国际比较视域下1990—2019年中国5岁以下儿童疾病负担研究  

Burden of disease and risk factors among children under 5 years in China from 1990 to 2019:a perspective of international comparison

作　　者：李福明 谢士钰[1,2] 姜之歆 鲍诗意[1,2] 任延峰 陈英耀 Li Fuming;Xie Shiyu;Jiang Zhixin;Bao Shiyi;Ren Yanfeng;Chen Yingyao(School of Public Health,Fudan University,Shanghai 200032,China;NHC Key Laboratory of Health Technology Assessment(Fudan University),Shanghai 200032,China)

机构地区：[1]复旦大学公共卫生学院,上海200032 [2]国家卫生健康委员会卫生技术评估重点实验室(复旦大学),上海200032

出　　处：《中华预防医学杂志》2022年第5期619-625,共7页Chinese Journal of Preventive Medicine

基　　金：国家卫生健康委员会委托项目“影响儿童健康主要因素及政策研究”(20201999310)。

摘　　要：利用全球疾病负担数据库2019版(GBD 2019)数据,选取1990—2019年国内外5岁以下儿童标化死亡率与标化伤残调整寿命年(DALYs)率作为评价指标,比较分析中国和国外5岁以下儿童的疾病负担现状及差异,并对中国不同性别5岁以下儿童疾病负担变化趋势及差异进行分析。1990—2019年中国5岁以下儿童全因标化死亡率由1153.81/10万降至160.39/10万,全因标化DALYs率由104426.40/10万降至16479.01/10万。2019年新生儿早产、先天性心脏异常、下呼吸道感染位列中国5岁以下儿童疾病负担前3位,除新生儿早产疾病负担低于北美外,均远高于西欧和北美同期水平。肺部吸入物和气道异物、溺水在内的非故意伤害类疾病负担均高于西欧和北美。中国5岁以下男童和女童前10位疾病和伤害的标化死亡率和标化DALYs率均呈逐年下降趋势(P<0.05),其中多数标化率男童高于女童(P<0.05)。1990—2019年中国5岁以下儿童疾病负担大幅度下降,但相较于国外仍要加强新生儿早产、出生缺陷、非故意伤害类疾病的防控,针对性别差异采取不同干预措施,改善儿童整体健康水平。Based on the Global Burden of Disease study 2019,the standardized mortality rate and disability-adjusted life years(DALYs)rate of children under 5 years old were selected as evaluation indicators to compare and analyze the current situation and differences of disease burden of children under 5 years old between China and other regions from 1990 to 2019.The change trend and difference of disease burden of children under 5 years old in China were analyzed by sexes.From 1990 to 2019,the all-cause standardized mortality rate of children under 5 years old in China decreased from 1153.81/100000 to 160.39/100000,and the all-cause standardized DALY rate decreased from 104426.40/100000 to 16479.01/100000.In 2019,neonatal preterm birth,congenital heart anomalies and lower respiratory infections ranked the top three disease burden of children under 5 years old in China.Except that the disease burden of neonatal preterm birth was lower than that in North America,they were much higher than that in Western Europe and North America in the same period.The burden of unintentional injury diseases,including pulmonary aspiration and foreign body in airway and drowning,was higher than that in Western Europe and North America.The standardized mortality and DALY rate of the top ten diseases and injuries in boys and girls under 5 years old in China showed a downward trend(P<0.05),and most of them were higher in boys than girls(P<0.05).From 1990 to 2019,the disease burden of children under 5 years old in China decreased significantly.However,compared other regions,it is still necessary to strengthen the prevention and control of neonatal premature birth,birth defects and unintentional injuries,and take different sex-specific interventions to improve the overall health of children.

关 键 词：全球疾病负担 中国 5岁以下儿童 比较分析 

分 类 号：R195.4[医药卫生—卫生统计学]