Wang Haitao, Zhang Ping, Zhao Qi, Ma Wei
Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong Province, China.
Department of Infectious Disease Control and Prevention, Decheng District Center for Disease Control and Prevention, Dezhou, Shandong Province, China.
J Travel Med. 2024 Dec 10;31(8). doi: 10.1093/jtm/taae140.
Typhoid and paratyphoid fever, collectively known as enteric fever, are systemic infections caused by Salmonella enterica and are highly prevalent in children. We aimed to describe the global burden, trends and inequalities of enteric fever among children under 15 years from 1990 to 2019 based on data from the Global Burden of Diseases, Injuries, and Risk Factors Study 2019 (GBD 2019).
In this secondary analysis of GBD 2019, we extracted data for incident cases, deaths and disability-adjusted life-years (DALYs) as measures of enteric fever burden. We estimated the average annual percentage changes (AAPCs) in enteric fever incidence, mortality and DALYs rate to quantify trends over time. Cross-country inequalities in enteric fever incidence were measured using the slope index of inequality and concentration index.
In 2019, the global cases of typhoid and paratyphoid were 4 833 282 and 1 793 172, respectively, both lower than those in 1990. On secondary analysis, paratyphoid incidence decreased at a faster rate than typhoid from 1990 to 2009, whereas the incidence of paratyphoid (AAPC = -3.78, 95% CI: -4.07, -3.49) declined slower than that of typhoid (AAPC = -4.32, 95% CI: -4.50, -4.13) from 2010 to 2019 (P < 0.05) at the global level. The incidence burden of enteric fever increased in Australasia (AAPC = 1.28, 95% CI: 0.77, 1.78) and Western Europe (AAPC = 0.77, 95% CI: 0.44, 1.11). Death and DALYs burden in low socio-demographic index (SDI) region showed a stable trend. A significant reduction in SDI-related inequality occurred, with the concentration index falling from -0.31 in 1990 to -0.22 in 2019.
The global disease burden of enteric fever and the magnitude of inequalities across countries have declined since 1990, but low SDI countries remain a region of concern. Travellers from Oceania and Western Europe to endemic regions should be particularly aware of the risk of enteric fever.
伤寒和副伤寒热统称为肠热病，是由肠炎沙门氏菌引起的全身性感染，在儿童中高度流行。我们旨在根据《2019年全球疾病、伤害及危险因素负担研究》（GBD 2019）的数据，描述1990年至2019年15岁以下儿童肠热病的全球负担、趋势和不平等情况。
在这项对GBD 2019的二次分析中，我们提取了作为肠热病负担衡量指标的新发病例、死亡和伤残调整生命年（DALY）的数据。我们估计了肠热病发病率、死亡率和DALY率的年均百分比变化（AAPC），以量化随时间的趋势。使用不平等斜率指数和集中指数来衡量各国之间肠热病发病率的不平等情况。
2019年，全球伤寒和副伤寒病例分别为4833282例和1793172例，均低于1990年。在二次分析中，1990年至2009年期间，副伤寒发病率下降速度比伤寒快，而在全球范围内，2010年至2019年期间，副伤寒发病率（AAPC = -3.78，95%CI：-4.07，-3.49）下降速度比伤寒（AAPC = -4.32，95%CI：-4.50，-4.13）慢（P < 0.05）。在澳大拉西亚（AAPC = 1.28，95%CI：0.77，1.78）和西欧（AAPC = 0.77，95%CI：0.44，1.11），肠热病的发病负担有所增加。社会人口学指数（SDI）较低地区的死亡和DALY负担呈稳定趋势。与SDI相关的不平等现象显著减少，集中指数从1990年的-0.31降至2019年的-0.22。
自1990年以来，全球肠热病的疾病负担和各国之间的不平等程度有所下降，但社会人口学指数较低的国家仍然是一个值得关注的地区。从大洋洲和西欧前往流行地区的旅行者应特别注意肠热病的风险。
