The Global, Regional, and National Burden of Inflammatory Bowel Disease among Children and Adolescents from 1990 to 2021 and Trend Projections up to 2036

Abstract

Background/aims: Early-onset inflammatory bowel disease (EO-IBD) poses a global health challenge with its distinct clinical manifestations and complex progression.

Methods: In this study, IBD cases occurring before age 20 were defined as EO-IBD. Data were extracted from the Global Burden of Disease 2021 database. Temporal trends were assessed using Joinpoint regression analysis, and future epidemiological trends were projected using the Bayesian age-period-cohort (BAPC) model. Health disparities across various sociodemographic index (SDI) regions were quantified using the slope index of inequality and concentration index.

Results: From 1990 to 2021, the global number of EO-IBD cases increased, while the incidence rates showed minimal change. Mortality and disability-adjusted life years (DALYs) rates briefly increased before a rapid decline after 1992. In 2021, males had higher mortality and DALYs rates due to EO-IBD than females. The highest mortality and DALYs rates were observed in the <5 years and 15 to 19 years age groups. Geographically, high SDI regions had the highest incidence, prevalence, and DALYs rates, while low SDI regions had the highest mortality rates. BAPC projections indicate that by 2036, the age-standardized incidence rate and prevalence rate will increase, whereas the age-standardized mortality rate and DALYs rates will continue to decline.

Conclusions: The incidence of EO-IBD is projected to exhibit an increasing trend in the future. Although the global mortality and DALYs rates of EO-IBD have decreased, significant disparities persist across age groups and regions. Targeted prevention and control strategies are needed to address the needs of high-risk populations and regions.

Keywords: Adolescents; Child; Global Burden of Disease; Inflammatory bowel disease; Projection.