基于全球疾病负担数据库探讨1990－2021年中国脑膜炎疾病负担及危险因素分析

Exploration of disease burden and risk factors of meningitis in China from 1990 to 2021 base on Global Burden of Disease study database

    摘要
  • 摘要:
    目的 分析1990－2021年中国居民脑膜炎疾病负担状况及未来演变趋势。
    方法 基于2021年全球疾病负担研究数据库，检索获得中国脑膜炎疾病负担、病原学及可归因危险因素相关数据。应用Joinpoint联结点回归模型，分析1990－2021年中国脑膜炎疾病负担状况；应用贝叶斯年龄-时期-队列模型，预测2022－2031年中国居民的脑膜炎疾病负担变化趋势。
    结果 2021年中国总人群脑膜炎的标化发病率、标化死亡率及标化伤残调整寿命年率（ASDR）分别为5.79/100 000、0.48/100 000和27.95/100 000，与1990年相比，平均年度变化百分比分别为−5.31%、−6.31%、−7.15%，疾病负担最重且下降幅度最大的均为＜5岁年龄组。1990－2021年，所有病原体导致的脑膜炎标化死亡率（ASMR）和标化伤残调整寿命年率（ASDR）疾病负担均呈降低态势，而流感嗜血杆菌与脑膜炎奈瑟菌导致的疾病负担下降幅度最大。同期我国5岁以下儿童群体因各类危险因素所致的脑膜炎疾病负担整体下降，其中固体燃料导致的家庭空气污染相关死亡率和伤残调整生命年（DALYs）率降幅最大。贝叶斯APC模型预测得出2022－2031年中国居民脑膜炎标化发病率、标化死亡率、标化DALYs率将持续降低。
    结论 1990－2021年中国总人群脑膜炎疾病负担持续降低。流感嗜血杆菌与脑膜炎奈瑟菌所致疾病负担降幅最大，但抗菌药物耐药构成新挑战；＜5岁儿童群体为疾病负担重点人群，其主要危险因素包括早产低体质量等。

     

    Abstract:
    OBJECTIVE  To analyze the disease burden of meningitis among Chinese residents from 1990 to 2021 and its future evolution trend.
    METHODS  Based on the Global Burden of Disease Study database in 2021, relevant data on the disease burden, etiology and attributable risk factors of meningitis in China were retrieved. The Joinpoint regression model was applied to analyze the disease burden of meningitis in China from 1990 to 2021. the Bayesian age-period-cohort （APC） model was used to predict the changing trend of the disease burden of meningitis among Chinese residents from 2022 to 2031.
    RESULTS  In 2021, the standardized incidence rate, standardized mortality rate and age-standardized disability-adjusted life-year rate （ASDR） of meningitis in the total population in China were 5.79/100 000, 0.48/100 000 and 27.95/100 000, respectively. Compared with those in 1990, the average annual percentage changes （AAPCs） were −5.31%, −6.31% and −7.15%, respectively. The age group under 5 years old had the heaviest disease burden and the largest decrease. From 1990 to 2021, the disease burden of age-standardized mortality rate （ASMR） and ASDR of meningitis caused by all pathogens showed a decreasing trend, with the largest decreases in the disease burden caused by Haemophilus influenzae and Neisseria meningitidis. During the same period, the overall disease burden of meningitis caused by various risk factors decreased among children under 5 years old in China, with the largest decreases in mortality and disability-adjusted life-years （DALYs） rates associated with household air pollution caused by solid fuels. The Bayesian APC model predicted that the standardized incidence rate, standardized mortality rate and standardized DALYs rate of meningitis among Chinese residents will continue to decrease from 2022 to 2031.
    CONCLUSIONS  From 1990 to 2021, the disease burden of meningitis in the total population in China continues to decrease. The disease burden caused by Haemophilus influenzae and Neisseria meningitidis shows the largest decreases, but antimicrobial drug resistance poses new challenges. Children under 5 years old are the key population for disease burden, and their main risk factors include preterm birth and low birth weight.

     

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