Trends and cross-country inequalities in the global burden of neurodevelopmental disorders among children aged 0-14 from 1990 to 2021.

This study looked at autism, ADHD, and intellectual disability rates in children worldwide from 1990-2021. Autism rates increased slightly over time, while ADHD and intellectual disability rates decreased. The research found big differences between countries - autism and ADHD are more common in wealthier countries, while intellectual disability is more common in poorer countries. The study predicts these patterns will continue, showing the need for better healthcare planning worldwide.

This global epidemiological study analyzed trends in three neurodevelopmental disorders (ASD, ADHD, and IDID) among children aged 0-14 across 204 countries from 1990-2021 using Global Burden of Disease data. Results showed divergent trends: ASD prevalence increased annually by 0.09%, while ADHD decreased by 0.08% and IDID decreased by 0.86%. Significant health inequalities were identified, with ASD and ADHD burdens concentrated in high sociodemographic index countries, while IDID burden was higher in low sociodemographic index regions. Projections to 2046 suggest continued slight decreases in ASD and ADHD prevalence, with slight increases in IDID.

The study highlights persistent cross-country inequalities and emphasizes the need for targeted public health strategies and equitable healthcare resource allocation.

Results suggest need for healthcare system planning to address increasing ASD identification globally. The persistent inequalities highlight requirements for tailored public health approaches - enhanced diagnostic and support services in high-SDI countries for ASD/ADHD, and prevention/early intervention programs in low-SDI countries for intellectual disabilities. Resource allocation should consider these geographic disparities.

Study relies on Global Burden of Disease estimates which may have varying data quality across countries. Changes in diagnostic criteria and awareness over the 31-year period could confound true prevalence trends. The abstract doesn't specify methodology details or control for potential confounding factors affecting international comparisons.

To evaluate the trends and cross-country inequalities of three common neurodevelopmental disorders (NDDs): Autism spectrum disorders (ASD), Attention-deficit/hyperactivity disorder (ADHD) and Idiopathic developmental intellectual disability (IDID) among children aged 0-14, and further predicted its changes to 2046. The estimates and their 95% uncertainty interval (UI) for prevalence of ASD, ADHD and IDID among children aged 0-14 across 204 countries were extracted from Global Burden of Disease (GBD) 2021. Joinpoint regression analysis was used to calculate the average annual percentage changes (AAPC). The slope index of inequality (SII) and concentration index recommended by the World Health Organization (WHO) are two standard indicators for measuring absolute and relative gradient inequality.

Our study used these two indicators to quantify the inequality of this three common NDDs burden between countries with different Sociodemographic Index (SDI). Finally, we used the Nordpred model to predict the disease burden of NDDs in 2046. The AAPC (95% confidence interval [CI]) in prevalence of the three common NDDs among children aged 0-14 worldwide from 1990 to 2021 were as follows: ASD 0.09 (0.08 to 0.09), ADHD -0.08 (-0.12 to -0.04) and IDID -0.86 (-0.88 to -0.84). The SII (95% CI) changed from 27.09 (-29.98 to 84.17) in 1990 to 38.36 (-21.48 to 98.20) in 2021 for ASD, from 1402.78 (1100.25 to 1705.31) in 1990 to 1402.76 (1083.55 to 1721.97) in 2021 for ADHD, from -594.52 (-755.05 to -434.00) in 1990 to -545.94 (-673.19 to -418.69) in 2021 for IDID.

The concentration index (95% CI) showed 0.15 (0.07 to 0.23) in 1990 and 0.19 (0.10 to 0.26) in 2021 for ASD, 0.07 (-0.02 to 0.16) in 1990 and 0.02 (-0.07 to 0.11) in 2021 for ADHD, 0.44 (0.34 to 0.53) in 1990 and 0.39 (0.28 to 0.48) in 2021 for IDID. Compared to 2021, the age-standardized prevalence rates (ASPR) in 2046 of the three common NDDs showed a slight decrease in ASD and ADHD, a slight increase in IDID. As a major public health concern, the global burden of NDDs in children exhibited distinct trends from 1990 to 2021: an increasing trend for ASD, and decreasing trends for ADHD and IDID. Health inequalities persist across these conditions.

The burdens of ASD and ADHD are primarily concentrated in high-SDI countries/territories, whereas the burden of IDID is more prevalent in low-SDI countries/territories. Therefore, targeted public health strategies and equitable allocation of healthcare resources are essential to effectively mitigate the burden of NDDs.