Abstract: Objective　To analyze the trends in the disease burden of schistosomiasis in China from 1992 to 2021, and to project the disease burden of schistosomiasis in China from 2022 to 2030, so as to provide insights into the elimination of schistosomiasis in China.  Methods　The prevalence, age⁃standardized prevalence, disability⁃adjusted life year (DALYs) rate and age⁃standardized DALYs rate of schistosomiasis, as well as the years lost due to disability (YLDs) rate and age⁃standardized YLDs rate of anemia attributable to Schistosoma infections in China, the world and different socio⁃demographic index (SDI) regions were captured from the Global Burden of Disease Study 2021 (GBD 2021) data resources, and the trends in the disease burden due to schistosomiasis were evaluated with estimated annual percentage change (EAPC) and its 95% confidence interval (CI). In addition, the age, period and cohort effects on the prevalence of schistosomiasis were examined in China using an age⁃period⁃cohort (APC) model, and the disease burden of schistosomiasis was predicted in China from 2022 to 2030 using a Bayesian age⁃period⁃cohort (BAPC) model.  Results　The age⁃standardized prevalence and DALYs rate of schistosomiasis, and the age⁃standardized YLDs rate of anemia attributable to Schistosoma infections were 761.32/105, 5.55/105 and 0.38/105 in China in 2021. These rates were all lower than the global levels (1 914.30/105, 21.90/105 and 3.36/105, respectively), as well as those in the medium SDI regions (1 413.61/105, 12.10/105 and 1.93/105, respectively), low⁃medium SDI regions (2 461.03/105, 26.81/105 and 4.48/105, respectively), and low SDI regions (5 832.77/105, 94.48/105 and 10.65/105, respectively), but higher than those in the high SDI regions (59.47/105, 0.49/105 and 0.05/105, respectively) and high⁃medium SDI regions (123.11/105, 1.20/105 and 0.12/105, respectively). The prevalence and DALYs rate of schistosomiasis were higher among men (820.79/105 and 5.86/105, respectively) than among women (697.96/105 and 5.23/105, respectively) in China in 2021, while the YLDs rate of anemia attributable to Schistosoma infections was higher among women (0.66/105) than among men (0.12/105). The prevalence of schistosomiasis peaked at ages of 30 to 34 years among both men and women, while the DALYs rate of schistosomiasis peaked among men at ages of 15 to 19 years and among women at ages of 20 to 24 years. The age⁃standardized prevalence of schistosomiasis showed a moderate decline in China from 1992 to 2021 relative to different SDI regions [EAPC = -1.51%, 95% CI: (-1.65%, -1.38%)], while the age⁃standardized DALYs rate [EAPC = -3.61%, 95% CI: (-3.90%, -3.33%)] and age⁃standardized YLDs rate of anemia attributable to Schistosoma infections [EAPC = -4.16%, 95% CI: (-4.38%, -3.94%)] appeared the fastest decline in China from1992 to 2021 relative to different SDI regions. APC modeling showed age, period, and cohort effects on the trends in the prevalence of schistosomiasis in China from 1992 to 2021, and the prevalence of schistosomiasis appeared a rise followed by decline with age, and reduced with period and cohort. BAPC modeling revealed that the age⁃standardized prevalence and age⁃standardized DALYs rate of schistosomiasis, and age⁃standardized YLDs rate of anemia attributable to Schistosoma infections all appeared a tendency towards a decline in China from 2022 to 2030, which reduced to 722.72/105 [95% CI: (538.74/105, 906.68/105)], 5.19/105 [95% CI: (3.54/105, 6.84/105)] and 0.30/105 [95% CI: (0.21/105, 0.39/105)] in 2030, respectively. Conclusions　The disease burden of schistosomiasis appeared a tendency towards a decline in China from 1992 to 2021, and is projected to appear a tendency towards a decline from 2022 to 2030. There are age, period and cohort effects on the prevalence of schistosomiasis in China. Precision schistosomiasis control is required with adaptations to current prevalence and elimination needs.  

Key words: Schistosomiasis, Burden of disease, Prevalence, Disability?adjusted life year, Year lost due to disability, Age?period?cohort model, Bayesian age?period?cohort model

摘要： 目的　分析1992—2021年我国血吸虫病疾病负担变化趋势、预测2022—2030年我国血吸虫病疾病负担，为我国血吸虫病消除工作提供参考。方法　从全球疾病负担研究（global burden of disease，GBD）数据库中获取1992—2021年我国、全球及不同社会人口学指数（socio⁃demographic index，SDI）地区人群血吸虫病患病率、年龄标化患病率、伤残调整寿命年（disability adjusted life year，DALYs）率、年龄标化DALYs率及归因于血吸虫感染的贫血伤残损失寿命年（years lost due to disability，YLDs）率、归因于血吸虫感染的贫血年龄标化YLDs率，计算各指标估计年度变化百分比（estimated annual percentage change，EAPC）及其95%可信区间（confidence Interval，CI）以分析疾病负担变化趋势。采用年龄⁃时期⁃队列（age⁃period⁃cohort，APC）模型分析1992—2021年我国人群血吸虫病患病率随年龄、时期和出生队列的变化趋势，采用贝叶斯年龄⁃时期⁃队列（Bayesian age⁃period⁃cohort，BAPC）模型预测2022—2030年我国血吸虫病疾病负担。结果　       2021年，我国人群血吸虫病年龄标化患病率为761.32/10万、年龄标化DALYs率为5.55/10万、归因于血吸虫感染的贫血年龄标化YLDs率为0.38/10万，均低于全球水平（分别为1 914.30/10万、21.90/10万、3.36/10万）及中SDI地区（1 413.61/10万、12.10/10万、1.93/10万）、低⁃中SDI地区（分别为2 461.03/10万、26.81/10万、4.48/10万）和低SDI地区（分别为5 832.77/10万、94.48/10万、10.65/10万），但高于高SDI地区（分别为59.47/10万、0.49/10万、0.05/10万）和高⁃中SDI地区（分别为123.11/10万、1.20/10万、0.12/10万）。2021年，我国男性人群血吸虫病患病率（820.79/10万）、DALYs率（5.86/10万）均高于女性人群（分别为697.96/10万、5.23/10万）；女性人群归因于血吸虫感染的贫血YLDs率（0.66/10万）高于男性（0.12/10万）；不同性别人群血吸虫病患病率高峰均为30 ~ 34岁组，男性、女性人群血吸虫病DALYs率高峰分别为15 ~ 19岁与20 ~ 24岁。与不同SDI地区人群比较，1992—2021年我国人群血吸虫病年龄标化患病率下降速度中等［EAPC = -1.51%，95% CI：（-1.65%，-1.38%）］，年龄标化DALYs率［EAPC = -3.61%，95% CI：（-3.90%，-3.33%）］与归因于血吸虫感染的贫血年龄标化YLDs率［EAPC = -4.16%，95% CI：（-4.38%，-3.94%）］下降速度均最快。APC模型建模结果显示，1992—2021年我国人群血吸虫病患病率变化具有年龄、时期和队列效应，随年龄增长先上升后下降、随时期递进和出生队列推移均下降。BAPC模型预测显示，2022—2030年我国人群血吸虫病年龄标化患病率、年龄标化DALYs率和归因于血吸虫感染的贫血年龄标化YLDs率均呈下降趋势，2030年分别为722.72/10万［95% CI：（538.74/10万，906.68/10万）］、5.19/10万［95% CI：（3.54/10万，6.84/10万）］和0.30/10万［95% CI：（0.21/10万，0.39/10万）］。结论　1992—2021年我国血吸虫病疾病负担呈下降趋势，预测2022—2030年我国血吸虫病疾病负担亦呈下降趋势。年龄、时期和队列均对人群血吸虫病患病率存在影响，需结合流行现状和防控需求精准开展消除血吸虫病工作。

关键词: 血吸虫病, 疾病负担, 患病率, 伤残调整寿命年, 伤残损伤寿命年, 年龄?时期?队列模型, 贝叶斯年龄?时期?队列模型