全球、区域和国家层面 1990 年至 2021 年与儿童和青少年乙型肝炎相关的总负担。

Global, regional, and national total burden related to hepatitis B in children and adolescents from 1990 to 2021.

机构信息

School of Public Health, Shanxi Medical University, Taiyuan, China.

Center of Clinical Epidemiology and Evidence Based Medicine, Shanxi Medical University, Taiyuan, China.

出版信息

BMC Public Health. 2024 Oct 23;24(1):2936. doi: 10.1186/s12889-024-20462-4.

DOI:10.1186/s12889-024-20462-4

PMID:39443929

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11515762/

Abstract

BACKGROUND

Hepatitis B remains a significant global health concern with widespread communicability. Nevertheless, data on its burden and trends in children and adolescents were limited. We aim to evaluate the global, regional, and national trends of total burden related to hepatitis B in children and adolescents aged 0-19 years from 1990 to 2021.

METHODS

The age-standardized incidence, prevalence, mortality, and disability-adjusted life years (DALYs) were calculated by the Global Burden of Disease (GBD) study from 1990 to 2021. These indicators were stratified by sex, age, socio-demographic index (SDI), and disease stage. We calculated the correlation between them and SDI. The temporal trends were examined using the annual average percentage change (AAPC) and joinpoint regression.

RESULTS

The global age-standardized incidence of hepatitis B in children and adolescents decreased from 1385.20 per 100,000 population in 1990 to 418.68 per 100,000 population in 2021, with an AAPC of -3.76%. Similarly, age-standardized DALYs decreased from 70.78 per 100,000 population to 36.31 per 100,000 population, with an AAPC of -2.13%. The age-standardized prevalence (AAPC - 3.53%) and mortality (AAPC - 2.09%) of hepatitis B also decreased significantly. From 1990 to 2021, the age-standardized incidence and prevalence among males exhibited a higher trend compared to females, although both declined over time. These two indicators also decreased across all age subgroups, with consistently higher rates observed in the 15-19 age group compared to other age groups. The burden of hepatitis B demonstrated a notable reduction in countries with high-middle SDI, while it was highest in countries with low SDI. In 2021, Central sub-Saharan Africa and West sub-Saharan Africa reported the highest age-standardized incidence. For age-standardized DALYs, South Asia was the only region to experience an increase (AAPC 1.09%), while East Asia showed the largest decline (AAPC - 7.58%). Alcohol and drug use remained important risk factors for DALYs among people aged 15-19 years. Furthermore, the impact of drug use on disease burden was increasing, particularly in high-SDI countries.

CONCLUSIONS

The global burden and trends of hepatitis B decreased significantly in children and adolescents, exhibiting regional and national variations. Management of alcohol and drug use remains a major challenge for people aged 15-19 years.

摘要

背景

乙型肝炎仍然是一个全球性的健康问题，具有广泛的传染性。然而，关于儿童和青少年乙型肝炎负担和趋势的数据有限。我们旨在评估 1990 年至 2021 年期间，全球 0-19 岁儿童和青少年乙型肝炎相关总负担的全球、区域和国家趋势。

方法

全球疾病负担（GBD）研究使用年龄标准化发病率、患病率、死亡率和伤残调整生命年（DALYs）来计算。这些指标按性别、年龄、社会人口指数（SDI）和疾病阶段进行分层。我们计算了它们之间的相关性及其与 SDI 的相关性。使用年度平均百分比变化（AAPC）和联合回归分析来检查时间趋势。

结果

全球儿童和青少年乙型肝炎的年龄标准化发病率从 1990 年的每 10 万人 1385.20 例下降到 2021 年的每 10 万人 418.68 例，AAPC 为-3.76%。同样，年龄标准化 DALYs 从每 10 万人 70.78 例下降到每 10 万人 36.31 例，AAPC 为-2.13%。乙型肝炎的年龄标准化患病率（AAPC-3.53%）和死亡率（AAPC-2.09%）也显著下降。1990 年至 2021 年间，男性的年龄标准化发病率和患病率呈上升趋势，而女性则呈下降趋势。这两个指标在所有年龄组中均呈下降趋势，15-19 岁年龄组的发病率和患病率始终高于其他年龄组。乙型肝炎的负担在中高 SDI 国家显著降低，而在 SDI 较低的国家最高。2021 年，中撒哈拉非洲和西撒哈拉非洲报告了最高的年龄标准化发病率。在年龄标准化 DALYs 方面，只有南亚呈上升趋势（AAPC 1.09%），而东亚则呈最大下降趋势（AAPC-7.58%）。酒精和药物使用仍然是 15-19 岁人群 DALYs 的重要危险因素。此外，药物使用对疾病负担的影响在增加，尤其是在高 SDI 国家。