Faizi Najeebullah
Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, China.
Department of Community Health, Kabul University of Medical Science "Abu Ali Ibn Sina", Kabul, Afghanistan.
Prev Med Rep. 2025 Apr 9;54:103061. doi: 10.1016/j.pmedr.2025.103061. eCollection 2025 Jun.
Road injuries pose a major public health challenge, particularly in low-income, conflict-affected regions like Afghanistan. Despite issues like poor infrastructure and weak traffic regulations, no national study has assessed the road injury burden. This study examines Afghanistan's road injury burden from 1990 to 2021.
This epidemiological study utilized the global burden of diseases (GBD) 2021 data. Key metrics included age-standardized mortality rate (ASMR), age-standardized disability-adjusted life-years rate (ASDR), years of life lost (YLL), and years lived with disability (YLD) per 100,000 population. Trends were analyzed using joinpoint analysis to determine annual and average annual percent changes (APC and AAPC). Estimates were presented with a 95 % uncertainty Interval, and statistical significance was assessed via permutation tests ( < 0.05).
Between 1990 and 2021, Afghanistan's road injury burden declined across all indicators (ASMR: -1.2 %, ASDR, YLL, YLD). Males (1.2 %) and children (AAPC: -3.1 %) saw the steepest declines, while the elderly (-0.7 %) had the slowest. Motor vehicle injuries dropped most (1.3 %), followed by pedestrian (1.0 %) and motorcyclist (0.9 %) injuries.Period-specific trends showed fluctuations: ASMR, ASDR, and YLL rose (1990-1997), then declined, except YLD, which increased post-2018 (+0.5 %). From 2017 to 2021, YLD rose across all age groups (except 0-14 years). Post-2014, motorcycle-related ASMR increased (+0.3 % APC), while from 2017 to 2021, ASDR and YLD increased across all injury types (+0.4 % to +1.3 % APC).
Despite progress, rising DALYs and YLDs, especially from 2017 onward, highlight a growing disability road injury burden, necessitating targeted interventions to address long-term disability and mitigate its public health impact.
道路伤害构成了一项重大的公共卫生挑战，尤其是在阿富汗这样的低收入、受冲突影响的地区。尽管存在基础设施差和交通法规薄弱等问题，但尚无全国性研究评估道路伤害负担。本研究考察了1990年至2021年阿富汗的道路伤害负担。
这项流行病学研究利用了2021年全球疾病负担（GBD）数据。关键指标包括年龄标准化死亡率（ASMR）、年龄标准化残疾调整生命年率（ASDR）、每10万人口的生命损失年数（YLL）和残疾生存年数（YLD）。使用连接点分析来确定年度和平均年度百分比变化（APC和AAPC），以分析趋势。估计值以95%的不确定性区间呈现，并通过置换检验评估统计学显著性（<0.05）。
1990年至2021年期间，阿富汗的道路伤害负担在所有指标上均有所下降（ASMR：-1.2%，ASDR、YLL、YLD）。男性（1.2%）和儿童（AAPC：-3.1%）的下降幅度最大，而老年人（-0.7%）的下降幅度最小。机动车伤害下降最多（1.3%），其次是行人伤害（1.0%）和摩托车手伤害（0.9%）。特定时期的趋势呈现出波动：ASMR、ASDR和YLL在1990 - 1997年上升，然后下降，但YLD除外，YLD在2018年后有所增加（+0.5%）。2017年至2021年，所有年龄组的YLD均有所上升（0 - 14岁年龄组除外）。2014年后，与摩托车相关的ASMR有所增加（APC为+0.3%），而2017年至2021年，所有伤害类型的ASDR和YLD均有所增加（APC为+0.4%至+1.3%）。
尽管取得了进展，但伤残调整生命年和残疾生存年数的上升，尤其是从2017年起，凸显了道路伤害导致的残疾负担日益加重，有必要采取针对性干预措施来应对长期残疾并减轻其对公共卫生的影响。
