Clasen Thomas, Pruss-Ustun Annette, Mathers Colin D, Cumming Oliver, Cairncross Sandy, Colford John M
Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA; Department of Disease Control, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK.
Trop Med Int Health. 2014 Aug;19(8):884-93. doi: 10.1111/tmi.12330. Epub 2014 Jun 9.
The 2010 global burden of disease (GBD) study represents the latest effort to estimate the global burden of disease and injuries and the associated risk factors. Like previous GBD studies, this latest iteration reflects a continuing evolution in methods, scope and evidence base. Since the first GBD Study in 1990, the burden of diarrhoeal disease and the burden attributable to inadequate water and sanitation have fallen dramatically. While this is consistent with trends in communicable disease and child mortality, the change in attributable risk is also due to new interpretations of the epidemiological evidence from studies of interventions to improve water quality. To provide context for a series of companion papers proposing alternative assumptions and methods concerning the disease burden and risks from inadequate water, sanitation and hygiene, we summarise evolving methods over previous GBD studies. We also describe an alternative approach using population intervention modelling. We conclude by emphasising the important role of GBD studies and the need to ensure that policy on interventions such as water and sanitation be grounded on methods that are transparent, peer-reviewed and widely accepted.
2010年全球疾病负担（GBD）研究是估算全球疾病和伤害负担以及相关风险因素的最新努力。与以往的GBD研究一样，这次最新的研究反映了方法、范围和证据基础的持续演变。自1990年首次开展GBD研究以来，腹泻病负担以及因水和环境卫生不足所致的负担已大幅下降。虽然这与传染病趋势和儿童死亡率一致，但归因风险的变化也归因于对改善水质干预措施研究的流行病学证据的新解释。为了给一系列配套论文提供背景信息，这些论文提出了关于水、环境卫生和个人卫生不足导致的疾病负担及风险的替代假设和方法，我们总结了以往GBD研究中不断演变的方法。我们还描述了一种使用人群干预模型的替代方法。我们在结论中强调了GBD研究的重要作用，以及确保诸如水和环境卫生等干预措施的政策基于透明、经过同行评审且被广泛接受的方法的必要性。
