Maternal, Newborn, Child and Adolescent Health and Ageing Department, WHO, Geneva, Switzerland
Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.
BMJ Glob Health. 2021 Mar;6(3). doi: 10.1136/bmjgh-2021-004996.
Non-fatal health loss makes a substantial contribution to the total disease burden among children and adolescents. An analysis of these morbidity patterns is essential to plan interventions that improve the health and well-being of children and adolescents. Our objective was to describe current levels and trends in the non-fatal disease burden from 2000 to 2016 among children and adolescents aged 0-19 years.
We used years lost due to disability (YLD) estimates in WHO's Global Health Estimates to describe the non-fatal disease burden from 2000 to 2016 for the age groups 0-27 days, 28 days-11 months, 1-4 years, 5-9 years, 10-14 years and 15-19 years globally and by modified WHO region. To describe causes of YLDs, we used 18 broad cause groups and 54 specific cause categories.
In 2016, the total number of YLDs globally among those aged 0-19 years was about 130 million, or 51 per 1000 population, ranging from 30 among neonates aged 0-27 days to 67 among older adolescents aged 15-19 years. Global progress since 2000 in reducing the non-fatal disease burden has been limited (53 per 1000 in 2000 for children and adolescents aged 0-19 years). The most important causes of YLDs included iron-deficiency anaemia and skin diseases for both sexes, across age groups and regions. For young children under 5 years of age, congenital anomalies, protein-energy malnutrition and diarrhoeal diseases were important causes of YLDs, while childhood behavioural disorders, asthma, anxiety disorders and depressive disorders were important causes for older children and adolescents. We found important variations between sexes and between regions, particularly among adolescents, that need to be addressed context-specifically.
The disappointingly slow progress in reducing the global non-fatal disease burden among children and adolescents contrasts starkly with the major reductions in mortality over the first 17 years of this century. More effective action is needed to reduce the non-fatal disease burden among children and adolescents, with interventions tailored for each age group, sex and world region.
非致命性健康损失是儿童和青少年总疾病负担的重要组成部分。分析这些发病模式对于规划改善儿童和青少年健康和福祉的干预措施至关重要。我们的目标是描述 2000 年至 2016 年期间 0 至 19 岁儿童和青少年的非致命性疾病负担的当前水平和趋势。
我们使用世界卫生组织全球健康估计数中因残疾导致的年数（YLD）估计数，描述了全球 0-27 天、28 天至 11 个月、1-4 岁、5-9 岁、10-14 岁和 15-19 岁儿童和青少年的非致命性疾病负担，以及根据世界卫生组织修订区域的情况。为了描述 YLD 的原因，我们使用了 18 个广泛的病因组和 54 个具体的病因类别。
2016 年，全球 0-19 岁人群的 YLD 总数约为 1.30 亿，占人口的 51/1000，从 0-27 天新生儿的 30 到 15-19 岁青少年的 67。自 2000 年以来，全球在减少非致命性疾病负担方面的进展有限（2000 年，0-19 岁儿童和青少年为 53/1000）。YLD 的最重要原因包括男女两性、各年龄组和各区域的缺铁性贫血和皮肤病。对于 5 岁以下的幼儿，先天性异常、蛋白质能量营养不良和腹泻病是 YLD 的重要原因，而儿童期行为障碍、哮喘、焦虑症和抑郁症则是大龄儿童和青少年的重要原因。我们发现了性别和区域之间的重要差异，尤其是在青少年中，需要具体情况具体解决。
与本世纪前 17 年中死亡率的大幅下降形成鲜明对比的是，儿童和青少年的全球非致命性疾病负担的缓慢进展令人失望。需要采取更有效的行动来减少儿童和青少年的非致命性疾病负担，针对每个年龄组、性别和世界区域制定干预措施。
