Global, regional, and national burden of pediatric intracerebral hemorrhage from 1990 to 2021: a systematic analysis for the global burden of disease study 2021

Abstract

Background: Pediatric intracerebral hemorrhage (ICH) represents a significant contributor to global mortality and disability among children, yet its long-term epidemiological patterns are underexplored. Methods: Data on the incidence, prevalence, mortality, and disability-adjusted life years (DALYs) of pediatric ICH in individuals under 14 years of age were obtained from the 2021 Global Burden of Disease (GBD) database. Analyses were conducted at the global, regional, and national scales. Results: In 2021, an estimated 67,781 new cases were identified globally (3.37 per 100,000), a 23% decline from 1990. In 2021, there were 540,195 prevalent cases (31.06 per 100,000), a 14.75% decrease from 1990. In 2021, ICH caused 10,556 deaths (0.52 per 100,000), a 71% reduction from 1990. In 2021, the total DALYs was 974,154 (48.42 per 100,000), a 70% reduction from 1990. At the country level, Sierra Leone had the greatest incidence rate, in contrast to the Russian Federation. Sierra Leone had the highest prevalence rate, while Lithuania had the lowest. The Lao People’s Democratic Republic had the highest mortality rate, whereas Lithuania reported the lowest. Regarding DALYs, Sierra Leone ranked highest and Lithuania had the lowest. An inverse correlation was found between ICH burden and socio-demographic index (SDI), with significant differences across sex and age groups, notably affecting male children and infants under one year. Conclusions: Despite a decline in pediatric ICH burden in recent decades, it remains a major public health concern, particularly in low SDI regions and among vulnerable populations like male infants.