Peer-reviewed article
Global, Regional, and National Burden of Child Growth Failure, 1990-2021: A Systematic Analysis for the Global Burden of Disease Study 2021.
Kelly Lin, Nicholas Buys, Jun Zhou, Yanfei Qi, Jing Sun ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This study analyzed global trends in child growth failure (stunting, wasting, and underweight) from 1990 to 2021 using data from the Global Burden of Disease study. Growth failure burden and mortality have declined globally over 30 years, but improvements are unequal: high-income and upper-middle-income countries showed much faster progress than low-income regions. Low-income countries still bear a disproportionately high burden of child malnutrition and related deaths, particularly in children under 5 years old.
Key points
- High-middle SDI countries achieved the greatest reduction in growth failure disability-adjusted life years (AAPC = -0.96) and mortality (AAPC = -0.96) in children under 5
- Low SDI countries showed less pronounced improvements in growth failure DALYs (AAPC = -0.64), years lived with disability (AAPC = -0.21), and mortality (AAPC = -0.57)
- Improvements in disease burden and mortality are smallest in older age groups, with the lowest reduction in children aged 15-19 years
- Barriers to nutritional supplement delivery and quality healthcare access in low SDI regions are hindering progress against child growth failure
Limitations
This is a descriptive epidemiological analysis using GBD data that documents trends but does not evaluate specific interventions or explain the causes of regional disparities. The study cannot establish causation or identify which specific policies or programmes are responsible for improvements in different countries.
Abstract
Background/Objectives: Child growth failure is a manifestation of chronic malnutrition expressed in stunting, wasting, and underweight in children. This study aimed to analyze global trends in child growth failure disease burden and mortality across children of all age groups on a global, regional, and national level. Methods: This cross-sectional study utilized data from the 1990 and 2021 Global Burden of Disease (GBD) study. Growth failure Disability-adjusted life years (DALYs), years lived with a disability (YLDs), and mortality in children under 20 years of age were analyzed. Average annual percentage change (AAPC) was calculated to determine and identify improvements in growth failure disease burden and mortality in the past 30 years. Results: Greatest reduction in growth failure DALYs (AAPC = -0.96, 95% CI = -0.97 to -0.95), YLDs (AAPC = -0.73, 95% CI = -0.77 to -0.66) and mortality rate (AAPC = -0.96, 95% CI = -0.97 to -0.95) in children under 5 years of age was observed in high-middle SDI countries. In contrast, improvements in the number of growth failure DALYs (AAPC = -0.64, 95% CI = -0.76 to -0.53), YLDs (AAPC = -0.21, 95% CI = -0.25 to -0.13) and mortalities (-0.57, 95% CI = -0.59 to -0.52) are less pronounced in regions with low SDI scores. Improvements in disease burden and mortality are reduced in older age groups, with the lowest reduction observed in children 15-19 years old. Conclusions: Barriers hindering the delivery of nutritional supplements and access to quality healthcare in regions with low SDI scores need to be overcome to address the disproportionately high numbers of growth failure DALYs, YLDs, and mortalities in regions with low SDI.