ORIGINAL RESEARCH article
Front. Pediatr.
Sec. Pediatric Otolaryngology
Global Burden of Childhood Otitis Media Attributable to Secondhand Smoke from 1990 to 2021: A Systematic Analysis of the Global Burden of Disease Study 2021
Provisionally accepted
- Affiliated Hospital of North Sichuan Medical College, Nanchong, China
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Abstract 12 Background 13 Childhood otitis media is significantly influenced by exposure to 14 secondhand smoke , posing a considerable challenge to pediatric 15 health. Utilizing data obtained from the Global Burden of Disease Study 16 (GBD) 2021, this population-based burden analysis examines the worldwide 17 impact of SHS-associated otitis media among children aged 0-14 years 18 between 1990 and 2021, while forecasting epidemiological patterns up to 19 2051. 20 Methods 21 The GBD 2021 dataset served as the foundation for evaluating four key 22 metrics: disability-adjusted life years (DALYs), age-standardized rates for 23 DALYs (ASDR), years lived with disability (YLDs), and age-standardized 24 YLD rates (ASYR) associated with pediatric middle ear infections caused 25 by SHS exposure. Joinpoint regression modeling was employed to detect 26 epidemiological trend change points, while disparity assessment in health 27 outcomes examined variations across socioeconomic and demographic strata. 28 Burden projection was conducted through implementation of an 29 autoregressive integrated moving average (ARIMA) statistical framework. 30 Results 31 The global YLDs due to childhood otitis media attributable to SHS 32 decreased by 17.65% in 1990-2021. The ASYR decreased by 28.78%. The ASDR falling by 32.08%. The 36 burden was consistently greater in males compared to females, with the 37 highest impact observed in regions with low and middle SDI regions. 38 Joinpoint regression analysis revealed the greatest decline in ASYR 39 occurred in 2003-2008, while the most significant decrease in ASDR 40 occurred in 1994-1999. Health inequality analysis showed a reduction in 41 inequality from 1990 to 2021. ARIMA projections suggest a further decline 42 in global ASYR and ASDR by 2051, although an increase may occur in 43 middle SDI regions. 44 Conclusion 45 While there has been a general decrease in the global burden of childhood 46 otitis media linked to secondhand smoke exposure. Certain regions continue to 48 experience a disproportionately high burden. These findings call for 49 continued investment in public health strategies that not only limit SHS 50 exposure but also address healthcare access gaps in underserved 51 populations.
Keywords: Childhood otitis media, secondhand smoke, Joinpoint regression analysis, Health inequality analysis, autoregressive integrated moving average, global burden of disease 2021
Received: 30 Apr 2025; Accepted: 17 Nov 2025.
Copyright: © 2025 Li, Zou and chun. 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:
Kai Zou, zoukai@nsmc.edu.cn
Pan Qing chun, 309042390@qq.com
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