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

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

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。

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".