EClinicalMedicine. 2026 Mar 13;93:103827. doi: 10.1016/j.eclinm.2026.103827. eCollection 2026 Mar.
ABSTRACT
BACKGROUND: Non-communicable diseases (NCDs) are a major contributor to morbidity and mortality worldwide, yet their burden among adolescents and young adults in the Middle East and North Africa (MENA) region remains underexplored. Understanding age-, sex-, and country-specific patterns is critical in a region marked by conflict, demographic transition, and rapid urbanization.
METHODS: We used estimates from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2023 to quantify mortality and disability due to NCDs among people aged 10-24 years across 21 MENA countries from 1990 to 2023. Causes were analyzed by three hierarchical levels of the GBD 2023 cause list. For each cause, mortality, years of life lost (YLLs), years lived with disability (YLDs), and disability-adjusted life-years (DALYs) with 95% uncertainty intervals (UIs) were extracted and stratified by sex, age group, and country. Temporal trends (1990-2023) and associations between Level 2 NCD DALY rates and each country's Socio-demographic Index (SDI) were assessed using correlation. Analyses were performed using R (version 2025.09.0) and Julia (version 1.10).
FINDINGS: In 2023, NCDs accounted for 76.0% (95% UI 71.5-79.6) of all YLDs and 29.0% (27.0-32.3) of total deaths among young people aged 10-24 years in MENA. Among NCDs, cardiovascular diseases and neoplasms were the leading causes of mortality (9.64 [7.64-12.14] and 6.93 [6.05-7.78] per 100,000, respectively), whereas mental disorders were the main contributors to YLDs (2916.2 [2013.4-4165.8] per 100,000) and DALYs (2916.3 [2013.4-4165.9] per 100,000). NCD mortality was higher in males than females (37.9 vs 18.6 per 100,000), while females had slightly higher DALY rates (8970.4 vs 8221.6 per 100,000). From 1990 to 2023, mortality due to NCDs declined by 33.6% and YLLs by 34.2%, reflecting steady improvements until 2019 before plateauing during and after the COVID-19 period. Over the same timeframe, YLDs declined modestly until 2019 but increased thereafter (+8.6% [-3.4 to 21.9]), largely due to mental and metabolic disorders. The largest declines were seen for digestive (-60.9%) and cardiovascular diseases (-43.6%), whereas increases occurred in mental (128.4%) and substance-use disorders (12.9%). Countries with higher SDI scores had lower DALY rates for cardiovascular, digestive, neoplastic, and other NCDs.
INTERPRETATION: Integrated, youth-responsive NCD and mental health services are needed to address rising disability and health loss among young people in the MENA region.
FUNDING: Khalifa University of Science and Technology.
PMID:41859676 | PMC:PMC12995710 | DOI:10.1016/j.eclinm.2026.103827