血吸虫病疾病负担研究II慢性血吸虫病健康不公平性的测量

Burden of disease in schistosomiasis japonica II Measurement of health inequali-ties due to chronic schistosomiasis

目的对慢性血吸虫病所致的健康不公平性进行测量与评价。方法以湖区两县慢性血吸虫病的健康寿命损失年为基础数据,采用集中指数(曲线)和基尼系数(洛伦兹曲线)对慢性血吸虫病疾病负担在年龄和地区间的分布差异进行定量分析。结果女性和男性年龄集中指数分别为0.395和0.380,男女间无明显差异;仅占人口总数30%的45岁以上各人群疾病负担均约占各自总体的近60%。当涂县和汉寿县基尼指数分别为0.666和0.451,一类村和二类村的疾病负担占各县总量的60%以上。结论集中指数和基尼系数及相关曲线直观量化了慢性血吸虫病所致的健康不公平性,45岁以上人群和二类以上流行村是病情控制的重点。

Objective To measure and evaluate the health inequalities due to chronic schistosomiasis japonica.Methods Based on years lived with disability（YLD） caused by chronic schistosomiasis,a concentration index and Gini index,along with a concentration curve and Lorenz curve,the health inequalities between sexes,age groups or endemicities were identified and quanti-fied.Results The age concentration index was 0.395 of females and 0.380 of males,with no significant difference between them.More than 60% of YLD was contributed by those aged ≥45 years old who accounted for about a third of total population in both sexes.Gini index was 0.666 of Dangtu County and 0.451 of Hanshou County,and 60% of YLD was contributed by the highly endemic villages.Conclusions The concentration index and Gini index could quantify the magnitude of health inequalities well.The priority of morbidity control should be given to those aged ≥45 years old and living in highly endemic villages.