Abstract
INTRODUCTION: Childhood poisoning remains a significant global public health challenge, driving ongoing efforts to reduce its effect across countries and regions. However, most previous studies have been limited to individual medical centers or specific geographic areas, lacking a comprehensive global comparison. Therefore, this study aims to utilize the Global Burden of Disease (GBD) database to assess the burden of childhood poisoning among children under 14 years old at the global, regional, and national levels from 1990 to 2021. METHODS: Secondary analysis using data from the 2021 GBD database was conducted to assess the burden and temporal trends of childhood poisoning from 1990 to 2021. Health inequality was evaluated using the Slope Index of Inequality and the Concentration Index. Additionally, a frontier analysis was performed to identify regions with the potential for burden reduction. RESULTS: Between 1990 and 2021, the global age-standardized incidence rate (ASIR), age-standardized mortality rate (ASMR), and age-standardized disability-adjusted life years rate (ASDR) for childhood poisoning declined. In 2021, the ASIR, ASMR, and ASDR for children under 14 years old per 100,000 population was 40.46 (95% UI: 24.87-63.29), 0.45 (95% UI: 0.28-0.65), and 40.2 (95% UI: 26.32-57.93). Across different SDI regions, high-SDI countries had the highest ASIR, while low-SDI countries had the highest ASMR and ASDR. Among the 204 countries analyzed, Norway had the highest ASIR in 2021, whereas South Sudan had the highest ASMR and ASDR. Health inequality analysis revealed that while the gap between low- and high-SDI countries narrowed over time, children in lower-SDI countries continued to experience a significantly higher disability burden. Frontier analysis revealed a negative correlation between ASDR and SDI; however, childhood poisoning burdens varied significantly among countries with similar SDI levels. CONCLUSION: Between 1990 and 2021, the global burden of childhood poisoning declined, yet health inequalities remain, with less-developed countries disproportionately affected. Future efforts should strengthen emergency response systems in these regions, promote poisoning prevention and safe storage regulations in higher-development countries, and further investigate childhood poisoning risk factors.