Global, Regional and National Burden of Paediatric Atopic Dermatitis: A Trend and Geographic Inequalities Analysis

To characterize global, regional, and national trends of pediatric atopic dermatitis (AD) disease burden in the context of socioeconomic status, health service coverage, and population-level factors.The study included an estimated global prevalence of 78.68 to 84.35 million pediatric patients with AD spanning across 204 countries. Inclusion criteria comprised patients younger than 19 years and those diagnosed with atopic dermatitis.The study was a retrospective repeated cross-sectional study design using epidemiologic estimates from the Global Burden of Disease (GBD) 2019 dataset. The data were stratified by age, divided into younger than 5 years, 5 to 9 years, 10 to 14 years, and 15 to 19 years. Other variables included regions segregated by sociodemographic index, universal health coverage index, and geography, with these definitions established within the GBD dataset and with the sociodemographic index and universal health coverage index serving as proxies for socioeconomic status and health service coverage, respectively. The study used Pearson correlation analyses and linear regression models to determine associations between epidemiologic variables and other variables, such as sociodemographic index and universal health coverage index. The study applied decomposition analysis to quantify the net effects of population-level factors on changes in prevalent and incident cases of atopic dermatitis.The prevalence of AD globally increased from 78.68 million in 1990 to 84.35 million in 2019. Incident cases increased from 11.72 million to 12.42 during the same period. Regionally, prevalence and incidence had decreasing trends in middle, high-middle, and high sociodemographic index regions, whereas the greatest increases in prevalent and incident cases were in the low sociodemographic regions. Sub-Saharan Africa had increasing trends of absolute and age-standardized prevalence and incidence of atopic dermatitis, whereas eastern and central Europe had decreasing trends. Overall, this study found significant negative correlations between relative changes in prevalence and incidence with both sociodemographic index and universal health coverage index. This study also found significant negative correlations between estimated percentile changes of age-standardized prevalence and incidence with both sociodemographic index and universal health coverage index.Pediatric AD prevalence increased globally over the past 3 decades, mainly due to overall population growth. There were disparities in prevalence and incidence of pediatric AD with regional geographic trends as well as significant associations with sociodemographic index and universal health coverage index.AD is the most common chronic skin condition in children, resulting in heightened risk for comorbidities and increased disease burden. Previous epidemiological studies within the global pediatric atopic dermatitis population largely focused on resource-rich countries. This study reported critical geographic and socioeconomic disparities in pediatric atopic dermatitis epidemiology. The findings of this study are important considerations for future health care policies and international and regional interventions for pediatric atopic dermatitis.