Study on the 1990–2021 trend of global childhood respiratory infection and tuberculosis disease burden and related risk factors

Background Respiratory tract infections (RTIs) and tuberculosis (TB) impose a critical global health burden on children, serving as leading causes of morbidity and mortality. Lower respiratory tract infections (LRIs) remain the primary cause of death in under-5 s, though mortality has declined recently. Objective This study aims to analyze trends in RTIs and TB among 0–14-year-olds using Global Burden of Disease (GBD) data from 1990 to 2021. Methods Global data on childhood RTIs and TB were collected from GBD, with standardized methods used to assess disease burden trends, age/sex/SDI differences, and the contribution of 11 risk factors. Results From 1990 to 2021, incidences of upper RTIs, otitis media, and TB decreased, but overall RTIs increased. Neonatal LRI had the highest mortality (1,560.6/100 k). Male children showed higher TB incidence/mortality. Low-SDI areas had the highest burden (mortality 2.036/100 k), while high-SDI areas saw the largest TB mortality drop (95.7%). Underweight remained the main risk factor, with DALY rate falling 80.3%, though household air pollution, low birth weight, short gestation, and high temperature rose in rank. Conclusion Global childhood respiratory disease burden faces challenges, requiring strengthened international cooperation and targeted interventions, especially in low-SDI regions, to improve public health and nutrition.