Wang Shuai, Zhang Tao, Wang Kaixin, Li Dongming, Cao Xueyuan
Department of Gastric and Colorectal Surgery, General Surgery Center, The First Hospital of Jilin University, Changchun, Jilin, China.
Department of Anesthesiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China.
Int Breastfeed J. 2025 Mar 26;20(1):19. doi: 10.1186/s13006-025-00713-9.
Understanding the spatial and temporal patterns of the disease burden of childhood diarrhea attributable to suboptimal breastfeeding (including non-exclusive and discontinued breastfeeding) is crucial for global health policy and intervention strategies. This study aimed to comprehensively assess the global, regional, and national burden of childhood diarrheal diseases attributable to suboptimal breastfeeding in 204 countries and territories from 1990 to 2021.
This study utilized data from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 to estimate deaths, disability-adjusted life years (DALYs), age-standardized mortality rate (ASMR), and age-standardized DALY rate (ASDR) of childhood diarrheal diseases attributable to suboptimal breastfeeding. Suboptimal breastfeeding was assessed as a combination of non-exclusive breastfeeding and discontinued breastfeeding. And the average annual percentage change (AAPC) from 1990 to 2021 was calculated to determine long-term trends. Additionally, frontier analyses were conducted to evaluate the efficiency of different countries in reducing the disease burden relative to their socio-demographic index (SDI) levels.
By 2021, the global number of deaths and DALYs attributable to childhood diarrheal diseases due to suboptimal breastfeeding was 63,133 and 573,430, respectively. Between 1990 and 2021, the number of deaths and DALYs, as well as ASMR (AAPC: -5.40) and ASDR (AAPC: -5.38), declined by approximately 80%. However, significant disparities persist across regions. Low-SDI regions, particularly in Western Sub-Saharan Africa, continued to bear the highest disease burden. At the countries or territories level, Nigeria, India, and Chad recorded the highest number of deaths and DALYs, while Chad, South Sudan, and Lesotho exhibited the highest ASMR and ASDR values. Similar patterns were observed for non-exclusive and discontinued breastfeeding, with the greatest burden concentrated in resource-limited settings.
While the global burden of childhood diarrheal diseases attributable to suboptimal breastfeeding has significantly declined over the past three decades, the disease burden remains disproportionately high in less developed regions. These findings underscore the urgent need for targeted public health policies and interventions to promote exclusive and continued breastfeeding, especially in high-burden regions, to further reduce preventable childhood morbidity and mortality.
了解因母乳喂养不当（包括非纯母乳喂养和停止母乳喂养）导致的儿童腹泻疾病负担的时空模式，对于全球卫生政策和干预策略至关重要。本研究旨在全面评估1990年至2021年期间204个国家和地区因母乳喂养不当导致的儿童腹泻疾病的全球、区域和国家负担。
本研究利用全球疾病、伤害及风险因素负担研究（GBD）2021的数据，来估计因母乳喂养不当导致的儿童腹泻疾病的死亡人数、伤残调整生命年（DALY）、年龄标准化死亡率（ASMR）和年龄标准化DALY率（ASDR）。母乳喂养不当被评估为非纯母乳喂养和停止母乳喂养的综合情况。并计算了1990年至2021年的年均百分比变化（AAPC），以确定长期趋势。此外，还进行了前沿分析，以评估不同国家相对于其社会人口指数（SDI）水平在减轻疾病负担方面的效率。
到2021年，因母乳喂养不当导致的儿童腹泻疾病的全球死亡人数和伤残调整生命年分别为63133人和573430人。1990年至2021年期间，死亡人数、伤残调整生命年以及年龄标准化死亡率（AAPC：-5.40）和年龄标准化DALY率（AAPC：- .38）下降了约80%。然而，各地区之间仍存在显著差异。低社会人口指数地区，特别是撒哈拉以南非洲西部地区，继续承担着最高的疾病负担。在国家或地区层面，尼日利亚、印度和乍得的死亡人数和伤残调整生命年最多，而乍得、南苏丹和莱索托的年龄标准化死亡率和年龄标准化DALY率最高。非纯母乳喂养和停止母乳喂养也观察到类似模式，最大负担集中在资源有限的地区。
虽然在过去三十年中，因母乳喂养不当导致的儿童腹泻疾病的全球负担显著下降，但在欠发达地区，疾病负担仍然过高。这些发现强调了迫切需要有针对性的公共卫生政策和干预措施，以促进纯母乳喂养和持续母乳喂养，特别是在高负担地区，以进一步降低可预防的儿童发病率和死亡率。
