Burden of digestive congenital anomalies in the Middle East and North Africa region between 1990 and 2021

BACKGROUND: Digestive congenital anomalies (DCAs), the fourth leading cause of death and disability among all congenital birth defects, have a substantial impact on both the duration and quality of life. This study aimed to present the burden and socioeconomic associates of DCAs in the Middle East and North Africa (MENA) region from 1990 to 2021. METHODS: DCAs were defined based on the International Classification of Diseases codes (ICD-9: 750-751.9, 756.6-756.79; ICD-10: Q38-Q45.8, Q79.0-Q79.59). Mortality was estimated using the Cause of Death Ensemble Model, and DisMod-MR 2.1 was employed to model cause-specific mortality and excess mortality. Metrics were presented as crude counts and age-standardized rates per 100,000, with 95% uncertainty intervals. The association between socio-demographic index (SDI) and DCAs burden was examined using smoothing spline models. RESULTS: In 2021, the age-standardized incidence rate of DCAs in the MENA region was 7.17 (5.64, 9.15), while the age-standardized point prevalence was 50.57 (40.88, 59.51) per 100,000 individuals. MENA had a DALY rate of 67.85 (47.56, 88.75) and a death rate of 0.74 (0.50, 0.97). From 1990 to 2021, there were significant reductions in the age-standardized rates of incidence (-25.99% [-33.70, -17.06]), prevalence (-10.55% [-18.88, -2.04]), DALY (-62.35% [-78.36, -10.86]), and death (-62.97% [-78.95, -10.76]) associated with DCAs in MENA. In 2021, Afghanistan had the greatest age-standardized DALY rate, while Qatar had the lowest. Males generally had a greater burden of DCAs. A negative association was identified between age-standardized DALY rates and the SDI for DCAs in the MENA. CONCLUSIONS: From 1990 to 2021, we observed a significant decrease in the burden of DCAs in MENA, although the trends vary across countries. These findings offer crucial insights for developing effective prevention and management strategies for these anomalies.