Faculty of Medicine, Primary Care Medicine Department, Universiti Teknologi MARA, Selangor, Malaysia; Centre for Adolescent Health, Royal Children's Hospital, Murdoch Children Research Institute, Parkville, Victoria, Australia.
Centre for Adolescent Health, Royal Children's Hospital, Murdoch Children Research Institute, Parkville, Victoria, Australia; Department of Paediatrics, The University of Melbourne, Parkville, Victoria, Australia; South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia; Burnet Institute, Melbourne, Australia.
J Adolesc Health. 2017 Oct;61(4):424-433. doi: 10.1016/j.jadohealth.2017.05.014. Epub 2017 Aug 31.
A rapid epidemiological transition in developing countries in Southeast Asia has been accompanied by major shifts in the health status of children and adolescents. In this article, mortality estimates in Malaysian children and adolescents from 1990 to 2013 are used to illustrate these changes.
All-cause and cause-specific mortality estimates were obtained from the 2013 Global Burden of Disease Study. Data were extracted from 1990 to 2013 for the developmental age range from 1 to 24 years, for both sexes. Trends in all-cause and cause-specific mortality for the major epidemiological causes were estimated.
From 1990 to 2013, all-cause mortality decreased in all age groups. Reduction of all-cause mortality was greatest in 1- to 4-year-olds (2.4% per year reduction) and least in 20- to 24-year-olds (.9% per year reduction). Accordingly, in 2013, all-cause mortality was highest in 20- to 24-year-old males (129 per 100,000 per year). In 1990, the principal cause of death for 1- to 9-year boys and girls was vaccine preventable diseases. By 2013, neoplasms had become the major cause of death in 1-9 year olds of both sexes. The major cause of death in 10- to 24-year-old females was typhoid in 1990 and neoplasms in 2013, whereas the major cause of death in 10- to 24-year-old males remained road traffic injuries.
The reduction in mortality across the epidemiological transition in Malaysia has been much less pronounced for adolescents than younger children. The contribution of injuries and noncommunicable diseases to adolescent mortality suggests where public health strategies should focus.
东南亚发展中国家快速的流行病学转变伴随着儿童和青少年健康状况的重大变化。本文利用马来西亚儿童和青少年 1990 年至 2013 年的死亡率估计值来说明这些变化。
所有原因和特定原因的死亡率估计值均来自 2013 年全球疾病负担研究。从 1990 年到 2013 年，为两性从 1 岁到 24 岁的发育年龄范围提取数据。估计了主要流行病学原因的所有原因和特定原因死亡率的趋势。
1990 年至 2013 年，所有年龄段的全因死亡率均下降。1 至 4 岁儿童的全因死亡率降幅最大（每年减少 2.4%），20 至 24 岁儿童降幅最小（每年减少 0.9%）。因此，2013 年 20 至 24 岁男性全因死亡率最高（每年每 10 万人 129 人）。1990 年，1 至 9 岁男孩和女孩的主要死因是可通过疫苗预防的疾病。到 2013 年，肿瘤已成为两性 1 至 9 岁儿童的主要死因。1990 年 10 至 24 岁女性的主要死因是伤寒，2013 年是肿瘤，而 10 至 24 岁男性的主要死因仍是道路交通伤害。
马来西亚在流行病学转变过程中，青少年的死亡率下降幅度明显低于幼儿。伤害和非传染性疾病对青少年死亡率的影响表明，公共卫生战略应重点关注哪些方面。
