2008-2013年广西居民恶性肿瘤疾病负担的研究

目的 了解广西恶性肿瘤所造成的疾病负担,探讨其现状及发展趋势,为有针对性的制定肿瘤防治策略提供参考依据。方法 收集广西7个疾病监测点死因监测系统中居民因恶性肿瘤死亡的数据,用伤残调整寿命年（disability adjusted life year,DALY）计算恶性肿瘤的疾病负担。结果 2008-2013年广西居民恶性肿瘤疾病负担为373 684.40人年,其中男性占68.36%,女性31.64%;每千人DALY损失为17.91,男性为23.26 DALYs/千人,女性为11.96 DALYs/千人。2008-2011年恶性肿瘤DALY和DALY强度逐年增高,2011-2013年逐年减少。恶性肿瘤DALY强度最大的年龄段是70岁以上。疾病负担最重的前5位肿瘤为肝癌,气管、支气管与肺癌、其他恶性肿瘤、胃癌和结直肠癌。结论 广西恶性肿瘤疾病负担处于全国平均水平,但仍需进一步加强肿瘤防治工作。     

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.     

辽宁省城乡居民糖尿病及其并发症疾病负担研究

目的了解辽宁省城乡居民糖尿病及其并发症的疾病负担水平和特征。方法依据辽宁省糖尿病患病和死亡资料,采用全球疾病负担研究方法,计算辽宁省城乡居民糖尿病的伤残调整生命年(DisabilityAdjusted Life Years,DALY)。结果辽宁省糖尿病疾病负担(DALY)每10万人损失健康寿命299.4人.a,女性高于男性(351.1/10万:252.3/10万),城市高于农村(474.1/10万:215.8/10万),农村YLD/YLL比值(0.47)明显低于城市(0.96)。结论辽宁省糖尿病DALY是GBD2000对中国糖尿病及其并发症疾病负担估计值的2.0倍,城市居民糖尿病DALY已接近发达国家水平。     

汉中市农村脑卒中患者失能调整生命年的研究

目的了解脑卒中造成农村人口的疾病负担,为促进我国脑卒中疾病负担的研究及今后卫生资源的合理配置提供参考;同时简化失能调整生命年(DALY)运算中失能的评估方式。方法整群抽样,采用自行设计的问卷,入户调查,调查脑卒中全部现患患者164人。问卷内容主要包括一般情况和失能的评估。结果汉中市农村脑卒中患者DALY为598.88 a,其中因死亡损失了471.05 a,失能损失了127.83 a,患者平均损失3.65个DALYs,汉中市农村人口每千人损失8.0个DALYs;以70~74岁年龄组损失最多;失能损失中,以65~69岁年龄组为最多,死亡的损失中,以55~59岁年龄组为最多,按性别分组后,男性损失343.26个DALYs,女性损失255.62个DALYs,分别占总损失的57.3%和42.7%。男性以55~59岁年龄组损失最多,女性以65~69岁年龄组损失最多。40~44岁年龄组的每个患者平均损失数最多,按残疾期限分组后,残疾1~4 a的损失DALY最多。将患者按照失能程度分组,存活的患者中,失能程度0.01~0.10的人数最多,失能程度0.51~0.60的DALY最多,失能程度0.51~0.60的人均DALY最多,达2.78个DALYs。结论脑卒中对我国造成的疾病负担高于发达国家,一方面可能由于我国脑卒中发病率和死亡率比较高,另一方面可能由于DALY本身的缺陷导致我国疾病负担的高估。     

Burden of Cervical Cancer in the Eastern Mediterranean Region During the Years 2000 and 2017: Retrospective Data Analysis of the Global Burden of Disease Study

BackgroundCervical cancer is a growing health concern, especially in resource-limited settings.ObjectiveThe objective of this study was to assess the burden of cervical cancer mortality and disability-adjusted life years (DALYs) in the Eastern Mediterranean Region (EMR) and globally between the years 2000 and 2017 by using a pooled data analysis approach.MethodsWe used an ecological approach at the country level. This included extracting data from publicly available databases and linking them together in the following 3 steps: (1) extraction of data from the Global Burden of Disease (GBD) study in the years 2000 and 2017, (2) categorization of EMR countries according to the World Bank gross domestic product per capita, and (3) linking age-specific population data from the Population Statistics Division of the United Nations (20-29 years, 30-49 years, and >50 years) and GBD’s data with gross national income per capita and globally extracted data, including cervical cancer mortality and DALY numbers and rates per country. The cervical cancer mortality rate was provided by the GBD study using the following formula: number of cervical cancer deaths × 100,000/female population in the respective age group.ResultsThe absolute number of deaths due to cervical cancer increased from the year 2000 (n=6326) to the year 2017 (n=8537) in the EMR; however, the mortality rate due to this disease decreased from the year 2000 (2.7 per 100,000) to the year 2017 (2.5 per 100,000). According to age-specific data, the age group ≥50 years showed the highest mortality rate in both EMR countries and globally, and the age group of 20-29 years showed the lowest mortality rate both globally and in the EMR countries. Further, the rates of cervical cancer DALYs in the EMR were lower compared to the global rates (2.7 vs 6.8 in 2000 and 2.5 vs 6.8 in 2017 for mortality rate per 100,000; 95.8 vs 222.2 in 2000 and 86.3 vs 211.8 in 2017 for DALY rate per 100,000; respectively). However, the relative difference in the number of DALYs due to cervical cancer between the year 2000 and year 2017 in the EMR was higher than that reported globally (34.9 vs 24.0 for the number of deaths and 23.5 vs 18.1 for the number of DALYs, respectively).ConclusionsWe found an increase in the burden of cervical cancer in the EMR as per the data on the absolute number of deaths and DALYs. Further, we found that the health care system has an increased number of cases to deal with, despite the decrease in the absolute number of deaths and DALYs. Cervical cancer is preventable if human papilloma vaccination is taken and early screening is performed. Therefore, we recommend identifying effective vaccination programs and interventions to reduce the burden of this disease.     

The Relationship Between Disability-Adjusted Life Years of Cataracts and Ambient Erythemal Ultraviolet Radiation in China

Background

Cataracts are one of the major public health problems worldwide. Ultraviolet radiation (UVR) is one of the risk factors for cataract development. We analyzed the relationship between disability-adjusted life year (DALY) rates of cataracts and UVR exposure in China.

Methods

DALY rates of cataracts and UVR exposure in 31 regions of China were calculated based on data from the Second China National Sample Survey on Disability and the United States’ National Aeronautics and Space Administration database. The relationship between the DALY rates of cataracts and UVR was estimated by Spearman rank correlation analysis and linear regression analysis.

Results

The elderly (≥65 years) had higher DALY rates of cataracts than the whole population. The DALY rate of cataracts in the agricultural population was higher than that observed in the non-agricultural population. The DALY rates of cataracts were positively associated with UVR The DALY rates of cataracts in regions with higher UVR were higher than those in regions with lower UVR. An increase in the daily ambient erythemal UVR of 1000 J/m² was associated with an increase in the DALY rates of cataracts by 92 DALYs/100 000 (R² = 0.676) among the whole population, 34 DALYs/100 000 among the population <65 years old (R² = 0.423), 607 DALYs/100 000 among the population aged 65–74 years (R² = 0.617), and by 1342 DALYs/100 000 among the population ≥75 years old (R² = 0.758).

Conclusions

DALY rates of cataracts increased with increases in UVR exposure in 31 regions of China. Greater exposure to UVR increases the disease burden of cataracts in the whole population, especially in the elderly and among the agricultural population.Key words: cataract, UVR exposure, disease burden, DALYs     

我国女性乳腺癌所致DALY疾病负担：2000-2050年分析与预测

目的 基于全球疾病负担项目2019年最新开放数据,分析我国女性人群因乳腺癌所致伤残调整寿命年（DALY）负担的现况、既往与未来并行国际比较。方法 摘录描述DALY总数、世界标化率值及不同亚组构成,分析我国女性乳腺癌2000-2019年趋势、2019年现况与国际现况比较;利用Joinpoint行2050年预测,主要指标为平均年度变化百分比（AAPC）。结果 2000-2019年,我国女性乳腺癌所致的DALY数在所有女性癌种中的顺位由第四位升至第二位,DALY总数增长了48.4%,其中伤残损失寿命年的占比从4.8%增至8.8%;标化DALY率仅有略微下降（AAPC=-0.3%,其中2016-2019年转为上升,AAPC=1.6%）。2019年,我国女性乳腺癌所致标化DALY率为278.0/10万,DALY数为287.7万人年（占全球乳腺癌的14.2%,占我国女性全部癌种负担的12.1%）,其中26.5%有明确归因（以超重与肥胖最多,为33.6万人年;月经、生育等常见乳腺癌影响因素相关数据在平台未见）;预测提示,2050年,我国女性乳腺癌所致DALY总数将达380.0万人年~516.2万人年,较2019年增加32.1%~79.4%。年龄分布方面,2000-2019年,年龄别DALY数和DALY率峰值均后移,年龄≥ 65岁者的DALY数较<65岁者增长更快（AAPC分别为4.8%和1.3%）;2019年的45~74岁（中国女性乳腺癌筛查与早诊早治指南推荐筛查起始年龄）女性贡献了全部DALY负担的74.3%。结论 近20年我国女性乳腺癌所致DALY率基本未变,近年甚至有增加;若无持续扩大的有效干预,伴随人口老龄化的放大作用,乳腺癌所致DALY在我国女性人群的负担将会加重。乳腺癌主要危险因素相关DALY负担归因数据报道仍有限。     

1990年与2013年中国70岁及以上老年人跌倒疾病负担分析

目的 分析1990年与2013年中国≥ 70岁人群跌倒的疾病负担,为制定老年人跌倒预防控制策略措施提供依据。方法 利用2013年全球疾病负担研究结果,采用因跌倒死亡数/标化死亡率、过早死亡损失寿命年（YLL）/标化YLL率、伤残损失寿命年（YLD）/标化YLD率、伤残调整寿命年（DALY）/标化DALY率等指标,对中国≥ 70岁老年人跌倒疾病负担进行描述,通过比较1990年与2013年相应指标的变化,描述疾病负担变化情况。结果 2013年中国≥ 70岁人群因跌倒造成的死亡人数、YLL、YLD和DALY分别为4.88万人年、43.96万人年、29.58万人年和73.54万人年;标化死亡率、YLL率、YLD率和DALY率分别为561.71/10万、55.87/10万、373.98/10万和929.85/10万。随着年龄增加,因跌倒造成的疾病负担加重。与1990年相比,2013年跌倒造成的死亡数量、YLL、YLD和DALY分别增加308.80%、161.01%、54.67%和104.47%;男性增幅高于女性。与1990年相比,2013年≥ 70岁人群因跌倒标化死亡率、标化YLL率和DALY率分上升为63.67%、38.54%和73.08%;而标化YLD率下降17.90%。结论 跌倒给中国≥ 70岁人群造成沉重的疾病负担,与1990年相比,2013年跌倒对中国≥ 70岁人群造成疾病负担有所增加。     

失能调整寿命年与人力资本法结合估计间接经济负担的研究

目的介绍失能调整寿命年（DALY）与人力资本法结合估计间接经济负担的方法。方法按照全球疾病负担研究（GBD）中计算DALY的方法，以年龄组分别计算出DALY，再利用DALY与人力资本法结合的方法中推荐的生产力权重加权求和。结果首先在计算DALY中，固定取值均参照GBD，惟一的主观指标是失能评估，在GBD中，要求8～12名各个国家和地区的不同专业的专家组成团，采用人数交换法和时间交换法评估失能，显然这样的方法在大多数研究中均无法实现。采用稍加修改的日常生活行为能力（ADL）量表，按照GBD中失能的理解重新赋值后计算出失能权重；其次，依据国民生产总值（GNP）及不同年龄组在社会价值的创造中赋予的不同生产力权重，分别计算出不同年龄组的间接经济负担，最后相加求得总人口的间接经济负担。结论DALY与人力资本法结合的方法估算间接经济负担是目前较为合理的方法，但其中DALY的计算较困难。     

宁波市区居民四种主要慢性病的疾病负担研究

目的分析宁波市城区居民四种主要慢性病的疾病负担.方法采用疾病负担的测量指标即伤残调整健康生命年(DALY)为单位进行评价.结果观察人群的DALY损失为135.38人年,DALY损失率为13.42%,推算全人群的DALY损失为6.41%.结论宁波市慢性病负担高于全国平均水平.     

Burden of Disease from Toxic Waste Sites in India,Indonesia, and the Philippines in 2010

Background: Prior calculations of the burden of disease from toxic exposures have not included estimates of the burden from toxic waste sites due to the absence of exposure data.Objective: We developed a disability-adjusted life year (DALY)-based estimate of the disease burden attributable to toxic waste sites. We focused on three low- and middle-income countries (LMICs): India, Indonesia, and the Philippines.Methods: Sites were identified through the Blacksmith Institute’s Toxic Sites Identification Program, a global effort to identify waste sites in LMICs. At least one of eight toxic chemicals was sampled in environmental media at each site, and the population at risk estimated. By combining estimates of disease incidence from these exposures with population data, we calculated the DALYs attributable to exposures at each site.Results: We estimated that in 2010, 8,629,750 persons were at risk of exposure to industrial pollutants at 373 toxic waste sites in the three countries, and that these exposures resulted in 828,722 DALYs, with a range of 814,934–1,557,121 DALYs, depending on the weighting factor used. This disease burden is comparable to estimated burdens for outdoor air pollution (1,448,612 DALYs) and malaria (725,000 DALYs) in these countries. Lead and hexavalent chromium collectively accounted for 99.2% of the total DALYs for the chemicals evaluated.Conclusions: Toxic waste sites are responsible for a significant burden of disease in LMICs. Although some factors, such as unidentified and unscreened sites, may cause our estimate to be an underestimate of the actual burden of disease, other factors, such as extrapolation of environmental sampling to the entire exposed population, may result in an overestimate of the burden of disease attributable to these sites. Toxic waste sites are a major, and heretofore underrecognized, global health problem.     

The burden of disease and injury in Serbia

BACKGROUND: In the last decade of the 20th century, a considerable effort has been put into the development of summary measures of population health that combine information on mortality and non-fatal health outcomes. We used the DALYs (Disability adjusted life years) method to assess the burden of disease and injury in the population of Serbia. METHODS: Our study, largely based on the methods developed for the Global burden of disease study, was conducted between October 2002 and September 2003. DALYs, stratified by gender and age, were calculated for 18 selected health conditions for the population of Serbia, Serbia and Montenegro for 2000. Years of life lost (YLL) were calculated using country mortality statistics, while years lived with disability (YLD) were calculated using different sources of information. Also, the YLD/YYL ratio and age-adjusted rates of DALYs were calculated. RESULTS: Ischaemic heart disease, cerebrovascular diseases, lung cancer, unipolar depressive disorders, and diabetes mellitus were responsible for almost two-thirds (70%) of the total burden of 18 selected disorders in Serbia 2000. The leading five causes for males were ischaemic heart disease (26.1 DALY per 1000), stroke (17.9), lung cancer (12.7), road traffic accidents (6.5), and self-inflicted injuries (5.5). For females, the leading five causes were stroke (18.1 DALY per 1000), ischaemic heart disease (14.1), depression (8.7), breast cancer (6.1), and diabetes mellitus (5.2). CONCLUSIONS: The final results of the study have shown that the national health priority areas should cover cardiovascular diseases, cancers, and mental health.     

Cross-national comparability of burden of disease estimates: the European Disability Weights Project

OBJECTIVE: To investigate the sources of cross-national variation in disability-adjusted life-years (DALYs) in the European Disability Weights Project. METHODS: Disability weights for 15 disease stages were derived empirically in five countries by means of a standardized procedure and the cross-national differences in visual analogue scale (VAS) scores were analysed. For each country the burden of dementia in women, used as an illustrative example, was estimated in DALYs. An analysis was performed of the relative effects of cross-national variations in demography, epidemiology and disability weights on DALY estimates. FINDINGS: Cross-national comparison of VAS scores showed almost identical ranking orders. After standardization for population size and age structure of the populations, the DALY rates per 100000 women ranged from 1050 in France to 1404 in the Netherlands. Because of uncertainties in the epidemiological data, the extent to which these differences reflected true variation between countries was difficult to estimate. The use of European rather than country-specific disability weights did not lead to a significant change in the burden of disease estimates for dementia. CONCLUSIONS: Sound epidemiological data are the first requirement for burden of disease estimation and relevant between-countries comparisons. DALY estimates for dementia were relatively insensitive to differences in disability weights between European countries.     

Disease Burdens of Alzheimer's Disease,Vascular Dementia,and Mild Cognitive Impairment

ObjectivesUnderstanding disability-adjusted life-years (DALYs) based on dementia subtypes and mild cognitive impairment (MCI) is essential for optimal resource allocation. This study aimed to investigate disease burdens of various dementias and MCI in a representative South Korean population.DesignRetrospective cohort study.Setting and Participants6481 Korean older adults.MethodsWe estimated the disease-specific DALYs.ResultsDALYs due to MCI and all-cause dementia are estimated to increase from 1295 per 100,000 in 2016 to 9501 per 100,000 in 2065. In 2016, DALYs attributed to Alzheimer's dementia, vascular dementia, and MCI accounted for 33% (423 per 100,000), 20% (316 per 100,000), and 24% (123 per 100,000), respectively, of the total DALYs due to MCI and all-cause dementia. In 2065, DALYs due to Alzheimer's dementia, vascular dementia, and MCI will account for 38% (3654 per 100,000), 17% (1654 per 100,000), and 27% (2585 per 100,000) of total DALYs due to MCI and all-cause dementia, respectively.The years of life lived with disability (YLDs) due to MCI and all-cause dementia are estimated to rise from 479 per 100,000 in 2016 to 2807 per 100,000 in 2065. In 2016, YLDs due to Alzheimer's dementia, vascular dementia, and MCI composed 37% (177 per 100,000), 18% (85 per 100,000), and 15% (70 per 100,000), respectively, of the total YLDs due to MCI and all-cause dementia. In 2065, YLDs due to Alzheimer's dementia, vascular dementia, and MCI will account for 48% (1358 per 100,000), 15% (410 per 100,000), and 10% (290 per 100,000), respectively, of total YLDs due to MCI and all-cause dementia.Conclusions and ImplicationsConsidering the rapidly growing disease burden, resources should be allocated to continuously monitor and manage the MCI and dementia burden. Particular attention to Alzheimer's dementia is required considering its significant contribution to current and future disease burden, especially to YLD.     

The Disease and Economic Burdens of Esophageal Cancer in China from 2013 to 2030: Dynamic Cohort Modeling Study

BackgroundEsophageal cancer (EC) is the sixth leading cause of tumor-related deaths worldwide. Estimates of the EC burden are necessary and could offer evidence-based suggestions for local cancer control.ObjectiveThe aim of this study was to predict the disease burden of EC in China through the estimation of disability-adjusted life years (DALYs) and direct medical expenditure by sex from 2013 to 2030.MethodsA dynamic cohort Markov model was developed to simulate EC prevalence, DALYs, and direct medical expenditure by sex. Input data were collected from the China Statistical Yearbooks, Statistical Report of China Children’s Development, World Population Prospects 2019, and published papers. The JoinPoint Regression Program was used to calculate the average annual percentage change (AAPC) of DALY rates, whereas the average annual growth rate (AAGR) was applied to analyze the changing direct medical expenditure trend over time.ResultsFrom 2013 to 2030, the predicted EC prevalence is projected to increase from 61.0 to 64.5 per 100,000 people, with annual EC cases increasing by 11.5% (from 835,600 to 931,800). The DALYs will increase by 21.3% (from 30,034,000 to 36,444,000), and the years of life lost (YLL) will account for over 90% of the DALYs. The DALY rates per 100,000 people will increase from 219.2 to 252.3; however, there was a difference between sexes, with an increase from 302.9 to 384.3 in males and a decline from 131.2 to 115.9 in females. The AAPC was 0.8% (95% CI 0.8% to 0.9%), 1.4% (95% CI 1.3% to 1.5%), and –0.7% (95% CI –0.8% to –0.7%) for both sexes, males, and females, respectively. The direct medical expenditure will increase by 128.7% (from US $33.4 to US $76.4 billion), with an AAGR of 5.0%. The direct medical expenditure is 2-3 times higher in males than in females.ConclusionsEC still causes severe disease and economic burdens. YLL are responsible for the majority of DALYs, which highlights an urgent need to establish a beneficial policy to reduce the EC burden.     

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。     

南通市经济技术开发区居民2013年恶性肿瘤疾病负担分析

目的 分析2013年南通市经济技术开发区(开发区)恶性肿瘤的死亡流行特征及疾病负担,为恶性肿瘤防治提供科学依据。 方法 通过计算恶性肿瘤死亡率、标化死亡率、伤残调整寿命年(disability adjusted life years,DALYs)、早死所致寿命年(years of life lost,YLLs)和残疾所致寿命年(years lived with disability,YLDs)指标,分析主要恶性肿瘤的疾病负担和人群分布特征。 结果 2013年南通市开发区恶性肿瘤死亡率为209.88/10万,标化死亡率为103.20/10万。恶性肿瘤所致DALYs率为20.66/千人,男性和女性分别为26.97/千人和14.50/千人。恶性肿瘤DALYs损失以YLLs为主,占86.27%。DALYs前5位与死亡率顺位一致,依次为肺癌、肝癌、胃癌、结直肠癌和食管癌,其中男性DALYs率最高的为肝癌6.66/千人,女性DALYs率最高的是肺癌3.13/千人。 结论 肺癌和肝癌仍是危害南通市开发区居民健康的主要癌种,45岁以上人群是预防和干预的重点人群,应针对性开展筛查和防治工作,以减少疾病负担。     

江苏省狂犬病疾病负担研究

目的通过对江苏省狂犬病的疾病负担进行统计分析和综合评价,为制定疾病防制策略提供参考依据。方法收集2008—2018年江苏省狂犬病疫情资料,进行流行病学特征分析,同时使用世界卫生组织(WHO)公布的计算工具评估因狂犬病早死导致的伤残调整寿命年(DALYs),并结合人力资本法评估早死间接经济负担。结果2008—2018年江苏省累计报告狂犬病病例565例,男女性别比为1∶0.42,所有病例中农民超过了73%;DALYs总损失为12318.22人年,年均损失1119.84人年;DALY强度为0.014人年/1000人;男性年均损失DALYs783.82人年,显著高于女性(t=2.984,P<0.05);45~59岁年龄组损失的DALYs居首位,约占总损失的35.15%;70~79岁年龄组DALY强度最高,为0.0219人年/1000人;江苏省每年因狂犬病死亡导致的间接经济负担为4929.29万元,其中45~59岁组所占比例最高。结论狂犬病主要负担人群为男性以及45~59岁年龄组人群,此外<15岁青少年儿童的负担也较大,应加强对此部分人群的关注,并制定相应防控对策。     

上海市徐汇区80岁以下居民糖尿病疾病负担及其趋势分析

[目的]对上海市徐汇区居民糖尿病进行疾病负担的测量和分析,探讨其演变趋势. [方法]数据源自1999-2011年上海市徐汇区疾病预防控制中心死亡登记系统,对象为所有80岁以下、徐汇区户籍、死因为糖尿病的居民共计1780人.分别计算残疾损失健康生命年(YLD)、死亡损失年(YLL)及伤残调整寿命年(DALY),并对DALY作时间趋势检验,对具有时间趋势特征者建立灰色动态模型GM(1,1)进行预测. [结果]近13年该区80岁以下糖尿病DALY均高于2004年全国水平和新兴市场经济体;男、女性糖尿病所致残疾负担均远高于死亡负担,残疾所致负担占67.5％;近13年男性糖尿病DALY有随时间延长而增长的趋势(u=2.92,P＜0.01),利用灰色动态模型预测2012-2013年徐汇区80岁以下糖尿病的每千人DALY分别为7.66、8.26. [结论]该区糖尿病疾病负担较重,糖尿病所致残疾负担较死亡负担严重,男性疾病负担有上升的趋势.     

Measuring the Burden of Disease in Korea, 2008-2018

The study aims to examine the current status and differences in the burden of disease in Korea during 2008-2018. We calculated the burden of disease for Koreans from 2008 to 2018 using an incidence-based approach. Disability adjusted life years (DALYs) were expressed in units per 100 000 population by adding years of life lost (YLLs) and years lived with disability (YLDs). DALY calculation results were presented by gender, age group, disease, region, and income level. To explore differences in DALYs by region and income level, we used administrative district and insurance premium information from the National Health Insurance Service claims data. The burden of disease among Koreans showed an increasing trend from 2008 to 2018. By 2017, the burden of disease among men was higher than that among women. Diabetes mellitus, low back pain, and chronic lower respiratory disease were ranked high in the burden of disease; the sum of DALY rates for these diseases accounted for 18.4% of the total burden of disease among Koreans in 2018. The top leading causes associated with a high burden of disease differed slightly according to gender, age group, and income level. In this study, we measured the health status of Koreans and differences in the population health level according to gender, age group, region, and income level. This data can be used as an indicator of health equity, and the results derived from this study can be used to guide community-centered (or customized) health promotion policies and projects, and for setting national health policy goals.