Global burden of disease analysis of acute lymphoblastic leukemia in children in Africa: Incidence, prevalence, and DALYs (1990–2023).

e18620 Background: Hematological malignancies, including leukemia, lymphoma, and multiple myeloma, contribute significantly to the global cancer burden and are 5th most common cause of cancer related mortality . In Africa, infection-related risks, poor surveillance, and delayed care cause higher mortality than in high-income regions. However, mortality patterns by age, time, and region remain poorly characterized due to under-representation of African communities in cancer registries. This study examines mortality trends from Acute Lymphoblastic leukemia (ALL) among children aged 1–14 years in Africa. Methods: Data from the 2023 Global Burden of Disease (GBD) database was analyzed to evaluate ALL related Disability-Adjusted Life Years (DALYs), Age-Standardized Death Rate (ASDRs), Incidence Rate (ASIR) and Prevalence Rates (ASPR), among children aged 1-14 years in African regions. Trends from 1990 to 2023 were assessed using Annual Average Percentage Change (AAPC), Annual Percentage Change (APC) was also calculated for specific time intervals to identify periods of significant mortality shifts from the overall trend. Results: DALYs attributed to ALL showed statistically significant downward trend across all regions of Africa, with the recorded overall AAPC of -1.24% (95% CI -1.39 to -1.10, p value < 0.00001). Regionally, the Eastern region showed the steepest decline with recorded AAPC of -1.57%, followed by Northern (AAPC = -1.50%). The overall ASIR was also consistent with the DALY trend, with recorded AAPC of -0.86% (95% CI -1.00 to -0.71, p value < 0.00001). Region based analysis showed the Eastern region leading the way with AAPC of -1.49%, followed by Western region (AAPC = -1.18%). Overall ASPR was negative with AAPC of -0.46% (95% CI -0.60 to -0.35, p value < 0.00001). Based on regions, marked decline in ASPR were seen in the Southern region with AAPC of -1.05%, followed by Eastern (AAPC = -0.91%), however the northern region showed an inclining trend with AAPC of 1.33%. Conclusions: In conclusion, our study shows that the burden due to ALL among children aged 1-14 years in Africa has reduced significantly over the past three decades, reflected by both DALYs and other parameters. While some fluctuations exist, the overall trajectory suggests improved outcomes, but further research is required to identify risk factors and systemic flaws contributing to these diverse trends.