Infections remain a major threat to children worldwide

In 2021, infectious diseases caused by bacteria and viruses resulted in over one million deaths among children aged 0 to 14 worldwide. Among these diseases, digestive disorders were the leading cause with over 600,000 deaths, followed by lower respiratory tract infections and meningitis. The bacterium Streptococcus pneumoniae was the deadliest, responsible for 173,000 deaths, and was the leading cause in 18 of the 21 regions studied, with the highest rates observed in Oceania. It is also the primary cause of disabilities and loss of healthy life years, as is rotavirus, which mainly affects the youngest children.

The least developed regions, particularly in sub-Saharan Africa, bear the heaviest burden. Newborns are the most affected, with increased risks during the first week of life. Boys also experience a greater impact than girls, a difference that could be explained by biological vulnerabilities. Infections with Klebsiella pneumoniae are particularly dangerous for babies, while Streptococcus pneumoniae becomes the main threat after the neonatal period.

Projections for 2050 indicate an overall decline in these diseases, but some, such as respiratory infections caused by Mycoplasma pneumoniae, meningitis caused by Neisseria meningitidis, and digestive disorders linked to bacteria like Salmonella and norovirus, are expected to remain major challenges. This uneven decline is partly explained by improvements in socio-economic conditions, measured by a composite indicator combining income, education, and fertility rates. The higher this indicator, the lower the disease burden, except for boys, where the relationship is less clear.

Vaccines have already significantly reduced mortality related to pathogens such as Haemophilus influenzae, but their effectiveness varies by region. In low-income countries, vaccine coverage remains insufficient, and the emergence of antibiotic-resistant strains further complicates the fight against these infections. Prenatal care and hygiene measures in neonatal services could also play a key role in limiting transmission.

Differences between boys and girls are observed in almost all disease categories, with a systematically higher burden for the former. This could be linked to immunological or anatomical differences, although the exact reasons remain unclear. The poorest regions, where access to clean water and healthcare is limited, continue to pay the heaviest toll, particularly in the face of digestive diseases.

Forecasts suggest that, without additional efforts, some infections could even re-emerge, particularly due to antibiotic resistance or gaps in vaccination campaigns. Future strategies will therefore need to combine vaccination, infection prevention in newborns, rational antibiotic management, and strengthening health systems to reduce these persistent inequalities.

Credits

Source Study

DOI: https://doi.org/10.1007/s15010-026-02863-2

Title: Global, regional, and national burden of pathogen-attributable infectious diseases in children by age and sex, 1990–2021: a systematic analysis

Journal: Infection

Publisher: Springer Science and Business Media LLC

Authors: Xin Zhao; Zenghou Liu; Yanwei Wang; Yanhua Wang; Wendi Zhang; Xiaoxin Wang; Dalu Song; Zhuohui Zhao; Xin Liu