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.     

血吸虫病疾病负担的研究I慢性血吸虫病健康寿命损失年的计算与评价

目的探讨慢性血吸虫病疾病负担的评价指标及其计算方法。方法根据2004-2005年在湖区两县开展的血吸虫病流行病学专题调查数据分别计算居民不同年龄组、性别和流行村类型等的专属血吸虫病患病率。根据专题调查得出的年龄别伤残权重,按年龄和性别分层,求得健康寿命损失年（YLD）及YLD率,并推算两县的总体YLD。结果当涂县总体YLD为1056.26人年,汉寿县总体YLD为3967.43人年。两县一类村YLD占慢性血吸虫病疾病负担的37.95%,高年龄组和男性的YLD率较高。与非流行区比较,慢性血吸虫病给流行区人口平均增加了4.398人年/1000人（当涂县）和1.505人年/1000人（汉寿县）的疾病负担。结论对慢性血吸虫病YLD进行评价,有助于确定重点干预地区和人群,并可为干预措施的效果评价等提供新指标。     

血吸虫病疾病负担研究II慢性血吸虫病健康不公平性的测量

目的对慢性血吸虫病所致的健康不公平性进行测量与评价。方法以湖区两县慢性血吸虫病的健康寿命损失年为基础数据,采用集中指数（曲线）和基尼系数（洛伦兹曲线）对慢性血吸虫病疾病负担在年龄和地区间的分布差异进行定量分析。结果女性和男性年龄集中指数分别为0.395和0.380,男女间无明显差异;仅占人口总数30%的45岁以上各人群疾病负担均约占各自总体的近60%。当涂县和汉寿县基尼指数分别为0.666和0.451,一类村和二类村的疾病负担占各县总量的60%以上。结论集中指数和基尼系数及相关曲线直观量化了慢性血吸虫病所致的健康不公平性,45岁以上人群和二类以上流行村是病情控制的重点。     

基于全球视角的中国骨关节炎疾病负担分析

目的 掌握我国30岁以上人群骨关节炎的疾病负担现状与趋势，发现重点人群，为制定骨关节炎综合防制策略提供科学依据。方法 利用全球疾病负担数据库2019（GBD 2019），对中国30岁以上人群按照性别、年龄分组描述骨关节炎的发病率、患病率、伤残损失健康生命年（Years lived with disability, YLD），并与全球和日本、印度进行比较，分析1990—2019年骨关节炎的疾病负担与其变化趋势。作图使用GraphPad Prism 8软件。结果 2019年，中国骨关节炎患病人数约1.33亿，所致YLD约472.49万人年，占中国全因YLD的3.07%，占全球骨关节炎导致YLD的24.93%；其发病率高峰在50～54岁年龄组，各年龄段女性发病率均约为男性的1.5倍。1990—2019年，中国骨关节炎发病率、患病率、YLD率均呈逐年上升趋势，2019年依次为750.96/10万、9337.15/10万、224.78/10万，较1990年分别增加93.62%、113.53%、116.13%，均远超同期日本、印度及全球的增幅；年龄标准化后的以上指标显示，中国骨关节炎疾病负担低于日本、高于印度、接近全球平均水平。结论 随着人口老龄化程度的加深，1990—2019年我国30岁以上人群骨关节炎疾病负担越来越重，一级预防重点人群为35岁以下和未患病人群，尤其是女性，可见制定科学有效的骨关节炎综合防制方案已迫在眉睫。     

某市居民主要恶性肿瘤疾病负担分析

摘要:目的　分析2014年某市居民主要恶性瘤疾病负担情况,为卫生行政部门制定肿瘤防治措施提供参考依据。方法　对2014年某市居民主要恶性肿瘤发病和死亡病例资料进行统计分析,利用全球疾病负担研究中使用的专门公式计算恶性肿瘤的死亡损失生命年（YLL）、伤残损失年（YLD）和伤残调整寿命年（DALY）评价该地居民主要恶性肿瘤的疾病负担。结果　该地居民由恶性肿瘤导致的疾病负担为每千人22.7251个DALYs,其中YLLs为17.2218,占75.78%,YLDs为5.5033,占24.22%。DALY前5位的恶性肿瘤为肝癌（26.59%）、肺癌（14.50%）、胃癌（7.91%）、宫颈癌（7.47%）、鼻咽癌（4.00%）,占到该市居民全部恶性肿瘤疾病负担的60.47%。男性居民由恶性肿瘤导致的疾病负担为女性的1.70倍,肝癌、肺癌、胃癌、肠癌、白血病的DALYs男性高于女性,而鼻咽癌、胰腺癌、淋巴癌的DALYs女性高于男性,男性与女性DALY顺位有所不同。结论　该市居民恶性肿瘤疾病负担主要由早死所致,肝癌、肺癌、胃癌、宫颈癌和鼻咽癌是恶性肿瘤防治的重点。     

Burden of musculoskeletal pain in Japan

Based on the prevalence of musculoskeletal pain in the context of interference with daily activities (IDA) and treatment for musculoskeletal disorders in the study population (n = 3188), we estimated the prevalence and years lived with disability (YLD) of musculoskeletal pain in Japan. The total of 42287 thousand (41.2%) of Japanese adult people was estimated to suffer from musculoskeletal pain. Among them, 9127 thousand was estimated to interfere with daily activities due to the pain. Overall YLD for musculoskeletal pain in Japan were estimated at 1297843.7 (1263.6 per 100000). The YLD for Pain without IDA were 33159.3 (32.3 per 100000) and the YLD for Pain with IDA were 1264684.4 (1231.3 per 100000). One-way sensitivity analysis showed that the YLD of musculoskeletal pain might increase to 4421844.0 (4305.2 per 100000) with the increased disability weight for Pain without IDA of 0.1, while they might inversely decrease to 1018875.0 (992.0 per 100000) with the increased treatment rate in Pain with IDA of 100%. Musculoskeletal pain imposes a substantial burden on the Japanese adult population. To allow the population to keep their health-related quality of life, health professionals should pay more attention to musculoskeletal pain and make positive efforts to improve prevention and control of musculoskeletal pain.     

杭州市和富阳县6种病失能寿命损失年（YLD）估算的探索

目的：探索失能寿命损失年（YLD）及权重的估算方法。方法：采用不同标准对6种疾病的失能权重进行了评估,并估算其失能寿命损失年（YLD）。结果：肺癌和精神分裂症评估得到的权重与世界银行的权重差异明显,肺结核和脑卒中判差别不明显,车祸和白内障的权重与世办银行的权重之间无可比性,结论：此次调查结果,无法判断在国内使用六级失能等级标准和七级失能等级标准的明显不同,为中国开展相应类型的研究提供了有价值的信息。     

The burden of cancer in New Zealand: a comparison of incidence and DALY metrics and its relevance for ethnic disparities

Aim : Cancer burden measured in disability adjusted life years (DALYs) captures survival and disability impacts of incident cancers. In this paper, we estimate the prospective burden of disease arising from 27 cancer sites diagnosed in 2006, by sex and ethnicity; and determine how its distribution differs from that for incidence rates alone. Methods : Using a prospective approach, Markov and cancer disease models were used to estimate DALYs with inputs of population counts, incidence and excess mortality rates, disability weights, and background mortality. DALYs were discounted at 3.5% per year. Results : The age standardised Māori:non‐Māori incidence rate ratios were 1.00 for males and 1.19 for females, whereas for DALYs they were greater at 1.42 for males and 1.68 for females. The total burden of cancer for 2006 incident cases (i.e. not age standardised) was estimated to be approximately 127,000 DALYs. Breast (27%), lung (14%) and colorectal (13%) cancers for females and lung (16%), colorectal (14%), and prostate (16%) cancers for males were the top contributors. By ethnicity, Māori experienced a substantially higher burden from lung cancer (around 25% for both sexes). Conclusions: Due to Māori both having higher rates of cancers with a worse survival (e.g. lung cancer), and tending to have worse survival for each cancer site, ethnic disparities in the age‐standardised DALY burden were greater than those for incidence (rate ratios of 1.52 and 1.07 respectively, sexes pooled).     

Health impact assessment of increasing public transport and cycling use in Barcelona: A morbidity and burden of disease approach

Objective

Quantify the health impacts on morbidity of reduced car trips and increased public transport and cycling trips.

Methods

A health impact assessment study of morbidity outcomes related to replacing car trips in Barcelona metropolitan (3,231,458 inhabitants). Through 8 different transport scenarios, the number of cases of disease or injuries related to physical activity, particulate matter air pollution < 2.5 μm (PM_2.5) and traffic incidents in travelers was estimated. We also estimate PM_2.5 exposure and cases of disease in the general population.

Results

A 40% reduction in long-duration car trips substituted by public transport and cycling trips resulted in annual reductions of 127 cases of diabetes, 44 of cardiovascular diseases, 30 of dementia, 16 minor injuries, 0.14 major injuries, 11 of breast cancer and 3 of colon-cancer, amounting to a total reduction of 302 Disability Adjusted Life Years per year in travelers. The reduction in PM_2.5 exposure in the general population resulted in annual reductions of 7 cases of low birth weight, 6 of preterm birth, 1 of cardiovascular disease and 1 of lower respiratory tract infection.

Conclusions

Transport policies to reduce car trips could produce important health benefits in terms of reduced morbidity, particularly for those who take up active transportation.     

血吸虫病疾病负担研究 Ⅳ 慢性血吸虫病的社区危险因素

目的 目的 探讨湖沼型流行区社区水平 （村级） 卫生经济因素与慢性血吸虫病疾病负担的关系。方法 方法 收集2004－ 2005年安徽当涂县和湖南汉寿县以行政村为单位的社会经济学资料, 建立慢性血吸虫病疾病负担伤残调整寿命年 （Years lived with disability,YLD） 数据。以每村家庭第一主成分的中位数代表各村的经济发展水平, 对中位数进行排序, 并分成5 等分, 再计算两个县YLD的经济集中指数; 以各样本村的每千人口YLD为因变量, 用多元回归分析对经济水平、 安全饮水、卫生厕所、 村与疫水的平均距离等社区卫生经济进行多因素分析。结果 结果 当涂县和汉寿县YLD的集中指数分别为-0.12 和0.03, YLD在村级经济水平间分布均衡; 当涂县与汉寿县社区经济 “最差、 较差、 中等、 较好、 最好” 分类的每千人YLD分别为5.87、 4.43、 3.38、 0.76人年/1 000人和0.76人年/1 000人与5.38、 11.80、 5.17、 8.19人年/1 000人和9.58人年/1 000人, 2个县村级经济水平与血吸虫病疾病负担呈非线性关系。多元回归分析显示, 行政村离疫水越远, YLD越小(P < 0.01), 人均水田面积越多YLD越大(P < 0.05)。结论 结论 社区经济水平与血吸虫病疾病负担呈非线性关系, 但村与疫水距离、 种植水田的面积与居民疾病负担关系密切。