Li Chaohui, Liu Hui, Wang Kai
School of Public Health, Xinjiang Medical University, Urumqi, Xinjiang, China.
College of Medical Engineering and Technology, Xinjiang Medical University, Urumqi, Xinjiang, China.
PLoS Negl Trop Dis. 2025 May 27;19(5):e0013155. doi: 10.1371/journal.pntd.0013155. eCollection 2025 May.
Trachoma is primarily transmitted through direct contact, and its complications-such as trichiasis and corneal opacity-significantly impair patients' quality of life and result in substantial productivity losses. This study explores the differences in disability-adjusted life years (DALYs) and prevalence of trachoma globally, across regions with varying Socio-demographic Index (SDI) levels, and in China, while also projecting future trends specific to China.
This study, based on data from the Global Burden of Disease (GBD) database, utilized Joinpoint regression to analyze temporal trends in the age-standardized prevalence rate (ASPR) of trachoma in China from 1990 to 2021. The age-period-cohort (APC) model is used to estimate the net effects of age, period, and cohort on disease burden. Through decomposition analysis, the impact of aging, population growth, and epidemiological changes on trachoma disease burden is explored. In addition, the Bayesian Age-Period-Cohort (BAPC) model was used to project trends in the disability-adjusted life years (DALYs) rate and prevalence over the next 15 years, offering valuable insights for optimizing prevention and control strategies and consolidating achievements in disease elimination.
From 1990 to 2021, the ASPR and ASDR of trachoma exhibited a consistent downward trend in China, globally, and across regions with varying SDI levels. In 2021, the crude prevalence and crude DALYs rates of trachoma in China increased with age, reaching their peak in the 70-74-year age group. Marked disparities were observed among different SDI regions, with high-SDI areas recording the lowest prevalence and DALYs burden, while low-SDI regions experienced the highest. It is expected that from 2022 to 2036, the ASPR and ASDR of male and female populations aged 15 and above in China will both show a downward trend and continue to approach 0.
The continuous decline in the burden of trachoma disease in China from 1990 to 2021 indicates significant achievements in trachoma prevention and treatment. However, attention still needs to be paid to the elderly population aged 60 and above, and health education for the entire population should be strengthened to reduce the disease burden caused by trachoma in China.
沙眼主要通过直接接触传播，其并发症，如倒睫和角膜混浊，严重损害患者的生活质量，并导致大量生产力损失。本研究探讨全球、不同社会人口指数（SDI）水平地区以及中国沙眼的伤残调整生命年（DALY）和患病率差异，同时预测中国特有的未来趋势。
本研究基于全球疾病负担（GBD）数据库的数据，利用Joinpoint回归分析1990年至2021年中国沙眼年龄标准化患病率（ASPR）的时间趋势。年龄-时期-队列（APC）模型用于估计年龄、时期和队列对疾病负担的净影响。通过分解分析，探讨老龄化、人口增长和流行病学变化对沙眼疾病负担的影响。此外，使用贝叶斯年龄-时期-队列（BAPC）模型预测未来15年伤残调整生命年（DALY）率和患病率的趋势，为优化预防和控制策略以及巩固疾病消除成果提供有价值的见解。
1990年至2021年，中国、全球以及不同SDI水平地区的沙眼ASPR和年龄标准化残疾率（ASDR）均呈持续下降趋势。2021年，中国沙眼的粗患病率和粗DALY率随年龄增加，在70-74岁年龄组达到峰值。不同SDI地区存在明显差异，高SDI地区的患病率和DALY负担最低，而低SDI地区最高。预计2022年至2036年，中国15岁及以上男性和女性人群的ASPR和ASDR均将呈下降趋势，并继续趋近于0。
1990年至2021年中国沙眼疾病负担持续下降，表明沙眼防治取得显著成效。然而，仍需关注60岁及以上老年人群，应加强全民健康教育，以降低中国沙眼所致疾病负担。
