中国 1990-2019 年 14 岁以下儿童交通伤害负担及危险因素变化趋势
Trends in transport injuries burden and risk factors among children under 14 years old in China: 1990-2019.
机构信息
School of Public Health, Shantou University, No. 243 Daxue Road, Shantou, 515063, Guangdong, China.
Injury Prevention Research Center, Shantou University Medical College, No.22 Xinling Road, Shantou, 515041, Guangdong, China.
出版信息
BMC Public Health. 2024 Aug 21;24(1):2273. doi: 10.1186/s12889-024-19755-5.
BACKGROUND
Transport injuries (TI) remains one of leading causes of death in children in China. This study aimed to analyze the temporal trend of disease burden and associated risk factors of TI among children aged 0-14 years in China, utilizing data from 1990 to 2019.
METHODS
We retrieved data of disease burden and risk factors of TI among children aged 0-14 year in China from 1990 to 2019 from the Global Burden of Disease (GBD) dataset. We estimated incidence rate, death rate, and disability adjusted life years (DALYs) rate with a 95% uncertainty interval (95% UI), stratified by age, sex, and all type-road users. Trends in disease burden with annual percentage changes (APC) and average annual percent change (AAPC) were performed by Joinpoint regression model.
RESULTS
The incidence rate (AAPC = 1.18%, P < 0.001) of TI among children aged 0-14 years showed an increasing trend, whereas mortality rate (AAPC = -3.87%, P < 0.001) and DALYs rate (AAPC = -3.83%, P < 0.001) decreased annually. Notably, boys experienced a higher increase in incidence (1.30%) compared to girls (1.06%), but a faster decrease in mortality and DALYs rate (-3.90% vs. -3.82%, -3.88% vs. -3.79%, respectively) (P < 0.001). Declines in death rates and DALYs rates were observed across all age groups (P < 0.001), while remained the highest among children aged 0-4 in 2019. Among different road-type users, cyclist road injuries were identified as the primary cause of TI (182.3 cases per 100,000) while pedestrians were the group with the highest mortality (2.9 cases per 100,000) and DALYs rate (243 cases per 100,000) in 2019. Besides, alcohol use was a significant risk factors for TI, while low temperature appeared to be a protective factor.
CONCLUSION
Future efforts must prioritize raising awareness among children and their guardians to mitigate the disease burden of TI in children. It's critical to enhance preventive interventions for boys, children aged 0-4 and vulnerable road users such as pedestrians and cyclists in future.
背景
交通伤害（TI）仍然是中国儿童死亡的主要原因之一。本研究旨在利用 1990 年至 2019 年中国疾病负担和危险因素监测系统的数据，分析中国 0-14 岁儿童 TI 的疾病负担的时间趋势及其相关危险因素。
方法
我们从全球疾病负担（GBD）数据库中检索了 1990 年至 2019 年中国 0-14 岁儿童 TI 的疾病负担和危险因素数据。我们用 95%置信区间（95%UI）分层计算了年龄、性别和所有类型道路使用者的发病率、死亡率和伤残调整生命年（DALYs）率。通过 Joinpoint 回归模型，用年度百分比变化（APC）和平均年度百分比变化（AAPC）来评估疾病负担的变化趋势。
结果
0-14 岁儿童 TI 的发病率（AAPC=1.18%，P<0.001）呈上升趋势，而死亡率（AAPC=-3.87%，P<0.001）和 DALYs 率（AAPC=-3.83%，P<0.001）则呈逐年下降趋势。值得注意的是，男孩的发病率上升幅度（1.30%）高于女孩（1.06%），但死亡率和 DALYs 率的下降速度更快（-3.90%比-3.82%，-3.88%比-3.79%）（P<0.001）。所有年龄组的死亡率和 DALYs 率都呈下降趋势（P<0.001），但在 2019 年，0-4 岁儿童的死亡率和 DALYs 率仍处于最高水平。在不同道路类型的使用者中，骑车者的道路交通伤害是 TI 的主要原因（每 10 万人中有 182.3 例），而行人的死亡率（每 10 万人 2.9 例）和 DALYs 率（每 10 万人 243 例）最高。此外，饮酒是 TI 的一个重要危险因素，而低温似乎是一个保护因素。
结论
未来必须优先提高儿童及其监护人的意识，以减轻儿童 TI 的疾病负担。未来的重点必须放在增强男孩、0-4 岁儿童和弱势道路使用者（如行人、骑自行车的人）的预防干预措施上。
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