1990―2019年中国与“一带一路”沿线南亚三国结核病疾病负担研究

赵飞; 裴航; 姚媛媛; 刘兴荣

doi:10.16462/j.cnki.zhjbkz.2023.02.008

1990―2019年中国与“一带一路”沿线南亚三国结核病疾病负担研究

doi: 10.16462/j.cnki.zhjbkz.2023.02.008

730000 兰州，兰州大学公共卫生学院

基金项目:

甘肃省社科规划重点招标课题 20ZD017

兰州大学“一带一路”专项经费资助项目 2018

详细信息

通讯作者:
刘兴荣，E-mail: liuxr@lzu.edu.cn

中图分类号: R183.3
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- 被引次数: 0
出版历程
- 收稿日期: 2022-05-06
- 修回日期: 2022-07-29
- 网络出版日期: 2023-02-20
- 刊出日期: 2023-02-10

Disease burden of tuberculosis in China and three South Asia countries along the Belt and Road, 1990-2019

School of Public Health, Lanzhou University, Lanzhou 730000, China

Funds:

Social Science Planning Major Project of Gansu Province 20ZD017

Special Foundation of "The Belt and Road" of Lanzhou University 2018

More Information

Corresponding author: LIU Xing-rong, E-mail: liuxr@lzu.edu.cn

摘要

摘要: 目的分析1990―2019年中国与“一带一路”沿线孟加拉国、印度、巴基斯坦等三个南亚国家结核病疾病负担变化，为中国与部分沿线国家结核病防治和开展结核病领域国际卫生合作提供科学参考。方法基于2019年全球疾病负担研究(Global Burden of Disease Study 2019, GBD 2019)数据，采用发病率、死亡率和伤残调整寿命年(disability-adjusted life years, DALYs)等指标描述结核病疾病负担，同时采用年均变化百分比(average annual percent change, AAPC)分析其变化趋势。结果 1990―2019年中国与南亚三个国家结核病的标化发病率(age-standardized incidence rate, ASIR)、标化死亡率(age-standardized mortality rate, ASMR)和标化DALY率(age-standardized DALY rate, ASDR)均呈现下降趋势，降幅在42.85%~90.23%，AAPC在-7.77%~-1.90%且其趋势变化差异均有统计学意义(均有P＜0.05)。2019年四国中巴基斯坦结核病的ASIR、ASMR和ASDR最高。除巴基斯坦外均是男性结核病的ASIR、ASMR和ASDR高于女性。四国结核病发病率、死亡率和DALY率均随年龄的上升而增加。结论 1990―2019年四国结核病疾病负担总体呈下降趋势，但仍较高，距WHO终止结核病策略目标差距仍较大；印度等南亚三国结核病的ASIR总体高于中国，在“一带一路”建设中应将结核病防治作为国际卫生合作的重点。
- 核病 /
- 疾病负担 /
- “一带一路”
Abstract: Objective The study aiming at analyzing the disease burden of tuberculosis in China, Bangladesh, India and Pakistan along the "Belt and Road" from 1990 to 2019, and to provide scientific evidence for tuberculosis prevention and control and international cooperation in the field of tuberculosis in China and other countries along the "Belt and Road". Methods Based on data from the Global Burden of Disease Study 2019 (GBD 2019), we used the incidence rate, the mortality rate and the disability-adjusted life years (DALYs) to describe the disease burden of tuberculosis from 1990 to 2019. And we applied the average annual percent change (AAPC) to analyze the trend of disease burden in tuberculosis. Results From 1990 to 2019, the age-standardized incidence rate (ASIR), the age-standardized mortality rate (ASMR) and the age-standardized DALY rate (ASDR) of tuberculosis in four countries decreased between 42.85% and 90.23%. The AAPC ranged from -7.77% to -1.90% and the trend was statistically significant (all P < 0.05). In 2019, Pakistan had the highest ASIR, ASMR and ASDR of tuberculosis among the four countries. Except in Pakistan, the ASIR, ASMR and ASDR of tuberculosis in males were higher than those in females. The incidence, mortality and DALY rates of tuberculosis increased with age in the four countries. Conclusions Although the disease burden of tuberculosis in the four countries showed an overall downward trend from 1990 to 2019, it was still far from the target of WHO strategy to stop tuberculosis. The ASIR of tuberculosis in the three South Asian countries, such as India, is generally higher than that in China; Therefore, tuberculosis prevention and control should be considered as a priority area of international health cooperation in the construction of the "Belt and Road".
- Tuberculosis /
- Burden of disease /
- "Belt and Road"

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图 1 1990―2019年结核病ASIR、ASMR和ASDR的AAPC

注：A：ASIR；B：ASMR；C：ASDR。

Figure 1. The AAPC in ASIR, ASMR, and ASDR of Tuberculosis from 1990 to 2019

下载: 全尺寸图片幻灯片

图 2 1990―2019年不同年龄组结核病的发病率、死亡率和DALY率的AAPC

注：A: 发病率；B: 死亡率；C: DALY率。

Figure 2. The AAPC by age group in incidence rate, mortality rate and DALY rate of Tuberculosis from 1990 to 2019

下载: 全尺寸图片幻灯片

表 1 四国不同性别人群的结核病疾病负担

Table 1. The disease burden of Tuberculosis by sexes in four countries

国家	ASIR(/10万)			ASMR(/10万)			ASDR(/10万)
国家	男性	女性	合计	男性	女性	合计	男性	女性	合计
孟加拉国
1990年	492.86	427.13	464.66	172.59	89.62	135.24	5 566.82	3 352.79	4 559.63
2019年	147.85	130.58	139.38	28.86	15.84	22.59	846.21	524.15	687.43
变化率(%)	-70.00	-69.43	-70.00	-83.28	-82.32	-83.30	-84.80	-84.37	-84.92
印度
1990年	398.03	381.20	390.22	147.52	93.97	121.72	4 560.55	3 307.84	3 962.74
2019年	247.55	199.21	223.01	47.47	25.33	36.11	1 533.76	877.98	1 203.98
变化率(%)	-37.81	-47.74	-42.85	-67.82	-73.05	-70.33	-66.37	-73.46	-69.62
巴基斯坦
1990年	477.49	495.06	487.00	104.65	86.53	96.57	3 568.02	3 542.10	3 570.91
2019年	253.45	260.82	256.88	55.33	36.94	46.29	1 872.44	1 452.79	1 665.86
变化率(%)	-46.92	-47.32	-47.25	-47.12	-57.31	-52.06	-47.52	-58.99	-53.35
中国
1990年	120.56	99.76	109.32	27.19	14.71	20.20	877.43	563.73	714.86
2019年	56.08	30.60	42.93	3.15	1.05	1.97	110.11	47.06	77.42
变化率(%)	-53.49	-69.33	-60.73	-88.43	-92.85	-90.23	-87.45	-91.65	-89.17

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表 2 四国不同年龄人群的结核病疾病负担(岁)

Table 2. The disease burden of Tuberculosis by ages in four countries (years-old)

国家	发病率(/10万)				死亡率(/10万)				DALY率(/10万)
国家	0~＜15	15~＜50	50~＜70	≥70	0~＜15	15~＜50	50~＜70	≥70	0~＜15	15~＜50	50~＜70	≥70
孟加拉国
1990年	124.81	486.68	760.33	882.78	31.75	49.88	283.24	794.78	2 802.40	2 948.23	8 898.25	12 141.17
2019年	37.42	151.03	230.70	264.55	2.28	8.17	44.69	160.42	212.68	487.89	1 431.91	2 416.52
变化率(%)	-70.02	-68.97	-69.66	-70.03	-92.83	-83.61	-84.22	-79.82	-92.41	-83.45	-83.91	-80.10
印度
1990年	97.83	403.48	672.15	783.45	18.89	49.44	263.79	681.07	1 682.92	2 826.97	8 264.33	11 265.96
2019年	33.20	251.47	396.80	390.62	2.13	16.99	83.55	211.92	205.37	999.42	2 695.30	3 429.92
变化率(%)	-66.06	-37.67	-40.97	-50.14	-88.72	-65.64	-68.33	-68.88	-87.80	-64.65	-67.39	-69.55
巴基斯坦
1990年	170.51	507.83	763.17	869.02	29.92	42.18	186.62	549.22	2 695.87	2 540.81	6 024.73	8 686.40
2019年	108.70	290.27	351.22	368.16	8.97	22.26	88.17	263.22	833.03	1 351.62	2 867.49	4 186.95
变化率(%)	-36.25	-42.84	-53.98	-57.64	-70.03	-47.23	-52.75	-52.07	-69.10	-46.80	-52.40	-51.80
中国
1990年	44.29	91.30	202.08	309.14	7.00	6.08	42.97	125.48	632.57	365.80	1 354.53	2 189.74
2019年	10.33	42.66	70.20	119.81	0.19	0.79	3.63	15.82	23.61	62.68	135.93	332.17
变化率(%)	-76.67	-53.28	-65.26	-61.24	-97.29	-87.00	-91.56	-87.39	-96.27	-82.86	-89.96	-84.83

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