Global, Regional, and National Epidemiology of Thalassemia in Childhood from 1990 to 2021

Objective: To analyze trends in prevalence, mortality, and disability-adjusted life years (DALYs) of childhood thalassemia from 1990 to 2021. Methods: Using the 2021 Global Burden of Disease (GBD) database, we conducted a cross-sectional study of children aged 0 - 14 years across 204 countries. We analyzed prevalence, mortality, and DALYs by region, country, age, sex, and Sociodemographic Index (SDI), calculating average annual percentage changes (EAPCs) to assess trends. Results: In 2021, there were 869,327 cases of childhood thalassemia globally. From 1990 to 2021, global prevalence decreased by 19.09%, and deaths declined from 12,018 to 5897. The mortality rate dropped from 0.69 to 0.29 per 100,000. High SDI regions had the lowest prevalence, mortality, and DALYs, all showing downward trends. Middle SDI regions had higher prevalence rates, while low and lower-middle SDI regions saw increases. Cambodia had the highest prevalence rate in 2021 (418 per 100,000), China had the highest number of cases (327,889), Pakistan had the highest DALYs (116987.40), and Guinea-Bissau had the highest DALYs rate (155.55 per 100,000). Conclusions: Childhood thalassemia remains a significant global health challenge. Despite declines in global prevalence, mortality, and DALYs, the burden remains high, especially in low SDI regions. Understanding the epidemiology of childhood thalassemia can aid in its prevention and control.