Abstract: Objective　To assess the burden of clonorchiasis and identify its temporal and spatial changes in China, thus to provide insights into the control and prevention of the diseases. Methods　The disability?adjusted life years (DALYs) was employed as the primary indicator for the disease burden. The prevalence data of Clonorchis sinensis infection were obtainted from the three national surveys on important human parasitic diseases in China, conducting during the period from 1988 to 1922, from 2001 to 2004 and from 2014 to 2016, respectively, and the demographic data from National Bureau of Statistics of China. DALYs of clonorchiasis were calculated and the temporal changes were analyzed at both national and provincial levels, using the disability weight (DW) obtained from a community study in China. Sensitivity analysis was carried out to compare the resulted DALYs of China calculated under the method adopted in this study and that calculated with other commonly used methods. Results　The national burden of clonorchiasis was 489 174.04 [95% confidence interval (CI): (391 648.87, 597 509.87)] DALYs in China in 2016, indicating 0.36 [95% CI: (0.28, 0.43)] DALYs per 1 000 populations. The regions with a high burden of clonorchiasis were concentrated in southern China and northeastern China, and the provinces with the three highest burdens of clonorchiasis included Guangxi Zhuang Autonomous Region, Guangdong Province and Heilongjiang Province, which accounted for 91.18% of total burdens of clonorchiasis in China. During the periods of the three national surveys on important human parasitic diseases in China, the national burden of clonorchiasis was found to show a tendency of first rise and then decrease in China; however, the burden of clonorchiasis has recently shown a tendency towards a rise in Guangxi Zhuang Autonomous Region, Heilongjiang Province and Jiangxi Province. Sensitivity analysis showed that the calculation of diseases burden with age?stratified prevalence of clonorchiasis was similar to that of our method without age stratification; however, the burden estimates calculated only based on the DW of the severe symptoms were much lower than our estimates. Conclusions　The burden of clonorchiasis is high in China, with a large regional difference. Recently, the overall burden of clonorchiasis has shown a tendency of decline in China; however, there is a tendency towards a rise in some provinces. Therefore, the control of clonorchiasis requires more adaptations to local circumstances.

Key words: Clonorchiosis, Burden of disease, Disability?adjusted life years, Years lived with disability, Disability weight, China

摘要： 目的　估算全国华支睾吸虫病疾病负担及其变化趋势，分析其空间分布特征，为该病防治提供科学依据。方法　基于1988—1992、2001—2004年和2014—2016年3次全国人体重要寄生虫病现状调查华支睾吸虫感染率数据和国家统计局人口学数据，将伤残调整寿命年（disability?adjusted life year，DALY）作为疾病负担的主要评价指标，参照WHO基于患病率估计DALY的方法，用基于中国社区研究获得的不同症状加权的伤残权重（disability weight，DW），估算全国和各省华支睾吸虫病疾病负担，并分析其时间变化趋势。将以上方法估算出的全国华支睾吸虫病疾病负担结果与其他常用方法估算结果比较，进行敏感性分析。结果　2016年全国华支睾吸虫病DALY为489 174.04 [95% 置信区间（confidence interval，CI）：（391 648.87，597 509.87）]人·年，每1 000人口损失DALY为0.36 [95% CI：（0.28，0.43）]人·年。疾病负担较高地区集中在华南和东北地区，其中DALY最大的3个省份依次为广西壮族自治区、广东省和黑龙江省，其疾病负担之和占全国总疾病负担的91.18%。1992、2004年及2016年3个时间段，全国华支睾吸虫病疾病负担呈先升高后降低的趋势，但广西壮族自治区、黑龙江省和江西省近年来呈上升趋势。敏感性分析显示，分年龄组计算的疾病负担与本研究未分年龄组的计算结果接近，但仅考虑重度感染所计算的结果明显低于本研究。结论　全国华支睾吸虫病疾病负担较高、地区差异大，总体呈先升高后降低的趋势，但部分省份呈上升趋势，应因地制宜地开展防治工作。

关键词: 华支睾吸虫病, 疾病负担, 伤残调整寿命年, 伤残损失寿命年, 伤残权重, 中国