目的 分析1990-2021年中国5岁以下儿童结核病疾病负担变化趋势，为制定中国儿童结核病防控措施提供科学依据。方法 基于2021年全球疾病负担数据集(GBD 2021)，收集1990-2021年中国和全球5岁以下儿童结核病发病率、患病率、死亡率和伤残调整生命年(disability-adjusted life year，DALY)等数据。比较不同性别儿童和不同类型结核病发病率、患病率、死亡率和DALY率，采用Joinpoint回归模型计算1990-2021年中国和全球儿童结核病疾病负担变化的年度百分比(APC)和平均年度百分比(AAPC)，分析其变化趋势。结果 2021年中国5岁以下儿童结核病新发病例数、患病数和死亡数分别为0。97万，847。78万和0。02万例，所致DALY为2。71万人年。1990-2021年中国和全球5岁以下儿童结核病发病率、患病率、死亡率、DALY率均呈下降趋势(AAPC值分别为-5。45，-1。14％，-12。37％，-11。34％;-2。38％，-1。41％，-4。66％，-4。56％，P值均＜0。05);中国5岁以下儿童结核病发病率、死亡率、DALY率下降均快于全球总体水平(P＜0。05)。1992年及以后，男童结核病新发病例数、患病数、死亡病例数和所致DALY均高于女童。1990-2021年药物敏感结核病发病率、患病率、死亡率、DALY率均呈下降趋势，耐多药结核病发病率和患病率在2015年后有所上升。结论 1990-2021年中国5岁以下儿童结核病疾病负担下降明显，但近年来耐多药结核病疾病负担有所上升。需高度重视儿童结核病防控工作，进一步完善耐药结核病的诊断和治疗。
Temporal trend of tuberculosis burden among children under 5 years old in China from 1990 to 2021
Objective To analyze the trends in disease burden of tuberculosis among children under 5 years of age in China from 1990 to 2021,so as to provide insights for future tuberculosis control measures among children in China.Methods Based on the Global Burden of Disease(GBD)2021 datasets,the incidence,prevalence,mortality and disability-adjusted life year(DALY)of tuberculosis of children under 5 years of age in China and globally were collected from 1990 to 2021.The incidence,prevalence,mortality and DALY rate of tuberculosis were compared by genders and types.In addition,the annual percent change(APC)and the average annual percent change(AAPC)of children's tuberculosis burden in China and globally from 1990 to 2021 were calculated by using the Joinpoint regression model,and the changing trends were analyzed.Results The numbers of incident,prevalent and dead tuberculosis cases were 9 700,8 477 800 and 200 among children under 5 years of age in China in 2021,and the DALY due to tuberculosis were 27 100 person-years.There were significant reductions in incidence,prevalence,mortality and DALY rate of tuberculosis among children under 5 years of age in China(AAPC=-5.45％,-1.14％,-12.37％,-11.34％)and globally(AAPC=-2.38％,-1.41％,-4.66％,-4.56％),and the reductions in the incidence,mortality and DALY rate were more significant in China than globally(P＜0.05).In 1992 and later,the numbers of incident,prevalent and dead tuberculosis cases and the DALY of tuberculosis were higher among male than among female.In addition,the disease burden of drug-susceptible tuberculosis appeared a tendency of downward in China from 1990 to 2021,while the incidence and prevalence of extensively drug-resistant tuberculosis rose since 2015.Conclusions The disease burden of tuberculosis remarkably reduced among children under 5 years of age in Chi-na from 1990 to 2021.However,the burden of disease due to multidrug-resistant tuberculosis appeared an upward trend recently.Increased attention is required to be paid to the prevention and control of tuberculosis among children and improved diagnosis and treatment of drug-resistant tuberculosis are recommended.
TuberculosisCost of illnessRegression analysisDisability-adjusted life yearChild,preschool
NETL
NSTL
万方数据
