# Study on the 1990–2021 trend of global childhood respiratory infection and tuberculosis disease burden and related risk factors

**Authors:** Jie Chen, Chao Fang, Weihong Lu, Xiangtao Wu, Xingliang Zhang

PMC · DOI: 10.3389/fpubh.2025.1609990 · 2025-07-30

## TL;DR

This study examines global trends in childhood respiratory infections and tuberculosis from 1990 to 2021, highlighting risk factors and regional disparities.

## Contribution

The novel contribution is a comprehensive analysis of disease burden trends and risk factors using GBD data for children aged 0–14 years.

## Key findings

- Mortality from neonatal lower respiratory infections was highest at 1,560.6 per 100,000.
- Low-SDI regions had the highest disease burden, while high-SDI areas saw a 95.7% drop in TB mortality.
- Underweight remained the main risk factor, though household air pollution and low birth weight increased in significance.

## Abstract

Respiratory tract infections (RTIs) and tuberculosis (TB) impose a critical global health burden on children, serving as leading causes of morbidity and mortality. Lower respiratory tract infections (LRIs) remain the primary cause of death in under-5 s, though mortality has declined recently.

This study aims to analyze trends in RTIs and TB among 0–14-year-olds using Global Burden of Disease (GBD) data from 1990 to 2021.

Global data on childhood RTIs and TB were collected from GBD, with standardized methods used to assess disease burden trends, age/sex/SDI differences, and the contribution of 11 risk factors.

From 1990 to 2021, incidences of upper RTIs, otitis media, and TB decreased, but overall RTIs increased. Neonatal LRI had the highest mortality (1,560.6/100 k). Male children showed higher TB incidence/mortality. Low-SDI areas had the highest burden (mortality 2.036/100 k), while high-SDI areas saw the largest TB mortality drop (95.7%). Underweight remained the main risk factor, with DALY rate falling 80.3%, though household air pollution, low birth weight, short gestation, and high temperature rose in rank.

Global childhood respiratory disease burden faces challenges, requiring strengthened international cooperation and targeted interventions, especially in low-SDI regions, to improve public health and nutrition.

## Linked entities

- **Diseases:** tuberculosis (MONDO:0018076), otitis media (MONDO:0005441)

## Full-text entities

- **Diseases:** ear infections (MESH:D010031), TB (MESH:D014376), respiratory pathogens (MESH:D012131), Mycoplasma pneumoniae (MESH:D011019), pneumonia (MESH:D011014), COVID-19 (MESH:D000086382), sinusitis (MESH:D012852), pulmonary TB (MESH:D014397), bronchitis (MESH:D001991), HAP (MESH:D004618), bacterial pneumonia (MESH:D018410), infection (MESH:D007239), dehydration (MESH:D003681), GBD (MESH:D001037), LRIs (MESH:D012141), SDI (MESH:D009800), tonsillitis (MESH:D014069), nasopharyngitis (MESH:D009304), Malnutrition (MESH:D044342), Underweight (MESH:D013851), Disease (MESH:D004194), death (MESH:D003643), stunted growth (MESH:D006130), zinc deficiency (MESH:C564286), acute malnutrition (MESH:D000067011), respiratory disease (MESH:D012140), wasting (MESH:D019282), mucosal damage (MESH:D052016), respiratory syncytial virus infection (MESH:D018357), Otitis media (MESH:D010033), HIV infection (MESH:D015658), vitamin A deficiency (MESH:D014802), tuberculous pleurisy (MESH:D014396)
- **Chemicals:** PAF (-), vitamin A (MESH:D014801)
- **Species:** Enterovirus (genus) [taxon 12059], Homo sapiens (human, species) [taxon 9606]

## Figures

5 figures with captions in the complete paper: https://tomesphere.com/paper/PMC12343556/full.md

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Source: https://tomesphere.com/paper/PMC12343556