Global, regional, and national minimum estimates of children affected by COVID-19-associated orphanhood and caregiver death, by age and family circumstance up to Oct 31, 2021: an updated modelling study.
Global, regional, and national minimum estimates of children affected by COVID-19-associated orphanhood and caregiver death, by age and family circumstance up to Oct 31, 2021: an updated modelling study.
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DOI：
10.1016/s2352-4642(22)00005-0
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发表时间：
2022-04
期刊：
影响因子：
--
通讯作者：
Sherr L
中科院分区：
文献类型：
--
作者：
Unwin HJT;Hillis S;Cluver L;Flaxman S;Goldman PS;Butchart A;Bachman G;Rawlings L;Donnelly CA;Ratmann O;Green P;Nelson CA;Blenkinsop A;Bhatt S;Desmond C;Villaveces A;Sherr L
在我们估计的2020年3月1日至2021年4月30日的6个月内，新型冠状病毒变体的扩散、更新的死亡率数据以及疫苗接种的差异增加了经历COVID-19相关疾病的儿童数量。为了提供应对信息，我们旨在对受COVID-19相关性死亡和护理人员死亡影响的儿童数量增加以及累积死亡年龄组分布和情况（母亲或父亲死亡）进行建模。我们使用更新后的超额死亡率和生育率数据，对21个国家的2020年3月1日至2021年4月30日的原始研究期间COVID-19相关的产妇和护理人员死亡的最低估计值的增加进行了建模，以包括2021年5月1日至10月31日的新期间。孤儿被定义为父母一方或双方死亡;主要照顾者的损失包括父母死亡或一方或双方监护祖父母的死亡;次要照顾者的损失包括共同居住的祖父母或亲属。我们使用逻辑回归，并进一步将西欧国家的固定效应纳入我们之前的模型，以避免过度预测该地区的护理人员流失。在整个20个月的时间里，我们根据年龄（0 - 4岁，5 - 9岁和10 - 17岁）和母亲或父亲的生育情况对儿童进行分组，使用生育率贡献，我们对全球和区域孤儿数量进行了建模。95%可信区间（CrIs）给出了所有估计值。受COVID-19相关疾病影响的儿童人数和照顾者死亡人数估计增加了90.0%（95%CrI 89·7 - 90·4）从2021年4月30日至10月31日，从2 737 300（95%CrI 1 976 100 - 2 987 000）到5 200 300（3 619 400 - 5 731 400）。2020年3月1日至2021年10月31日期间，491 300 0 - 4岁儿童，736 800估计有726900 - 746500名5 - 9岁儿童和2146700名（2120900 - 2174200名）10 - 17岁儿童经历了与COVID-19相关的疾病。在全球范围内，76.5%（95%CrI 76.3 - 76.7）的儿童是父亲的孤儿，而23.5%（23.3 - 23.7）是母亲的孤儿。在每个年龄组和地区，父亲生育率都超过母亲生育率。我们的研究结果显示，受COVID-19相关疾病影响的儿童人数和照顾者死亡人数在6个月内几乎是大流行最初14个月后人数的两倍。在整个20个月期间，500万COVID-19死亡意味着520万儿童失去了父母或照顾者。我们关于儿童年龄和情况的数据应支持全球儿童大流行应对规划。英国研究和创新（全球挑战研究基金、工程和物理科学研究理事会和医学研究理事会）、橡树基金会、英国国家卫生研究所、美国国家卫生研究院和伦敦帝国理工学院伦敦。
In the 6 months following our estimates from March 1, 2020, to April 30, 2021, the proliferation of new coronavirus variants, updated mortality data, and disparities in vaccine access increased the amount of children experiencing COVID-19-associated orphanhood. To inform responses, we aimed to model the increases in numbers of children affected by COVID-19-associated orphanhood and caregiver death, as well as the cumulative orphanhood age-group distribution and circumstance (maternal or paternal orphanhood). We used updated excess mortality and fertility data to model increases in minimum estimates of COVID-19-associated orphanhood and caregiver deaths from our original study period of March 1, 2020–April 30, 2021, to include the new period of May 1–Oct 31, 2021, for 21 countries. Orphanhood was defined as the death of one or both parents; primary caregiver loss included parental death or the death of one or both custodial grandparents; and secondary caregiver loss included co-residing grandparents or kin. We used logistic regression and further incorporated a fixed effect for western European countries into our previous model to avoid over-predicting caregiver loss in that region. For the entire 20-month period, we grouped children by age (0–4 years, 5–9 years, and 10–17 years) and maternal or paternal orphanhood, using fertility contributions, and we modelled global and regional extrapolations of numbers of orphans. 95% credible intervals (CrIs) are given for all estimates. The number of children affected by COVID-19-associated orphanhood and caregiver death is estimated to have increased by 90·0% (95% CrI 89·7–90·4) from April 30 to Oct 31, 2021, from 2 737 300 (95% CrI 1 976 100–2 987 000) to 5 200 300 (3 619 400–5 731 400). Between March 1, 2020, and Oct 31, 2021, 491 300 (95% CrI 485 100–497 900) children aged 0–4 years, 736 800 (726 900–746 500) children aged 5–9 years, and 2 146 700 (2 120 900–2 174 200) children aged 10–17 years are estimated to have experienced COVID-19-associated orphanhood. Globally, 76·5% (95% CrI 76·3–76·7) of children were paternal orphans, whereas 23·5% (23·3–23·7) were maternal orphans. In each age group and region, the prevalence of paternal orphanhood exceeded that of maternal orphanhood. Our findings show that numbers of children affected by COVID-19-associated orphanhood and caregiver death almost doubled in 6 months compared with the amount after the first 14 months of the pandemic. Over the entire 20-month period, 5·0 million COVID-19 deaths meant that 5·2 million children lost a parent or caregiver. Our data on children's ages and circumstances should support pandemic response planning for children globally. UK Research and Innovation (Global Challenges Research Fund, Engineering and Physical Sciences Research Council, and Medical Research Council), Oak Foundation, UK National Institute for Health Research, US National Institutes of Health, and Imperial College London.
影响因子：
3.8
作者：
Ezell J;Harrison SE;Jiang Y;Li X
通讯作者：
Li X