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 Global Research on Developmental Disabilities Collaborators (original) (raw)
Related papers
The Lancet Global Health
Background 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. Methods 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. Findings 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. Interpretation 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. Funding The Bill & Melinda Gates Foundation.
Disabilities in Early Childhood: A Global Health Perspective
Children
Prior to the launch of the United Nations Sustainable Development Goals (SDGs) in 2015, childhood disability was rarely considered an important subject in global health. The SDGs till 2030 now require that children under 5 years who are at risk of not benefitting from inclusive quality education are identified, monitored, and promptly supported. A new tool for identifying children who are not developmentally on track has been developed by UNICEF but has limited sensitivity for detecting children with disabilities due to reliance on parental assessment of child behavior in certain everyday situations. In this paper, we identified conditions that are commonly associated with developmental disabilities based on the International Classification of Diseases (ICD) codes and clarified the concept of “developmentally on track” as it relates to children with developmental disabilities and developmental delays. We summarized the latest evidence on the global burden of developmental disabiliti...
Frontiers in Public Health, 2023
The provisions of the United Nation's Sustainable Development Goals (SDGs) for disability-inclusive education have stimulated a growing interest in ascertaining the prevalence of children with developmental disabilities globally. We aimed to systematically summarize the prevalence estimates of developmental disabilities in children and adolescents reported in systematic reviews and meta-analyses. Methods: For this umbrella review we searched PubMed, Scopus, Embase, PsycINFO, and Cochrane Library for systematic reviews published in English between September and August. Two reviewers independently assessed study eligibility, extracted the data, and assessed risk of bias. We reported the proportion of the global prevalence estimates attributed to country income levels for specific developmental disabilities. Prevalence estimates for the selected disabilities were compared with those reported in the Global Burden of Disease (GBD) Study. Results: Based on our inclusion criteria, systematic reviews reporting prevalence estimates for attention-deficit/hyperactivity disorder, autism spectrum disorder, cerebral palsy, developmental intellectual disability, epilepsy, hearing loss, vision loss and developmental dyslexia were selected from , identified articles. Global prevalence estimates were derived from cohorts in high-income countries in all cases except epilepsy and were calculated from nine to countries. Sensory impairments were the most prevalent disabilities (approximately %) and cerebral palsy was the least prevalent disability (approximately .-. %) based on the eligible reviews. Pooled estimates for geographical regions were available for vision loss and developmental dyslexia. All studies had a moderate to high risk of bias. GBD prevalence estimates were lower for all disabilities except cerebral palsy and intellectual disability. Conclusion: Available estimates from systematic reviews and meta-analyses do not provide representative evidence on the global and regional prevalence Frontiers in Public Health frontiersin.org Olusanya et al.. /fpubh.. of developmental disabilities among children and adolescents due to limited geographical coverage and substantial heterogeneity in methodology across studies. Population-based data for all regions using other approaches such as reported in the GBD Study are warranted to inform global health policy and intervention.
Children with developmental disabilities in the majority of the world
2009
The majority of children with neurodevelopmental disabilities are thought to live in 'developing countries' (Helander 2000), more recently called majority world countries (MWC). These countries are those where economic growth, modernization, political freedom, social justice, and the general quality of people's lives are considered to be inadequate by people from more developed countries (Stone 1999). The causes and outcome of children with neurodevelopmental disabilities in these countries appears to be different from more developed countries. In these countries, access to medical and rehabilitative services for children with neurodevelopmental disabilities is mainly confined to urban centers (Helander 1993). The identification of children with disabilities in MWC is problematic, making estimates of the total burden of disability difficult. Disability depends upon cultural and social perceptions, with identification based upon causality, valued and devalued attributes, and often anticipated adult status (Groce 1999). Attributes determine the detection of disability within society; thus, those societies that value physical strength will identify children with physical impairment more readily. Causality often dictates the manner in which children with disabilities are treated within society, and can include 'evil' spirits, 'witchcraft,' as well as more recognizable biomedical causes. However, for the purposes of estimating the burden, and comparing the prevalence between regions, definitions that can be used across cultures have been developed. INTERNATIONAL CLASSIFICATION OF DISABILITY In 1980, the World Health Organization (WHO) set out definitions for impairment, disability, and handicap in the manual of International Classification of Impairment, Disability and Handicap. This classification was revised in 1997 to focus on components of health rather than on the consequences of diseases, thus offering a broader biopsychosocial perspective with a functional view of health-related conditions. Under the auspices of the WHO, International Classification of Impairment, Disability and Handicap developed into the International Classification of Function !
BMJ Global Health, 2021
Introduction Non-fatal health loss makes a substantial contribution to the total disease burden among children and adolescents. An analysis of these morbidity patterns is essential to plan interventions that improve the health and well-being of children and adolescents. Our objective was to describe current levels and trends in the non-fatal disease burden from 2000 to 2016 among children and adolescents aged 0-19 years. Methods We used years lost due to disability (YLD) estimates in WHO's Global Health Estimates to describe the non-fatal disease burden from 2000 to 2016 for the age groups 0-27 days, 28 days-11 months, 1-4 years, 5-9 years, 10-14 years and 15-19 years globally and by modified WHO region. To describe causes of YLDs, we used 18 broad cause groups and 54 specific cause categories. Results In 2016, the total number of YLDs globally among those aged 0-19 years was about 130 million, or 51 per 1000 population, ranging from 30 among neonates aged 0-27 days to 67 among older adolescents aged 15-19 years. Global progress since 2000 in reducing the non-fatal disease burden has been limited (53 per 1000 in 2000 for children and adolescents aged 0-19 years). The most important causes of YLDs included iron-deficiency anaemia and skin diseases for both sexes, across age groups and regions. For young children under 5 years of age, congenital anomalies, protein-energy malnutrition and diarrhoeal diseases were important causes of YLDs, while childhood behavioural disorders, asthma, anxiety disorders and depressive disorders were important causes for older children and adolescents. We found important variations between sexes and between regions, particularly among adolescents, that need to be addressed contextspecifically. Conclusion The disappointingly slow progress in reducing the global non-fatal disease burden among children and adolescents contrasts starkly with the major reductions in mortality over the first 17 years of this century. More effective action is needed to reduce the non-fatal disease burden among children and adolescents, with interventions tailored for each age group, sex and world region.
Developmental Medicine & Child Neurology, 2012
Low-and middle-income countries are experiencing a significant reduction in mortality of children under 5 years of age. This reduction is bringing in its wake large numbers of surviving children with developmental delays and disabilities. Very little attention has been paid to these children, most of whom receive minimal or no support. Thus, there is an urgent need to recognize that improving the quality of life of the survivors must complement mortality reduction in healthcare practice and programs. The incorporation of early evaluation and intervention programs into routine pediatric care is likely to have the most impact on the quality of life of these children. We therefore call for leadership from practitioners, governments, and international organizations to prioritize regular childhood developmental surveillance for possible delays and disabilities, and to pursue early referral for intervention. DEVELOPMENTAL DELAYS AND DISABILITIES IN LOW-AND MIDDLE-INCOME COUNTRIES In low-and middle-income countries (LMICs), a marked decline in mortality among children under 5 years of age has begun and is accelerating. 1-4 This trend is clearly related, at least in part, to the achievements of world campaigns to eradicate or ameliorate the impact of HIV/AIDS, tuberculosis, malaria, and malnutrition, among other conditions. The 22% reduction in child mortality achieved thus far still falls behind the target set by the United Nations, 5 and efforts need to be intensified to reach those goals. Nonetheless, the resulting societal changes are already profound, and these too will accelerate in coming years. Within this increasing survivor group in LMICs, it is estimated that more than 200 million children have developmental delay or disability. 6 The components of this enormous problem have been studied from many angles. Studies of survivors of HIV/AIDS 7,8 and malaria, 9 for example, show that they have a high prevalence of neurodevelopmental delays, cerebral palsy, 10-12 and intellectual disability. 13 In essence, there is an emerging new population of children in LMICs with developmental delays and disabilities whose existence must be recognized and dealt with in all health practice and planning.
Children with Disabilities: THE STATE OF THE WORLD’S CHILDREN 2013
veryniceDesign) for the infographic on universal design published online at <www.unicef.org/sowc2013>. UNICEF country and regional offices and headquarters divisions contributed to this report or to related online content or advocacy materials by submitting findings or photographs, taking part in formal reviews or commenting on drafts. Many UNICEF offices and national committees arranged to translate or adapt the report for local use.
Journal of Clinical Epidemiology, 2000
Variability in approaches to define and classify disability has constituted persistent problems in documenting the epidemiology of disability and providing appropriate services. The major institutions of health care, mental health, and welfare often have separate systems of classification and terminology related to defining eligibility for programs and funding for services. In 1980, the International Classification of Impairments, Disabilities and Handicaps-ICIDH was published by the World Health Organization as a companion document of the International Classification of Disease to document the consequences of illness or injury. Current problems concerning the classification of childhood disability in health, education, and related services have resulted in growing interest in the revision of the ICIDH as a classification tool. The strengths and limitations of the ICIDH are examined in general, as well as with specific reference to its ability to document the nature and epidemiology of childhood disability. This paper (1) describes the ICIDH taxonomy and representative contributions; (2) reviews issues and concerns contributing to its revision; (3) summarizes changes in the revised ICIDH2 draft document, and (4) identifies issues of particular relevance to children and public health applications.