Information, Evidence and Research Cluster, World Health Organization, Geneva, Switzerland.
PLoS Negl Trop Dis. 2007 Nov 7;1(2):e114. doi: 10.1371/journal.pntd.0000114.
Reliable, comparable information about the main causes of disease and injury in populations, and how these are changing, is a critical input for debates about priorities in the health sector. Traditional sources of information about the descriptive epidemiology of diseases, injuries, and risk factors are generally incomplete, fragmented, and of uncertain reliability and comparability. The Global Burden of Disease (GBD) study has provided a conceptual and methodological framework to quantify and compare the health of populations using a summary measure of both mortality and disability, the disability-adjusted life year (DALY).This paper describes key features of the Global Burden of Disease analytic approach, which provides a standardized measurement framework to permit comparisons across diseases and injuries, as well as risk factors, and a systematic approach to the evaluation of data. The paper describes the evolution of the GBD, starting from the first study for the year 1990, summarizes the methodological improvements incorporated into GBD revisions for the years 2000-2004 carried out by the World Health Organization, and examines priorities and issues for the next major GBD study, funded by the Bill & Melinda Gates Foundation, and commencing in 2007.The paper presents an overview of summary results from the Global Burden of Disease study 2002, with a particular focus on the neglected tropical diseases, and also an overview of the comparative risk assessment for 26 global risk factors. Taken together, trypanosomiasis, Chagas disease, schistosomiasis, leishmaniasis, lymphatic filariasis, onchocerciasis, intestinal nematode infections, Japanese encephalitis, dengue, and leprosy accounted for an estimated 177,000 deaths worldwide in 2002, mostly in sub-Saharan Africa, and about 20 million DALYs, or 1.3% of the global burden of disease and injuries. Further research is currently underway to revise and update these estimates.
可靠、可比的人群疾病和伤害主要病因信息，以及这些病因的变化趋势，是卫生部门优先事项讨论的重要依据。传统的疾病、伤害和危险因素描述性流行病学信息来源通常是不完整、零散的，并且可靠性和可比性不确定。全球疾病负担（GBD）研究提供了一个概念和方法框架，使用死亡率和失能率的综合衡量指标（伤残调整生命年[DALY]）来量化和比较人群的健康状况。本文描述了全球疾病负担分析方法的主要特点，该方法提供了标准化的衡量框架，允许对疾病和伤害以及风险因素进行比较，并提供了一种系统的方法来评估数据。本文描述了 GBD 的演变，从第一个 1990 年的研究开始，总结了世界卫生组织进行的 2000-2004 年 GBD 修订中纳入的方法改进，并审查了下一次由比尔及梅琳达·盖茨基金会资助的、2007 年开始的主要 GBD 研究的优先事项和问题。本文概述了 2002 年全球疾病负担研究的综合结果，特别关注被忽视的热带病，并概述了 26 种全球风险因素的相对风险评估。总的来说，2002 年全世界有 177,000 人死于锥虫病、恰加斯病、血吸虫病、利什曼病、丝虫病、盘尾丝虫病、肠道线虫感染、日本脑炎、登革热和麻风病，主要在撒哈拉以南非洲，约 2000 万伤残调整生命年（DALY），占疾病和伤害全球负担的 1.3%。目前正在进行进一步的研究，以修订和更新这些估计。
