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全球、高SDI国家和中国 < 5岁儿童1990 — 2019年下呼吸道感染疾病负担变化趋势

Trend changes in disease burden of lower respiratory infections among children under 5 years of age in the world, high SDI countries, and China from 1990 to 2019 – an analysis of GBD 2019 data

    摘要
  • 摘要:
    目的 了解全球、高社会人口指数（SDI）国家和中国 < 5岁儿童1990 — 2019年下呼吸道感染（LRIs）疾病负担的变化趋势，为科学制定和及时调整儿童LRIs防控策略，评估防治措施的效果提供参考依据。
    方法 收集2019年全球疾病负担研究（GBD 2019）数据库中1990 — 2019年全球、高SDI国家和中国 < 5岁儿童LRIs疾病负担的相关数据，采用发病率、死亡率和伤残调整寿命年（DALY）率等指标进行描述性分析，采用Joinpoint回归模型分析LRIs疾病负担的变化趋势。
    结果 全球、高SDI国家和中国 < 5岁儿童1990 — 2019年LRIs的发病率分别从1990年的14129.55/10万、6619.66/10万和14492.75/10万下降至2019年的6801.55/10万、5064.93/10万和4134.33/10万，平均年度变化百分比（AAPC）分别为 – 2.49%、 – 0.91%和 – 4.23%（均P < 0.05）；全球、高SDI国家和中国 < 5岁儿童1990 — 2019年LRIs的死亡率分别从1990年的349.48/10万、9.22/10万和336.63/10万下降至2019年的101.37/10万、2.27/10万和18.10/10万，AAPC分别为 – 4.21%、 – 4.74%和 – 9.67%（均P < 0.05）；全球、高SDI国家和中国 < 5岁儿童1990 — 2019年LRIs的DALY率分别从1990年的30726.35/10万、820.29/10万和29660.06/10万下降至2019年的8925.53/10万、206.76/10万和1602.53/10万，AAPC分别为 – 4.20%、 – 4.66%和 – 9.63%（均P < 0.05）；全球、高SDI国家和中国 < 5岁各年龄段儿童1990 — 2019年LRIs的发病率、死亡率和DALY率均呈下降趋势（均P < 0.05），以0～6 d和7～27 d新生儿的疾病负担为最高，1～4岁幼儿的疾病负担为最低。
    结论 全球、高SDI国家和中国 < 5岁儿童1990 — 2019年LRIs的疾病负担均呈下降趋势，但新生儿的疾病负担依然较高，应加强新生儿LRIs的预防与控制以进一步降低 < 5岁儿童LRIs的疾病负担。

     

    Abstract:
    Objective To understand the trend changes in the burden of lower respiratory infections (LRIs) among children aged < 5 years in the world, high socio-demographic index (SDI) countries, and China from 1990 to 2019, to provide reference for the formulation and timely adjustment of LRIs prevention and control strategies for children, and to evaluate the effect of prevention and treatment measures.
    Methods Data on the burden of LRIs among children aged < 5 years in the world, high SDI countries, and China from 1990 to 2019 were collected from the Global Burden of Disease Study 2019 (GBD 2019) database. Descriptive analysis was performed using indicators such as incidence rate, mortality rate, and disability-adjusted life-year (DALY) rate. Joinpoint regression model was used to analyze the trend changes in the burden of LRIs.
    Results Among children aged < 5 years in the world, high SDI countries, and Chin, the incidence rate (1/100 000) of LRIs decreased from 14 129.55, 6 619.66, and 14 492.75 in 1990 to 6 801.55, 5 064.93, and 4 134.33 in 2019, with the annual average percentage change (AAPC) of – 2.49%, – 0.91%, and – 4.23% (all P < 0.05); the mortality rate (1/100 000) of LRIs decreased from 349.48, 9.22, and 336.63 in 1990 to 101.37, 2.27, and 18.10 in 2019, with AAPC of – 4.21%, – 4.74%, and – 9.67% (all P < 0.05); and the DALY rate (1/100 000) decreased from 30 726. 35, 820.29, and 29 660.06 in 1990 to 8 925.53, 206.76, and 1 602.53 in 2019, respectively, with the AAPC of – 4.20%, – 4.66%, and – 9.63% (all P < 0.05). The age-specific incidence rate, mortality rate, and DALY rate of LRIs among children aged < 5 years in the world, high SDI countries, and China all showed a decreasing trend from 1990 to 2019 (all P < 0.05), with the highest burden in newborns aged 0 – 6 days and 7 – 27 days, and the lowest burden in children aged 1 – 4 years.
    Conclusion The burden of LRIs among children aged < 5 years in the world, high SDI countries and China showed a decreasing trend from 1990 to 2019, but the burden in newborns remained high. Prevention and control of LRIs in newborns should be strengthened to further reduce the burden of LRIs among children aged < 5 years.

     

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