Evolving trends and burden of iron deficiency among children, 1990-2019: a systematic analysis for the global burden of disease study 2019

Dan Long; Chenhan Mao; Yaxuan Liu; Tao Zhou; Yin Xu; Ying Zhu

doi:10.3389/fnut.2023.1275291

Evolving trends and burden of iron deficiency among children, 1990-2019: a systematic analysis for the global burden of disease study 2019

Front Nutr. 2023 Dec 7:10:1275291. doi: 10.3389/fnut.2023.1275291. eCollection 2023.

Authors

Dan Long^#¹, Chenhan Mao^#², Yaxuan Liu¹, Tao Zhou¹, Yin Xu¹, Ying Zhu¹

Affiliations

¹ The First Hospital of Hunan University of Chinese Medicine, Changsha, Hunan, China.
² Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China.

^# Contributed equally.

Abstract

Objectives: We aimed to provide a timely, comprehensive, and reliable assessment of the burden of iron deficiency (ID) in children between 1990 and 2019 at the global, regional, and national levels to inform policymakers in developing locally appropriate health policies.

Methods: Data related to ID among children younger than 15 years old were analyzed by sex, age, year, socio-demographic index (SDI), and location according to the Global Burden of Disease Study 2019 (GBD 2019). Age-standardized rates were used to compare the burden between different regions and countries. Furthermore, the Joinpoint regression model was used to assess temporal trends from 1990 to 2019.

Results: In 2019, the number of prevalent cases and disability-adjusted life years (DALYs) for ID in children were 391,491,699 and 13,620,231, respectively. The global age-standardized prevalence and DALY rates for childhood ID in 2019 were 20,146.35 (95% confidence interval: 19,407.85 to 20,888.54) and 698.90 (466.54 to 1015.31) per 100,000, respectively. Over the past 30 years, the global prevalence of ID among children has been highest in low-SDI regions, particularly in Western Sub-Saharan Africa, South Asia, and Eastern Sub-Saharan Africa. Since 1990, the prevalence and DALY of ID in children have been declining in most geographic regions. Nationally, Ecuador, China, and Chile have shown the most significant decreases in prevalence. The greatest decline in age-standardized DALY rate was observed in Ecuador, while Burkina Faso experienced the highest increase. Bhutan had the highest prevalence and DALY rates in 2019. On the age level, the prevalence was relatively higher among the <5 years age group. At the gender dimension, the prevalence of ID in children overall was more pronounced in girls than in boys, as was the case for DALY.

Conclusion: Although the burden of ID in children has been declining, this disease remains a major public health problem, especially in countries with low SDI. Children younger than 5 years of age are an important group for whom targeted measures are needed to reduce the burden of ID.

Keywords: Joinpoint regression model; children; epidemiology; global burden of disease; iron deficiency.

Grants and funding

The author(s) declare financial support was received for the research, authorship, and/or publication of this article. This study was supported by grants from the National Natural Science Foundation of China (81874466, 81904176 and 82374426), Natural Science Foundation of Hunan Province (2021JJ30531 and 2023JJ60044), Hunan Province Administration of Traditional Chinese Medicine (B2023079), Clinical Medical Technology Innovation Guide Project of Hunan Province (2021SK51413), and domestic first-class construction discipline of Chinese Medicine in Hunan University of Chinese Medicine.