1990—2019年中国利什曼病发病趋势及年龄-时期-队列模型分析  

Incidence trends and age-period-cohort analysis of leishmaniasis in China from 1990 to 2019

作　　者：白金姝 秦丽岩[1] 史光忠 王锋[1] 王福双 李瑞[3] 赵江山[2] BAI Jinshu;QIN Liyan;SHI Guangzhong;WANG Feng;WANG Fushuang;LI Rui;ZHAO Jiangshan(School of Public Health,Xinjiang Medical University,Urumqi 830011,Xinjiang Uygur Autonomous Region,China;Center for Disease Control and Prevention of Xinjiang Uygur Autonomous Region;Basic Medical College,Xinjiang Medical University)

机构地区：[1]新疆医科大学公共卫生学院,新疆乌鲁木齐830011 [2]新疆维吾尔自治区疾病预防控制中心 [3]新疆医科大学基础医学院

出　　处：《热带病与寄生虫学》2024年第2期76-82,共7页Journal of Tropical Diseases and Parasitology

基　　金：国家卫生健康委寄生虫病原与媒介生物学重点实验室开放研究课题(WSBKFKT2019-07)。

摘　　要：目的分析1990—2019年中国利什曼病发病率的变化趋势,探究年龄、时期及队列因素对利什曼病发病率的影响,为中国利什曼病的防控政策的制定提供参考依据。方法利用2019年全球疾病负担数据库作为数据来源,提取1990—2019年中国利什曼病发病人数、粗发病率、标化发病率等数据。运用Joinpoint回归模型分析1990—2019年中国利什曼病标化发病率的变化趋势,并计算年度变化百分比(annual percentage change,APC)与平均年度变化百分比(average annual percentage change,AAPC)。采用年龄-时期-队列模型分析年龄、时期及队列因素对中国利什曼病发病率的影响。结果1990—2019年中国利什曼病发病数从4487例减至904例,降幅79.85%;粗发病率从0.38/10万降至0.06/10万,降幅84.21%;标化发病率从0.37/10万降至0.08/10万,降幅78.38%。Joinpoint回归模型结果显示,1990—2019年中国利什曼病全人群、男性和女性标化发病率均呈下降趋势,AAPC分别为-5.00%、-5.06%、-4.95%,差异均有统计学意义(t=-90.65、-90.70、-90.82,P均<0.01)。年龄-时期-队列模型结果显示,1990—2019年中国人群利什曼病发病风险随着年龄的增长而降低(RR值从5.24降至0.23),随着时期的推移而降低(RR值从2.14降至0.67),越晚出生的队列其发病风险越小(RR值从7.86降至0.12)。结论1990—2019年我国利什曼病呈低度流行态势,利什曼病防治效果显著,但仍需加强对重点区域传播媒介的干预和高危人群的防护,以降低我国利什曼病疾病负担。Objective To analyze the change trend of leishmaniasis incidence in China from 1990 to 2019,and investigate the influence of age,period and cohort factors on the incidence of leishmaniasis for reference to develop the prevention and control policy for this prevalence in China.Methods By the 2019 Global Burden of Disease Database as information source,the data on the incidence,crude incidence and standardized incidence of leishmaniasis in China from 1990 to 2019 were extracted.The Joinpoint regression model was used to analyze the change trend of leishmaniasis standardized incidence in China from 1990 to 2019,and the annual percentage change(APC)and average annual percentage change(AAPC)were calculated.An age-period-cohort model was used to analyze the effects of age,period and cohort factors on the incidence of leishmaniasis in China.Results From 1990 to 2019,the incidence of leishmaniasis in China was decreased from 4487 to 904 cases,with a decrease of 79.85%.The crude incidence and the standard incidence were declined from 0.38/100000 to 0.06/100000 and from 0.37/100000 to 0.08/100000,with a drop of 84.21%and 78.38%,respectively.The Joinpoint regression model showed that the standardized incidence of leishmaniasis in the whole population,men and women in China from 1990 to 2019 represented a decreasing trend,and AAPC was-5.00%,-5.06%and-4.95%,respectively,with statistically significant differences(t=-90.65,-90.70,-90.82,all P<0.01).The results of age-period-cohort model analysis suggested that the risk of leishmaniasis in the Chinese population from 1990 to 2019 was decreased with age(RR:5.24 to 0.23)and period(RR:2.14 to 0.67),and the risk of leishmaniasis was lessened with later birth cohort(RR:7.86 to 0.12).Conclusion The low prevalence of leishmaniasis in China from 1990 to 2019 indicates that the prevention and control of leishmaniasis in China has achieved remarkable results,yet it is still necessary to strengthen the intervention of the vector and the protection of high-risk populations to reduce the bur

关 键 词：利什曼病 发病率 Joinpoint回归 年龄-时期-队列模型 中国 

分 类 号：R531.6[医药卫生—内科学] R181.3[医药卫生—临床医学]