Pre-COVID era pediatric disease incidence in Kazakhstan: regional panel data analysis of multiple disease groups (2010-2019)

Nurlan Smagulov¹Olzhas Zhamantayev^2*Aidar Aitkulov^1*Nurbek Yerdessov²Karina Nukeshtayeva²Zhanerke Bolatova²Zhyldyz Kurzhunbaeva³

• ¹Buketov Karaganda State University, Karaganda, East Kazakhstan, Kazakhstan
• ²Karaganda State Medical University, Karaganda, Kazakhstan
• ³University of Insubria, Varese, Lombardia, Italy

Background: While child morbidity in Kazakhstan is studied, existing research often prioritizes mortality or infectious diseases over non-communicable conditions. This study fills this gap by examining socioeconomic, demographic, and healthcare factors linked to respiratory diseases, asthma, and nervous system disorders among children aged 0–14 years across Kazakhstan from 2010 to 2019 highlighting regional context.Methods: Panel data from 14 regions were analyzed using linear mixed models with autoregressive covariance to address regional and temporal heterogeneity. Log-transformed incidence rates of respiratory diseases (J00-J99), asthma (J45), and nervous system diseases (G00-G99) were modeled against predictors including GRP per capita, unemployment, population density, Gini coefficient, pediatrician density, and hospital resources. Other variables with variance inflation factors ≥5 were excluded to mitigate multicollinearity.Results: Respiratory diseases showed the highest mean incidence (57,329.86 per 100,000), with significant regional variation. Aqtöbe, Atyrau, and South Kazakhstan had 12–25% lower incidence compared to Zhambyl (reference), while Pavlodar and North Kazakhstan had 35–61% higher rates. A 1% increase in population density correlated with a 1.05% decrease in respiratory disease incidence (p = 0.008), whereas unemployment was linked to a 0.41% rise (p = 0.029). Asthma incidence increased by 140% over the decade, with higher rates in regions with greater income inequality (0.26% increase per 1% rise in low-income households, p = 0.032). Nervous system disorders showed limited associations, with unemployment as the sole predictor (0.69% increase per 1% rise, p = 0.040). Temporal trends revealed declines in most diseases, but neoplasms, diabetes, and asthma increased significantly.Conclusion: The study addresses the lack of localized socioeconomic and healthcare analyses for respiratory diseases, asthma, and nervous system disorders among children, providing evidence for region-specific policy interventions. Respiratory diseases and asthma among Kazakhstani children 0-14 years had associations with the regional economic conditions, healthcare utilization, and inequality. Population density and income inequality were consistent predictors, while nervous system disorders showed fewer clear associations. Our findings show distinct regional patterns in pediatric morbidity, linking health outcomes to localized socioeconomic and healthcare conditions.