Regional disparities in the burden of disease attributable to unsafe water and poor sanitation in China
Regional disparities in the burden of disease attributable to unsafe water and poor sanitation in China
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DOI：
10.2471/blt.11.098343
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发表时间：
2012-08-01
期刊：
影响因子：
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通讯作者：
Remais, Justin V
中科院分区：
文献类型：
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作者：
Carlton, Elizabeth J;Liang, Song;Remais, Justin V
目的评估中国不安全饮用水和卫生条件差的疾病负担，确定高负担人群，并提出改善措施。方法对中国不安全饮用水和卫生条件差的疾病负担进行评估，包括接触生物污染的土壤和水所导致的疾病水资源管理不善造成的疾病（腹泻病、蠕虫病和血吸虫病）和病媒传播（疟疾、登革热和日本脑炎）。这些数据来自中国国家传染病报告系统、国家蠕虫病调查和国家水和卫生调查。在中国和国际literature.Findings的数据估计每个健康状况的比例归因于不安全的水和恶劣的环境卫生和个人卫生在中国，在2008年，3.27亿人在中国缺乏管道饮用水和5.35亿缺乏获得改善的卫生设施。同年，不安全的水和恶劣的环境卫生和个人卫生造成该国281万残疾调整生命年（DSDs）和62，800人死亡，其中83%的可归因负担发生在5岁以下的儿童身上。人均负担沿着东西梯度增加，人均收入最低的内陆省份负担最重。结论尽管取得了显著进展，但中国仍需要针对经济发展较慢的省份开展基础设施改善项目。需要改进监测、加强监管监督和提高政府透明度，以更好地估计被微生物和化学污染的水以及恶劣的环境卫生和个人卫生对人类健康的影响。
Objective To estimate the disease burden attributable to unsafe water and poor sanitation and hygiene in China, to identify high-burden groups and to inform improvement measures.Methods The disease burden attributable to unsafe water and poor sanitation and hygiene in China was estimated for diseases resulting from exposure to biologically Contaminated soil and water (diarrhoeal disease, helminthiases and schistosomiasis) and vector transmission resulting from inadequate management of water resources (malaria, dengue and Japanese encephalitis). The data were obtained from China's national infectious disease reporting system, national helminthiasis surveys and national water and sanitation surveys. The fraction of each health condition attributable to unsafe water and poor sanitation and hygiene in China was estimated from data in the Chinese and international literature.Findings In 2008, 327 million people in China lacked access to piped drinking water and 535 million lacked access to improved sanitation. The same year, unsafe water and poor sanitation and hygiene accounted for 2.81 million disability-adjusted life years (DALYs) and 62 800 deaths in the country, and 83% of the attributable burden was found in children less than 5 years old. Per capita DALYs increased along an east west gradient, with the highest burden in inland provinces having the lowest income per capita.Conclusion Despite remarkable progress, China still needs to conduct infrastructural improvement projects targeting provinces that have experienced slower economic development. Improved monitoring, increased regulatory oversight and more government transparency are needed to better estimate the effects of microbiologically and chemically contaminated water and poor sanitation and hygiene on human health.