While the rate of cases of children with intracranial hemorrhage (ICH), also known as bleeding in the brain, has decreased over the last few decades, it remains a significant public health concern, according to an analysis published recently in the journal Children.
Fetal and neonatal alloimmune thrombocytopenia (FNAIT) is a major risk factor for ICH.
ICH is the main type of stroke that occurs among children globally, accounting for approximately half of all cases. Experts estimate that a third of ICH leads to death, while those who survive often suffer from long-term brain damage.
While there has been significant progress in preventing ICH in children, data on how prevalent this condition is worldwide is lacking. Researchers hence conducted a study to better understand how the number of cases of pediatric ICH has changed over the last few decades.
To acquire data, researchers accessed the database of the Global Burden of Disease (GBD) project, an ambitious global initiative that estimates the impact of 371 health conditions across 204 countries. Specifically, researchers focused on cases of ICH among children between 0 and 14 years of age from 1990-2021.
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The results showed a dramatic decrease in the number of pediatric ICH cases over the last few decades. In 1990, the number of new cases worldwide was 88,407; in 2021, this had fallen by 23% to 67,781.
The global incidence rate of ICH among children fell from 5.08 to 3.37 per 100,000 persons from 1990 to 2021. Among children of all ages, infants (children under one year of age) had the highest incidence rate in both 1990 and 2021 (9.68 per 100,000 population and 6.09 per 100,000 population, respectively).
The number of deaths associated with pediatric ICH fell from 36,052 in 1990 to 10,556 in 2021, representing a 71% reduction. Total disability-adjusted life years, which represent the years of healthy life lost to disability, had reduced by 70% in 2021 from 1990, with differences existing between various parts of the globe.
Researchers also noted that male infants faced a significantly higher risk of ICH compared with females, and regions with fewer resources continued to experience a high disease burden.
“Although overall trends from 1990 to 2021 suggest a decline in incidence, prevalence, mortality, and DALYs metrics, the disease burden remains persistently high in regions with low [socioeconomic index] to address these persistent disparities, health system planners and decision-makers should allocate resources more efficiently,” the authors of the study wrote. “Customized prevention and intervention measures for pediatric ICH are essential to meet future healthcare demands.”
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