Deaths and years of life lost from diarrheal diseases attributable to low birth weight among neonates in Eastern sub-Saharan Africa, from 1990 to 2023

Background Low birth weight (LBW) is a significant determinant of diarrheal disease burden among neonates, yet comprehensive evidence on LBW-attributable diarrheal mortality in Eastern Sub-Saharan Africa (ESSA) remains scarce. This study described deaths and years of life lost (YLLs) from diarrheal diseases attributable to LBW among neonates in ESSA from 1990 to 2023. Methods This study used GBD 2023 estimates and methods to describe deaths and YLLs from diarrheal diseases attributable to LBW among neonates (0–27 days) in the ESSA countries. All neonates in the ESSA region with available GBD 2023 estimates for diarrheal diseases attributable to low birth weight were included. Results In 2023, diarrheal diseases attributable to LBW caused 3,486 deaths (95% UI: 2,106–5,544), corresponding to a death rate of 325 per 100,000 neonates (95% UI: 196–517). The burden was higher among early neonates (756 per 100,000; 95% UI: 461–1,148) than late neonates (179 per 100,000; 95% UI: 100–300). Somalia had the highest death rate (2,415 per 100,000; 95% UI: 1,312–4,072), while Uganda had the lowest (59 per 100,000; 95% UI: 26–108). The YLLs rate was 29,251 per 100,000 neonates (95% UI: 17,677–46,520). Between 1990 and 2023, mortality and YLLs declined by 77%, with no significant change in South Sudan. Conclusion Despite substantial declines, LBW-attributable diarrheal mortality remains a significant public health concern in ESSA, with marked geographic and age-related disparities. Targeted interventions to improve maternal nutrition, antenatal care, and early neonatal management are urgently needed in high-burden settings.