Global, regional, and national burden of disorders affecting the nervous system, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021

BackgroundDisorders affecting the nervous system are diverse and include neurodevelopmental disorders, late-life neurodegeneration, and newly emergent conditions, such as cognitive impairment following COVID-19. Previous publications from the Global Burden of Disease, Injuries, and Risk Factor Study estimated the burden of 15 neurological conditions in 2015 and 2016, but these analyses did not include neurodevelopmental disorders, as defined by the International Classification of Diseases (ICD)-11, or a subset of cases of congenital, neonatal, and infectious conditions that cause neurological damage. Here, we estimate nervous system health loss caused by 37 unique conditions and their associated risk factors globally, regionally, and nationally from 1990 to 2021.MethodsWe estimated mortality, prevalence, years lived with disability (YLDs), years of life lost (YLLs), and disability-adjusted life-years (DALYs), with corresponding 95% uncertainty intervals (UIs), by age and sex in 204 countries and territories, from 1990 to 2021. We included morbidity and deaths due to neurological conditions, for which health loss is directly due to damage to the CNS or peripheral nervous system. We also isolated neurological health loss from conditions for which nervous system morbidity is a consequence, but not the primary feature, including a subset of congenital conditions (ie, chromosomal anomalies and congenital birth defects), neonatal conditions (ie, jaundice, preterm birth, and sepsis), infectious diseases (ie, COVID-19, cystic echinococcosis, malaria, syphilis, and Zika virus disease), and diabetic neuropathy. By conducting a sequela-level analysis of the health outcomes for these conditions, only cases where nervous system damage occurred were included, and YLDs were recalculated to isolate the non-fatal burden directly attributable to nervous system health loss. A comorbidity correction was used to calculate total prevalence of all conditions that affect the nervous system combined.FindingsGlobally, the 37 conditions affecting the nervous system were collectively ranked as the leading group cause of DALYs in 2021 (443 million, 95% UI 378–521), affecting 3·40 billion (3·20–3·62) individuals (43·1%, 40·5–45·9 of the global population); global DALY counts attributed to these conditions increased by 18·2% (8·7–26·7) between 1990 and 2021. Age-standardised rates of deaths per 100 000 people attributed to these conditions decreased from 1990 to 2021 by 33·6% (27·6–38·8), and age-standardised rates of DALYs attributed to these conditions decreased by 27·0% (21·5–32·4). Age-standardised prevalence was almost stable, with a change of 1·5% (0·7–2·4). The ten conditions with the highest age-standardised DALYs in 2021 were stroke, neonatal encephalopathy, migraine, Alzheimer's disease and other dementias, diabetic neuropathy, meningitis, epilepsy, neurological complications due to preterm birth, autism spectrum disorder, and nervous system cancer.InterpretationAs the leading cause of overall disease burden in the world, with increasing global DALY counts, effective prevention, treatment, and rehabilitation strategies for disorders affecting the nervous system are needed

Stunting and associated factors among primary school children in Ethiopia: School-based cross-sectional study

Background: Stunting is a common type of undernutrition in schoolchildren, and it has a significant negative impact on academic performance. Stunting refers to a child who is too short for their age. It is the result of chronic or recurring malnutrition. Stunting can have far-reaching consequences that last a lifetime. Malnutrition is still a major public health concern in developing countries, including Ethiopia, with an estimated 118 million people going hungry by 2020. Therefore, this study was intended to assess the prevalence and associated factors of stunting among primary school children. Methods: A cross-sectional school-based study was conducted in Gedeo Zone, South Ethiopia. A multistage sampling technique was used to get a total of 500 study participants from May 1 to June 30, 2021. Data was collected by using face-to-face interviews with structured questionnaires. It was entered into Epi Data version 3.1 and exported to SPSS version 23 for analysis. Variables with a p value of 0.25 in bivariate analysis were fitted to multivariable analysis. A multivariable logistic regression model with a 95% confidence interval and a P-Value of 0.05 was used. Results: The study found that 203 (40.6%) of the 500 primary students enrolled were stunted (95% CI: 17–47). Stunting was significantly associated with educational status [AOR 2.49 (95%CI (1.23, 4.06)], dietary diversity [AOR 2.0, (95%CI (1.64, 3.54)], child age [AOR 3.48, (95%CI (2.04, 6.16)], family size [AOR 2.18, (95%CI (2.06, 4.49)], and family type [AOR 2.94, (95%CI (1.84, 4.72)]. Conclusion: More than one-third of elementary school children were stunted. Implementing school health and nutrition initiatives to improve the nutritional status of school-age children in the study area is critical, as is considering a strategy to improve children's wellbeing through cross-cutting child wellbeing strategies, with a special focus on vulnerable children. It should be considered to empower vulnerable families who are at risk of having a child with stunting to improve children's home environments

Global, regional, and national burden of disorders affecting the nervous system, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021

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