A Global, Regional, and National Survey on Burden and Quality of Care
Index (QCI) of Leukemia in Children: Global Burden of Disease Systematic
Analysis 1990-2021
Abstract
Background: While the global childhood leukemia burden has
declined since 1990, it remains the leading cause of childhood cancer
mortality. Disparities in outcomes are stark, with high-income countries
achieving significantly higher survival rates compared to
resource-limited settings. This underscores the critical role of
healthcare quality. Methods: We analyzed data on childhood
leukemia (aged 0-14) from the Institute for Health Metrics and
Evaluation Global Burden of Disease project (1990-2021), including
incidence, mortality, prevalence, and other health metrics. To assess
the Quality of Care Index (QCI), we implemented a four-step process
involving data acquisition and cleaning, optional data reduction,
calculation of secondary measures and application of Principal Component
Analysis (PCA), and finally data visualization. PCA identified a single
component as the QCI, with higher scores indicating better quality of
care. Results: Childhood leukemia incidence, mortality, and
Disability-Adjusted Life Years (DALYs) declined globally, but regional
disparities persist. High-middle Sociodemographic Index (SDI) countries
have the highest incidence, while low SDI settings have the highest
mortality and DALY rates. Global QCI average is 67.8, with variation
between regions and SDI levels. High SDI countries have the highest QCI,
while low SDI settings have the lowest. QCI decreases with age, and
gender distribution is relatively equal globally, except in low and
low-middle SDI settings. Conclusion: Despite global progress in
reducing childhood leukemia, significant healthcare disparities persist.
Future efforts must prioritize addressing these inequities, ensuring
equitable access to quality care, and eliminating disparities based on
SDI, age, and gender.