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. 2024 Oct 23;24(1):2936.
doi: 10.1186/s12889-024-20462-4.

Global, regional, and national total burden related to hepatitis B in children and adolescents from 1990 to 2021

Jinbo Li  1   2 , Ziyi Gao  1   2 , Hongjing Bai  1   2 , Weigang Wang  1   2 , Yandi Li  1   2 , Jia Lian  1   2 , Yaling Li  1   2 , Yongliang Feng  3   4 , Suping Wang  5   6
Affiliations

Global, regional, and national total burden related to hepatitis B in children and adolescents from 1990 to 2021

Jinbo Li et al. BMC Public Health. .

Abstract

Background: Hepatitis B remains a significant global health concern with widespread communicability. Nevertheless, data on its burden and trends in children and adolescents were limited. We aim to evaluate the global, regional, and national trends of total burden related to hepatitis B in children and adolescents aged 0-19 years from 1990 to 2021.

Methods: The age-standardized incidence, prevalence, mortality, and disability-adjusted life years (DALYs) were calculated by the Global Burden of Disease (GBD) study from 1990 to 2021. These indicators were stratified by sex, age, socio-demographic index (SDI), and disease stage. We calculated the correlation between them and SDI. The temporal trends were examined using the annual average percentage change (AAPC) and joinpoint regression.

Results: The global age-standardized incidence of hepatitis B in children and adolescents decreased from 1385.20 per 100,000 population in 1990 to 418.68 per 100,000 population in 2021, with an AAPC of -3.76%. Similarly, age-standardized DALYs decreased from 70.78 per 100,000 population to 36.31 per 100,000 population, with an AAPC of -2.13%. The age-standardized prevalence (AAPC - 3.53%) and mortality (AAPC - 2.09%) of hepatitis B also decreased significantly. From 1990 to 2021, the age-standardized incidence and prevalence among males exhibited a higher trend compared to females, although both declined over time. These two indicators also decreased across all age subgroups, with consistently higher rates observed in the 15-19 age group compared to other age groups. The burden of hepatitis B demonstrated a notable reduction in countries with high-middle SDI, while it was highest in countries with low SDI. In 2021, Central sub-Saharan Africa and West sub-Saharan Africa reported the highest age-standardized incidence. For age-standardized DALYs, South Asia was the only region to experience an increase (AAPC 1.09%), while East Asia showed the largest decline (AAPC - 7.58%). Alcohol and drug use remained important risk factors for DALYs among people aged 15-19 years. Furthermore, the impact of drug use on disease burden was increasing, particularly in high-SDI countries.

Conclusions: The global burden and trends of hepatitis B decreased significantly in children and adolescents, exhibiting regional and national variations. Management of alcohol and drug use remains a major challenge for people aged 15-19 years.

Keywords: Disability-adjusted life years; Epidemiology; Global burden of Disease; Hepatitis B virus; Incidence; Trend.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Joinpoint regression analysis of total burden related to hepatitis B in children and adolescents from 1990 to 2021 at the global level (A) Age-standardized incidence trends; (B) Age-standardized prevalence trends; (C) Age-standardized mortality trends; (D) Age-standardized DALYs trends. APC annual percentage change, AAPC average annual percentage change, DALYs disability-adjusted life-years
Fig. 2
Fig. 2
Incidence and DALYs of total burden related to hepatitis B in children and adolescents from 1990 to 2021 at the global level (A) Cases and age-standardized incidence by sex; (B) Cases and age-standardized DALYs by sex; (C) Cases and age-standardized incidence by age; (D) Cases and age-standardized DALYs by age. DALYs disability-adjusted life-years
Fig. 3
Fig. 3
Age-standardized incidence and DALYs of total burden related to hepatitis B in children and adolescents in 204 countries and territories (A) Age-standardized incidence in 2021; (B) AAPC in age-standardized incidence from 1990 to 2021; (C) Age-standardized DALYs in 2021; (D) AAPC in age-standardized DALYs from 1990 to 2021. DALYs disability-adjusted life-years, AAPC average annual percentage change
Fig. 4
Fig. 4
Global, regional, and national levels of total burden related to hepatitis B in children and adolescents by SDI (A) Age-standardized incidence from 1990 to 2021 at the global and 21 regions levels; (B) Age-standardized incidence in 2021 in 204 countries and territories; (C) Age-standardized DALYs from 1990 to 2021 at the global and 21 regions levels; (D) Age-standardized DALYs in 2021 in 204 countries and territories. For each region, points from left to right depict estimates from each year from 1990 to 2021. Expected trends based on SDI and disease age-standardized rates in all locations were shown as the black line with LOWESS (locally weighted scatterplot smoothing) methods. DALYs disability-adjusted life-years, SDI socio-demographic index
Fig. 5
Fig. 5
Proportion of total burden related to hepatitis B DALYs attributable to alcohol use and drug use among people aged 15–19 years from 1990 to 2021 at the global and SDI levels DALYs disability-adjusted life-years, SDI socio-demographic index
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