1990-2015年中国5岁以下儿童营养缺乏性疾病负担

Burden of nutritional deficiencies of children under 5 years old in China,1990-2015

目的分析1990-2015年中国5岁以下儿童营养缺乏性疾病负担状况及25年间的变化情况。方法基于2015年全球疾病负担研究中,1990、1995、2000、2005、2010和2015年中国31个省(自治区、直辖市),以及香港特别行政区和澳门特别行政区,共33个省的5岁以下儿童主要营养缺乏性疾病负担总体及分病种营养缺乏性疾病负担数据资料,应用流行病学方法描述并分析5岁以下儿童营养缺乏性疾病患病率、死亡率和伤残调整生命年率(disability adjusted life year,DALY率)的人群、时间和地区分布及变化情况。结果2015年中国5岁以下儿童营养缺乏性疾病患病率为17.26%,DALY率为776.26人年/10万,5岁以下儿童DALY率在1990年基础上下降了71.42%。在过去的25年间,中国东、中、西部地区5岁以下儿童营养缺乏性疾病负担均呈现持续下降的趋势,且营养缺乏性疾病负担性别差距逐渐缩小。在5岁以下儿童主要营养缺乏性疾病中,蛋白质-能量营养不良和缺铁性贫血疾病负担相对较高。与1990年相比,5岁以下儿童缺铁性贫血DALY率仅下降了15.68%,低于其他疾病下降幅度。结论1990-2015年中国5岁以下儿童营养缺乏性疾病负担持续下降,疾病负担在不同疾病种类以及地区分布中仍存在差异。

OBJECTIVE To quantify and describe the distribution and trends of burden of nutritional deficiencies among children under 5 years old in China from 1990 to 2015.METHODS Subnational data of China on children under 5 years old in 33 provinces and autonomous regions,which including 31 mainland regions,Hong Kong and Macao Special Administrative Regions,were extracted from the result of Global Burden of Disease Study 2015(GBD 2015).Based on the method of descriptive epidemiology,we analyzed the prevalence,mortality as well as disability adjusted life year(DALY)rate of nutritional deficiencies among children under 5 years old by sex,time and locations in China,as well as its temporal trend since 1990.RESULTS In 2015,the prevalence of nutritional deficiencies among children under 5 years old was 17.26%,and the DALY rate was 776.26 person-years per 100000.Compared to 1990,the DALY rate of nutritional deficiencies declined by 71.42%.The DALY rate of nutritional deficiencies decreased in the past 25 years in Eastern,Central and Western China.Meanw hile,the gap in disease burden between boys and girls declined.Among diseases caused by nutritional deficiencies,burden of protein-energy malnutrition and iron deficiency anemia among children under 5 years old were relatively higher.Compared to 1990,the DALY rate of iron deficiency anemia among children under 5 years old declined by 15.68%,which was lower than other nutritional deficiencies among children in 2015.CONCLUSION From 1990 to 2015,the disease burden caused by nutritional deficiencies among Chinese children under 5 years old showed downtrend.There were still differences of disease burden distributions between regions and common nutritional deficiencies.