Epidemiology Group, Institute of Applied Health Sciences, School of Medicine and Dentistry, University of Aberdeen, Polwarth Building, Foresterhill, Aberdeen AB25 2ZD, UK.
Rheumatology (Oxford). 2014 Apr;53(4):650-7. doi: 10.1093/rheumatology/ket387. Epub 2013 Dec 9.
For effective health care provision, knowledge of disease prevalence is paramount. There has been no systematic endeavour to establish continent-based AS estimates, however, prevalence is thought to vary by country and background HLA-B27 prevalence. This study aimed to estimate AS prevalence worldwide and to calculate the expected number of cases.
A systematic literature search was conducted. Prevalence data were extracted and used to calculate the mean prevalence by continent and the expected number of cases based on country-specific prevalence (or, if missing, the prevalence from neighbouring countries). A second estimate was made using the prevalence from countries with similar HLA-B27 prevalences if a country-specific prevalence estimate was not available.
The mean AS prevalence per 10,000 (from 36 eligible studies) was 23.8 in Europe, 16.7 in Asia, 31.9 in North America, 10.2 in Latin America and 7.4 in Africa. Additional estimates, weighted by study size, were calculated as 18.6, 18.0 and 12.2 for Europe, Asia and Latin America, respectively. There were sufficient studies to estimate the number of cases in Europe and Asia, calculated to be 1.30-1.56 million and 4.63-4.98 million, respectively.
This study represents the first systematic attempt to collate estimates of AS prevalence into a single continent-based estimate. In addition, the number of expected cases in Europe and Asia was estimated. Through reviewing the current literature, it is apparent that the continuing conduct of epidemiological studies of AS prevalence is of great importance, particularly as diagnostic capabilities improve and with the recent development of the criteria for axial SpA.
为了提供有效的医疗保健，了解疾病的流行情况至关重要。然而，目前尚未进行系统的努力来确定基于大陆的 AS 估计值，因为流行情况被认为因国家和背景 HLA-B27 流行情况而异。本研究旨在估计全球 AS 的流行情况并计算预期病例数。
进行了系统的文献检索。提取流行数据并用于按大陆计算平均流行率，并根据特定国家的流行率（或如果缺失，则根据邻国的流行率）计算预期病例数。如果无法获得特定国家的流行率估计值，则使用具有相似 HLA-B27 流行率的国家的流行率进行第二次估计。
每 10,000 人中 AS 的平均流行率（来自 36 项合格研究）在欧洲为 23.8，亚洲为 16.7，北美为 31.9，拉丁美洲为 10.2，非洲为 7.4。按研究规模加权的其他估计值分别为欧洲、亚洲和拉丁美洲的 18.6、18.0 和 12.2。有足够的研究来估计欧洲和亚洲的病例数，分别计算为 130-156 万和 463-498 万。
本研究代表了首次尝试将 AS 流行率的估计值汇总到单一基于大陆的估计值中。此外，还估计了欧洲和亚洲的预期病例数。通过回顾当前的文献，很明显，继续进行 AS 流行率的流行病学研究非常重要，特别是随着诊断能力的提高以及最近制定了轴性 SpA 的标准。
