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

Abstract

SummaryBackgroundThe 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.MethodsWe 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.FindingsGlobally, 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.InterpretationThe 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.FundingThe Bill & Melinda Gates Foundation.

Confirmation that variants in TTI2 are responsible for autosomal recessive intellectual disability

“…Intellectual disability (ID) is a common neurodevelopmental disorder with a prevalence of 10.4/1000 population 1 and a major socioeconomic burden. 2 In the last few years, next-generation DNA sequencing has led to tremendous progress in deciphering monogenic causes of ID. In particular, the strategy of trio-whole exome sequencing (WES) has led to a detection rate of de novo dominant pathogenic variants in ID that varies from 20% to 60%.…”

Empowering self-help groups for caregivers of children with disabilities in Kilifi, Kenya: Impacts and their underlying mechanisms

“…Zimmerman and colleagues [31][32][33][34]58] might explain this as the antithesis of empowerment. Having a child with a disability was considered generally incongruent with acceptability in the prevailing culture, and indeed triggered negative responses from others in the family and in the community as reported previously [4,5,[17][18][19][21][22][23][24][25][26]. Thus both caregiver and child were effectively marginalised in their own community, with a lack of knowledge, limited support and no opportunity for joining their efforts with others-critical components of the empowerment construct described by Perkins & Zimmerman [58].…”

“…Using a 5% prevalence of childhood disability [3], it was estimated there were 27,743 children with a disability. In this setting, disability is often associated with negative images and explained by breach of social conventions by one or other of the parents, which has aroused the wrath of ancestors, supernatural forces, the will of God or unexplained events [4]. Thus stigma associated with disability was present in the community.…”

Estimated prevalence of disability and developmental delay among preschool children in rural Malawi: Findings from “Tikule Limodzi,” a cross‐sectional survey

“…The Global Burden of Diseases, Injuries, and Risk Factors Study 2016 defined developmental disabilities as a group of conditions resulting from impairments that affect a child's physical, learning, or behavioural functioning (Olusanya et al, ). Despite the acknowledged limitations of the available primary data, the study estimated a prevalence of developmental disabilities in children under 5 to be 8.4% or 52.9 million with 94.9% (50.2 million) of these children living in LMICs.…”