Childhood ALL burden drops but inequalities persist

The global burden of childhood acute lymphoblastic leukemia (ALL) has gradually decreased, with steady improvements in quality of care, but inequalities remain a significant challenge, according to a study.

A group of researchers used data from the Global Burden of Disease Study 2021 to analyse the temporal trends in the global burden of childhood ALL from 1990 to 2021. They quantified care quality using the quality of care index (QCI) and assessed gender disparities using the gender disparity ratio (GDR).

Furthermore, the researchers performed trend analyses using the estimated annual percentage change (EAPC) and explored the associations between QCI, GDR, and the sociodemographic index (SDI). Finally, they evaluated inequalities in QCI and GDR across regions using the slope index of inequality (SII) and health inequality concentration index.

A significant decrease occurred in the incidence and death rates, as well as disability-adjusted life years and years of life lost due to childhood ALL from 1990 to 2021. However, the number of prevalence increased by 66.818 percent and the prevalence crude rate by 37.923 percent.

Improvements in global care quality persisted, with an EAPC of 2.566 (95 percent confidence interval, 2.488‒2.645). In 2021, high-income areas like Western Europe had the highest concentration of regions with high QCI, while low-income areas like sub-Saharan Africa and Oceania had the greatest number of regions with low QCI.

The health inequality concentration index of global quality care dropped from 0.550 in 1990 to 0.395 in 2021, but the SII rose from 35.396 to 87.141. Care quality was consistently higher in females than in males, especially in low and low-middle SDI regions. On the other hand, the disparities seen in high and middle SDI regions were narrowing steadily.

“Future efforts should focus on increasing healthcare resource allocation in low SDI regions, enhancing international cooperation, improving the quality and accessibility of care in priority regions, and promoting global health equity,” the researchers said.