1990—2019年亚洲地区下呼吸道感染的疾病负担分析及2020—2029年预测  

Disease burden analysis of lower respiratory infections in Asia between 1990 and 2019 and forecast from 2020 to 2029

作　　者：丁东方 杨瑶 林锦绣 李玉柱 朱毅 卢金梅 DING Dong-fang;YANG Yao;LIN Jin-xiu;LI Yu-zhu;ZHU Yi;LU Jin-mei(Hua Shan Hospital Fu Dan University,Shanghai 200040,China;不详)

机构地区：[1]复旦大学附属华山医院重症医学科,上海200040 [2]郑州大学第五附属医院肌肉骨骼疼痛康复科,河南郑州450052 [3]郑州大学,河南郑州450000 [4]中国人民解放军总医院海南医院呼吸与危重症医学科,海南三亚572013

出　　处：《中华医院感染学杂志》2024年第16期2411-2416,共6页Chinese Journal of Nosocomiology

摘　　要：目的分析1990-2019年亚洲48个国家和地区按年龄、性别和国家划分的下呼吸道感染(LRIs)的疾病负担及其可归因风险因素以及未来10年的趋势预测。方法通过2019年全球疾病负担(GBD)数据库,报告了LRIs导致的残疾调整生命年(DALYs)和年龄标准化DALYs率;通过R4.2.2软件中移动自回归平均模型(ARI-MA)对2020-2029年亚洲地区LRIs的年龄标准化DALYs率进行预测。结果2019年,亚洲地区LRIs的总体DALYs为4277.77万人年,自1990年以来下降了69.1%;LRIs的总体年龄标准化DALYs率为每10万人1130例(999.4~1291),自1990年以来下降了70.5%,EAPC为-4.20(4.29~4.11);2019年印度的DALYs(1852.70万人年)最高,其次为巴基斯坦(486.06万人年)和中国(402.07万人年),LRIs年龄标准化DALYs率最高的是柬埔寨(3385.66/10万),其次是老挝(2665.93/10万)和阿富汗(2642.72/10万);2019年在亚洲地区全年龄段人群中,LRIs的DALYs率在0~5岁患儿中最大,其中0~6天新生儿的疾病负担最重;2019年亚洲地区儿童消瘦(3489.26/10万)、低体质量儿童(1934.65/10万)和固体燃料引起的居家空气污染(1434.29/10万)是<5岁LRIs患儿DALYs率的三大危险因素。结论尽管LRIs的疾病负担在1990-2019年期间以及2020-2029年的预测中均为下降趋势,但<5岁患儿的疾病负担仍然较重。应实施接种疫苗,改善营养和运动等相应的预防措施,重点是减少相关风险因素的暴露,特别是在欠发达国家。OBJECTIVE To analyze the burden of disease of lower respiratory infections(LRIs)by age,sex,and country and their attributable risk factors in 48 countries and territories in Asia from 1990 to 2019,and to predict the trend in the next 1O years.METHODS We analyzed disability-adjusted life years(DALYs)and age-standardized DALYs rates due to LRIs through the 2019 global burden of disease(GBD)database.Age-standardized DALYs rates of LRIs in Asia during 2020-2029 were predicted by autoregressive integrated moving average(ARIMA)model in R 4.2.2 software.RESULTS In 2019,the overall DALYs of LRIs in the Asian region was 42777700 person-years,which was decreased by 69.1%since 1990.The overall age-standardized DALYs rate for LRIs was 1130 cases per 100000 people(999.4 to 1291),a decline of 70.5%since 1990,with an EAPC of-4.20(-4.29 to 4.11).In 2019,the number of DALYs in India was the highest(18527000 person-years),followed by Pakistan(4860600 person-years)and China(4020700 person-years),and the highest age-standardized DALYs rate for LRIs was in Cambodia(3385.66 per 100000),followed by Laos(2665.93 per 100000)and Afghanistan(2642.72 per 100000).In 2019,among all-age populations in the Asian region,the rate of DALYs for LRIs was the greatest among children aged o-5 years,and the burden of disease was the highest among newborns aged 0 to 6 days.Wasting of children(3489.26/100000),low birth weight(1934.65/100000),and household air pollution from solid fuels(1434.29/100,000)were the top three risk factors for the low rate of DALYs in patients<5 years with LRIs in the Asian region in 2019.CONCLUSION Although the burden of disease in LRIs is on a downward trend over the period 1990-2019 and in projections for 2020-2029,the burden of disease in children<5 years old remains high.Coresponding preventive measures such as vaccination,improved nutrition and exercise should be implemented,focusing on reducing exposure to relevant risk factors,especially in less developed countries.

关 键 词：流行病学 下呼吸道感染 DALYS 疾病负担 危险因素 预测 亚洲 

分 类 号：R181[医药卫生—流行病学]