Analysis of the burden and trends of dengue fever in China on the global perspective
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摘要:
目的 分析1990―2021年我国登革热疾病负担及变化趋势, 并与全球人群进行对比, 以期为全球化背景下中国登革热防控策略的制定提供科学依据。 方法 收集2021全球疾病负担(global burden of disease, GBD 2021)的相关数据, 提取并计算1990―2021年中国与全球登革热疾病负担年龄标化发病率(age-standard incidence rate, ASIR)、年龄标化患病率(age-standard prevalence rate, ASPR)、年龄标化死亡率(age-standarized mortality rate, ASMR)以及年龄标化伤残疾病调整年(disability-adjust life years, DALY)率(age-standarized DALY rate, ASDR)等指标。采用Excel 2019软件进行数据预处理、R 4.3.1软件进行数据可视化、Joinpoint 5.0.2软件对时间趋势进行年度变化百分比(average annual percentage of change, AAPC)分析。 结果 1990―2021年中国登革热发病人数由4 364例增长至26 748例, 相对增长512.92%;患病数由256例增长至1 579例, 相对增长516.80%;死亡数由46例降至9例, 降幅为80.43%;DALY从3 568人年降至622人年, 降幅为82.57%。中国登革热ASIR、ASPR整体呈上升趋势(AAPC=5.39%、5.40%, 均P<0.001), ASMR、ASDR整体呈下降趋势(AAPC=-7.01%、-6.96%, 均P<0.001)。1990年和2021年中国登革热ASIR、ASPR均以5~<15岁年龄组最高, ASMR以<5岁年龄组为最高, 与全球同期水平一致。1990―2021年中国登革热的各项疾病负担指数每年均低于全球同期水平。 结论 中国登革热疾病负担低于全球同期水平, 但ASIR和ASPR仍呈上升趋势, 提示需要加大登革热疾病防控措施, 及时关注妇女、儿童与老人等易感人群。 -
关键词:
- 登革热 /
- 疾病负担 /
- Joinpoint回归模型 /
- 伤残调整寿命年
Abstract:Objective To analyze the disease burden and trend of dengue fever in China from 1990 to 2021, and compare it with global data, aiming to provide scientific evidence for the formulation of dengue prevention and control strategies in China under the context of globalization. Methods Relevant data of the global burden of disease 2021 (GBD 2021) database were collected to extract and calculate the age standardized incidence rate (ASIR), age standardized prevalence rate (ASPR), age standardized mortality rate (ASMR), age standardized disability-adjust life years(DALY) rate (ASDR) and other indicators of China and the global burden of dengue disease from 1990 to 2021. Data preprocessing was conducted using Excel 2019, data visualization with R 4.3.1, and trend analysis using the Joinpoint 5.0.2 software for average annual percentage change (AAPC). Results From 1990 to 2021, the number of dengue cases in China increased from 4 364 to 26 748, a relative increase of 512.92%; prevalence rose from 256 to 1 579, a relative increase of 516.80%; the number of deaths decreased from 46 to 9, a decrease of 80.43%; DALY decreased from 3 568 person-years to 622 person-years, a reduction of 82.57%. The age-standardized incidence and prevalence rates showed an overall upward trend (AAPC=5.39%, 5.40%, both P < 0.001), while age-standardized mortality and DALY rates showed an overall downward trend (AAPC=-7.01%, -6.96%, both P < 0.001). In both 1990 and 2021, the highest incidence and prevalence rates in China were observed in the 5- < 15 age group, while the highest mortality was seen in the < 5 age group, consistent with global patterns. From 1990 to 2021, China′s dengue disease burden indices were consistently lower than the global average. Conclusions The disease burden of dengue fever in China is lower than the global average, but both incidence and prevalence are still on the rise. This suggests the need to strengthen dengue prevention and control measures, with particular attention to vulnerable populations such as women, children, and the elderly. -
图 1 1990―2021年中国与全球登革热年龄标化率变化趋势
ASIR: 年龄标化发病率; ASMR: 年龄标化死亡率; ASPR: 年龄标化患病率; ASDR: 年龄标化DALY率。
Figure 1. Trends in age-standardized incidence, age-standardized prevalence, age-standardized mortality, and age-standardized DALY rates of dengue fever in China and globally: presentation based on the burden of disease for each year from 1990 to 2021
图 2 1990―2021年中国和全球登革热分性别疾病标化率双轴图
DALY: 伤残调整寿命年。
Figure 2. Trends in age-standardized incidence, age-standardized prevalence, age-standardized mortality, and age-standardized DALY rates of dengue fever in males and females in China and globally: presentation based on burden of disease data for each year from 1990 to 2021
表 1 1990―2021年中国与全球登革热疾病负担及AAPC值
Table 1. Trends in the number of dengue incidence, age-standardized incidence rate, number of cases, age-standardized prevalence rate, number of deaths, age-standardized mortality rate, absolute number of DALYs, and age-standardized DALY rate in China and globally: calculations based on the rate of change in the burden of disease from 1990 to 2021
组别 发病情况 患病情况 死亡情况 DALY率① 发病数/例 ASIR/10万-1 患病数/例 ASPR/10万-1 死亡数/例 ASMR/10万-1 绝对数/例 ASDR/10万-1① 中国 1990年 4 364 0.38 256 0.02 46 0.004 3 568 0.32 1995年 5 734 0.47 338 0.03 25 0.003 1 926 0.19 2000年 6 108 0.50 362 0.03 17 0.002 1 183 0.14 2005年 6 638 0.53 389 0.03 16 0.002 1 071 0.12 2010年 7 486 0.58 437 0.03 13 0.001 768 0.08 2015年 18 962 1.45 1 124 0.09 10 0.001 662 0.06 2021年 26 748 2.01 1 579 0.12 9 0.001 622 0.05 变化率/% 512.92 428.95 516.80 436.64 -80.43 -85.82 -82.57 -83.47 全球 1990年 26 447 129 481.85 1 577 834 28.75 14 315 0.27 1 248 669 21.63 1995年 31 825 056 542.49 1 898 986 32.37 15 712 0.28 1 361 998 22.79 2000年 34 341 241 554.10 2 048 704 33.06 17 389 0.30 1 471 399 23.90 2005年 39 840 480 608.41 2 377 906 36.31 20 751 0.34 1 686 834 26.28 2010年 50 271 167 724.32 2 998 844 43.21 26 908 0.41 2 103 734 31.01 2015年 63 881 370 868.06 3 810 446 51.78 30 469 0.43 2 316 890 32.37 2021年 58 964 185 752.04 3 517 384 44.86 29 076 0.38 2 076 525 27.76 变化率/% 122.95 56.07 122.92 56.03 103.12 40.74 66.30 28.34 注:AAPC, 平均年度变化百分比; DALY, 伤残调整寿命年; ASIR, 年龄标化发病率; ASPR, 年龄标化患病率; ASMR, 年龄标化死亡率; ASDR, 年龄标化DALY率。 表 2 1990―2021年中国和全球分年龄登革热疾病负担情况
Table 2. Trends in dengue incidence, prevalence, and mortality in different age groups in China and globally: calculations based on the rate of change of disease burden data from 1990 to 2021
组别 年龄组/岁 发病率/10万-1 患病率/10万-1 死亡率/10万-1 1990年 2021年 变化率/% 1990年 2021年 变化率/% 1990年 2021年 变化率/% 中国 <5 0.29 1.53 434.17 0.02 0.09 436.81 0.03 <0.01 -94.09 5~<15 0.50 2.42 385.47 0.03 0.14 387.77 <0.01 <0.01 -87.63 15~<50 0.34 2.14 512.53 0.02 0.12 515.46 <0.01 <0.01 -66.95 50~<70 0.33 1.36 308.73 0.01 0.08 310.80 <0.01 <0.01 -74.89 ≥70 0.46 1.50 223.70 0.02 0.09 225.33 <0.01 <0.01 -63.98 全球 <5 395.83 527.54 33.27 23.61 31.46 33.24 0.93 0.86 -7.29 5~<15 692.94 916.64 32.28 41.34 54.68 32.27 0.24 0.24 -1.74 15~<50 485.44 785.62 61.84 28.96 46.87 61.83 0.12 0.21 74.82 50~<70 349.45 610.47 74.69 20.85 36.41 74.62 0.19 0.37 91.81 ≥70 344.86 666.10 93.15 20.57 39.74 93.14 0.58 1.28 120.30 注:AAPC, 平均年度变化百分比; DALY, 伤残调整寿命年; ASIR, 年龄标化发病率; ASPR, 年龄标化患病率; ASMR, 年龄标化死亡率; ASDR, 年龄标化DALY率。 表 3 1990―2021中国和全球登革热Joinpoint分析结果
Table 3. 1990-2021 The results of Joint analysis on the burden of dengue disease in China and the world, including age standardized incidence rate, age standardized prevalence, age standardized mortality, and age standardized DALY rate
指标 区域 趋势变化1 趋势变化2 趋势变化3 AAPC /% 95% CI 年份 APC/% 95% CI 年份 APC/% 95% CI 年份 APC/% 95% CI ASIR 中国 1990-2010 1.63① 1.39~1.87 2010-2014 23.25① 19.80~26.80 2014-2021 6.93① 6.04~7.83 5.39① 4.96~5.84 全球 1990-2005 1.24① 0.98~1.50 2005-2014 4.05① 3.42~4.69 2014-2021 -2.20① -2.91~-1.48 1.25① 0.99~1.52 ASPR 中国 1990-2010 1.59① 1.34~1.84 2010-2014 23.65① 19.94~27.47 2014-2021 6.87① 5.92~7.82 5.40① 4.93~5.87 全球 1990-2005 1.24① 0.98~1.50 2005-2014 4.05① 3.43~4.68 2014-2021 -2.20① -2.90~-1.48 1.25① 0.99~1.51 ASMR 中国 1990-1998 -12.95① -14.61~-11.26 1998-2003 2.76 -1.86~7.59 2003-2021 -6.86① -7.36~-6.35 -7.01① -7.84~-6.17 全球 1990-2002 1.28① 0.84~1.72 2002-2013 3.16① 2.54~3.78 2013-2021 -1.47① -2.74~-0.20 1.22① 0.81~1.63 ASDR 中国 1990-1998 -12.61① -14.77~-10.40 1998-2002 1.62 -8.56~12.93 2002-2021 -6.23① -6.95~-5.50 -6.96① -8.34~-5.55 全球 1990-2003 1.61① 0.84~1.48 2003-2014 2.61① 2.02~3.19 2014-2021 -2.48① -3.71~-1.23 0.83① 0.48~1.19 注:APC, 年度变化百分比; AAPC, 平均年度变化百分比; ASIR, 年龄标化发病率; ASPR, 年龄标化患病率; ASMR, 年龄标化死亡率; ASDR, 年龄标化DALY率。
① P<0.05。 -
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