2004-2018年中国艾滋病发病与死亡趋势及其年龄-时期-队列模型分析  

AIDS in China from 2004 to 2018:Incidence and Mortality Trends and Age-period-cohort Effect Analysis

作　　者：赵虹琳 李巧梅 李婷婷 丁国武[1] ZHAO Honglin;LI Qiaomei;LI Tingting;DING Guowu(Institute of Social Medicine and Health Management,School of Public Health,Lanzhou University,Lanzhou 730000,China)

机构地区：[1]兰州大学公共卫生学院社会医学与卫生事业管理研究所,甘肃省兰州市730000

出　　处：《中国全科医学》2023年第4期409-416,共8页Chinese General Practice

摘　　要：背景艾滋病作为一种极具危害性的传染病,分析其发病率与死亡率变化趋势并探讨年龄、时期、队列3个因素对艾滋病发病率与死亡率的影响能够为艾滋病防控政策的制定提供一定的参考价值。目的分析2004—2018年中国艾滋病发病率与死亡率变化趋势,探究年龄、时期及队列因素对艾滋病发病率与死亡率的影响。方法于2022年3月,以中国公共卫生科学数据中心2004—2018年的网络直报系统数据作为数据来源,提取2004—2018年中国艾滋病各年龄组发病人数、发病率、死亡人数及死亡率数据。运用Joinpoint回归模型分析2004—2018年中国艾滋病发病率与死亡率的变化趋势,并计算年度变化百分比(APC)与平均年度变化百分比(AAPC);借助年龄-时期-队列模型分析年龄、时期及队列因素对中国艾滋病发病率与死亡率的影响。结果2004—2018年中国艾滋病发病率从0.2489/10^(5)升至4.9569/10^(5),死亡率从0.0605/10^(5)升至1.4312/10^(5)。Joinpoint回归模型结果显示,2004—2018年中国艾滋病发病率与死亡率分别年均上升22.70%〔95%CI(20.70%,24.80%)〕和18.80%〔95%CI(12.10%,25.90%)〕。年龄-时期-队列模型结果显示:年龄、时期及队列因素均对中国艾滋病发病率与死亡率有影响;2004—2018年中国艾滋病发病率与死亡率的纵向年龄曲线均呈“J”字形上升趋势,年龄别发病率从5~9岁组的0.0004/10^(5)上升至75~79岁组的2828.8285/10^(5),年龄别死亡率从5~9岁组的0.0004/10^(5)上升至75~79岁组的740.2974/10^(5);随着时期的推移,艾滋病发病与死亡风险均逐渐增加,以2009—2013年时期组为对照组〔时期率比(RR)值=1.0000〕,发病风险RR值由2004—2008年时期组的0.3156〔95%CI(0.2772,0.3594)〕上升至2014—2018年时期组的2.0244〔95%CI(1.8771,2.1832)〕,死亡风险RR值由2004—2008年时期组的0.3291〔95%CI(0.2917,0.3713)上升至2014—2018年时期组的1.5226〔95%CI(1.4128,1.6409)〕;�Background AIDS is a very hazardous infectious disease.The analysis of AIDS incidence and mortality trends and the age-period-cohort influence on them,may provide insights into the formulation of AIDS related prevention and control policies.Objective To assess AIDS incidence and mortality trends,and the impact of age,period and cohort on the incidence and mortality of AIDS in China from 2004 to 2018.Methods In March 2022,from the online direct reporting system of the Data-center of China Health Science,number of AIDS patients,AIDS incidence,number of patients dying of AIDS,AIDS mortality in China during 2004-2018 were extracted from the overall information during the period.The Joinpoint regression model was used to estimate the trend of AIDS incidence and mortality,and to calculate the annual percent change(APC)and average annual percent change(AAPC).The age-period-cohort model was used to assess the influence of age,period and cohort on the trend of AIDS incidence and mortality.Results During the period from 2004 to 2018,the incidence of AIDS in China increased from 0.2489/100000 to 4.9569/100000,and AIDS mortality increased from 0.0605/100000 to 1.4312/100000.Joinpoint regression analysis revealed that the incidence and mortality of AIDS in China had an average annual increase of 22.70%〔95%CI(20.70%,24.80%)〕and 18.80%〔95%CI(12.10%,25.90%)〕in the period,respectively(P<0.05).The age-period-cohort analysis indicated that age,period and cohort all affected AIDS incidence and mortality(P<0.05).The temporal trend in age-specific AIDS incidence or mortality showed a J-shaped curve of growth.The AIDS incidence increased from 0.0004/100000 in 5-9-year-olds to 2828.8285/100000 in 75-79-year-olds,and the AIDS mortality increased from 0.0004 in 5-9-year-olds to 740.2974 in 75-79-year-olds.With the passage of time,the risk of AIDS incidence and mortality increased gradually:compared with the rate ratio of AIDS incidence and mortality(RR=1.0000)in 2009-2013,the RR of AIDS incidence increased from 0.3156〔95%CI(0.27

关 键 词：获得性免疫缺陷综合征 发病率 死亡率 疾病负担 趋势分析 年龄-时期-队列模型 

分 类 号：R512.91[医药卫生—内科学]