1990 年至 2019 年北非和中东地区神经障碍的流行病学特征：2019 年全球疾病负担研究结果。

Epidemiological Features of Neurological Disorders in North Africa and the Middle East from 1990 to 2019: Results from the Global Burden of Disease Study 2019.

机构信息

Behavioral Disease Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran.

出版信息

Arch Iran Med. 2023 Feb 1;26(2):76-85. doi: 10.34172/aim.2023.13.

DOI:10.34172/aim.2023.13

PMID:37543927

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10685897/

Abstract

BACKGROUND

The burden of neurological disorders increases with population growth and aging and nearly three-quarters of the global burden of neurological disorders has been reported in low- and middle-income countries. Therefore, this study aimed to report the epidemiological features and the burden of neurological disorders in North Africa and the Middle East (NAME) countries.

METHODS

The study population included 21 countries in the NAME region with a population of more than 600 million. The Global Burden of Disease (GBD) 2019 database was used. In GBD 2019, neurological disorders are classified into 7 diseases and injuries. Incidence rates, prevalence rates, death rates, disability adjusted life years (DALYs) rates by age-standardized rate (ASR) per 100000 people were measured. Also, the attributed burden to high body mass index (BMI), high fasting plasma glucose, smoking, and alcohol use were reported.

RESULTS

The highest incidence rates of neurological disorders in 2019 were in Iran 11293.27 (95% UI, 10132.62-12499.59) and Egypt 10257.33 (95% UI, 9189.37-11341.16), respectively, and the highest mortality 41.12 (95% UI, 17.68-92.44) and DALYs 1503.0 (95% UI, 853.8-2492.15) rates were in Afghanistan. In NAME region, the incidence and prevalence rate of neurological disorders increased by 0.84% (10006.37 to 10090.79) and 1.36% (33711.72 to 34170.57) respectively, while the mortality and DALYs rate decreased by 2.75% (34.11 to 33.17) and 3.92% (1438.48 to 1382.14) between 1990 and 2019. The highest decrement of the neurological disorders-related DALYs with a 10.10% decrement pertained to Afghanistan (1671.86 to 1503). The highest increment of the neurological disorders-related DALYs with a 1.89% increment pertained to Morocco (1330.69 to 1355.83). The highest attributed DALYs to alcohol use pertained to Turkey 9.8 (95% UI, 4.23-18.05). The highest attributed DALYs to high BMI 112.23 (95% UI, 29.3-285.75) and high fasting plasma glucose 100.36 (95% UI, 18.79-302.85) pertained to Qatar. The highest attributed DALYs to smoking pertained to Lebanon 106.34 (95% UI, 37.65-253.87). Most DALYs were associated with those aged 75 years and more.

CONCLUSION

Despite progressive reduction in death due to neurological disorders in the NAME region in recent decades, there was a considerable and increasing number of people affected by different neurological disorders. As populations age, societies will face more challenges regarding prevention, detection, treatment, and rehabilitation.

摘要

背景

随着人口增长和老龄化，神经障碍的负担日益加重，全球近四分之三的神经障碍负担发生在中低收入国家。因此，本研究旨在报告北非和中东（NAME）国家的神经障碍流行病学特征和负担。

方法

研究人群包括 NAME 地区 21 个国家，人口超过 6 亿。使用全球疾病负担（GBD）2019 数据库。在 GBD 2019 中，神经障碍分为 7 种疾病和损伤。以年龄标准化率（ASR）每 100000 人衡量发病率、患病率、死亡率、残疾调整生命年（DALYs）率。此外，还报告了归因于高体重指数（BMI）、高空腹血糖、吸烟和饮酒的负担。

结果

2019 年神经障碍发病率最高的国家分别为伊朗 11293.27（95%置信区间 10132.62-12499.59）和埃及 10257.33（95%置信区间 9189.37-11341.16），死亡率和 DALYs 最高的国家分别为阿富汗 41.12（95%置信区间 17.68-92.44）和 1503.0（95%置信区间 853.8-2492.15）。在 NAME 地区，神经障碍的发病率和患病率分别增加了 0.84%（从 10006.37 增加到 10090.79）和 1.36%（从 33711.72 增加到 34170.57），而死亡率和 DALYs 率则分别下降了 2.75%（从 34.11 下降到 33.17）和 3.92%（从 1438.48 下降到 1382.14）。1990 年至 2019 年期间，与神经障碍相关的 DALYs 减少最多的是阿富汗（减少 10.10%，从 1671.86 减少到 1503）。与神经障碍相关的 DALYs 增加最多的是摩洛哥（增加 1.89%，从 1330.69 增加到 1355.83）。归因于饮酒的 DALYs 最高的是土耳其 9.8（95%置信区间 4.23-18.05）。归因于高 BMI 的 DALYs 最高的是卡塔尔 112.23（95%置信区间 29.3-285.75）和高空腹血糖 100.36（95%置信区间 18.79-302.85）。归因于吸烟的 DALYs 最高的是黎巴嫩 106.34（95%置信区间 37.65-253.87）。大多数 DALYs 与 75 岁及以上的人群有关。