近日，海南医学院杨国静教授团队研究了中国被忽视热带疾病负担估计的差异。该项研究成果发表在2025年2月18日出版的《英国医学杂志》上。

该研究旨在评估中国六种被忽视的热带疾病的真实数据与2021年全球疾病负担（GBD）估计值之间的差异。此外，评估GBD模型在中国背景下的适用性，并评估中国历史上针对被忽视热带疾病的预防和控制政策的有效性。

研究组采用现实世界数据和GBD 2021（2004-2020）的比较研究，主要指标为残疾调整生命年（DALYs）。将基于2004年至2020年麻风病、包虫病、血吸虫病、内脏利什曼病、登革热和狂犬病报告数据的DALYs与GBD 2021数据库的估计DALYs进行了比较。此外，还将中国预防和控制被忽视热带疾病的历史政策与现实世界的残疾调整生命年相结合并进行了分析。

报告的数据来源于中国疾病预防控制中心的中国公共卫生科学数据中心和相关报告。GBD 2021和GBD 2019的数据来自GBD数据库。这些数据包括中国所有31个省（包括自治区和直辖市）和新疆生产建设兵团。

基于六种被忽视的热带疾病报告数据的实际DALYs总量从2004年的26万人年减少到2020年的1.9万人年，减少了93%（24.1万/26万人年）。2004年至2020年的17年平均现实DALYs与同期GBD 2021的估计值相比，麻风病为42 v 500，包虫病为960 v 11000，血吸虫病为64000 v 98000，内脏利什曼病为56 v 16000，登革热为190 v 780，狂犬病为47000 v 67000。六种被忽视的热带疾病的GBD估计值与实际DALYs的比率为：麻风病17、包虫病11、血吸虫病1.5、内脏利什曼病280、登革热4.2、狂犬病1.4。

研究结果表明，仅依赖全球估计值，如GBD的估计值，可能无法充分捕捉到中国被忽视的热带疾病的动态。将当地流行病学数据纳入全球卫生评估对于制定准确有效的公共卫生政策至关重要。这项研究强调了不断更新和改进数据收集和监测方法的重要性，以使公共卫生战略适应不断变化的疾病模式。

Title: Discrepancies in neglected tropical diseases burden estimates in China: comparative study of real-world data and Global Burden of Disease 2021 data (2004-2020)

Author: Guo-Jing Yang, Han-Qi Ouyang, Zi-Yu Zhao, Wei-Hao Li, Ibrahima Socé Fall, Amadou Garba Djirmay, Xiao-Nong Zhou

Issue&Volume: 2025/02/18

Abstract:

Objectives To assess the discrepancies between real-world data and the Global Burden of Disease (GBD) 2021 estimates for six neglected tropical diseases in China. Additionally, to evaluate the applicability of the GBD model within the Chinese context and to assess the effectiveness of China's historical prevention and control policies for neglected tropical diseases.

Design Comparative study of real-world data and GBD 2021 (2004-2020).

Main outcome measures Disability adjusted life years (DALYs).

Methods DALYs based on reported data for leprosy, echinococcosis, schistosomiasis, visceral leishmaniasis, dengue, and rabies from 2004 to 2020 were compared with the estimated DALYs from the GBD 2021 database. Additionally, we combined and analysed China's historical policies on prevention and control of neglected tropical diseases with real-world DALYs.

Data sources Reported data were sourced from the Chinese Center for Disease Control and Prevention’s China Public Health Science data centre and related reports. Data for GBD 2021 and GBD 2019 were obtained from GBD databases. These data included all of China’s 31 provinces (including autonomous regions and municipalities) and the Xinjiang Production and Construction Corps.

Results The total real-world DALYs based on reported data of six neglected tropical diseases decreased from 260000 person years in 2004 to 19000 person years in 2020, with a 93% (241000/260000 person years) reduction. The 17 year average real-world DALYs from 2004 to 2020 versus the GBD 2021 estimates for the same period were 42 v 500 for leprosy, 960 v 11000 for echinococcosis, 64000 v 98000 for schistosomiasis, 56 v 16000 for visceral leishmaniasis, 190 v 780 for dengue, and 47000 v 67000 for rabies. The ratios of the GBD estimates to the real-world DALYs for the six neglected tropical diseases were 17 for leprosy, 11 for echinococcosis, 1.5 for schistosomiasis, 280 for visceral leishmaniasis, 4.2 for dengue, and 1.4 for rabies.

Conclusions The findings indicate that reliance solely on global estimates, such as those of the GBD, may not sufficiently capture the dynamics of neglected tropical diseases in China. Integrating local epidemiological data into global health assessments is crucial to develop accurate and effective public health policies. This study highlights the importance of continuously updating and improving data collection and surveillance methods to adapt public health strategies to evolving disease patterns.

DOI: 10.1136/bmj-2024-080969

Source: https://www.bmj.com/content/388/bmj-2024-080969