Incidence, Prevalence, and Mortality of diseases among Children and Adolescents in national and subnational levels of Iran, 1990-2021: A systematic analysis for the Global Burden of Disease 2021

Introduction: Child and youth mortality serves as a critical indication of a nation's growth, with significant ramifications for the future of its people. Current statistics on Iranian children and adolescents' disease patterns are inadequate and outdated. This study seeks to examine the incidence, prevalence, and death rates of diseases in children and adolescents at both national and subnational levels in Iran, utilizing the Global Burden of Disease (GBD) 2021 data. Methods: We employed data from the GBD 2021 study regarding all-cause mortality in children and adolescents, sourced from the Institute for Health Metrics and Evaluation. This research analyzes the patterns in the primary and secondary tiers of the GBD cause hierarchy of mortality and morbidity. We analyze the incidence, prevalence, and mortality rates for children and adolescents under 20 years old in Iran and its 31 provinces from 1990 to 2021. Results: From 1990 to 2021, there has been a significant reduction in incidence (28.1%), prevalence (19.7%), and death (90.6%) from all causes among children and adolescents in Iran. Several rates that decreased included those for communicable, maternal, neonatal, and nutritional diseases (CMNNDs), non-communicable diseases (NCDs), and injuries. The sole rate that increased was the prevalence rate for NCDs, rising from 82437.7 (95% UI: 80130.1 to 84458.9) to 83458.5 (81399.3 to 85197.9), representing a 1.2% increase. In 2021, respiratory infections and tuberculosis, intestinal infections, and other non-communicable disorders exhibited the greatest incidence rates across all provinces. Moreover, in most areas, transportation injuries, maternal and neonatal disorders, and other non-communicable diseases exhibited the highest mortality rates. Conclusion: This study highlights the remarkable advancements achieved in lowering mortality, incidence, and prevalence rates among children and adolescents in Iran over the last thirty years; Despite progress, challenges remain, particularly concerning NCDs. Policymakers should draw on insights from studies like these to create specific strategies that respond to the evolving health needs of children and adolescents in Iran, while also working to reduce health inequalities across different provinces.