Global Pediatric Epilepsy Burden: Analysis of the Global Burden of Disease Database (1990-2021) With Projections to...

To examine the trends in epilepsy prevalence, incidence, mortality, and disability-adjusted life years (DALYs) among children aged 0-14 years from 1990 to 2021, and projected the epidemiological patterns for the next decade to 2035.

Employing standardized Global Burden of Disease approaches, our study evaluated the burden of pediatric epilepsy in 204 countries and regions from 1990 to 2021. Our objective was to provide a comprehensive assessment of the health impact of pediatric epilepsy by incorporating four critical epidemiological indicators-prevalence, incidence, mortality, and DALYs-including their trends and projecting them for the next decade. These data are presented as both raw counts and age-standardized rates per 100,000 people, accompanied by 95% uncertainty intervals (UIs).

From 1990 to 2021, global age-standardized Prevalence Rate (ASPR), age-standardized Mortality Rate (ASMR), and age-standardized Disability-Adjusted Life Years rate (ASDR) generally declined, while age-standardized Incidence Rate (ASIR) slightly increased. In 2021, global ASPR and ASIR were 302.99 (95% UI: 212.38-411.09) and 61.00 (95% UI: 39.09-86.21), respectively, while ASMR and ASDR were 0.90 (95% UI: 0.69-1.06) and 177.17 (95% UI: 134.25-236.27), with males generally higher than females. The 10-14 years age group had the highest prevalence, and the under-one age group the lowest, with ASIR, ASMR, and ASDR age distributions reversed. ASPR and ASIR were highest in high Socio-Demographic Index (SDI) regions, with Equatorial Guinea, Ecuador, and Gabon highest, and North Korea, Solomon Islands, and China lowest. ASMR and ASDR were highest in low SDI regions, with South Sudan, Zambia, and Tanzania highest, while Vietnam had the lowest ASMR, and Denmark and Sweden had the lowest ASDR.

Over the past 32 years, incidence, mortality, and DALYs for pediatric epilepsy have generally declined, yet regions with lower SDI still report higher mortality and DALYs. Males and infants under 1 year face a disproportionately higher burden of epilepsy. Projected declines in the global burden of pediatric epilepsy are anticipated through 2035, particularly among children under five years, with significant reductions in prevalence and DALYs. The decrease in epilepsy incidence and DALYs among males is more pronounced and rapid compared to females.