The global burden of typhoid and paratyphoid fevers: a systematic analysis for the Global Burden of Disease Study 2017
The global burden of typhoid and paratyphoid fevers: a systematic analysis for the Global Burden of Disease Study 2017
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DOI：
10.1016/s1473-3099(18)30685-6
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发表时间：
2019-04-01
影响因子：
56.3
通讯作者：
Hay, Simon I.
中科院分区：
文献类型：
--
作者：
Stanaway, Jeffrey D.;Reiner, Robert C.;Hay, Simon I.
背景 量化肠热病的全球负担对于了解健康损失和疾病的大规模空间分布很有价值。我们介绍了 2017 年全球疾病负担、伤害和危险因素研究 (GBD) 中对伤寒和副伤寒负担的估计，以及产生这些估计的方法。方法在这项系统分析中，我们按国家、年份和年龄细分了伤寒和副伤寒的相对贡献，并分析了发病率和死亡率的趋势。我们对伤寒和副伤寒的联合发病率进行了建模，并使用病因比例模型将这些总病例按比例分为伤寒和副伤寒。我们使用数据完整性足够高的国家的重要登记数据来估计死亡人数，并使用自然历史方法来估计其他地点的死亡人数。我们还估算了伤寒和副伤寒的伤残调整生命年 (DALY)。调查结果 在全球范围内，2017 年发生了 1,430 万例（95% 不确定区间 [UI] 12.5-16.3）伤寒和副伤寒病例，较 25 例下降了 44.6% (42.2-47.0)。 1990 年为 900 万（22.0-29.9）。年龄标准化发病率下降了 54 。 9% (53. 4-56.5)，从 1990 年每 10 万人年 439.2 (376.7-507.7) 人，增加到 2017 年每 10 万人年 197.8 (172.0-226.2) 人。2017 年，伤寒沙门氏菌引起76.3%（71.8-80.5）的肠热病病例。我们估计 2017 年全球病死率为 0.95% (0.54-1.53)，其中儿童和老年人以及低收入国家的病死率估计较高。因此，我们估计 2017 年全球有 13.59 万人 (76.9-218.9) 人死于伤寒和副伤寒，比 1990 年的 23.05 万人 (131.2-372.6) 下降了 41.0% (33.6-48.3)。总体而言，伤寒和副伤寒导致 980 万人死亡(5.6-15.8) 2017 年伤残调整生命年 (DALY)，下降 43.0% 1990 年，伤残调整生命年 (DALY) 从 1720 万 (9.9-27.8) 增至 (35.5-50.6)。 解释 尽管取得了显着进展，伤寒和副伤寒仍然是导致残疾和死亡的主要原因，数十亿人可能接触到病原体。尽管改善水和卫生设施仍然至关重要，但增加疫苗的使用（包括对婴儿和幼儿有效且具有较长保护期的伤寒结合疫苗）以及改进数据和监测以告知疫苗的推出可能会推动全球疾病负担的最大改善。版权所有 (C) 2019 作者。由爱思唯尔有限公司出版
Background Efforts to quantify the global burden of enteric fever are valuable for understanding the health lost and the large-scale spatial distribution of the disease. We present the estimates of typhoid and paratyphoid fever burden from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2017, and the approach taken to produce them.Methods For this systematic analysis we broke down the relative contributions of typhoid and paratyphoid fevers by country, year, and age, and analysed trends in incidence and mortality. We modelled the combined incidence of typhoid and paratyphoid fevers and split these total cases proportionally between typhoid and paratyphoid fevers using aetiological proportion models. We estimated deaths using vital registration data for countries with sufficiently high data completeness and using a natural history approach for other locations. We also estimated disability-adjusted life-years (DALYs) for typhoid and paratyphoid fevers.Findings Globally, 14.3 million (95% uncertainty interval [UI] 12.5-16.3) cases of typhoid and paratyphoid fevers occurred in 2017, a 44.6% (42.2-47.0) decline from 25 . 9 million (22.0-29.9) in 1990. Age-standardised incidence rates declined by 54 . 9% (53 . 4-56.5), from 439.2 (376.7-507.7) per 100 000 person-years in 1990, to 197.8 (172.0-226.2) per 100 000 person-years in 2017. In 2017, Salmonella enterica serotype Typhi caused 76.3% (71.8-80.5) of cases of enteric fever. We estimated a global case fatality of 0.95% (0.54-1.53) in 2017, with higher case fatality estimates among children and older adults, and among those living in lower-income countries. We therefore estimated 135.9 thousand (76.9-218.9) deaths from typhoid and paratyphoid fever globally in 2017, a 41.0% (33.6-48.3) decline from 230.5 thousand (131.2-372.6) in 1990. Overall, typhoid and paratyphoid fevers were responsible for 9.8 million (5.6-15.8) DALYs in 2017, down 43.0% (35.5-50.6) from 17.2 million (9.9-27.8) DALYs in 1990.Interpretation Despite notable progress, typhoid and paratyphoid fevers remain major causes of disability and death, with billions of people likely to be exposed to the pathogens. Although improvements in water and sanitation remain essential, increased vaccine use (including with typhoid conjugate vaccines that are effective in infants and young children and protective for longer periods) and improved data and surveillance to inform vaccine rollout are likely to drive the greatest improvements in the global burden of the disease. Copyright (C) 2019 The Author(s). Published by Elsevier Ltd.