ORIGINAL RESEARCH article
Front. Nutr.
Sec. Nutritional Epidemiology
Volume 12 - 2025 | doi: 10.3389/fnut.2025.1679081
This article is part of the Research TopicClinical Research on Nutrition and Children's Health: Focusing on Genetics, Metabolism, and the Gut MicrobiomeView all 5 articles
Global Trends, Inequalities, and Pathogen Shifts in Infectious Diarrhea Among Children Under Five: A Comprehensive Analysis of the Global Burden of Disease Study 1990–2021
Provisionally accepted
- 1Lanzhou University, Lanzhou, China
- 2First Hospital of Lanzhou University, Lanzhou, China
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Background: Infectious diarrhea is a major cause of morbidity and mortality among children under five, particularly in low-and middle-income countries. Despite notable improvements in public health, substantial regional, national, and socioeconomic disparities persist, while the evolving pathogen spectrum presents new challenges for prevention and control. Methods: We conducted a comprehensive analysis using data from the Global Burden of Disease (GBD) 2021 cycles, covering 204 countries and territories from 1990 to 2021. We assessed incidence, prevalence, mortality, and disability-adjusted life years (DALYs) at global, regional, national, and SDI quintile levels. Analytical methods included calculation of age-standardized rates (ASR), estimation of annual percentage changes (EAPC), joinpoint regression, inequality indices (SII and concentration index), frontier analysis, and pathogen-specific DALY trends. Results: Globally, incident cases and DALYs increased while ASRs for all burden indicators declined substantially from 1990 to 2021. The heaviest burdens persisted in South Asia and Western Sub-Saharan Africa. Although absolute global inequalities lessened, relative disparities in mortality and DALYs widened. Temporal and geographic
Keywords: Infectious diarrhea, Children under five, Global burden of disease, health inequality, Epidemiological Trends.
Received: 04 Aug 2025; Accepted: 15 Oct 2025.
Copyright: © 2025 Tian, Zheng, Li, Wu, Lin and Chen. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Zhaofeng Chen, zhfchen@lzu.edu.cn
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