收稿日期: 2025-02-14
修回日期: 2025-03-26
网络出版日期: 2025-10-09
基金资助
甘肃省自然科学基金(21JR11RA182);国家寄生虫资源库(NPRC-2019-194-30);中国疾病预防控制中心疾病控制科研技术储备项目(N241720)
Trend analysis and forecast of global burden of malaria from 1990 to 2035
Received date: 2025-02-14
Revised date: 2025-03-26
Online published: 2025-10-09
Supported by
Natural Science Foundation of Gansu Province(21JR11RA182);National Parasite Resource Bank(NPRC-2019-194-30);Chinese Center for Disease Control and Prevention Disease Control Scientific Research and Technology Reserve Project(N241720)
目的 分析1990—2021年全球疟疾疾病负担变化情况，并预测2022—2035年疟疾疾病负担变化趋势，为全球疟疾防控提供科学依据。方法 获取2021年全球疾病负担数据库中人口学数据、疟疾发病率、患病率、死亡率及伤残调整寿命年（DALY）率等数据，选取年龄标化发病率（ASIR）、年龄标化患病率（ASPR）、年龄标化死亡率（ASMR）、年龄标化DALY率（ASDR）及其95%不确定性区间（UI）和社会人口学指数（SDI）作为核心指标进行分析。采用平均年度变化百分比（AAPC）及95%置信区间（CI）作为主要指标，分析1990—2021年疟疾ASIR、ASPR、ASMR、ASDR的变化趋势，采用贝叶斯年龄-时期-队列分析（BAPC）模型对2022—2035年全球疟疾疾病负担进行预测，采用AAPC分析2022—2035年全球疟疾ASIR、ASPR、ASMR、ASDR之间的关系。结果 1990—2021年全球疟疾ASIR[AAPC = -7.25%，95%CI：（-11.68%，-2.81%）]、ASPR[AAPC = -14.42%，95%CI：（-15.99%，-12.84%）]、ASMR[AAPC = -0.06%，95%CI：（-0.08%，-0.05%）]和ASDR[AAPC = -4.86%，95%CI：（-5.81%，-3.91%）]均呈显著下降趋势。不同SDI地区各标化指标以低SDI地区下降幅度最大，其AAPC分别为-184.95%[95%CI：（-193.26%，-176.64%）]、-253.13%[95%CI：（-256.83%，-249.43%）]、-0.75%[95%CI：（-0.82%，-0.68%）]、-65.59%[95%CI：（-69.07%，-62.11%）]。2021年，不同地理区域以撒哈拉以南非洲中部地区疟疾的ASIR[21 152.56/10万，95%UI：（16 857.61/10万，26 956.39/10万）]、ASPR[21 328.79/10万，95%UI：（16 092.29/10万，28 557.44/10万）]最高，以撒哈拉以南非洲西部地区疟疾的ASMR[106.48/10万，95%UI：（38.23/10万，222.04/10万）]、ASDR[5 668.41/10万，95%UI：（2 216.18/10万，11 127.48/10万）]最高；不同国家以利比里亚的ASIR[27 702.66/10万，95%UI：（14 565.45/10万，38 887.49/10万）]、ASPR[29 248.89/10万，95%UI：（13 845.02/10万，47 808.36/10万）]最高，布基纳法索的ASMR[173.13/10万，95%UI：（75.38/10万，318.49/10万）]最高，塞拉利昂的ASDR[8 940.31/10万，95%UI：（3 029.75/10万，17 358.47/10万）]最高；不同年龄段，5岁以下人群疟疾发病人数（9 630.34万）、患病人数（3 174.9万）和发病率[14 631.95/10万，95%UI：（21 120.91/10万，10 175.30/10万）]、患病率[4 823.86/10万，95%UI：（5 361.59/10万，4 362.74/10万）]均最高。全球疟疾ASIR、ASPR、ASMR、ASDR与SDI呈负相关关系（r = -0.89、-0.89、-0.87、-0.87，均P < 0.01）。经BAPC模型预测，2022—2035年全球疟疾ASIR[AAPC = -17.12%，95%CI：（-17.24%，-16.99%）]、ASPR[AAPC = -5.93%，95%CI：（-6.07%，-5.80%）]、ASMR[AAPC = -0.10%，95%CI：（-0.10%，-0.11%）]和ASDR[AAPC = -9.63%，95%CI：（-9.65%，-9.62%）]均呈现下降趋势。结论 1990—2021年全球疟疾疾病负担持续下降，5岁以下儿童是高风险人群。2022—2035年全球疟疾疾病负担总体将呈继续下降的趋势。
杨国兵 , 何爱伟 , 秦宇 , 杨剑 , 王吉春 . 1990—2035年全球疟疾疾病负担趋势分析及预测[J]. 中国寄生虫学与寄生虫病杂志, 2025 , 43(4) : 526 -532 . DOI: 10.12140/j.issn.1000-7423.2025.04.012
Objective To analyze the trends in global burden of malaria from 1990 to 2021 and to predict the trends in malaria burden from 2022 to 2035, so as to provide a scientific basis for the global malaria control programm. Methods Demographic data, and the incidence, prevalence, mortality, and disability-adjusted life years (DALY) rates of malaria were extracted from the Global Burden of Disease 2021 Database, and the age-standardized incidence rate (ASIR), age-standardized prevalence rate (ASPR), age-standardized mortality rate (ASMR), age-standardized DALY rate (ASDR) of malaria with their 95% uncertainty intervals (UI), and socio-demographic index (SDI) were extracted. The trends in ASIR, ASPR, ASMR and ASDR of malaria from 1990 to 2021 were examined using average annual percent change (AAPC) with 95% confidence interval (CI). The global burden due to malaria was projected from 2022 to 2035 with a Bayesian age-period-cohort (BAPC) model, and the trends in ASIR, ASPR, ASMR and ASDR of malaria from 2022 to 2035 were analyzed with AAPC and 95%CI. Results Significant declines were observed globally in ASIR [AAPC = -7.25%, 95%CI: (-11.68%, -2.81%)], ASPR [AAPC = -14.42%, 95%CI: (-15.99%, -12.84%)], ASMR [AAPC = -0.06%, 95%CI: (-0.08%, -0.05%), and ASDR [AAPC = -4.86%, 95%CI: (-5.81%, -3.91%)] of malaria from 1990 to 2021. Across different SDI regions, the lowest SDI region demonstrated the most substantial decline in all standardized indicators, with AAPCs of -184.95% [95%CI: (-193.26%, -176.64%)], -253.13% [95%CI: (-256.83%, -249.43%)], -0.75% [95%CI: (-0.82%, -0.68%)], and -65.59% [95%CI: (-69.07%, -62.11%)], respectively. In 2021, the Central sub-Saharan Africa region had the highest malaria ASIR [21 152.56 per 100 000, 95%UI: (16 857.61, 26 956.39) per 100 000] and ASPR [21 328.79 per 100 000, 95%UI: (16 092.29, 28 557.44) per 100 000], whereas Western sub-Saharan Africa had the highest ASMR [106.48 per 100 000, 95%UI: (38.23, 222.04) per 100 000] and ASDR [5 668.41 per 100 000, 95%UI: (2 216.18, 11 127.48) per 100 000]. At the national level, Liberia reported the highest ASIR [27 702.66 per 100 000, 95%UI: (14 565.45, 38 887.49) per 100 000] and ASPR [29 248.89 per 100 000, 95%UI: (13 845.02, 47 808.36) per 100 000]; Burkina Faso had the highest ASMR [173.13 per 100 000, 95%UI: (75.38, 318.49) per 100 000]; and Sierra Leone recorded the highest ASDR [8 940.31 per 100 000, 95%UI: (3 029.75, 17 358.47) per 100 000]. Among different age groups, children under 5 years had the highest number of incident cases (96.303 4 million) and prevalent cases (31.749 million), as well as the highest incidence [14 631.95 per 100 000, 95%UI: (10 175.30, 21 120.91) per 100 000] and prevalence [4 823.86 per 100 000, 95%UI: (4 362.74, 5 361.59) per 100 000]. Globally, malaria ASIR, ASPR, ASMR, and ASDR showed strong inverse correlations with SDI (r = -0.89, -0.89, -0.87, -0.87, respectively; all P < 0.01). It was projected with the BAPC model that declining trends were seen in ASIR [AAPC = -17.12%, 95%CI: (-17.24%, -16.99%)], ASPR [AAPC = -5.93%, 95%CI: (-6.07%, -5.80%)], ASMR [AAPC = -0.10%, 95%CI: (-0.10%, -0.11%)], and ASDR [AAPC = -9.63%, 95%CI: (-9.65%, -9.62%)] of malaria from 2022 to 2035. Conclusion The global burden of malaria declined continuously from 1990 to 2021, with children under five years of age identified as high-risk populations. Forecasts suggest an overall tendency towards a continued decline in the global burden of malaria from 2022 to 2035.
Key words： Malaria; Burden of disease; Incidence; Prevalence; Mortality; Disability-adjusted life year
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