Trends in Burden of Diseases among Adolescents in Ethiopia, from 1990 to 2019: A Subnational Analysis in Global Burden of Diseases 2019 Study

Abstract

Abstract
Background: Adolescence is a time of major physical, social, and emotional changes and can present significant health risks. Nearly 35% of the global disease burden is believed to be rooted in adolescence. However, the burden of diseases among adolescents is poorly studied in Ethiopia despite having a large adolescent population.
Objective: The objective of this research is to analyze the patterns of premature mortality, disability, and overall disease burden among adolescents in Ethiopia from 1990 to 2019, considering age, gender, and regional variation.
Methods: Using the 2019 Global Burden of Disease data and estimation techniques, disability-adjusted life years, years lived with disabilities, years of life lost, and maternal mortality rates were calculated. The causes of death ensemble model (CODEm) and Bayesian meta-regression disease modeling (DisMR 2) methods were used to calculate fatal and non-fatal health metrics values over time. All available data sources were used for this analysis, including e population census, demographic surveillance, household surveys, disease registry, health service use, disease notifications, and other data. The 95% uncertainty intervals were computed to check for the presence of statistical significance in the trend. Rates were estimated per 100,000 populations.
Results: From 1990 to 2019, there was a significant decreasing trend in mortality rate from 237 deaths (226–248) to 56 deaths (50–69), years of life lost from 18,093 years lost (17,264–19,008) to 4,264 years lost (3,788–5,276), and disability-adjusted life years from 24,615 years (22,598–27,127) to 9,803 years (8,153–11,815) among early adolescents, whereas mortality rate from 402 deaths (384–423) to 98 deaths (83–117), years of life lost from 28,769 years lost (27,439–30,266) to 7,015 years lost (5,949–8,372), and disability-adjusted life years from 36,494 years (33,987–39,428) in 1990 to 13,591 years (11,433–16,068) among late adolescents. Moreover, there were slight variations in the burden of diseases by sex and region. The leading causes of the total burden of diseases were mental disorders, HIV/AIDS and sexually transmitted infections, skin diseases, enteric infections, malaria and neglected tropical diseases, nutritional deficiencies, unintended injuries, tuberculosis and respiratory infections, and maternal and neonatal disorders. Additionally, those causes on the bottom list in 1990 shifted to the top in 2019.
Conclusion: According to the study, there has been a decline in the burden of diseases among adolescents from 1990 to 2019, although with slight variations across regions. Adolescents experienced a triple burden of diseases, including communicable, maternal, neonatal, and nutritional conditions, non-communicable diseases, and injuries. As a result, interventions aimed at addressing the health issues of adolescents should prioritize increased access to healthcare services, enhanced health education programs, better distribution of disease prevention resources across regions, and higher investment in public health infrastructure. [Ethiop. J. Health Dev. 2023;37 (SI-2)]
Keywords: adolescent health, burden of diseases, disability, HIV/AIDS, injuries, maternal disorders