Tuberculosis DALY-Gap: Spatial and Quantitative Comparison of Disease Burden Across Urban Slum and Non-slum Census Tracts

To quantitatively assess disease burden due to tuberculosis between populations residing in and outside of urban informal settlements in Rio de Janeiro, Brazil, we compared disability-adjusted life years (DALYs), or “DALY-gap.” Using the 2010 Brazilian census definition of informal settlements as aglomerados subnormais (AGSN), we allocated tuberculosis (TB) DALYs to AGSN vs non-AGSN census tracts based on geocoded addresses of TB cases reported to the Brazilian Information System for Notifiable Diseases in 2005 and 2010. DALYs were calculated based on the 2010 Global Burden of Disease methodology. DALY-gap was calculated as the difference between age-adjusted DALYs/100,000 population between AGSN and non-AGSN. Total TB DALY in Rio in 2010 was 16,731 (266 DALYs/100,000). DALYs were higher in AGSN census tracts (306 vs 236 DALYs/100,000), yielding a DALY-gap of 70 DALYs/100,000. Attributable DALY fraction for living in an AGSN was 25.4 %. DALY-gap was highest for males 40–59 years of age (501 DALYs/100,000) and in census tracts with <60 % electricity (12,327 DALYs/100,000). DALY-gap comparison revealed spatial and quantitative differences in TB burden between slum vs non-slum census tracts that were not apparent using traditional measures of incidence and mortality. This metric could be applied to compare TB burden or burden for other diseases in mega-cities with large informal settlements for more targeted resource allocation and evaluation of intervention programs.     

同安区居民癌症负担中早死所致生命损失分析

目的：了解1990-2001年同安区居民癌症负担中因早死所致生命损失。方法：采用世界银行全球疾病负担评价指标体系和1990-2001年同安区死亡登记报告资料，分析恶性肿瘤给同安区居民健康造成的损失。结果：肝癌、食管癌、胃癌因早死所致生命损失年(YLLs)占恶性肿瘤总YLLs76．56％。其中．肝癌在恶性肿瘤YLLs顺位中位居第一。肺癌YLLs呈上升趋势。因早死所致生命损失主要发生在30-74岁年龄组人群。结论：消化道恶性肿瘤，尤其肝癌是危害该区居民生命健康的主要恶性肿瘤。     

2010-2014年浙江省温州市伤害死亡趋势及疾病负担分析

目的 了解浙江省温州市居民伤害死亡趋势及其疾病负担。方法 利用2010-2014年温州市死因监测资料，按ICD-10分类标准进行伤害死因编码。采用伤害死亡率、死因构成比、死因顺位等指标分析伤害死亡特征；用年估计变化百分比（EAPC）评价死亡率变化趋势；用潜在寿命损失年数（YPLL）、YPLL率、潜在工作损失年数（WYPLL）、WYPLL率以及潜在经济损失值（PEL）评估伤害的疾病负担。结果 2010-2014年温州市居民伤害死亡率为42.54/10万（男50.37/10万，女34.11/10万）。机械性窒息、溺亡、机动车辆交通事故和非故意跌落分别是0～、1～、15～及65～岁以上年龄组伤害死亡的首要原因。机动车辆交通事故、其他非故意事故以及自杀死亡率呈明显下降趋势，跌落、溺亡和机动车以外运输事故变化趋势不明显。2010-2014年温州市居民伤害死亡YPLL为239 382人年，WYPLL为182 350人年，伤害死亡所致的PEL达832 314.69万元。结论 伤害是温州市的主要死因之一，伤害死亡疾病负担重；不同类型伤害死亡变化趋势不同；应采取有效措施减少伤害死亡。     

Disease burden of respiratory syncytial virus infection in the pediatric population in Japan

IntroductionRespiratory syncytial virus (RSV) is one of the most common causes of lower respiratory tract infections in children aged <5 years and is associated with long-term respiratory morbidities such as recurrent wheezing and asthma, decreased lung function, and allergic sensitization. The objective of this review was to evaluate the epidemiology and burden of RSV infection in the pediatric population in Japan.MethodsStudies indexed in PubMed and ICHUSHI databases during January 2010–December 2020 were manually reviewed. Data on proportion of RSV infections, seasonality, length of stay (LoS), mortality, medical expenses, and palivizumab use were extracted from the selected articles.ResultsNinety-three articles were included (PubMed, 64; ICHUSHI, 29). The proportion of patients/samples with an RSV infection was 5.5%–66.7%, and 6.0%–29.9% in the inpatient and outpatient departments, respectively. RSV infections generally occurred during autumn/winter; however, recently the peak has shifted to summer. The LoS was variable and depended on factors such as age, infection severity, wheezing, and RSV subgroups. Mortality rates varied from <1% to 19% depending on the infection severity. The average daily hospitalization and intensive care unit cost was JPY 34,548 while intensive care unit incurred an additional cost of JPY 541,293. Palivizumab was indicated for high-risk infants and 0%–3% of patients required hospitalization despite palivizumab use.ConclusionsRSV imposes a significant burden on the Japanese healthcare system, suggesting a need to create awareness among caregivers of children, pregnant women and healthcare professionals to ensure early recognition of infection and adequate treatment or prophylaxis.     

专业防治宣教与高知人群血管性痴呆疾病负担的相关性

目的：研究专业防治宣教与高知人群血管性痴呆疾病负担的相关性。方法300例高知血管性痴呆者作为调研对象。评价其认知功能、日常生活的能力、伤残和存活年限，将患者分为A、B、C3组，A组接受宣教0次，B组接受宣教1～3次，C组接受宣教≥4次。计算出DALY（即伤残调整寿命年）的数值。结果3组DALY值中，A组为7·63±2·37，B组为7·51±1·75，C组为4·93±0·48，3组差异有统计学意义（均 P＜0·05）。结论专业化防治宣教和高知人群的血管性痴呆疾病负担相关，随着宣教次数（≥4次最佳）的增多，DALY值逐渐减小。     

利用DALY分析湖北省某市城区恶性肿瘤疾病负担

目的分析十堰市城市居民恶性肿瘤疾病负担情况，为制定相应防治策略和卫生规划提供科学依据。方法根据十堰市城区死因监测数据，计算城区居民死亡率、伤残调整寿命年（disabilityadjustedlifeyear，DALY），评价十堰市城区居民肿瘤疾病负担。结果十堰市恶性肿瘤疾病负担过早死亡损失寿命年（YLL）、伤残损失寿命年（YLD）、伤残调整寿命年（DALY）分别为20．27／1000、0．70／1000、20．97／1000；DALYs构成前5位的恶性肿瘤分别为肝癌（24．41％），气管、支气管、肺癌（21．77％），胃癌（11．71％），食道癌（8．00％），结肠直肠癌（6．05％）；DALYs随年龄段的增加而增加，15—29岁年龄段女性DALYs略高于男性，其他年龄段男性DALYs均高于女性。结论十堰市城区居民恶性肿瘤疾病负担处于平均水平，肝癌，气管、支气管、肺癌、胃癌，食道癌，结肠直肠癌疾病负担较重。     

我国棘球蚴病的疾病负担

棘球蚴病是一种严重危害人民健康和畜牧业发展的寄生虫病,日益受到社会各界的关注.该文从流行病学评价、经济负担等方面对棘球蚴病的疾病负担进行综述.     

居家精神分裂症患者直接照料者负担及相关因素

目的 探讨居家精神分裂症患者直接照料者所承受的负担及其影响因素.方法 应用问卷对106名精神分裂症患者的直接照料者进行调查.结果 精神分裂症患者直接照料者经济、心理方面的负荷较大.经配对t检验,经济负担、心理健康因子与其它因子两两之间的差异均具有统计学意义(P＜0.05).与常模相比,直接照料者更多采用消极应对方式,并与照料者负担呈正相关(P＜0.05);照料者负担还与患者的病程、康复状况、生活满意度、家庭关怀度指数相关(均P＜0.05).结论 应重视精神分裂症患者直接照料者负担,指导其采用积极应对方式,加强其家庭支持系统,积极鼓励患者自理,以减轻直接照料者负担.     

重症颅脑外伤患者抗生素相关性肠炎的疾病负担

目的:分析重症颅脑外伤患者发生抗生素相关性肠炎(AAC)的疾病负担,并探讨其预防和治疗对策。方法:回顾性分析157例重症颅脑外伤患者发生AAC与抗菌药物应用时间、剂量、种类的关系。结果:抗菌药物超量应用与AAC发生密切相关(P<0.01),以应用头孢菌素类为最高;而发生了AAC的重症颅脑外伤患者使用抗菌药物平均时间为(24.6±5.0)d,未发生AAC的重症颅脑外伤患者使用抗菌药物平均时间为(11.4±7.8)d,抗菌药物使用时间长短与AAC发生密切相关(P<0.01);不合理使用抗菌药物的发生率与AAC发生密切相关(P<0.01);观察组住院总费用为(73541±46724)元,对照组住院总费用为(38579±28572)元,其中药费观察组为(17824±21324)元,对照组为(9856±9547)元,2组的住院总费用、药费的差异均有统计学意义(P<0.01或P<0.05)。结论:重症颅脑外伤患者AAC有较大的疾病负担。预防重症颅脑外伤患者发生AAC的关键在于综合治疗,特别是广谱抗菌药物的合理应用。