Analysis of the burden of disease attributable to high temperature exposure in China and globally from 1990 to 2019 / 中华劳动卫生职业病杂志

Objective: To analyze the burden of disease attributable to high temperature exposure in China and globally from 1990 to 2019, and to study the current burden of disease in relevant populations. Methods: In October 2021, based on data from the global burden of disease 2019 (GBD 2019) study, population attributable fraction (PAF), number of deaths, mortality, disability-adjusted life year (DALY) and DALY rate of Chinese and global populations with different ages and genders in 1990 and 2019 were extracted and analyzed. The rate of change was calculated, the mortality rate was normalized by the age structure of the world standard population, and the causes of disease burden caused by high temperature exposure of Chinese residents were analyzed. Results: In 2019, compared with 1990, the PAF of Chinese and global population decreased by 43.98% and 12.41% respectively, the number of deaths increased by 29.55% and 49.40% respectively, the crude mortality rate increased by 7.81% and 3.30% respectively, the DALY decreased by 48.12% and 14.41% respectively, and the DALY rate decreased by 56.82% and 40.82% respectively. The mortality rate of the ≥70 age group was higher than that of other groups. The disease burden indicators such as PAF, standardized mortality and DALY attributable to high temperature exposure in men were higher than those in women. In 2019, the main cause of DALY affected by high temperature exposure in Chinese population was ischemic heart disease (84400 person-years), and the main cause of death was ischemic heart disease (4900 cases). Conclusion: The burden of diseases attributable to high temperature exposure is still serious in China and the world at large. Targeted interventions should be formulated for men, the elderly and people with occupational exposure, and a sound surveillance system should be established to reduce the burden of diseases caused by high temperature exposure.

Changes in the disease burden of liver cancer caused by nonalcoholic steatohepatitis in China 1990-2019 / 公共卫生与预防医学

Objective To describe and analyze the disease burden and its changing trend of liver cancer caused by nonalcoholic steatohepatitis (NASH) in China from 1990 to 2019, and to provide reference for reducing the morbidity and mortality of liver cancer in China. Methods Based on data from the Global Burden of Disease (GBD2019) study, different gender and age groups were selected. The morbidity, mortality, and disability adjusted life year (DALY) rate were used to analyze the disease burden of liver cancer caused by NASH in China from 1990 to 2019. The time trend was analyzed by using the Joinpoint regression model, and the annual percent of change (APC) and annual average percentage change (AAPC) of morbidity, mortality and DALY rate were calculated. Results Compared with 1990, the incidence rate, mortality rate and DALY rate of liver cancer caused by NASH in 2019 decreased by 4.05%, 12% and 25.79%, respectively. Age-standardized morbidity, standardized mortality and standardized DALY rates decreased by 49.50%, 54.72% and 58.45%, respectively. In 2019, the incidence rate, mortality data and DALY rate of liver cancer caused by NASH increased with age, and the highest mortality rate was among people over 85 years old. The average annual change percentage (AAPC) of age-standardized incidence rate, standardized mortality rate and standardized DALY rate of liver cancer caused by NASH from 1990 to 2019 were -2.65% ［95% CI（-3.09%，-2.21 %），P<0.001］, -2.86%［95% CI（-3.34%，-2.38 %），P<0.001］, and -2.91%［95% CI（-3.23%，-2.58%），P<0.001］，respectively. The AAPC of all indexes in males was higher than that in females. Conclusion From 1990 to 2019, the disease burden of liver cancer caused by NASH in China showed an overall downward trend. The AAPC of all indexes in males is higher than that in females, and the elderly population is a high-risk group.

The status and trend of child growth failure (CGF) burden in children aged < 5 years in China / 公共卫生与预防医学

Objective To analyze the status and trend for the mortality and DALY rates of child growth failure (CGF) in children aged < 5 years in China from 1990 to 2019, so as to provide a scientific basis for CGF prevention and control. Methods The mortality and DALY rates of CGF in children aged < 5 years from 1990 to 2019 were obtained from GBD 2019. The changes of these indicators with the years in China , the United States, Japan, Russia, India and the global were compared and analyzed. Results In 2019, the mortality of child wasting, child stunting and child underweight in children aged < 5 years in China were 9.62/100 000, 1.23/100 000, and 1.29/100 000 respectively, the mortality rates were 867.50/100 000 , 129.23/100 000 , and 112.87/100 000 rescpectively, higher than those of the United States, Japan, and Russia, and far lower than those of India and the global. The disease burden of three types of CGF were all higher in males than females, and higher in children aged < 1 years than children aged 1-4 years. From 1990 to 2019, the mortality and DALY rates of CGF in children aged < 5 years in China decreased from 300.41/100 000 and 26 445.38/100 000 to 10.49/100 000 and 943.57/100 000, respectively. China had the largest drop rate compared with all analyzed countries. As for children aged < 5 years in China, the DALY rate of lower respiratory infection ranked first in all the diseases caused by CGF. Conclusion From 1990 to 2019, the disease burden of CGF in children aged < 5 years has shown a significant decrease in China , but it is still far behind the developed countries. In the future, more attention should be paid to the problems of child growth in hope of reducing the mortality and DALY rates of CGF.

Analysis and prediction of burden of viral hepatitis C-associated diseases in China from 1990 to 2044 / 中国血吸虫病防治杂志

Objective To measure the burden of hepatitis C-associated diseases in China from 1990 to 2019, and to predict its changes from 2020 to 2044, so as to provide insights into formulation of the targeted hepatitis C control strategy. Methods The total burden due to hepatitis C-associated diseases in China from 1990 to 2019 were extracted from the Global Burden of Disease 2019 (GBD 2019) data resources, and the trends in age-standardized prevalence, incidence, mortality and disability-adjusted life years (DALYs) rate of hepatitis C-associated acute hepatitis C (AHC), chronic liver diseases (CLD) and liver cancer in China from 1990 to 2019 were evaluated in China from 1990 to 2019 using estimated annual percentage change (EAPC). In addition, the changes in the burden of hepatitis C-associated diseases were predicted in China from 2020 to 2044 using a Bayesian model. Results The prevalence, incidence, mortality and DALY rate of hepatitis C-associated diseases all appeared an overall tendency towards a decline in China from 1990 to 2019 (EAPC = −2.64%, −2.24%, −3.81% and −3.90%, respectively); however, there was a minor rise in the incidence and prevalence of hepatitis C-associated diseases from 2015 to 2019. The overall prevalence of hepatitis C-associated diseases reduced from 2 152.7/105 in 1990 to 1 254.1/105 in 2019 in China, with a reduction of 41.7%. The overall incidence reduced from 87.9/105 in 1990 to 55.0/105 in 2019 in China, with a reduction of 37.4%, and the highest incidence was seen for AHC, followed by CLD and liver cancer. The overall mortality and DALY rate of hepatitis C-associated diseases was 4.0/105 and 100.8/105 in China from 1990 to 2019, with CLD showing the largest contributions to the gross mortality and DALY. The mortality and DALY rate of hepatitis C-associated diseases were 5.5/105 and 142.4/105 among men in China in 2019, which were both much higher than among women (2.8/105 and 60.3/105, respectively), and the overall prevalence (1 604.9/105), mortality (30.2/105) and DALYs (437.1/105) of hepatitis C-associated diseases were all highest among patients at ages of 70 years and older, and the highest incidence was seen among patients at ages of 0 to 9 years (167.3/105). The incidence of hepatitis C-associated diseases was predicted to rise in China from 2020 to 2044; however, the DALY rate was projected to appear a tendency towards a decline. Conclusions Although the burden of hepatitis C-associated diseases showed a tendency towards a decline in China from 1990 to 2019, the burden remained high, and was predicted to slightly rise from 2020 to 2044. High attention should be paid to screening of hepatitis C among infants and treatment among adults.

Burden of hepatitis B-associated diseases in China from 1990 to 2030 / 中国血吸虫病防治杂志

Objective To measure the burden of hepatitis B-associated diseases in China from 1990 to 2019, and to predict its changes from 2020 to 2030. Methods The age-standardized prevalence, incidence, mortality and disability-adjusted life years (DALY) rate of hepatitis B-associated diseases in China from 1990 to 2019 were extracted from the Global Burden of Disease 2019 (GBD 2019) data resources, and the trends in burdens of hepatitis B-associated diseases were evaluated from 1990 to 2019 using estimated annual percentage change (EAPC) and annual percent change (APC). In addition, the changes in the burden of hepatitis B-associated diseases were predicted in China from 2020 to 2023 using the Bayesian model. Results The overall incidence of hepatitis B-associated diseases reduced from 2 725.98/105 in 1990 to 1 397.31/105 in 2019 in China [estimated annual percentage change (EAPC) = −2.35%, 95% confidential interval (CI): (−2.58%, −2.13%)], with a reduction in the prevalence from 12 239.53/105 in 1990 to 6 566.12/105 in 2019 [EAPC = −2.34%, 95% CI: (−2.54%, −2.14%)], a reduction in the mortality from 24.67/105 in 1990 to 8.07/105 in 2019 [EAPC = −4.92%, 95% CI: (−5.37%, −4.47%)], and a reduction in the DALY rate from 793.38/105 in 1990 to 247.71/105 in 2019 [(EAPC = −5.15%, 95% CI: (−5.64%, −4.66%)]. The DALY rate of hepatitis B-associated diseases were mainly attributed to liver cancer, and the DALY rate of hepatitis B-associated diseases appeared a tendency towards a rise in China from 2012 to 2019 [APC = 1.30%, 95% CI: (0.16%, 2.45%)]. The overall burden of hepatitis Bassociated diseases was higher in males than in females, and the DALY rate of hepatitis B-associated diseases increased with age, with the greatest DALY rate seen among patients at ages of 50 to 69 years. The overall incidence of hepatitis B-associated diseases was projected to be 866.79/105 in China in 2030, with the greatest incidence seen in acute hepatitis B (854.87/105), and the burden of hepatitis B-associated diseases was predicted to decline in China from 2020 to 2030; however, the burden of liver disease was projected to appear a tendency towards a rise. Conclusions The burden of hepatitis B-associated diseases appears an overall tendency towards a decline in China from 1990 to 2030; however, the burden of liver cancer appears a tendency towards aggravation. Early diagnosis and treatment of liver cancer should be given a high priority.

Disease burden of tumors among children aged 0 to 14 years in Chinain 1990 and 2019 / 预防医学

Objective@# To investigate trends in the disease burden of tumors among children aged 0 to 14 years in China in 1990 and 2019, so as to provide insights into management of pediatric tumors in China.@* Methods@#The Global Burden of Disease 2019 data were retrieved from the Global Health Data Exchange, and the mortality and disability adjusted life years (DALYs) of pediatric tumors were evaluated among children at ages of 0 to 14 years in China in 1990 and 2019, and the disease burdens due to pediatric tumors in China were compared with the regions with different social population index (SDI). @*Results@#The mortality of tumors decreased from 13.10/105 in 1990 to 4.96/105 in 2019 (a 62.17% reduction) among children aged 0 to 14 years in China, and the DALY rate decreased from 1 118.93/105 to 424.77/105 (a 62.04% reduction). The mortality and DALY rate of tumors decreased from 13.48/105 to 5.38/105, and from 1 147.09/105 to 458.65/105 among male children, and from 12.69/105 to 4.46/105, and from 1 088.22/105 to 384.94/105 among female children. The disease burden of pediatric tumors was concentrated among children at ages of 0 to 4 years. The three highest disease burdens of pediatric tumors were measured in leukemia, brain and nerve system tumors, and lymphoma in 2019. Compared with the regions with different SDI, the largest reductions were seen in the mortality and DALY rate of tumors among children at ages of 0 to 14 years in China, which were still higher than in middle, high-middle and high SDI regions. @*Conclusions@#The disease burden of tumors declined among children at ages of 0 to 14 years in China in 2019, compared with 1990; however, it is still higher than in middle and higher SDI regions. The disease burden of pediatric tumors was high among children at ages of 0 to 4 years and among male children, with leukemia, brain and nerve system tumors and lymphoma as predominant types.

Comparison of the disease burden of schistosomiasis globally and in China and Zimbabwe / 中国血吸虫病防治杂志

Objective To investigate the trends in the disease burden of schistosomiasis worldwide and in China, and Zimbabwe from 1990 to 2019, so as to provide insights into the formulation of the schistosomiasis control strategy in Zimbabwe. Methods Based on Global Burden of Disease Study 2019 (GBD 2019) data sources, the age-standardized prevalence, mortality, disability-adjusted life year (DALY) rate of schistosomiasis were compared in the world, China, and Zimbabwe and the trends in the disease burden of schistosomiasis from 1990 to 2019 were investigated using Joinpoint regression analysis. In addition, the associations between the burden of schistosomiasis worldwide and in China and Zimbabwe from 1990 to 2019 and socio-demographic index (SDI) were examined using Pearson correlation analysis. Results The age-standardized prevalence, mortality, and DALY rate of schistosomiasis were 1 804.95/105, 0.14/105 and 20.92/105 in the world, 707.09/105, 0.02/105 and 5.06/105 in China, and 2 218.90/105, 2.39/105 and 90.09/105 in Zimbabwe in 2019, respectively. The global prevalence, mortality, and DALY rate of schistosomiasis appeared a tendency towards a rise followed by a decline with age in 2019, while the prevalence and DALY rate of schistosomiasis appeared a tendency towards a sharp rise followed by a fluctuating decline in both China and Zimbabwe, and the mortality of schistosomiasis appeared a tendency towards a rise. The age-standardized prevalence [average annual percent change (AAPC) = −1.31%, −2.22% and −6.12%; t = −20.07, −83.38 and −53.06; all P values < 0.05)] and DALY rate of schistosomiasis (AAPC = −1.91%,−4.17% and −2.08%; t = −31.89, −138.70 and −16.45; all P values < 0.05) appeared a tendency towards a decline in the world, China and Zimbabwe from 1990 to 2019, and the age-standardized mortality of schistosomiasis appeared a tendency towards a decline in the world and China (AAPC = −3.46% and −8.10%, t = −41.03 and −61.74; both P values < 0.05), and towards a rise followed by a decline in Zimbabwe (AAPC = 1.35%, t = 4.88, P < 0.05). In addition, Pearson correlation analysis showed that the age-standardized prevalence (r = −0.75, P < 0.05), mortality (r = −0.73, P < 0.05), and DALY rate of schistosomiasis (r = −0.77, P < 0.05) correlated negatively with SDI in the world, China and Zimbabwe from 1990 to 2019. Conclusions The disease burden of schistosomiasis appeared a remarkable decline in China from 1990 to 2019, and the prevalence of schistosomiasis showed a tendency towards a decline in Zimbabwe from 1990 to 2019; however, the mortality and DALY rate of schistosomiasis in Zimbabwe topped in the world. A schistosomiasis control strategy with adaptations to local epidemiology and control needs of schistosomiasis is needed to facilitate the elimination of schistosomiasis in Zimbabwe.

Carga de enfermedad por COVID-19 en el departamento de Nariño, Colombia, 2020-2021 / Burden of disease of COVID-19 in the department of Nariño, Colombia, 2020-2021

RESUMEN Objetivos. Estimar la carga de enfermedad por COVID-19 en el departamento de Nariño, Colombia, a partir del indicador años de vida saludables ajustados por discapacidad (AVISA) entre marzo del 2020 a agosto del 2021. Materiales y métodos. Con la información del sistema de vigilancia nacional SIVIGILA se hizo la descripción y caracterización de los casos de COVID-19 reportados entre marzo/2020 a agosto/2021, según grupos de edad, sexo, etnia, municipios de residencia y subregiones de Nariño. Se estimaron tasas crudas y de mortalidad acumulada por COVID-19 para las variables previamente descritas. Se calcularon años perdidos por muerte prematura (APMP) y años vividos por discapacidad (AVD). Se estimaron los AVISA totales mediante la suma de APMP + AVD. Estos se calcularon por sexo, etnia, grupo de edad y subregiones de Nariño. Se estimaron los riesgos relativos a partir de las razones de tasas (RT) e intervalos de confianza del 95% para las variables del estudio. Resultados. Las tasas de morbilidad, mortalidad y AVISA más altas ocurrieron entre febrero y septiembre del 2021, en hombres, en mayores de 70 años, del grupo étnico minoritario afrodescendiente y en las subregiones Centro, Obando y Juanambú. La carga de enfermedad por COVID-19 en Nariño en el periodo de estudio es atribuida a los APMP, los cuales explican más del 97% de la misma. Conclusiones. Este es uno de los primeros estudios de carga de enfermedad a nivel regional, realizados en Colombia, que emplea una metodología estandarizada para COVID-19. Esta medición generaría estimaciones que permitirían focalizar recursos de forma intersectorial, mitigar el daño a poblaciones y áreas geográficas determinadas, especialmente las más vulnerables.

ABSTRACT Objectives. To estimate the burden of disease of COVID-19 in the department of Nariño, Colombia, based on the disability-adjusted life years (DALYs) between March 2020 and August 2021. Materials and methods. The description and characterization of COVID-19 cases reported between March 2020 and August 2021 was made according to age groups, sex, ethnicity, municipalities of residence and subregions of Nariño by using information from the national surveillance system SIVIGILA. Crude and cumulative mortality rates for COVID-19 were estimated for the previously described variables. Years lost due to premature death (YLL) and years lived with disability (YLD) were calculated. Total DALYs were estimated by adding YLL + YLD. These were calculated by sex, ethnicity, age group and subregions of Nariño. Relative risks were estimated from rate ratios (RR) and 95% confidence intervals for the study variables. Results. The highest morbidity, mortality and DALY rates occurred between February and September 2021, in men, in those older than 70 years, in the Afro-descendant ethnic minority group and in the Central, Obando and Juanambú subregions. The burden of disease of COVID-19 in Nariño during the study period is attributed to the YLL, which explain more than 97% of it. Conclusions. This is one of the first studies on burden of disease at the regional level, carried out in Colombia, that employs a standardized methodology for COVID-19. This measurement would generate estimates that would allow targeting resources in an intersectoral manner, mitigating the damage to specific populations and geographic areas, especially the most vulnerable ones.

Analysis of cerebrovascular disease between 1996 and 2021 in Minhang District of Shanghai / 上海预防医学

ObjectiveTo analyze the changing trend of cerebrovascular disease burden in Minhang District of Shanghai from 1996 to 2021， and to provide scientific evidence for government to formulate targeted cerebrovascular disease prevention and control strategies. MethodsMortality， years of life lost（YLL）， years of lived with disability（YLD） and disability⁃adjusted life years（DALY） were used to evaluate the burden of cerebrovascular diseases in Minhang District. Joinpoint linear regression was used to analyze the trend of disease burden. ResultsFrom 1996 to 2021， the YLL rate of cerebrovascular diseases in Minhang District showed a downward trend （whole population： APC=-1.69%， t=-6.9， P<0.05）， The YLD rate of cerebrovascular diseases showed a slow upward trend （whole population： APC=1.17%， t=3.5， P<0.05）， The DALY rate of cerebrovascular diseases showed a downward trend， and fluctuated since 2003 （whole population： APC= -1.43%， t=-5.6， P<0.05）. The YLL rate of cerebrovascular diseases in men was higher than that in women， and the YLD rate of cerebrovascular diseases in women was higher than that in men. After 2014， the DALY of cerebrovascular diseases in men was higher than that in women. With the increase of age， the burden of cerebrovascular diseases increased， and the burden of disease increased significantly in the age group above 70. ConclusionThe burden of cerebrovascular diseases in Minhang District is at a high level， and there are differences in age， gender and other aspects. Measures such as screening， intervention and rehabilitation need to be improved to reduce disability and premature death caused by cerebrovascular diseases and to reduce the burden of cerebrovascular diseases on individuals， families and society.

Survival and disease burden trend analysis of occupational pneumoconiosis from 1963 to 2020 in Shizuishan City / 中华劳动卫生职业病杂志

Objective: To understand the survival status and its influencing factors of occupational pneumoconiosis patients in Shizuishan City, and to analyze the disease burden of occupational pneumoconiosis and its trend, so as to provide scientific basis for formulating comprehensive prevention and treatment measures of occupational pneumoconiosis. Methods: A retrospective survey was conducted during July to December 2020 to explore the survival status of occupational pneumoconiosis patients who had been reported from 1963 to 2020 in Shizuishan City. The Kaplan-Meier method and Life-table method were used for survival analysis, and Cox proportional hazards regression model was used to analyze the influencing factors of survival time. The disability adjusted life years (DALY) was applied to analyze the disease burden of occupational pneumoconiosis and its temporal trend. Results: From 1963 to 2020, a total of 3263 cases of occupational pneumoconiosis were reported in Shizuishan City, of which 1467 died, so that the fatality rate was 44.96%. The median survival time was 26.71 years, average age of death was (70.55±10.92) years old. There were significant differences in the survival rates of occupational pneumoconiosis patients among different types, diagnosis age, exposure time, industry, initial diagnosis stage and whether upgraded (P<0.05) . As the survival time increased, the survival rate of patients decreased gradually. When the survival time was ≥50 years, the cumulative survival rate of patients was 4.20%. Cox regression analysis suggested that the type of pneumoconiosis, industry, diagnosis age, exposure time, initial diagnosis stage and whether upgraded were the influencing factors for the survival time of patients with occupational pneumoconiosis (P<0.05) . The total DALY attributable to occupational pneumoconiosis from 1963 to 2020 in Shizuishan City was 48026.65 person years, of which the years of life lost (YLL) was 15155.39 person years, and the average YLL was 10.33 years/person, and the years lost due to disability (YLD) was 32871.26 person years, and the average YLD was 10.07 years/person. The DALY attributed to coal worker's pneumoconiosis and silicosis were 39408.51 person years and 6565.02 person years, respectively, and they accounted for 82.06% and 13.67% of the total disease burden in Shizuishan City, respectively. The DALY caused by occupational pneumoconiosis in the age group of 40-49 years old and the first diagnosis of stage I occupational pneumoconiosis were higher, which were 20899.71 and 36231.97 person years, respectively. The average YLL and average YLD showed a volatility downtrend over time. Conclusion: The disease burden of occupational pneumoconiosis cannot be ignored in Shizuishan City, and timely targeted measures should be taken for key populations and key industries. It is recommended that life-cycle health management and hierarchical medical should be taken to improve the life quality of patients and prolong their lifes.

The current status and trends of chronic kidney disease (CKD) burden in China based on GBD Data / 公共卫生与预防医学

Objective To analyze the current status and trends of chronic kidney disease (CKD) burden in China from the global perspective, and to provide reference for the prevention and control of CKD in China. Methods The incidence, prevalence, mortality and disability adjusted life year (DALY) rate of China and other regions were retrieved from GBD 2019. Comparative analyses were carried out to reflect the burden of CKD. Results In 2019, the incidence and the prevalence in females were higher than those in males, while the mortality and the DALY rates in females were lower than those in males. There were obvious distinctions in different age groups and people over 65 years old had a higher CKD burden. The burden of CKD mainly came from hypertensive nephropathy and type 2 diabetic nephropathy. From 1990 to 2019, the DALY rate of CKD in China showed an overall upward trend. After eliminating the differences in age composition, the standardized DALY rate of CKD in China was higher than that in Japan, Korea and Ukraine although lower than the global. The main influencing factors of the burden of CKD were metabolic factors. Conclusion The burden of CKD in China is continuously rising. It is still necessary to pay attention to the three-level prevention and control, and focus on the key people groups and high-risk factors to further reduce the burden of CKD in China.

Global burden of periodontal disease and its relation with socioeconomic development during 1990-2019 / 浙江大学学报·医学版

To analyze the global burden of periodontal disease and its relation with socioeconomic development. Data of global disability-adjusted life year (DALY) due to periodontal disease and human development index (HDI) from 1990 to 2019 were obtained from Global Health Data Exchange (GHDx) and human development reports. The trend of the global burden of periodontal disease from 1990 to 2019 was described. The correlation between age-standardized DALY rates and HDI were examined in 2019, and between-country periodontal disease burden inequality from 1990 to 2019 was measured using health-related Gini coefficients and concentration indexes. From 1990 to 2019, the global DALY rate due to periodontal disease increased from 78.63 to 85.48, and the epidemiological burden did not increase significantly. Statistical differences were found across different HDI categories for age-standardized DALY rates of periodontal disease ( 44.315, <0.01) in 2019. Linear regression analysis also revealed a negative correlation between age-standardized DALY rate of periodontal disease and HDI ( = -0.417, <0.01) . Gini coefficients decreased from 0.361 to 0.281 and concentration indexes fell from 0.0339 to -0.0538 between 1990 and 2019. The global burden of periodontal disease did not increase between 1990 and 2019, though the socioeconomic-associated inequality still existed. The burden of periodontal disease was more concentrated in less developed countries, and the socioeconomic-associated inequality has increased since 2000.

Trend of disease burden of drowning in Chongqing residents, 2012-2018 / 公共卫生与预防医学

Objective To analyze the trend of the mortality and disease burden of drowning in Chongqing and provide suggestions for drowning prevention and control. Methods The information data on drowning deaths in Chongqing (ICD-10 code: W65-W74) from 2012 to 2018 were collected. SPSS 25.0 software was used to calculate and analyze indicators such as mortality, age standardized mortality rate by Chinese population (ASMRC), years of life lost with premature death (YLLs), years lived with disability (YLDs), and disability adjusted life years (DALYs). The differences of drowning mortality between male and female, urban and rural areas were tested by Chi-square test. The trend of drowning mortality and disease burden was calculated as annual percent change (APC) using curve-estimation model of logistic regression. The difference of APC was tested by t-test (α=0.05). Results The mortality and ASMRC of drowning decreased from 4.90/100 000 and 4.87/100 000 in 2012 to 3.85/100 000 and 3.59/100 000 in 2018, respectively. The APCs were -3.34% and -4.49%, respectively. There was no significant difference in the change trend (t value: 2.34 and 2.42, P>0.05). The mortality of drowning in the male was higher than that in the female (P0.05). Conclusion The mortality and disease burden of drowning in Chongqing showed a decreasing trend, which was lower than the national average level. Children, male and elderly people are the vulnerable population to prevent drowning, and rural areas are the key areas to prevent drowning.

Burden of dengue in Kerala using disability-adjusted life years from 2006 to 2016

Background: State-specific disability-adjusted life years (DALYs) are seldom calculated. Understanding the health and disease trends in groups of states is useful for finding the heterogeneity of disease epidemiology in the country. Objective: The objective of the study was to assess dengue burden in Kerala state, using DALY. Methods: DALY was computed using the DALY package of R. Incidence was derived using reported and estimated dengue cases for 2006–2016. Mortality was calculated using reported deaths. We computed DALYs using the mortality estimates for the South-East Asia region (SEAR) also. Sensitivity and scenario analyses were done. Results: The highest estimated relative DALY for dengue is 7.22 (95% confidence interval [CI]: 6.66–7.72) per lakh population. The DALY obtained using the mortality rates of SEAR ranged from 19.89 (95% CI: 8.44–29.45) per lakh population to 28.56 (95% CI: 17.04–38.05). We observed a cyclical pattern of increase in DALY every 2–3 years. The DALY in lower age groups is lesser. DALY in females was higher than males. Conclusions: The dengue-related DALY for the state of Kerala is lower than that of the global burden of disease due to lower mortality rates. Mortality reduction becomes the key to reducing burden, especially in areas of low incidence. The study also forms the benchmark for evaluating and implementing cost-effective measures for dengue control in the state.

Spatial distribution of cancer-related burden in Guangzhou from 2010 to 2013 / 中华流行病学杂志

Objective@#To evaluate the burden and to describe the characteristics of spatial distribution caused by malignant tumors among different administrative areas in Guangzhou from 2010- 2013.@*Methods@#Based on data from the Cancer Registry system and population in Guangzhou in 2010- 2013, disability-adjusted life year (DALY) was assessed on the disease burden of cancer, in accordance with the method used in the Global Burden of Disease study.@*Results@#The crude incidence rates of cancer appeared as 256.22/105 in 2010-2011 and 270.04/105 in 2012-2013, with the crude mortality rates as 143.17/105 and 148.01/105, respectively, in Guangzhou. Cancers caused 606 238.95 DALYs in 2010-2011 and 623 763.80 DALYs in 2012-2013 for both sexes and 37.63 and 37.81 person year per 1 000 persons, with the standardized DALY rates as 34.51‰, 34.00‰ respectively. Three administrative districts (Yuexiu, Haizhu and Liwan) were with the largest disease burden of cancers that accounted for 45% of the DALYs for the whole Conghua district, with liver cancer was the leading cancer on DALYs, and tracheal, bronchus and lung cancer ranked the first in the other districts.@*Conclusions@#In Guangzhou, disease burden caused by cancers was both prominently seen in the newly developed urban area and the old districts. It remains an arduous task to continue programs on control and prevention of cancers in this city.

Disease burden of influenza in schools and child care settings in rural areas of Hangzhou, 2016-2018 / 中华预防医学杂志

Objective@#The objective of this study was to analyze the disease burden of influenza in schools and child care settings in rural areas of Hangzhou.@*Methods@#Hospital visit influenza cases aged 3-17 years in hospitals that reported based on influenza surveillance system from 2016 to 2018 in Chun′an county, Hangzhou city were selected as study subjects and a total of 294 confirmed cases of influenza were selected using system sampling method. Questionnaires were designed to investigate the basic information and data on inpatients and outpatients among, health care and life quality, etc.. Direct and indirect economic burden and disability adjusted life year (DALY) were analyzed and compared among different age groups.@*Results@#The mean age of investigated subjects was (8.88±3.92) years. A total of 143 (48.64%) investigated cases were male. In total of 283 (96.26%) cases were outpatients. The total economic burden was 124 743.95 CNY. The mean economic burden was 424.30 CNY per person. The mean direct and indirect economic burden was 361.33 and 62.97 CNY per person respectively. The difference of the mean direct, indirect and total economic burden per person between different age group was statistically significant (P<0.001). The 3-5 years age group showed the highest economic burden with the median value of direct, indirect and total economic burden per person being 276.24, 50.98 and 321.26 CNY, respectively, while the 12-17 years age group showed the lowest values with 175.30, 26.54, 201.79 CNY, respectively. The DALY of 294 influenza cases was 1.18, and the median of burden strength was 3.21 DALY/thousand. The difference of the burden of strength between different age group influenza case was statistically significant (P<0.001), of which the 12-17 years age group showed the highest value with 4.25 DALYs/thousand while the 3-5 years age group showed the lowest value with 2.60 DALY/thousand.@*Conclusion@#The disease burden of influenza was heavy in schools and kindergartens in rural areas of Hangzhou city, with the cases aged from 3 to 5 years showing higher economic burden and cases aged from 12 to 17 years showing greater burden strength.

Burden Of Disease Attributable To Overweight And Obesity In Malaysia

@#The overweight and obese population may affect the population health which can lead to economic stability and development of the countries to be compromised. Thus, this study estimates the burden of disease attributable to overweight and obesity in Malaysia for adults aged 20-59 years old. Population attribution fraction (PAF) and disability-adjusted life year (DALY) have been used to quantify years of life lost from premature death and number of years lost due to disability resulting from obesity and overweight. The burden of disease attributable to overweight was 1582 and 1146 PYs per 1000 persons for male and female, respectively. Meanwhile, the burden of disease attributable to obesity was 2951 PYs per 1000 persons with women in the lead at 1657 PYs per 1000 persons. The burden of overweight and obesity among Malaysian adults is substantial. The outcome of this study is crucial as it gives a comprehensive information on the burden of overweight and obesity in Malaysia. The information from this study also enables the authorities to develop activities and programs to combat obesity and tomaintain healthy lifestyle among Malaysian.

Exploratory analysis on burden of disease attributable to asbestosis from 2006 to 2015 / 中华劳动卫生职业病杂志

Objective@#To analyze the levels and trends of the burden of disease attributable to asbestosis from 2006 to 2015.@*Methods@#Theincidence of asbestosis from 2006 to 2015 was used for calculation, with data of disability weight and remission rate from Global burden of disease study 2015 (GBD 2015) and DisMoD-MR 2.1 software for the calculation of duration and age of year onset. The reference template of GBD was adopted to calculate disability adjusted life year (DALY) , year of life lost (YLL) and year of lived with disability (YLD) value in order to analyze the level and changing trend of burden of disease attributable to asbestosis.@*Results@#A total YLD attributable to asbestosis during 2006 and 2015 in China was 39632. The YLD burden of female was more severe than male, which accounted for 20361 in female and 19271 in male. In 2015, DALY attributable to asbestosis decreased from 8623.76 in 2006 to 6436. Among that, in 2015, YLD was 6436 and YLL was 73.76. 2006 had a highest level of DALY and 2008 had the lowest level of DALY, which accounted for 8623.76 in 2006 and 1558 in 2008. DALY during 2008 and 2015 had a fluctuant increase, and both male and female had such trend.@*Conclusion@#The level of burden of disease attributable to asbestosis is higher in male than in female during 2006 and 2015. Between 2006 and 2015, burden of disease attributable to asbestosis has a fluctuant increase trend.

Temporal Trend in Lung Cancer Burden Attributed to Ambient Fine Particulate Matter in Guangzhou, China / 生物医学与环境科学（英文）

<p><b>OBJECTIVE</b>To estimate the lung cancer burden that may be attributable to ambient fine particulate matter (PM2.5) pollution in Guangzhou city in China from 2005 to 2013.</p><p><b>METHODS</b>The data regarding PM2.5 exposure were obtained from the 'Ambient air pollution exposure estimation for the Global Burden of Disease 2013' dataset at 0.1° ×0.1° spatial resolution. Disability-adjusted life years (DALYs) were estimated based on the information of mortality and incidence of lung cancer. Comparative risk analysis and integrated exposure-response function were used to estimate attributed disease burden.</p><p><b>RESULTS</b>The population-weighted average concentration of PM2.5 was increased by 34.6% between 1990 and 2013, from 38.37 μg/m3 to 51.31 μg/m3. The lung cancer DALYs in both men and women were increased by 36.2% from 2005 to 2013. The PM2.5 attributed lung cancer DALYs increased from 12105.0 (8181.0 for males and 3924.0 for females) in 2005 to 16489.3 (11291.7 for males and 5197.6 for females) in 2013. An average of 23.1% lung cancer burden was attributable to PM2.5 pollution in 2013.</p><p><b>CONCLUSION</b>PM2.5 has caused serious but under-appreciated public health burden in Guangzhou and the trend deteriorates. Effective strategies are needed to tackle this major public health problem.</p>

A cost-effectiveness analysis on universal infant rotavirus vaccination strategy in China / 中华流行病学杂志

Objective To evaluate the cost-effectiveness of current universal infant rotavirus vaccination strategy,in China.Methods Through constructing decision tree-Markov model,we simulated rotavirus diarrhea associated cost and health outcome on those newborns in 2012 regarding different vaccination programs as:group with no vaccination,Rotavirus vaccination group and Rotateq vaccination group,respectively.We determined the optimal program,based on the comparison between incremental cost-effectiveness ratio (ICER) and China' s 2012 per capital gross domestic product (GDP).Results Compared with non-vaccination group,the Rotavirus vaccination and Rotateq vaccination groups had to pay 3 760 Yuan and 7 578 Yuan (both less than 2012 GDP per capital) to avert one disability adjusted life years (DALY) loss,respectively.Results from sensitivity analysis indicated that both results were robust.Compared with Rotavirus vaccination program,the Rotateq vaccination program had to pay extra 81 068 Yuan (between 1 and 3 times GDP per capital) to avert one DALY loss.Data from the sensitivity analysis indicated that the result was not robust.Conclusion From the perspective of health economics,both two-dose Rotarix vaccine and three-dose's Rotateq vaccine programs were highly cost-effective,when compared to the non-vaccination program.It was appropriate to integrate rotavirus vaccine into the routine immunization program.Considering the large amount of extra cost that had to spend on Rotateq vaccination program,results from the sensitivity analysis showed that it was not robust.Rotateq vaccine required one more dose than the Rotarix vaccine,to be effective.However,it appeared more difficult to practice,suggesting that it was better to choose the Rotarix vaccine,at current stage.