背景:儿童和青少年是急性病毒性肝炎(AVH)的高危人群,但是针对它们的流行病学研究已经被成人慢性B和C所掩盖。我们提供全球,区域,以及国家对1990年至2019年20岁以下人群的AVH负担及其趋势的估计。
方法:使用来自全球疾病负担研究(GBD)2019的AVH数据。计算了发病率和残疾调整寿命年(DALYs),用估计的年度百分比变化(EAPC)和Joinpoint回归分析趋势。
结果:2019年,全球儿童和青少年中报告了156.39(95%不确定区间145.20-167.16)百万新的AVH病例,产生1.98(1.50-2.55)百万DALYs。幼儿发病率(<5岁),年龄较大的儿童(5-9岁),青少年(10-19岁)为12,799(11,068-14,513),5,108(4829-5411),和3020(2724-3339)每100,000人口,分别。全球AVH发病率显示线性下降,EAPC为-0.66(-0.68至-0.65)。高发地区包括撒哈拉以南非洲,大洋洲,南亚,中亚,印度,巴基斯坦,尼日利亚面临最大的负担。主要原因是甲型肝炎,其次是戊型肝炎,B,所有类型的肝炎都呈下降趋势,尤其是乙型肝炎。此外,我们证实了AVH发病率和社会经济学之间的关联,疫苗,和晚期肝病。
结论:有效的乙型和丙型肝炎疫苗和治疗提供了根除的机会。扩大诊断和治疗覆盖面对于解决为儿童和青少年提供服务的差距至关重要。
BACKGROUND: Children and adolescents are at high risk for acute viral hepatitis (AVH), but epidemiological research focusing on them has been overshadowed by adult chronic B and C. We provide global, regional, and national estimates of the AVH burden and their trends on people under 20 years from 1990 to 2019.
METHODS: AVH data from Global Burden of Disease
Study (GBD) 2019 was used. Incidence and disability-adjusted life years (DALYs) were calculated, analyzing trends with estimated annual percentage change (EAPC) and Joinpoint regression.
RESULTS: In 2019, 156.39 (95% uncertainty interval 145.20-167.16) million new cases of AVH were reported among children and adolescents globally, resulting in 1.98 (1.50-2.55) million DALYs. Incidence rates for young children (< 5 years), older children (5-9 years), and adolescents (10-19 years) were 12,799 (11,068-14,513), 5,108 (4829-5411), and 3020 (2724-3339) per 100,000 population, respectively. The global AVH incidence displayed a linear decline with an EAPC of - 0.66 (- 0.68 to - 0.65). High-incidence regions included sub-Saharan Africa, Oceania, South Asia, and Central Asia, with India, Pakistan, and Nigeria facing the greatest burden. Leading causes were hepatitis A, followed by hepatitis E, B, and C. All hepatitis types showed declining trends, especially hepatitis B. Furthermore, we confirmed the association between the AVH incidence and the socioeconomics, vaccine, and advanced liver diseases.
CONCLUSIONS: Effective vaccines and treatments for hepatitis B and C offer eradication opportunities. Broadening diagnostic and therapeutic coverage is vital to address disparities in service provision for children and adolescents.