全球疾病负担研究中的非致命负担估计值可用于当地吗？南非对中风和糖尿病模型的调查。

Can non-fatal burden estimates from the Global Burden of Disease study be used locally? An investigation using models of stroke and diabetes for South Africa.

机构信息

Burden of Disease Research Unit, South African Medical Research Council , Cape Town, South Africa.

School of Population and Global Health, The University of Western Australia , Australia.

出版信息

Glob Health Action. 2021 Jan 1;14(1):1856471. doi: 10.1080/16549716.2020.1856471.

DOI:10.1080/16549716.2020.1856471

PMID:33393896

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7801091/

Abstract

: The Global Burden of Disease (GBD) approach estimates disease burden by combining fatal (years of life lost) and non-fatal burden prevalence-based years of life lived with disability (PYLDs) estimates. Although South Africa has data to estimate mortality, prevalence data to estimate non-fatal burden are sparse. PYLD estimates from the GBD study for South Africa can potentially be used. However, there is a divergence in mortality estimates for South Africa between the second South African National Burden of Disease (SANBD2) and 2013 GBD studies. : We investigated the feasibility of utilising GBD PYLD estimates for stroke and diabetes by exploring different disease modelling scenarios. : DisMod II software-generated South African stroke and diabetes PYLDs for 2010 from models using local epidemiological parameters and demographic data for people 20-79 years old. We investigated the impact on PYLD estimates of 1) differences in the cause-of-death envelope, 2) differences in the cause-specific mortality estimates (increase/decrease by 15% for stroke and 30% for diabetes), and 3) difference using local disease parameters compared to other country or region parameters. Differences were expressed as ratios, average ratios and ratio ranges. : Using the GBD cause-of-death envelope (16% more deaths than SANBD2) and holding other parameters constant yielded age-specific ratios of PYLDs for stroke and diabetes ranging between 0.89 and 1.07 (average 0.98) for males. Similar results were observed for females. A 15% change in age-specific stroke mortality showed little difference in the ratio comparison of PYLDs (range 0.98-1.02) while a 30% change in age-specific diabetes mortality resulted in a ratio range of 0.96-1.07 for PYLDs depending on age. : This study showed that GBD non-fatal burden estimates (PYLDs) can be used for stroke and diabetes non-fatal burden in the SANBD2 study.

摘要

全球疾病负担（GBD）方法通过结合致命性（损失的生命年）和基于流行率的非致命性残疾生命年（PYLD）估计来评估疾病负担。虽然南非有数据来估计死亡率，但用于估计非致命性负担的流行率数据却很少。GBD 研究中南非的 PYLD 估计值可以被使用。然而，南非的死亡率估计值在第二次南非国家疾病负担（SANBD2）和 2013 年 GBD 研究之间存在差异。

我们通过探索不同的疾病建模方案，研究了利用 GBD PYLD 估计值来评估中风和糖尿病的可行性。

使用 DisMod II 软件生成的南非 2010 年中风和糖尿病的 PYLD 数据，模型使用了当地 20-79 岁人群的流行病学参数和人口数据。我们研究了以下三种情况对 PYLD 估计值的影响：1）死因范围的差异；2）特定病因死亡率估计值的差异（中风增加/减少 15%，糖尿病增加/减少 30%）；3）使用当地疾病参数与其他国家或地区参数的差异。差异用比值、平均比值和比值范围表示。

使用 GBD 的死因范围（比 SANBD2 多 16%的死亡人数），并保持其他参数不变，对于男性，中风和糖尿病的特定年龄 PYLD 比值在 0.89 到 1.07 之间（平均为 0.98）。对于女性，也观察到了类似的结果。在特定年龄的中风死亡率变化 15%的情况下，PYLD 比值的比较差异很小（比值范围为 0.98-1.02），而特定年龄的糖尿病死亡率变化 30%的情况下，PYLD 的比值范围为 0.96-1.07，取决于年龄。

本研究表明，GBD 的非致命性负担估计值（PYLD）可用于 SANBD2 研究中的中风和糖尿病非致命性负担。