Global, regional, and national burdens of cirrhosis in children and adolescents aged under 19 years from 1990 to 2019

Abstract

Background & aims Cirrhosis was the leading cause of morbidity and mortality in adults, but data on the burden and trends were sparse in children and adolescents. We aimed to assess the trends in 204 countries and territories over the past 30 years in children and adolescents aged 0–19 years. Methods Data on cirrhosis was collected by the Global Burden of Disease (GBD) 2019 database from 1990 to 2019. We reported on the number, rates, and average annual percentage changes (AAPCs) of incidence and disability-adjusted life-years (DALYs) of cirrhosis at global, regional, and national level. Results Globally, the incident numbers of cirrhosis in children and adolescents increased from 204,767 in 1990 to 241,364 in 2019, an increase of 17.9%, with an AAPC 0.13(0.10 to 0.16). Prevalence (AAPC = − 2.27[− 2.39 to − 2.15]), mortality (AAPC = − 1.68 [− 1.86 to − 1.5]), and DALYs rate (AAPC = − 1.72[− 1.88 to − 1.56]) of cirrhosis have decreased significantly. Cirrhosis incident rates varied between different ages. Cirrhosis caused by alcohol use (AAPC = 1[0.8 to 1.1]; incidence cases increased 48%), hepatitis C (AAPC = 0.4 [0.4 to 0.5]), NAFLD (AAPC = 0.5 [0.3 to 0.6]) have been increasing, while only hepatitis B (− 0.3[− 0.4 to − 0.2]) decreasing. Incidence cases of cirrhosis were increased in low (101.6%) and low-middle sociodemographic index (SDI 21.1%) areas, while decreasing in middle and above SDI areas. At the regional level, the largest increases count was observed in Sub-Saharan Africa. Conclusions Global incidence rate of cirrhosis has been increasing, while the DALYs rate has been decreasing in children and adolescents. Morbidity of cirrhosis caused by hepatitis B declined, while hepatitis C, NAFLD, and alcohol use increased.

Changing epidemiology of inflammatory bowel disease in children and adolescents

“…In this study, data related to IBD from 1990 to 2019 were stratified by SDI, gender, and age group. Based on the WHO definition and previous studies [ 15 , 16 ], we divided children and adolescents into four age groups: younger children (< 5 years), older children (5–9 years), younger adolescents (10–14 years), and older adolescents (15–19 years).…”

Epidemiological analysis reveals a surge in inflammatory bowel disease among children and adolescents: A global, regional, and national perspective from 1990 to 2019 – insights from the China study

“…According to the World Health Organization (WHO) definition, children and adolescents are individuals aged zero to 19. We divided the whole data into four age groups: young children (<5 years), older children (5-9 years), younger adolescents (10-14 years), and older adolescents (15-19 years) [25][26][27].…”