Developmental disabilities among children younger than 5 years in 195 countries and territories, 1990-2016: a systematic analysis for the Global Burden of Disease Study 2016.
Developmental disabilities among children younger than 5 years in 195 countries and territories, 1990-2016: a systematic analysis for the Global Burden of Disease Study 2016.
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DOI：
10.1016/s2214-109x(18)30309-7
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发表时间：
2018-10
期刊：
影响因子：
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通讯作者：
Global Research on Developmental Disabilities Collaborators
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作者：
Global Research on Developmental Disabilities Collaborators
可持续发展目标（SDG）要求系统监测所有儿童的健康和福祉，以实现最佳的幼儿发展。然而，关于发育障碍儿童的全球流行病学数据很少。《2016年全球疾病、伤害和风险因素负担研究》全面评估了1990年至2016年195个国家和地区5岁以下儿童发育障碍的患病率和残疾生活年数。我们估计了癫痫、智力残疾、听力损失、视力损失、自闭症谱系障碍和注意缺陷多动障碍的患病率和YLD。YLD被估计为患病率估计值和每种互斥疾病的残疾权重的乘积，校正了合并症。我们使用DisMod-MR 2.1，一种贝叶斯元回归工具，对来自文献、健康调查、医院和索赔数据库、队列研究和疾病特异性登记的系统性综述的原始数据进行分析。2016年，全球有5290万（95%不确定区间[UI] 48.7 - 57.3;或8.4%[7.7 - 9.1]）5岁以下儿童（54%为男性）患有发育障碍，而1990年为5300万（49.0 - 57.1;或8.9%[8.2 - 9.5]）。这些儿童中约有95%生活在低收入和中等收入国家。这些儿童的YLD从1990年的380万（9 - 5% UI 2.8 - 4.9）增加到2016年的390万（2.9 - 5.2）。这些残疾占2016年5岁以下儿童所有健康状况的2930万YLD的13.3%。视力丧失是最普遍的残疾，其次是听力损失、智力残疾和自闭症谱系障碍。然而，智力残疾是1990年和2016年YLD的最大贡献者。尽管在1990年至2016年期间，所有国家（北美除外）5岁以下儿童的发育障碍患病率都有所下降，但撒哈拉以南非洲（71.3%）以及北非和中东（7.6%）的发育障碍儿童人数显著增加。2016年，南亚的发育障碍儿童患病率最高，北美最低。自1990年以来，发展性残疾的全球负担没有显著改善，这表明全球对儿童生存方案所导致的儿童的发展潜力关注不够，特别是在撒哈拉以南非洲和南亚。可持续发展目标提供了一个政策和行动框架，以满足有发展障碍或有发展障碍风险的儿童的需求，特别是在资源贫乏的国家。比尔及梅琳达·盖茨基金会。
The Sustainable Development Goals (SDGs) mandate systematic monitoring of the health and wellbeing of all children to achieve optimal early childhood development. However, global epidemiological data on children with developmental disabilities are scarce. The Global Burden of Diseases, Injuries, and Risk Factors Study 2016 provides a comprehensive assessment of prevalence and years lived with disability (YLDs) for development disabilities among children younger than 5 years in 195 countries and territories from 1990 to 2016. We estimated prevalence and YLDs for epilepsy, intellectual disability, hearing loss, vision loss, autism spectrum disorder, and attention deficit hyperactivity disorder. YLDs were estimated as the product of the prevalence estimate and the disability weight for each mutually exclusive disorder, corrected for comorbidity. We used DisMod-MR 2.1, a Bayesian meta-regression tool, on a pool of primary data derived from systematic reviews of the literature, health surveys, hospital and claims databases, cohort studies, and disease-specific registries. Globally, 52·9 million (95% uncertainty interval [UI] 48·7–57·3; or 8·4% [7·7–9·1]) children younger than 5 years (54% males) had developmental disabilities in 2016 compared with 53·0 million (49·0–57·1; or 8·9% [8·2–9·5]) in 1990. About 95% of these children lived in low-income and middle-income countries. YLDs among these children increased from 3·8 million (95% UI 2·8–4·9) in 1990 to 3·9 million (2·9–5·2) in 2016. These disabilities accounted for 13·3% of the 29·3 million YLDs for all health conditions among children younger than 5 years in 2016. Vision loss was the most prevalent disability, followed by hearing loss, intellectual disability, and autism spectrum disorder. However, intellectual disability was the largest contributor to YLDs in both 1990 and 2016. Although the prevalence of developmental disabilities among children younger than 5 years decreased in all countries (except for North America) between 1990 and 2016, the number of children with developmental disabilities increased significantly in sub-Saharan Africa (71·3%) and in North Africa and the Middle East (7·6%). South Asia had the highest prevalence of children with developmental disabilities in 2016 and North America had the lowest. The global burden of developmental disabilities has not significantly improved since 1990, suggesting inadequate global attention on the developmental potential of children who survived childhood as a result of child survival programmes, particularly in sub-Saharan Africa and south Asia. The SDGs provide a framework for policy and action to address the needs of children with or at risk of developmental disabilities, particularly in resource-poor countries. The Bill & Melinda Gates Foundation.