1990年与2013年中国0~14岁儿童伤害疾病负担分析

目的 分析1990年与2013年中国0~14岁儿童伤害疾病负担及变化情况。方法 利用2013年全球疾病负担中国及中国分省数据，采用死亡率和伤残调整寿命年（DALY）率等指标，分析1990年与2013年中国0~14岁儿童伤害疾病负担及变化情况。结果 2013年中国0~14岁儿童伤害死亡数为73 766人、死亡率为29.46/10万、DALY率为2 449.36/10万。男童伤害疾病负担各项指标均高于女童。各年龄组随着年龄增加伤害疾病负担逐渐降低。0~14岁儿童伤害死亡率和DALY率前5位地区均依次为新疆维吾尔自治区、西藏自治区、甘肃省、青海省和宁夏回族自治区。0~14岁儿童伤害死亡率和DALY率前三位伤害类型均为溺水、道路交通伤害和暴露于机械性力量。与1990年相比，0~14岁儿童伤害疾病负担各项指标均有明显下降，男童下降程度略低于女童，各年龄组也有不同程度下降，除宁夏回族自治区、云南省和重庆市以外，其余各地区0~14岁儿童伤害疾病负担均有不同程度的改善。结论 近年来中国0~14岁儿童伤害疾病负担有较明显改善，但伤害仍是中国0~14岁儿童面临的重要健康威胁之一。4岁以下男童的伤害疾病负担仍较严重，溺水和道路交通伤害是1~14岁儿童死亡的主要原因，部分地区需要进一步加强0~14岁儿童伤害防控工作。

Disease burden of injuries in children aged 0-14-year-old in 1990 and 2013, in China

Objective To analyze the disease burden of injuries in Chinese children aged between 0-14-year-old, in 1990 and 2013. Methods Data derived from the Global Burden of Disease 2013 was used to analyze the disease burden of injuries among children aged between 0-14-year-old in each province of China, using relevant indicators including mortality and the rate on disability-adjusted life years (DALY). Results In 2013, the number of deaths, rates on mortality and DALY caused by injuries in children aged between 0-14-year-old were 73 766, 29.46 per 100 000 and 2 449.36 per 100 000, respectively. Each indicator of injury burden appeared higher in boys than that in girls. With the increase of age, burden caused by injuries in each age group showed a decreasing trend. Provinces and autonomous regions as Xinjiang, Tibet, Gansu, Qinghai and Ningxia ranked the top 5 regions on both mortality rate and DALY rate among children aged between 0-14-year-old. The top 3 injury-related mortality rates and rate on DALY were drowning, road traffic injury and exposure to mechanic forces, among children. Compared to the disease burden of injuries in the 1990s, all indicators showed decreasing trends in children aged between 0-14-year-old, with girls more than boys, and variations in different age groups. In all areas of China, improvements were seen on intervention programs related to the injury-caused burden among children aged between 0-14-year-old, except for Ningxia, Yunnan and Chongqing. Conclusions During the last two decades, there had been significant improvements in reducing the injury-caused burden among the Chinese children aged between 0-14-year-old. However, injury is still the most important risk on health of children under 4-year-old, with boys in particular. Drowning and road traffic injury were the two leading causes of death in children aged between 1 and 14-year-old.