Supplementary Material for: Burden of Neurological disorders in children and adolescents (<20 years old) in North Africa and the Middle East (NAME) from 1990 to 2021

Abstract
Background: Neurological disorders impose a significant health burden globally, particularly in regions like North Africa and the Middle East (NAME) with unique healthcare and societal challenges. Despite progress in addressing neurological conditions, understanding the burden in pediatric and adolescent populations remains limited. This study analyzes the trends and burden of neurological conditions in individuals under 20 years old across the NAME super region from 1990 to 2021 using Global Burden of Diseases (GBD) data.

Methods: GBD 2021 data were analyzed to assess prevalence, incidence, years lived with disability (YLDs), years of life lost (YLLs), disability-adjusted life years (DALYs), and mortality rates. The data were stratified by age, sex, and socio-demographic index (SDI).

Results: Neurological condition prevalence in 2021 was 21,797.5 per 100,000, with tension-type headaches and migraines accounting for the majority of cases. Idiopathic epilepsy remained a leading cause of mortality, although it had a decrease of -50.9% in YLLs compared to 1990. Migraine affected about 9,161.9 per 100,000, increasing by 9.9% from 1990. It also accounted for the highest YLD rate (350.9). Despite decreases in YLLs and deaths, YLDs showed minimal change. Similarly, DALYs did not show significant change from 1990 (17.9%; 95% UI: -12.17 to 36.05). Higher SDI was associated with reduced DALYs but increased prevalence and YLDs.

Conclusion: The burden of neurological disorders in pediatric and adolescent populations in NAME highlights regional disparities and the need for targeted healthcare strategies. Enhanced screening, early diagnosis, and management are essential to reducing the burden of these disorders.