Infectious disease control should shift focus from young to older children and adolescents: Study

 

Three million children and adolescents die from infectious diseases every year, equivalent to one death every 10 seconds, with India, Nigeria and Pakistan sharing the highest disease burden, according to a new study published in The Lancet journal.

Infectious diseases were found to have caused more than half of such deaths in low to middle-income countries, compared with 6 per cent in high-income countries, the study led by Murdoch Children’s Research Institute, Australia, and the Institute for Health Metrics and Evaluation, US, said.

Looking across 204 countries between 1990 and 2019 from birth to 24 years of age, the study found infectious disease control measures to have largely focused on children aged under five, with scarce attention given to young people between five and 24 years old.

Noting this demographic shift in disease burden, the study, thus, called for global disease control efforts to have a greater focus on older children and adolescents.

Diarrhoea, pneumonia and malaria accounted for two-thirds of infectious diseases and death in this demographic, while HIV and tuberculosis were found to be the leading causes among older adolescents.

The shift in disease burden to older children and adolescents, the study said, was largely driven by the considerable infection control efforts targeting children under five years in low-income countries and slower progress made across the older age groups.

In light of the COVID-19 pandemic, and recent epidemics of Zika virus, Ebola and severe acute respiratory syndrome, the research would have important implications for global policy, financing, resource allocation and health systems, said Murdoch Children’s professor Peter Azzopardi.

He said it underscored the urgent need to take stock of infectious disease control.

More adolescents than younger children have been affected by these emergent diseases, challenging the almost exclusive focus on younger children within existing infectious disease control, the study said.

“The findings highlight the need for health systems, particularly in low-income countries, to continue to build capacity and scale up trusted interventions like immunisation programs.

“But there must also be investment in broader approaches that address social barriers such as adolescent males with HIV having better access to health care,” said Azzopardi.

The COVID-19 pandemic rightly focussed global attention on infectious diseases, said Susan Sawyer, Murdoch Children’s professor.

“This study reminds us of the importance of addressing the emerging, as well as the established, infectious diseases, especially in those aged 5-24 years who have too often been neglected by policy and programming,” she said.