TY - JOUR T1 - Child and Adolescent Health From 1990 to 2015: Findings From the Global Burden of Diseases, Injuries, and Risk Factors 2015 Study. JF - JAMA Pediatr Y1 - 2017 A1 - Kassebaum, Nicholas A1 - Kyu, Hmwe Hmwe A1 - Zoeckler, Leo A1 - Olsen, Helen Elizabeth A1 - Thomas, Katie A1 - Pinho, Christine A1 - Bhutta, Zulfiqar A A1 - Dandona, Lalit A1 - Ferrari, Alize A1 - Ghiwot, Tsegaye Tewelde A1 - Hay, Simon I A1 - Kinfu, Yohannes A1 - Liang, Xiaofeng A1 - Lopez, Alan A1 - Malta, Deborah Carvalho A1 - Mokdad, Ali H A1 - Naghavi, Mohsen A1 - Patton, George C A1 - Salomon, Joshua A1 - Sartorius, Benn A1 - Topor-Madry, Roman A1 - Vollset, Stein Emil A1 - Werdecker, Andrea A1 - Whiteford, Harvey A A1 - Abate, Kalkidan Hasen A1 - Abbas, Kaja A1 - Damtew, Solomon Abrha A1 - Ahmed, Muktar Beshir A1 - Akseer, Nadia A1 - Al-Raddadi, Rajaa A1 - Alemayohu, Mulubirhan Assefa A1 - Altirkawi, Khalid A1 - Abajobir, Amanuel Alemu A1 - Amare, Azmeraw T A1 - Antonio, Carl A T A1 - Arnlöv, Johan A1 - Artaman, Al A1 - Asayesh, Hamid A1 - Avokpaho, Euripide Frinel G Arthur A1 - Awasthi, Ashish A1 - Ayala Quintanilla, Beatriz Paulina A1 - Bacha, Umar A1 - Betsu, Balem Demtsu A1 - Barac, Aleksandra A1 - Bärnighausen, Till Winfried A1 - Baye, Estifanos A1 - Bedi, Neeraj A1 - Bensenor, Isabela M A1 - Berhane, Adugnaw A1 - Bernabe, Eduardo A1 - Bernal, Oscar Alberto A1 - Beyene, Addisu Shunu A1 - Biadgilign, Sibhatu A1 - Bikbov, Boris A1 - Boyce, Cheryl Anne A1 - Brazinova, Alexandra A1 - Hailu, Gessessew Bugssa A1 - Carter, Austin A1 - Castañeda-Orjuela, Carlos A A1 - Catalá-López, Ferrán A1 - Charlson, Fiona J A1 - Chitheer, Abdulaal A A1 - Choi, Jee-Young Jasmine A1 - Ciobanu, Liliana G A1 - Crump, John A1 - Dandona, Rakhi A1 - Dellavalle, Robert P A1 - Deribew, Amare A1 - deVeber, Gabrielle A1 - Dicker, Daniel A1 - Ding, Eric L A1 - Dubey, Manisha A1 - Endries, Amanuel Yesuf A1 - Erskine, Holly E A1 - Faraon, Emerito Jose Aquino A1 - Faro, Andre A1 - Farzadfar, Farshad A1 - Fernandes, Joao C A1 - Fijabi, Daniel Obadare A1 - Fitzmaurice, Christina A1 - Fleming, Thomas D A1 - Flor, Luisa Sorio A1 - Foreman, Kyle J A1 - Franklin, Richard C A1 - Fraser, Maya S A1 - Frostad, Joseph J A1 - Fullman, Nancy A1 - Gebregergs, Gebremedhin Berhe A1 - Gebru, Alemseged Aregay A1 - Geleijnse, Johanna M A1 - Gibney, Katherine B A1 - Gidey Yihdego, Mahari A1 - Ginawi, Ibrahim Abdelmageem Mohamed A1 - Gishu, Melkamu Dedefo A1 - Gizachew, Tessema Assefa A1 - Glaser, Elizabeth A1 - Gold, Audra L A1 - Goldberg, Ellen A1 - Gona, Philimon A1 - Goto, Atsushi A1 - Gugnani, Harish Chander A1 - Jiang, Guohong A1 - Gupta, Rajeev A1 - Tesfay, Fisaha Haile A1 - Hankey, Graeme J A1 - Havmoeller, Rasmus A1 - Hijar, Martha A1 - Horino, Masako A1 - Hosgood, H Dean A1 - Hu, Guoqing A1 - Jacobsen, Kathryn H A1 - Jakovljevic, Mihajlo B A1 - Jayaraman, Sudha P A1 - Jha, Vivekanand A1 - Jibat, Tariku A1 - Johnson, Catherine O A1 - Jonas, Jost A1 - Kasaeian, Amir A1 - Kawakami, Norito A1 - Keiyoro, Peter N A1 - Khalil, Ibrahim A1 - Khang, Young-Ho A1 - Khubchandani, Jagdish A1 - Ahmad Kiadaliri, Aliasghar A A1 - Kieling, Christian A1 - Kim, Daniel A1 - Kissoon, Niranjan A1 - Knibbs, Luke D A1 - Koyanagi, Ai A1 - Krohn, Kristopher J A1 - Kuate Defo, Barthelemy A1 - Kucuk Bicer, Burcu A1 - Kulikoff, Rachel A1 - Kumar, G Anil A1 - Lal, Dharmesh Kumar A1 - Lam, Hilton Y A1 - Larson, Heidi J A1 - Larsson, Anders A1 - Laryea, Dennis Odai A1 - Leung, Janni A1 - Lim, Stephen S A1 - Lo, Loon-Tzian A1 - Lo, Warren D A1 - Looker, Katharine J A1 - Lotufo, Paulo A A1 - Magdy Abd El Razek, Hassan A1 - Malekzadeh, Reza A1 - Markos Shifti, Desalegn A1 - Mazidi, Mohsen A1 - Meaney, Peter A A1 - Meles, Kidanu Gebremariam A1 - Memiah, Peter A1 - Mendoza, Walter A1 - Abera Mengistie, Mubarek A1 - Mengistu, Gebremichael Welday A1 - Mensah, George A A1 - Miller, Ted R A1 - Mock, Charles A1 - Mohammadi, Alireza A1 - Mohammed, Shafiu A1 - Monasta, Lorenzo A1 - Mueller, Ulrich A1 - Nagata, Chie A1 - Naheed, Aliya A1 - Nguyen, Grant A1 - Nguyen, Quyen Le A1 - Nsoesie, Elaine A1 - Oh, In-Hwan A1 - Okoro, Anselm A1 - Olusanya, Jacob Olusegun A1 - Olusanya, Bolajoko O A1 - Ortiz, Alberto A1 - Paudel, Deepak A1 - Pereira, David M A1 - Perico, Norberto A1 - Petzold, Max A1 - Phillips, Michael Robert A1 - Polanczyk, Guilherme V A1 - Pourmalek, Farshad A1 - Qorbani, Mostafa A1 - Rafay, Anwar A1 - Rahimi-Movaghar, Vafa A1 - Rahman, Mahfuzar A1 - Rai, Rajesh Kumar A1 - Ram, Usha A1 - Rankin, Zane A1 - Remuzzi, Giuseppe A1 - Renzaho, Andre M N A1 - Roba, Hirbo Shore A1 - Rojas-Rueda, David A1 - Ronfani, Luca A1 - Sagar, Rajesh A1 - Sanabria, Juan Ramon A1 - Kedir Mohammed, Muktar Sano A1 - Santos, Itamar S A1 - Satpathy, Maheswar A1 - Sawhney, Monika A1 - Schöttker, Ben A1 - Schwebel, David C A1 - Scott, James G A1 - Sepanlou, Sadaf G A1 - Shaheen, Amira A1 - Shaikh, Masood Ali A1 - She, June A1 - Shiri, Rahman A1 - Shiue, Ivy A1 - Sigfusdottir, Inga Dora A1 - Singh, Jasvinder A1 - Silpakit, Naris A1 - Smith, Alison A1 - Sreeramareddy, Chandrashekhar A1 - Stanaway, Jeffrey D A1 - Stein, Dan J A1 - Steiner, Caitlyn A1 - Sufiyan, Muawiyyah Babale A1 - Swaminathan, Soumya A1 - Tabarés-Seisdedos, Rafael A1 - Tabb, Karen M A1 - Tadese, Fentaw A1 - Tavakkoli, Mohammad A1 - Taye, Bineyam A1 - Teeple, Stephanie A1 - Tegegne, Teketo Kassaw A1 - Temam Shifa, Girma A1 - Terkawi, Abdullah Sulieman A1 - Thomas, Bernadette A1 - Thomson, Alan J A1 - Tobe-Gai, Ruoyan A1 - Tonelli, Marcello A1 - Tran, Bach Xuan A1 - Troeger, Christopher A1 - Ukwaja, Kingsley N A1 - Uthman, Olalekan A1 - Vasankari, Tommi A1 - Venketasubramanian, Narayanaswamy A1 - Vlassov, Vasiliy Victorovich A1 - Weiderpass, Elisabete A1 - Weintraub, Robert A1 - Gebrehiwot, Solomon Weldemariam A1 - Westerman, Ronny A1 - Williams, Hywel C A1 - Wolfe, Charles D A A1 - Woodbrook, Rachel A1 - Yano, Yuichiro A1 - Yonemoto, Naohiro A1 - Yoon, Seok-Jun A1 - Younis, Mustafa Z A1 - Yu, Chuanhua A1 - Zaki, Maysaa El Sayed A1 - Zegeye, Elias Asfaw A1 - Zuhlke, Liesl Joanna A1 - Murray, Christopher J L A1 - Vos, Theo KW - Adolescent KW - Adolescent Health KW - Age Factors KW - Cause of Death KW - Child KW - Child Health KW - Child Mortality KW - Disabled Children KW - Female KW - Global Burden of Disease KW - Global Health KW - Humans KW - Male KW - Pregnancy KW - Pregnancy Complications KW - Risk Factors KW - Sex Factors KW - Wounds and Injuries AB -

Importance: Comprehensive and timely monitoring of disease burden in all age groups, including children and adolescents, is essential for improving population health.

Objective: To quantify and describe levels and trends of mortality and nonfatal health outcomes among children and adolescents from 1990 to 2015 to provide a framework for policy discussion.

Evidence Review: Cause-specific mortality and nonfatal health outcomes were analyzed for 195 countries and territories by age group, sex, and year from 1990 to 2015 using standardized approaches for data processing and statistical modeling, with subsequent analysis of the findings to describe levels and trends across geography and time among children and adolescents 19 years or younger. A composite indicator of income, education, and fertility was developed (Socio-demographic Index [SDI]) for each geographic unit and year, which evaluates the historical association between SDI and health loss.

Findings: Global child and adolescent mortality decreased from 14.18 million (95% uncertainty interval [UI], 14.09 million to 14.28 million) deaths in 1990 to 7.26 million (95% UI, 7.14 million to 7.39 million) deaths in 2015, but progress has been unevenly distributed. Countries with a lower SDI had a larger proportion of mortality burden (75%) in 2015 than was the case in 1990 (61%). Most deaths in 2015 occurred in South Asia and sub-Saharan Africa. Global trends were driven by reductions in mortality owing to infectious, nutritional, and neonatal disorders, which in the aggregate led to a relative increase in the importance of noncommunicable diseases and injuries in explaining global disease burden. The absolute burden of disability in children and adolescents increased 4.3% (95% UI, 3.1%-5.6%) from 1990 to 2015, with much of the increase owing to population growth and improved survival for children and adolescents to older ages. Other than infectious conditions, many top causes of disability are associated with long-term sequelae of conditions present at birth (eg, neonatal disorders, congenital birth defects, and hemoglobinopathies) and complications of a variety of infections and nutritional deficiencies. Anemia, developmental intellectual disability, hearing loss, epilepsy, and vision loss are important contributors to childhood disability that can arise from multiple causes. Maternal and reproductive health remains a key cause of disease burden in adolescent females, especially in lower-SDI countries. In low-SDI countries, mortality is the primary driver of health loss for children and adolescents, whereas disability predominates in higher-SDI locations; the specific pattern of epidemiological transition varies across diseases and injuries.

Conclusions and Relevance: Consistent international attention and investment have led to sustained improvements in causes of health loss among children and adolescents in many countries, although progress has been uneven. The persistence of infectious diseases in some countries, coupled with ongoing epidemiologic transition to injuries and noncommunicable diseases, require all countries to carefully evaluate and implement appropriate strategies to maximize the health of their children and adolescents and for the international community to carefully consider which elements of child and adolescent health should be monitored.

VL - 171 IS - 6 U1 - http://www.ncbi.nlm.nih.gov/pubmed/28384795?dopt=Abstract ER -