Lin K, Zhang C, Xu Z, Li X, Huang R, Liu Y, Yu H, Gu L
Yantian District Center for Disease Control and Prevention, Shenzhen, Guangdong 518000, China.
Zhongguo Xue Xi Chong Bing Fang Zhi Za Zhi. 2025 Feb 13;37(1):24-34. doi: 10.16250/j.32.1915.2024170.
To analyze the trends in the disease burden of schistosomiasis in China from 1992 to 2021, and to project the disease burden of schistosomiasis in China from 2022 to 2030, so as to provide insights into the elimination of schistosomiasis in China.
The prevalence, age-standardized prevalence, disability-adjusted life year (DALYs) rate and age-standardized DALYs rate of schistosomiasis, as well as the years lost due to disability (YLDs) rate and age-standardized YLDs rate of anemia attributable to infections in China, the world and different socio-demographic index (SDI) regions were captured from the Global Burden of Disease Study 2021 (GBD 2021) data resources, and the trends in the disease burden due to schistosomiasis were evaluated with estimated annual percentage change (EAPC) and its 95% confidence interval (). In addition, the age, period and cohort effects on the prevalence of schistosomiasis were examined in China using an age-period-cohort (APC) model, and the disease burden of schistosomiasis was predicted in China from 2022 to 2030 using a Bayesian age-period-cohort (BAPC) model.
The age-standardized prevalence and DALYs rate of schistosomiasis, and the age-standardized YLDs rate of anemia attributable to infections were 761.32/10, 5.55/10 and 0.38/10 in China in 2021. These rates were all lower than the global levels (1 914.30/10, 21.90/10 and 3.36/10, respectively), as well as those in the medium SDI regions (1 413.61/10, 12.10/10 and 1.93/10, respectively), low-medium SDI regions (2 461.03/10, 26.81/10 and 4.48/10, respectively), and low SDI regions (5 832.77/10, 94.48/10 and 10.65/10, respectively), but higher than those in the high SDI regions (59.47/10, 0.49/10 and 0.05/10, respectively) and high-medium SDI regions (123.11/10, 1.20/10 and 0.12/10, respectively). The prevalence and DALYs rate of schistosomiasis were higher among men (820.79/10 and 5.86/10, respectively) than among women (697.96/10 and 5.23/10, respectively) in China in 2021, while the YLDs rate of anemia attributable to infections was higher among women (0.66/10) than among men (0.12/10). The prevalence of schistosomiasis peaked at ages of 30 to 34 years among both men and women, while the DALYs rate of schistosomiasis peaked among men at ages of 15 to 19 years and among women at ages of 20 to 24 years. The age-standardized prevalence of schistosomiasis showed a moderate decline in China from 1992 to 2021 relative to different SDI regions [EAPC = -1.51%, 95% : (-1.65%, -1.38%)], while the age-standardized DALYs rate [EAPC = -3.61%, 95% : (-3.90%, -3.33%)] and age-standardized YLDs rate of anemia attributable to infections [EAPC = -4.16%, 95% : (-4.38%, -3.94%)] appeared the fastest decline in China from1992 to 2021 relative to different SDI regions. APC modeling showed age, period, and cohort effects on the trends in the prevalence of schistosomiasis in China from 1992 to 2021, and the prevalence of schistosomiasis appeared a rise followed by decline with age, and reduced with period and cohort. BAPC modeling revealed that the age-standardized prevalence and age-standardized DALYs rate of schistosomiasis, and age-standardized YLDs rate of anemia attributable to infections all appeared a tendency towards a decline in China from 2022 to 2030, which reduced to 722.72/10 [95% : (538.74/10, 906.68/10)], 5.19/10 [95% : (3.54/10, 6.84/10)] and 0.30/10 [95% : (0.21/10, 0.39/10)] in 2030, respectively.
The disease burden of schistosomiasis appeared a tendency towards a decline in China from 1992 to 2021, and is projected to appear a tendency towards a decline from 2022 to 2030. There are age, period and cohort effects on the prevalence of schistosomiasis in China. Precision schistosomiasis control is required with adaptations to current prevalence and elimination needs.
分析1992年至2021年中国血吸虫病疾病负担的变化趋势，并预测2022年至2030年中国血吸虫病的疾病负担，为中国消除血吸虫病提供参考依据。
从《2021年全球疾病负担研究》（GBD 2021）数据资源中获取中国、全球及不同社会人口指数（SDI）区域的血吸虫病患病率、年龄标准化患病率、伤残调整生命年（DALY）率和年龄标准化DALY率，以及由感染所致贫血的伤残损失生命年（YLD）率和年龄标准化YLD率，采用年均变化率（EAPC）及其95%置信区间（CI）评估血吸虫病疾病负担的变化趋势。此外，利用年龄-时期-队列（APC）模型分析中国血吸虫病患病率的年龄、时期和队列效应，并采用贝叶斯年龄-时期-队列（BAPC）模型预测中国2022年至2030年的血吸虫病疾病负担。
2021年中国血吸虫病的年龄标准化患病率、DALY率，以及由感染所致贫血的年龄标准化YLD率分别为761.32/10万、5.55/10万和0.38/10万。这些率均低于全球水平（分别为1 914.30/10万、21.90/10万和3.36/10万），也低于中等SDI区域（分别为1 413.61/10万、12.10/10万和1.93/10万）、低-中等SDI区域（分别为2 461.03/10万、26.81/10万和4.48/10万）以及低SDI区域（分别为5 832.77/10万、94.48/10万和10.65/10万），但高于高SDI区域（分别为59.47/10万、0.49/10万和0.05/10万）和高-中等SDI区域（分别为123.11/10万、1.20/10万和0.12/10万）。2021年中国男性血吸虫病的患病率和DALY率（分别为820.79/10万和5.86/10万）高于女性（分别为697.96/10万和5.23/10万），而由感染所致贫血的YLD率女性（0.66/10万）高于男性（0.12/10万）。男性和女性血吸虫病患病率均在3034岁达到峰值，而男性血吸虫病DALY率在1519岁达到峰值，女性在20~24岁达到峰值。相对于不同SDI区域，1992年至2021年中国血吸虫病的年龄标准化患病率呈中度下降趋势[EAPC=-1.51%，95%CI：（-1.65%，-1.38%）]，而年龄标准化DALY率[EAPC=-3.61%，95%CI：（-3.90%，-3.33%）]和由感染所致贫血的年龄标准化YLD率[EAPC=-4.16%，95%CI：（-4.38%，-3.94%）]在1992年至2021年相对于不同SDI区域下降最快。APC模型显示了1992年至2021年中国血吸虫病患病率趋势的年龄、时期和队列效应，血吸虫病患病率随年龄呈先上升后下降趋势，并随时期和队列下降。BAPC模型显示，2022年至2030年中国血吸虫病的年龄标准化患病率、年龄标准化DALY率以及由感染所致贫血的年龄标准化YLD率均呈下降趋势，到2030年分别降至722.72/10万[95%CI：（538.74/10万，906.68/10万）]、5.19/10万[95%CI：（3.54/10万，6.84/10万）]和0.30/10万[95%CI：（0.21/10万，0.39/10万）]。
1992年至2021年中国血吸虫病疾病负担呈下降趋势，预计2022年至2030年也将呈下降趋势。中国血吸虫病患病率存在年龄、时期和队列效应。需要根据当前患病率和消除需求进行精准的血吸虫病防治。
