中国血吸虫病防治杂志 ›› 2023, Vol. 35 ›› Issue (2): 128-.

• 论著 • 上一篇    下一篇

全球背景下中国与津巴布韦血吸虫病疾病负担比较

李红梅,郑金鑫,钱颖骏,吕山,夏尚,周晓农*   

  1. 中国疾病预防控制中心寄生虫病预防控制所(国家热带病研究中心)、国家卫生健康委员会寄生虫病原与媒介生物学重点实验室、WHO热带病合作中心、科技部国家级热带病国际联合研究中心(上海 200025)
  • 出版日期:2023-04-15 发布日期:2023-05-19
  • 作者简介:李红梅,女,博士研究生,副研究员。研究方向:血吸虫病防控与全球卫生
  • 基金资助:
    国家热带病研究中心项目(131031104000160004);中非血吸虫病防控合作项目Ⅰ期项目(2020⁃C4⁃0001⁃2)

Comparison of the disease burden of schistosomiasis globally and in China and Zimbabwe

LI Hongmei, ZHENG Jinxin, QIAN Yingjun, LÜ Shan, XIA Shang, ZHOU Xiaonong*   

  1. National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention (Chinese Center for Tropical Diseases Research); National Health Commission Key Laboratory of Parasite and Vector Biology; WHO Collaborating Centre for Tropical Diseases; National Center for International Research on Tropical Diseases, Ministry of Science and Technology, Shanghai 200025, China
  • Online:2023-04-15 Published:2023-05-19

摘要: 目的 分析1990—2019年全球、中国和津巴布韦血吸虫病疾病负担变化趋势,为我国制定津巴布韦血吸虫病防控支持策略提供参考。方法 基于2019全球疾病负担研究(Global Burden of Disease Study 2019,GBD 2019)数据库,比较1990、2019年全球、中国和津巴布韦年龄标化血吸虫病患病率、死亡率和伤残调整寿命年(DALY)率,采用Joinpoint回归分析对1990—2019年上述指标变化趋势进行分析。采用Pearson相关分析评价1990—2019年全球、中国和津巴布韦血吸虫病疾病负担与社会人口指数(SDI)间的相关性。结果 2019年,全球年龄标化血吸虫病患病率、死亡率、DALY率分别为1 804.95/10万、0.14/10万和20.92/10万,中国分别为707.09/10万、0.02/10万和5.06/10万,津巴布韦分别为2 218.90/10万、2.39/10万和90.09/10万。随年龄增长,2019年全球血吸虫病患病率、死亡率和DALY率均呈先上升后下降的趋势;中国和津巴布韦血吸虫病患病率和DALY率呈先急剧上升、后波动下降的趋势,死亡率呈增加的趋势。1990—2019年全球、中国和津巴布韦年龄标化血吸虫病患病率 [平均年度变化百分比(AAPC)= -1.31%、-2.22%、-6.12%, t = 20.07、-83.38、-53.06,P均< 0.05)] 和DALY率(AAPC=-1.91%、-4.17%、-2.08%,t =-31.89、-138.70、-16.45,P均< 0.05)均呈逐年下降的趋势;全球、中国年龄标化血吸虫病死亡率呈逐年下降的趋势(AAPC=-3.46%、-8.10%,t =-41.03、-61.74,P均< 0.05),津巴布韦呈先上升后下降趋势(AAPC=1.35%,t = 4.88,P < 0.05)。Pearson相关分析结果显示,1990—2009年全球、中国和津巴布韦总体年龄标化患病率、死亡率、DALY率均与SDI呈负相关(r =-0.75、 -0.73、-0.77,P 均< 0.05)。结论 近30年来我国血吸虫病疾病负担明显下降;津巴布韦虽血吸虫病患病率下降,但死亡率和DALY率仍居全球前列。我国需结合津巴布韦血吸虫病流行现状和防控需求,建立符合当地实际的血吸虫病防控策略,助力其降低血吸虫病危害。

关键词: 血吸虫病, 疾病负担, 患病率, 死亡率, 伤残调整寿命年, 社会人口指数, 津巴布韦, 中国, 全球

Abstract: Objective To investigate the trends in the disease burden of schistosomiasis worldwide and in China, and Zimbabwe from 1990 to 2019, so as to provide insights into the formulation of the schistosomiasis control strategy in Zimbabwe. Methods Based on Global Burden of Disease Study 2019 (GBD 2019) data sources, the age⁃standardized prevalence, mortality, disability⁃adjusted life year (DALY) rate of schistosomiasis were compared in the world, China, and Zimbabwe and the trends in the disease burden of schistosomiasis from 1990 to 2019 were investigated using Joinpoint regression analysis. In addition, the associations between the burden of schistosomiasis worldwide and in China, and Zimbabwe from 1990 to 2019 and socio⁃demographic index (SDI) were examined using Pearson correlation analysis. Results The age⁃standardized prevalence, mortality, and DALY rate of schistosomiasis were 1 804.95/105, 0.14/105 and 20.92/105 in the world, 707.09/105, 0.02/105 and 5.06/105 in China, and 2 218.90/105, 2.39/105 and 90.09/105 in Zimbabwe in 2019, respectively. The global prevalence, mortality, and DALY rate of schistosomiasis appeared a tendency towards a rise followed by a decline with age in 2019, while the prevalence and DALY rate of schistosomiasis appeared a tendency towards a sharp rise followed by a fluctuating decline in both China and Zimbabwe, and the mortality of schistosomiasis appeared a tendency towards a rise. The age⁃standardized prevalence [average annual percent change (AAPC) = -1.31%,-2.22% and -6.12%; t = -20.07, -83.38 and -53.06; all P values < 0.05)] and DALY rate of schistosomiasis (AAPC = -1.91%,-4.17% and -2.08%; t = -31.89,-138.70 and -16.45; all P values < 0.05) appeared a tendency towards a decline with years. From 1990 to 2019, for the world, China and Zimbabwe, and the age⁃standardized mortality of schistosomiasis appeared a tendency towards a decline with years in the world and China (AAPC = -3.46% and -8.10%,t = -41.03 and-61.74; all P values < 0.05), and towards a rise followed by a decline in Zimbabwe (AAPC = 1.35%,t = 4.88,P < 0.05). In addition, Pearson correlation analysis showed that the age⁃standardized prevalence (r = -0.75, P < 0.05), mortality (r = -0.73, P < 0.05), and DALY rate of schistosomiasis (r = -0.77, P < 0.05) correlated negatively with SDI in the world, China and Zimbabwe from 1990 to 2019. Conclusions The disease burden of schistosomiasis appeared a remarkable decline in China from 1990 to 2019, and the prevalence of schistosomiasis showed a tendency towards decline in Zimbabwe from 1990 to 2019; however, the mortality and DALY rate of schistosomiasis in Zimbabwe topped in the world. A schistosomiasis control strategy with adaptations to local epidemiology and control needs of schistosomiasis is needed to facilitate the elimination of schistosomiasis in Zimbabwe.

Key words: Schistosomiasis, Disease burden, Prevalence, Mortality, Disability?adjusted life year, Socio?demographic index, Zimbabwe, China, Global

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