali BIKBOV Boris BURKART Katrin CARRERAS Giulia CHARALAMPOUS Periklis ABEBE Endeshaw Chekol CRUZ-MARTINS Natalia DAI Xiaochen DANDONA Lalit DANDONA Rakhi DEGUALEM Sayih Mehari DEMETRIADES Andreas K DEMLASH Alemayehu Anley DESTA Abebaw Alemayehu DIANATINASAB Mostafa DOAEI Saeid DOROSTKAR Fariba EFFENDI Diyan Ermawan EMAMI Amir BAIN Luchuo Engelbert ESKANDARIEH Sharareh ESMAEILZADEH Firooz FARAMARZI Ali FATEHIZADEH Ali FERRARA Pietro FETENSA Getahun FISCHER Florian FLOR Luisa S FOROUHARI Ali FOROUTAN Masoud GAIHRE Santosh GALEHDAR Nasrin GALLUS Silvano GAUTAM Rupesh K GEBREHIWOT Mesfin GEBREMESKEL Teferi Gebru GETACHER Lemma GETACHEW Motuma Erena GHAMARI Seyyed-Hadi NOUR Mohammad Ghasemi GOLEIJ Pouya GOLITALEB Mohamad GORINI Giuseppe GUPTA Vijai Kumar HASHEMIAN Maryam HASSANKHANI Hadi HEIDARI Mohammad HEYI Demisu Zenbaba ISOLA Gaetano JAAFARI Jalil JAVANMARDI Fatemeh JONAS Jost B JOZWIAK Jacek Jerzy JUERISSON Mikk KABIR Ali KABIR Zubair KALANKESH Laleh R KALHOR Rohollah KAUPPILA Joonas H KAUR Harkiran KAYODE Gbenga A KEIKAVOOSI-ARANI Leila KHAMMARNIA Mohammad MOIEN AB Khan KHATAB Khaled KASHANI Hamid Reza Khayat KOLAHI Ali-Asghar KOOHESTANI Hamid Reza KOYANAGI Ai KUMAR G Anil KURMI Om P KYU Hmwe Hmwe CARLO La Vecchia LALLUKKA Tea LIM Stephen S LOUREIRO Joana A MAHJOUB Soleiman MAHMOUDI Razzagh MAJEED Azeem RAD Elaheh Malakan MALEKI Afshin MANSOUR-GHANAEI Fariborz MARJANI Abdoljalal MATHIOUDAKIS Alexander G MEHRI Fereshteh MENTIS Alexios-Fotios A MESTROVIC Tomislav MIRICA Andreea MISGANAW Awoke MOHAMMADIAN-HAFSHEJANI Abdollah MOHAMMED Hussen MOHAMMED Shafiu MOKDAD Ali H MOKHTARZADEHAZAR Peyman MONASTA Lorenzo MORADI Maryam MORADZADEH Maliheh MOROVATDAR Negar MUELLER Ulrich Otto MULITA Francesk MULU Getaneh Baye B MUTHUPANDIAN Saravanan NAIK Ganesh R NASHWAN Abdulqadir J J NEJADGHADERI Seyed Aria NETSERE Henok Biresaw NOOR Nurulamin M NOORI Maryam OANCEA Bogdan OGUNTADE Ayodipupo Sikiru OKATI-ALIABAD Hassan OTOIU Adrian PADRON-MONEDERO Alicia PAKZAD Reza PANDEY Anamika PARDHAN Shahina PARIKH Romil R PATEL Jay PENSATO Umberto PEPRAH Prince PERICO Norberto PODDIGHE Dimitri POSTMA Maarten J RAHIM Fakher RAHIMI-MOVAGHAR Vafa RAHMANI Shayan RAHMANIAN Vahid RAWAF Salman RAZEGHIAN-JAHROMI Iman REGASA Misganu Teshoma REMUZZI Giuseppe REZAEIAN Mohsen RIAD Abanoub ROMERO-RODRIGUEZ Esperanza RONFANI Luca PRAMANIK Koushik Roy SABOUR Siamak SADEGHIAN Saeid SAEB Mohammad Reza SAFARY Azam SAHEBKAR Amirhossein SAHILEDENGLE Biniyam SAMADZADEH Sara SARVEAZAD Arash SETHI Yashendra SHAHABI Saeed SHAHRAKI-SANAVI Fariba SHAMS-BEYRANVAND Mehran SHARAFI Kiomars SHAREW Nigussie Tadesse SHEIKH Aziz SHEIKHI Rahim Ali SHIRI Rahman SOCEA Bogdan SOLTANI-ZANGBAR Mohammad Sadegh TABARES-SEISDEDOS Rafael TABATABAI Shima SOODEJANI Moslem Taheri OLIAEE Razieh Tavakoli TIYURI Amir TOVANI-PALONE Marcos Roberto TUALEKA Abdul Rohim VALIZADEH Rohollah JEF Van den Eynde VASANKARI Tommi Juhani VOS Theo WALDE Mandaras Tariku WANG Yanzhong WEI Fei-Long WESTERMAN Ronny YADAV Vikas YAYA Sanni ZARE Iman ZHU Bin ZOLADL Mohammad ZUMLA Alimuddin HAY Simon I PATTON George C

Year of publication 2023
Type Article in Periodical
Magazine / Source Lancet
MU Faculty or unit

Faculty of Medicine

Citation
Web https://www.sciencedirect.com/science/article/pii/S0140673623008607?via%3Dihub
Doi http://dx.doi.org/10.1016/S0140-6736(23)00860-7
Keywords communicable diseases; children; adolescents
Attached files
Description Background Communicable disease control has long been a focus of global health policy. There have been substantial reductions in the burden and mortality of communicable diseases among children younger than 5 years, but we know less about this burden in older children and adolescents, and it is unclear whether current programmes and policies remain aligned with targets for intervention. This knowledge is especially important for policy and programmes in the context of the COVID-19 pandemic. We aimed to use the Global Burden of Disease (GBD) Study 2019 to systematically characterise the burden of communicable diseases across childhood and adolescence. Methods In this systematic analysis of the GBD study from 1990 to 2019, all communicable diseases and their manifestations as modelled within GBD 2019 were included, categorised as 16 subgroups of common diseases or presentations. Data were reported for absolute count, prevalence, and incidence across measures of cause-specific mortality (deaths and years of life lost), disability (years lived with disability [YLDs]), and disease burden (disability-adjusted life-years [DALYs]) for children and adolescents aged 0-24 years. Data were reported across the Socio-demographic Index (SDI) and across time (1990-2019), and for 204 countries and territories. For HIV, we reported the mortality-to-incidence ratio (MIR) as a measure of health system performance. Findings In 2019, there were 3 & BULL;0 million deaths and 30 & BULL;0 million years of healthy life lost to disability (as measured by YLDs), corresponding to 288 & BULL;4 million DALYs from communicable diseases among children and adolescents globally (57 & BULL;3% of total communicable disease burden across all ages). Over time, there has been a shift in communicable disease burden from young children to older children and adolescents (largely driven by the considerable reductions in children younger than 5 years and slower progress elsewhere), although children younger than 5 years still accounted for most of the communicable disease burden in 2019. Disease burden and mortality were predominantly in low-SDI settings, with high and high-middle SDI settings also having an appreciable burden of communicable disease morbidity (4 & BULL;0 million YLDs in 2019 alone). Three cause groups (enteric infections, lower-respiratory-tract infections, and malaria) accounted for 59 & BULL;8% of the global communicable disease burden in children and adolescents, with tuberculosis and HIV both emerging as important causes during adolescence. HIV was the only cause for which disease burden increased over time, particularly in children and adolescents older than 5 years, and especially in females. Excess MIRs for HIV were observed for males aged 15-19 years in low-SDI settings. Interpretation Our analysis supports continued policy focus on enteric infections and lower-respiratory-tract infections, with orientation to children younger than 5 years in settings of low socioeconomic development. However, efforts should also be targeted to other conditions, particularly HIV, given its increased burden in older children and adolescents. Older children and adolescents also experience a large burden of communicable disease, further highlighting the need for efforts to extend beyond the first 5 years of life. Our analysis also identified substantial morbidity caused by communicable diseases affecting child and adolescent health across the world.
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