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中国艾滋病趋势预测:基于 2019 年全球疾病负担研究与 G20 国家的比较分析。

The trend of AIDS in China: A prediction and comparative analysis with G20 countries based on the Global Burden of Disease Study 2019.

机构信息

Clinical Nursing Teaching and Research Section, the Second Xiangya Hospital, Central South University, Changsha, Hunan, China.

Xiangya Nursing School, Central South University, Changsha, Hunan, China.

出版信息

J Glob Health. 2024 Mar 1;14:04029. doi: 10.7189/jogh.14.04029.

Abstract

BACKGROUND

In China, AIDS has become the most severe notifiable infectious disease. The study aimed to analyse and predict the trend of AIDS in China and compared with Group of Twenty (G20) countries.

METHODS

We utilised incidence, mortality or disability-adjusted life years (DALY), age-standardised rates (ASR), average annual percentage changes (AAPC) to estimate the trend via GBD 2019. The Joinpoint regression analysis was applied to identify the most significant years of change. We explored the relationship between AAPC and social development index (SDI) or health care access and quality (HAQ), and predicted trends for the next 20 years.

RESULTS

The DALY in G20 increase of 340.42%, and 794.50% in China. The age-standardised DALY rate (ASDR) in G20 was 309.49 (95% uncertainty interval (UI) = 284.69, 350.58) in 2019, with an AAPC of 4.30. Among G20, the United States had the highest DALY in 1990, but it experienced a significant decline. In China, the ASDR was 98.15 (95% UI = 78.78, 119.58) with the 5th AAPC ranking. In term of gender, the incidence, mortality, DALY, and ASR of them in China and G20 were all higher in males. Furthermore, the gender gap in China had been widening. The most significant periods of ASDR increase in China were 1990-1995 and 2013-2016, and 1990-1994 in G20. The prediction for DALY indicated that high SDI countries were expected to exhibit a stable or declining trend, while low SDI countries showed an upward trend. China demonstrated a 57.66% increase in 2040 compared to 2019.

CONCLUSIONS

AIDS continues to be a significant burden. In China, the ASIR exhibited a decline trend in certain age groups, while the ASMR and ASDR continued to increase, with a widening gender disparity. In addition, according to our predict results, some countries could not achieve the 2030 Agenda for Sustainable Development set by the UNAIDS. Therefore, it is necessary to establish more effective and targeted measures, as well as actively explore new treatment approaches.

摘要

背景

在中国,艾滋病已成为最严重的法定传染病。本研究旨在分析和预测中国艾滋病的趋势,并与二十国集团(G20)国家进行比较。

方法

我们利用发病率、死亡率或伤残调整生命年(DALY)、年龄标化率(ASR)、年均变化百分比(AAPC),通过 GBD 2019 来估计趋势。采用 Joinpoint 回归分析确定变化最显著的年份。我们探讨了 AAPC 与社会发展指数(SDI)或卫生保健可及性和质量(HAQ)之间的关系,并预测了未来 20 年的趋势。

结果

G20 国家的 DALY 增加了 340.42%,中国增加了 794.50%。2019 年,G20 国家的年龄标化 DALY 率(ASDR)为 309.49(95%不确定区间(UI)=284.69,350.58),AAPC 为 4.30。在 G20 国家中,美国在 1990 年的 DALY 最高,但呈显著下降趋势。在中国,ASDR 为 98.15(95% UI=78.78,119.58),AAPC 排名第五。在性别方面,中国和 G20 国家艾滋病的发病率、死亡率、DALY 和 ASR 均高于男性。此外,中国的性别差距一直在扩大。中国 ASDR 增长最显著的时期是 1990-1995 年和 2013-2016 年,以及 G20 国家的 1990-1994 年。DALY 的预测表明,高 SDI 国家预计呈稳定或下降趋势,而低 SDI 国家呈上升趋势。与 2019 年相比,中国在 2040 年预计将增长 57.66%。

结论

艾滋病仍是一个重大负担。在中国,某些年龄组的艾滋病发病率呈下降趋势,而死亡率和伤残调整生命年(DALY)率继续上升,性别差距扩大。此外,根据我们的预测结果,一些国家可能无法实现联合国艾滋病规划署设定的 2030 年可持续发展议程。因此,有必要制定更有效和有针对性的措施,并积极探索新的治疗方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/852b/10906135/1c6d94288c01/jogh-14-04029-F1.jpg

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