Liu Qiao, Zhang Shimo, Wu Yu, Shang Weijing, Liu Min, Liu Jue
Department of Epidemiology and Biostatistics, School of Public Health, Peking University, No. 38, Xueyuan Road, Haidian District, Beijing, 100191, China.
Health Emergency Management Center, Peking University, Haidian District, Beijing, China.
BMC Infect Dis. 2025 Apr 17;25(1):548. doi: 10.1186/s12879-025-10949-9.
The global burden of malaria among children remains severe; however, there is a dearth of comprehensive studies comparing this burden across different countries and regions. This study aims to analyze the patterns and trends in malaria burden among children under the age of 15 at global, regional, and national levels from 1990 to 2021, and to investigate the correlation between malaria burden and the developmental status of different countries.
This observational study utilized data from the Global Burden of Diseases Study to examine incidence and mortality rates of malaria in children under 15 between 1990 and 2021. The rates and absolute number of malaria cases and deaths showed the epidemic status of malaria. The estimated annual percentage change (EAPC) quantified the time trends of malaria burden. Nonlinear regression was conducted to explore the association between the Socio-demographic Index (SDI) and rates across countries from 1990 to 2021.
In 2021, there were 169,052,260 malaria cases and 469,881 deaths among children under 15 worldwide, with an incidence rate of 8402.78 per 100,000 and a mortality rate of 23.36 per 100,000. From 1990 to 2021, the global incidence rate of malaria in children under 15 showed a slight increase of 0.87% annually from 2015 to 2021, while the mortality rate decreased by 0.69% per year from 1990 to 2015 but remained stable thereafter. Additionally, there was a notable increase in the number of deaths and mortality rate from malaria in 2020 and 2021 compared to 2019. The most affected regions were in Sub-Saharan Africa, with Western, Eastern, and Central regions having the highest number of cases and deaths. Analysis by SDI indicated that low SDI regions experienced the highest burden of malaria, although all regions saw the highest incidence and mortality rates in children under 5. Despite improvements in mortality rates from 1990 to 2015, some regions such as Oceania, the Caribbean, Tropical Latin America, and North Africa and the Middle East observed increasing trends in incidence rates post-2015.
Improving socio-economic conditions is urgently needed to alleviate malaria-related morbidity and mortality among children. Our results highlight the need for targeted national policies and stronger international cooperation, especially in regions with low SDI and significant disparities. With concerted efforts, we can significantly reduce malaria's impact and move closer to a malaria-free world.
儿童疟疾的全球负担依然严峻；然而，缺乏对不同国家和地区间这一负担进行比较的全面研究。本研究旨在分析1990年至2021年全球、区域和国家层面15岁以下儿童疟疾负担的模式和趋势，并调查疟疾负担与不同国家发展状况之间的相关性。
这项观察性研究利用了全球疾病负担研究的数据，以检查1990年至2021年期间15岁以下儿童疟疾的发病率和死亡率。疟疾病例和死亡的发生率及绝对数量显示了疟疾的流行状况。估计年度百分比变化（EAPC）量化了疟疾负担的时间趋势。进行非线性回归以探索1990年至2021年期间不同国家社会人口指数（SDI）与发病率之间的关联。
2021年，全球15岁以下儿童中有169,052,260例疟疾病例和469,881例死亡，发病率为每10万人8402.78例，死亡率为每10万人23.36例。1990年至2021年，15岁以下儿童全球疟疾发病率在2015年至2021年期间每年略有上升0.87%，而死亡率在1990年至2015年期间每年下降0.69%，此后保持稳定。此外，与2019年相比，2020年和2021年疟疾死亡人数和死亡率显著增加。受影响最严重的地区是撒哈拉以南非洲，西部、东部和中部地区的病例和死亡人数最多。按SDI分析表明，低SDI地区疟疾负担最高，尽管所有地区5岁以下儿童的发病率和死亡率最高。尽管1990年至2015年死亡率有所改善，但大洋洲、加勒比地区、热带拉丁美洲以及北非和中东等一些地区在2015年后发病率呈上升趋势。
迫切需要改善社会经济状况，以减轻儿童疟疾相关的发病率和死亡率。我们的研究结果凸显了制定有针对性的国家政策和加强国际合作的必要性，特别是在SDI较低且差距较大的地区。通过共同努力，我们可以显著降低疟疾的影响，更接近无疟疾的世界。
