He Ran, Zhu Wenhao, Hui Shirong, Yu Meijie, Li Haochang, Li Yihao, Huang Peng, Yu Rongbin
Department of Epidemiology, National Vaccine Innovation Platform, Centre for Global Health, School of Public Health, Key Laboratory of Public Health Safety and Emergency Prevention and Control Technology of Higher Education Institutions in Jiangsu Province, Nanjing Medical University, Nanjing, China.
PLoS One. 2025 Aug 7;20(8):e0329475. doi: 10.1371/journal.pone.0329475. eCollection 2025.
Neglected Tropical Diseases (NTDs) and malaria represent significant public health threats, particularly in regions with low Socio-Demographic Index (SDI) levels. Despite global efforts to enhance prevention and control, disparities still persist. We aimed to assess the quality of care for NTDs and malaria through the quality of care index (QCI) to analyse differences in regions, genders, age groups, and to provide measures to improve the quality of care to reduce the burden of disease.
Using data from the Global Burden of Disease Study 2021 (GBD 2021), four secondary indicators were calculated using six primary indicators: incidence, mortality, prevalence, the disability-adjusted life years (DALYs), years of life lost, and years lived with disability to calculate the QCI through principal component analysis, and the gender disparity ratio was the ratio of female QCI to male QCI.
Globally, the incidence of NTDs and malaria increased, while age-standardized mortality rates (ASMRs) and DALYs declined from 1990 to 2021. In 2021, the QCI was highest in Bahrain, Qatar, and the United Arab Emirates, with scores of 91.9, 91.5, and 91.5, respectively. In contrast, Uganda, Niger, and Burkina Faso had the lowest QCIs, at 78.5, 77.1, and 75.2, respectively. QCI showed a positive correlation with a country's level of economic development, with lower quality of care observed in those under 10 and over 95 years, and largely equal quality of care received between genders.
This study revealed differences in the quality of care for NTDs and malaria across regions, genders, and age groups. There is an urgent need to improve care quality, particularly in low SDI areas and among young children. The study provides recommendations for enhancing the quality of care for NTDs and malaria and for developing more effective public health interventions.
被忽视的热带病（NTDs）和疟疾构成了重大的公共卫生威胁，尤其是在社会人口指数（SDI）水平较低的地区。尽管全球在加强预防和控制方面做出了努力，但差距仍然存在。我们旨在通过护理质量指数（QCI）评估NTDs和疟疾的护理质量，分析地区、性别、年龄组之间的差异，并提供提高护理质量的措施以减轻疾病负担。
利用2021年全球疾病负担研究（GBD 2021）的数据，使用六个主要指标计算四个次要指标：发病率、死亡率、患病率、残疾调整生命年（DALYs）、生命损失年数和残疾生存年数，通过主成分分析计算QCI，性别差异比为女性QCI与男性QCI之比。
全球范围内，1990年至2021年期间，NTDs和疟疾的发病率上升，而年龄标准化死亡率（ASMRs）和DALYs下降。2021年，巴林、卡塔尔和阿拉伯联合酋长国的QCI最高，分别为91.9、91.5和91.5。相比之下，乌干达、尼日尔和布基纳法索的QCI最低，分别为78.5、77.1和75.2。QCI与一个国家的经济发展水平呈正相关，10岁以下和95岁以上人群的护理质量较低，不同性别的护理质量基本相当。
本研究揭示了NTDs和疟疾在地区、性别和年龄组之间护理质量的差异。迫切需要提高护理质量，特别是在低SDI地区和幼儿中。该研究为提高NTDs和疟疾的护理质量以及制定更有效的公共卫生干预措施提供了建议。
