Zeng T, Lü S, Tian L, Li S, Sun L, Jia T
National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention (Chinese Center for Tropical Diseases Research), National Health Commission Key Laboratory of Parasite and Vector Biology, WHO Collaborating Centre for Tropical Diseases, National Center for International Research on Tropical Diseases, Shanghai 200025, China.
Jiangsu Institute of Parasitic Diseases, China.
Zhongguo Xue Xi Chong Bing Fang Zhi Za Zhi. 2023 Mar 6;35(1):7-14. doi: 10.16250/j.32.1374.2023001.
To analysize the temporal trends in the disease burden of major human parasitic diseases in China from 1990 to 2019, so as to provide the evidence for improving the parasitic disease control strategy in China.
The disability-adjusted life years (DALYs) of malaria, intestinal nematode infections, schistosomiasis, food-borne trematodiases, cysticercosis and echinococcosis in China from 1990 to 2019 were captured from the Global Burden of Disease Study 2019 (GBD 2019), and age- and gender-specific DALYs of parasitic diseases were estimated. The temporal trends in DALYs of malaria, intestinal nematode infections, schistosomiasis, food-borne trematodiases, cysticercosis and echinococcosis were evaluated in China from 1990 to 2019 using average annual percent change (AAPC) with Joinpoint regression analysis.
The DALYs were 643 836.42 person-years due to food-borne trematodiases, 156 853.03 person-years due to cysticercosis, 79 764.62 person-years due to schistosomiasis, 70 989.73 person-years due to intestinal nematode infections, 4 258.61 person-years due to echinococcosis and 264.86 person-years due to malaria in China in 2019, respectively. The overall DALYs of six parasitic diseases were higher among men (546 441.93 person-years) than among women (409 525.33 person-years), and were greater among adults at ages of 14 to 65 years (684 780.84 person-years) than among children at 14 years and lower (35 437.38 person-years) and the elderly at ages of 65 years and older (235 749.04 person-years). During the period from 1990 to 2019, food-borne trematodiases were the leading cause of DALYs among the six parasitic diseases, and cysticercosis shifted from the fourth leading cause in 1990 to the second leading cause of DALYs in China in 2019, while intestinal nematode infections shifted from the second leading cause in 1990 to the fourth leading cause of DALYs in 2019. The DALYs of major human parasitic diseases appeared an overall tendency towards a decline in China from 1990 to 2019, with the fastest drop seen in DALYs due to malaria (AAPC = -19.6%, = 0.003), followed by due to intestinal nematode infections (AAPC = -8.2%, < 0.001) and schistosomiasis (AAPC = -3.1%, < 0.001), and a slow decline was seen in the DALYs of food-borne trematodiases (AAPC = -1.0%, < 0.001), while there were no significant decrease in the DALYs of echinococcosis (AAPC = -0.5%, = 0.264) and the DALYs of cysticercosis appeared a tendency towards a rise (AAPC = 0.7%, < 0.001).
The disease burden of major human parasitic diseases appeared an overall tendency towards a decline in China from 1990 to 2019, with a high disease burden seen due to food-borne parasitic diseases, no remarkable reduction seen in echinococcosis, and a tendency towards a rise seen in cysticercosis. It is recommended to focus on echinococcosis control, and continue to consolidate the control achievements of other major human parasitic diseases in China; meanwhile, the surveillance and prevention of food-borne parasitic diseases should be reinforced.
分析1990年至2019年中国主要人体寄生虫病疾病负担的时间趋势，为完善中国寄生虫病防治策略提供依据。
从《2019年全球疾病负担研究》（GBD 2019）中获取1990年至2019年中国疟疾、肠道线虫感染、血吸虫病、食源性吸虫病、囊尾蚴病和棘球蚴病的伤残调整生命年（DALYs），并估算寄生虫病的年龄和性别特异性DALYs。采用平均年度百分比变化（AAPC）结合Joinpoint回归分析评估1990年至2019年中国疟疾、肠道线虫感染、血吸虫病、食源性吸虫病、囊尾蚴病和棘球蚴病DALYs的时间趋势。
2019年中国食源性吸虫病所致DALYs为643 836.42人年，囊尾蚴病所致为156 853.03人年，血吸虫病所致为79 764.62人年，肠道线虫感染所致为70 989.73人年，棘球蚴病所致为4 258.61人年，疟疾所致为264.86人年。六种寄生虫病的总体DALYs男性（546 441.93人年）高于女性（409 525.33人年），14至65岁成年人（684 780.84人年）高于14岁及以下儿童（35 437.38人年）和65岁及以上老年人（235 749.04人年）。在1990年至2019年期间，食源性吸虫病是六种寄生虫病中DALYs的主要原因，囊尾蚴病从1990年的第四大原因转变为2019年中国DALYs的第二大原因，而肠道线虫感染从1990年的第二大原因转变为2019年DALYs的第四大原因。1990年至2019年中国主要人体寄生虫病的DALYs总体呈下降趋势，其中疟疾下降最快（AAPC = -19.6%，P = 0.003），其次是肠道线虫感染（AAPC = -8.2%，P < 0.001）和血吸虫病（AAPC = -3.1%，P < 0.001），食源性吸虫病DALYs呈缓慢下降趋势（AAPC = -1.0%，P < 0.001），而棘球蚴病DALYs无显著下降（AAPC = -0.5%，P = 0.264），囊尾蚴病DALYs呈上升趋势（AAPC = 0.7%，P < 0.001）。
1990年至2019年中国主要人体寄生虫病疾病负担总体呈下降趋势，食源性寄生虫病疾病负担较高，棘球蚴病下降不明显，囊尾蚴病呈上升趋势。建议重点防控棘球蚴病，继续巩固中国其他主要人体寄生虫病的防治成果；同时，加强食源性寄生虫病的监测与预防。
