Global Efforts to Reduce Infectious Diseases Must Extend Beyond Early Childhood

A recent study indicates there should be an increased emphasis on older children and adolescents in global endeavors to decrease rates of infectious diseases following a transfer of disease burden to this particular population group.

Led by the Murdoch Children's Research Institute and the Institute for Health Metrics and Evaluation, the study revealed that efforts to control infectious diseases have primarily concentrated on children below the age of five, leaving limited attention towards individuals aged between five and 24 years old.

The Lancet publication presented findings from the study, highlighting that approximately three million children and adolescents lose their lives to infectious diseases annually, which equates to a staggering rate of one death every 10 seconds. The research examined data spanning from 1990 to 2019 across 204 countries, encompassing individuals from birth to 24 years of age.

Among children and adolescents, two-thirds of infectious diseases and fatalities are attributed to diarrhea, pneumonia, and malaria. When focusing on older adolescents, HIV and tuberculosis emerged as the primary causes of concern.

The transition of infectious disease burden from young children to older children and adolescents can be attributed mainly to the significant infection control measures directed towards children under the age of five in low-income countries, coupled with slower advancements made in the older age groups. In 1990, a substantial 85 percent of the infectious disease burden was observed among children below the age of five. However, by 2019, this proportion had decreased to 75 percent, indicating a notable shift in disease burden across different age demographics.

In low to middle-income countries, infectious diseases accounted for over half of the deaths among children and adolescents, whereas in high-income countries, this percentage was much lower at 6 percent. The countries bearing the greatest burden of infectious diseases were India, Nigeria, and Pakistan.

Within Australia, the infectious diseases that impose the highest burden from birth to 24 years predominantly encompass upper respiratory tract infections like sinusitis and tonsillitis, along with infectious skin conditions such as shingles and cellulitis. In high-income countries, the leading causes of disease burden are linked to conditions that result in disability, emphasizing the significance of examining the broader impact of a disease on an individual's life rather than solely focusing on mortality rates.

Dr. Jessica Kerr from Murdoch Children's Research Institute emphasized the need for a broader policy focus that encompasses older children and adolescents. She highlighted the importance of taking decisive action to prevent tuberculosis and HIV in this population group. This underscores the significance of addressing infectious diseases beyond early childhood and implementing targeted interventions to tackle these specific diseases among older age groups.

"Deaths from infectious diseases primarily occur in children under the age of five, hence although diminishing this has been a notable accomplishment, it must not monopolize our attention," she expressed.

"The substantial decline has brought about a transfer of disease burden from young children to older children and adolescents, further strengthened by the predominant emphasis on younger children in infectious disease control initiatives. Presently, there exists an unfulfilled healthcare requirement among older children and adolescents, necessitating the global community's advocacy for policy reform and financial support to tackle this issue."

According to professor Peter Azzopardi from Murdoch Children's Research Institute, the findings of this research will hold significant implications for global policy, financing, resource distribution, and healthcare systems, particularly in light of recent health emergencies.

"The COVID-19 pandemic, along with recent outbreaks of Zika virus, Ebola, and severe acute respiratory syndrome, highlights the critical importance of reassessing infectious disease control measures," he stated. "Several of these emerging diseases have disproportionately impacted adolescents rather than younger children, which challenges the prevailing emphasis on younger children in current infectious disease control strategies. These findings underscore the necessity for health systems, especially in low-income nations, to persistently enhance their capabilities and expand the reach of established interventions like immunization programs. However, it is equally crucial to invest in comprehensive approaches that tackle social obstacles, such as improving healthcare accessibility for adolescent males with HIV."

Professor Susan Sawyer from Murdoch Children's Research Institute stated that the COVID-19 pandemic appropriately redirected global attention toward infectious diseases. "This study serves as a reminder of the significance of addressing both emerging and established infectious diseases, particularly among individuals aged 5-24 years, who have frequently been overlooked in terms of policy and programming," she emphasized.

Source: Murdoch Children's Research Institute