Centre for Healthy Start Initiative, Lagos, Nigeria;
Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland.
Pediatrics. 2020 Jul;146(1). doi: 10.1542/peds.2019-2623. Epub 2020 Jun 17.
Estimates of children and adolescents with disabilities worldwide are needed to inform global intervention under the disability-inclusive provisions of the Sustainable Development Goals. We sought to update the most widely reported estimate of 93 million children <15 years with disabilities from the Global Burden of Disease Study 2004.
We analyzed Global Burden of Disease Study 2017 data on the prevalence of childhood epilepsy, intellectual disability, and vision or hearing loss and on years lived with disability (YLD) derived from systematic reviews, health surveys, hospital and claims databases, cohort studies, and disease-specific registries. Point estimates of the prevalence and YLD and the 95% uncertainty intervals (UIs) around the estimates were assessed.
Globally, 291.2 million (11.2%) of the 2.6 billion children and adolescents (95% UI: 249.9-335.4 million) were estimated to have 1 of the 4 specified disabilities in 2017. The prevalence of these disabilities increased with age from 6.1% among children aged <1 year to 13.9% among adolescents aged 15 to 19 years. A total of 275.2 million (94.5%) lived in low- and middle-income countries, predominantly in South Asia and sub-Saharan Africa. The top 10 countries accounted for 62.3% of all children and adolescents with disabilities. These disabilities accounted for 28.9 million YLD or 19.9% of the overall 145.3 million (95% UI: 106.9-189.7) YLD from all causes among children and adolescents.
The number of children and adolescents with these 4 disabilities is far higher than the 2004 estimate, increases from infancy to adolescence, and accounts for a substantial proportion of all-cause YLD.
为了根据可持续发展目标中包含残疾问题的规定为全球干预措施提供信息，我们需要估算全世界残疾儿童和青少年的人数。我们试图更新全球疾病负担研究 2004 年报告的残疾儿童和青少年人数最多的估计值，即 9300 万 15 岁以下残疾儿童。
我们分析了 2017 年全球疾病负担研究的数据，该数据涉及儿童癫痫、智力残疾、视力或听力损失以及伤残调整寿命年（YLD）的患病率，这些数据来源于系统评价、健康调查、医院和索赔数据库、队列研究以及特定疾病登记处。我们评估了患病率和 YLD 的点估计值及其 95%置信区间（UI）。
在全球范围内，2017 年估计有 2.6 亿儿童和青少年（95%UI：2.499 亿至 3.354 亿）中有 1 种指定残疾，占 29120 万（11.2%）。这些残疾的患病率随年龄增长而增加，从 1 岁以下儿童的 6.1%上升到 15 至 19 岁青少年的 13.9%。共有 27520 万（94.5%）生活在中低收入国家，主要分布在南亚和撒哈拉以南非洲。前 10 个国家占所有残疾儿童和青少年的 62.3%。这些残疾导致了 2890 万 YLD，占儿童和青少年所有病因 YLD（14530 万[95%UI：10690 万至 18970 万]）的 19.9%。
患有这 4 种残疾的儿童和青少年人数远远高于 2004 年的估计值，从婴儿期到青春期逐渐增加，占所有病因 YLD 的很大比例。
