Zhu MengLan, Huang ZiLing, Liu TongTong, Wu ChenNan, Shang ZhiHan, Zhang LuLu
Sanitation Teaching and Research Section, Department of Health Service, Naval Medical University, Shanghai, China.
Otolaryngology Department of Unit 32265 of the People's Liberation Army, Guangzhou, China.
Front Public Health. 2025 Jan 7;12:1483149. doi: 10.3389/fpubh.2024.1483149. eCollection 2024.
Norovirus remains a significant viral cause of waterborne and foodborne gastroenteritis outbreaks and epidemics worldwide. The burden of norovirus extends across different income settings.
Leveraging secondary data from the 2021 Global Burden of Diseases Study, our analysis spanned the period from 1990 to 2021 to assess the burden of norovirus-associated diseases (NADs). We utilized descriptive statistics to examine global mortality rates and disability-adjusted life years (DALYs). For trend analysis, we employed annual percentage change (EAPC) through linear regression and applied Joinpoint analysis to identify significant changes over time. A comprehensive age-period-cohort model evaluated the key mortality risk factors. Furthermore, a Bayesian age-period-cohort analysis was conducted to forecast trends up to 2035, providing valuable insights for policy formulation and resource allocation.
In 2021, the global age-standardized mortality rate (ASMR) for NADs was 1.62 per 100,000 population (95% UI: 0.35 to 2.91), while the age-standardized DALY rates (ASDR) was 79.02 years per 100,000 population (95% UI: 26.61 to 132.26). A downward trend was observed in most regions and countries, with EAPC of -4.29% (95% UI: -4.53 to -4.05) for ASMR and -4.40% (95% UI: -4.62 to -4.19) for ASDR from 1990 to 2021. Notably, children under 5 years old had considerably higher ASDR: 475.52 years (95% UI: 160.73 to 893.72) per 100,000 for males and 335.44 years (95% UI: 112.29 to 623.48) per 100,000 for females. Mortality risk from NADs escalated with age, with a peak of 69.27 (95% CI: 64.04 to 74.92) per 100,000 for the under-five age group, and 11.38 (95% CI: 10.59 to 12.22) per 100,000 for individuals over 95 years. Bayesian Age-Period Cohort projections indicate a continued decline in ASMR and ASDR through 2035.
Between 1990 and 2021, ASMR and ASDR for NADs significantly declined due to public health interventions, vaccination, and improved sanitation. However, norovirus remains highly contagious, especially among children and the older adult. Projections suggest a continued decrease in the burden of such diseases by 2035. To further reduce this burden, preventive measures like vaccination and infection control strategies are essential for high-risk populations, alongside ongoing research into norovirus epidemiology and transmission dynamics.
诺如病毒仍然是全球水源性和食源性肠胃炎暴发及流行的重要病毒病因。诺如病毒造成的负担在不同收入水平的地区都有体现。
利用2021年全球疾病负担研究的二手数据，我们的分析涵盖了1990年至2021年期间，以评估诺如病毒相关疾病（NADs）的负担。我们使用描述性统计来研究全球死亡率和伤残调整生命年（DALYs）。对于趋势分析，我们通过线性回归采用年度百分比变化（EAPC），并应用Joinpoint分析来确定随时间的显著变化。一个综合的年龄-时期-队列模型评估了主要的死亡风险因素。此外，还进行了贝叶斯年龄-时期-队列分析，以预测到2035年的趋势，为政策制定和资源分配提供有价值的见解。
2021年，NADs的全球年龄标准化死亡率（ASMR）为每10万人1.62例（95% UI：0.35至2.91），而年龄标准化伤残调整生命年率（ASDR）为每10万人79.02年（95% UI：26.61至132.26）。在大多数地区和国家都观察到了下降趋势，1990年至2021年期间，ASMR的EAPC为-4.29%（95% UI：-4.53至-4.05），ASDR的EAPC为-4.40%（95% UI：-4.62至-4.19）。值得注意的是，5岁以下儿童的ASDR相当高：男性每10万人为475.52年（95% UI：160.73至893.72），女性每10万人为335.44年（95% UI：112.29至623.48）。NADs的死亡风险随着年龄增长而上升，5岁以下年龄组每10万人的峰值为69.27（95% CI：64.04至74.92），95岁以上个体每10万人为11.38（95% CI：10.59至12.22）。贝叶斯年龄-时期-队列预测表明，到2035年ASMR和ASDR将持续下降。
在1990年至2021年期间，由于公共卫生干预、疫苗接种和卫生条件改善，NADs的ASMR和ASDR显著下降。然而，诺如病毒仍然具有高度传染性，尤其是在儿童和老年人中。预测表明，到2035年此类疾病的负担将继续下降。为了进一步减轻这一负担，针对高危人群的疫苗接种和感染控制策略等预防措施至关重要，同时要持续开展诺如病毒流行病学和传播动态的研究。
