背景:世界卫生组织宣布了到2030年结束性传播感染(STI)流行的目标。为量身定制的预防策略提供参考,我们分析了1990年至2019年按地理区域和年龄组划分的性传播感染趋势和差异.
方法:梅毒的年新感染人数和年龄标准化发病率(ASR),衣原体,淋病,滴虫病,和生殖器疱疹的记录来自2019年的全球疾病负担研究。我们通过计算新感染的变化和ASR的估计年度百分比变化(EAPC)来量化性传播感染的时间趋势。
结果:梅毒的ASR,衣原体,滴虫病,生殖器疱疹增加1.70%(95%置信区间[CI],1.62-1.78%),0.29%(95%CI0.04-0.54%),0.27%(95%CI0.03-0.52%),2010年至2019年,全球每年为0.40%(95%CI0.36-0.44%),分别,而淋病没有。美洲地区的梅毒ASR增幅最大(热带拉丁美洲:EAPC,5.72;95%CI5.11-6.33),衣原体(高收入北美:EAPC,1.23;95%CI0.73-1.73),和淋病(高收入北美:EAPC,0.77;95%CI0.12-1.41)。此外,撒哈拉以南非洲南部和东亚毛滴虫的ASR增幅最大(EAPC,0.88;95%CI0.57-1.20)和生殖器疱疹(EAPC,1.44;95%CI0.83-2.06),分别。近年来,全球梅毒发病率最高的人群往往更年轻(2010年25-29岁与2019年20-24岁),但北非和中东年龄较大(20-24岁vs.25-29岁);在撒哈拉以南非洲南部,衣原体往往年龄较大(25-29岁与30-34岁),但在澳大利亚更年轻(40-44岁vs.25-29岁);在高收入的北美,生殖器疱疹往往年龄较大(20-24岁与25-29岁)和南亚(25-29岁vs.30-34岁)。
结论:梅毒,衣原体,滴虫病,从2010年到2019年,生殖器疱疹的ASR呈增加趋势。各地理区域和年龄组趋势的差异表明,需要在关键区域和人群中采取更有针对性的预防战略。
BACKGROUND: World Health Organization announced its goal of ending sexually transmitted infection (STI) epidemics by 2030. To provide a reference for tailored prevention strategies, we analyzed trends and differences in STIs by geographical regions and age groups from 1990 to 2019.
METHODS: Annual number of new infections and age-standardized incidence rates (ASRs) of syphilis, chlamydia, gonorrhea, trichomoniasis, and genital herpes were recorded from the 2019 Global Burden of Disease
study. We quantified the temporal trends of STIs by calculating changes in new infections and estimated annual percentage changes (EAPCs) of ASR.
RESULTS: The ASRs of syphilis, chlamydia, trichomoniasis, and genital herpes increased by 1.70% (95% confidence interval [CI], 1.62-1.78%), 0.29% (95% CI 0.04-0.54%), 0.27% (95% CI 0.03-0.52%), and 0.40% (95% CI 0.36-0.44%) per year from 2010 to 2019 worldwide, respectively, while that of gonorrhea did not. The American regions had the greatest increase in ASR for syphilis (tropical Latin America: EAPC, 5.72; 95% CI 5.11-6.33), chlamydia (high-income North America: EAPC, 1.23; 95% CI 0.73-1.73), and gonorrhea (high-income North America: EAPC, 0.77; 95% CI 0.12-1.41). Additionally, southern sub-Saharan Africa and East Asia had the greatest increase in ASR for trichomoniasis (EAPC, 0.88; 95% CI 0.57-1.20) and genital herpes (EAPC, 1.44; 95% CI 0.83-2.06), respectively. In the most recent years, the population with the greatest incidence of syphilis tended to be younger globally (25-29 years in 2010 vs. 20-24 years in 2019) but older in North Africa and Middle East (20-24 year vs. 25-29 years); with chlamydia tended to be older in southern sub-Saharan Africa (25-29 years vs. 30-34 years) but younger in Australasia (40-44 years vs. 25-29 years); with genital herpes tended to be older in high-income North America (20-24 years vs. 25-29 years) and South Asia (25-29 years vs. 30-34 years).
CONCLUSIONS: Syphilis, chlamydia, trichomoniasis, and genital herpes showed a trend of increasing ASR from 2010 to 2019. The differences in trends by geographical regions and age groups point to the need for more targeted prevention strategies in key regions and populations.