背景:地中海贫血是全球范围内重大的公共卫生挑战。然而,地中海贫血的全球负担和与之相关的差异仍然知之甚少。我们的研究旨在揭示全球地中海贫血的长期时空趋势,区域,和国家层面,分析年龄的影响,时间段,和出生队列,并指出地中海贫血负担的全球差异。
方法:我们从2019年全球疾病负担研究(GBD)中提取了有关地中海贫血负担的数据。我们采用连接点回归模型来评估地中海贫血负担的时间趋势,并采用年龄-时期-队列模型来评估年龄的影响。period,和地中海贫血死亡率队列。
结果:从1990年到2019年,地中海贫血事件病例数,普遍的情况下,死亡病例,残疾调整寿命年(DALYs)下降了20.9%,3.1%,38.6%,和43.1%,分别。年龄标准化的发病率,患病率,死亡率,DALY在各个地区都出现了下降,中高,中间,和中低端社会人口指数(SDI),然而,在SDI低和SDI中低端地区以及东南亚,在五岁以下儿童中达到顶峰。男性的全球患病率高于女性。全球死亡率随着年龄的增长而持续下降。
结论:地中海贫血的全球负担显著下降,然而,在性别方面存在显著差异,年龄组,perments,出生队列,SDI地区,和GBD地区。系统性干预措施,包括早期筛查,遗传咨询,婚前健康检查,产前诊断应优先考虑低,和中低端SDI,特别是在东南亚。未来基于人群的研究应特别关注地中海贫血亚型和输血需求。国家登记处应通过新生儿筛查加强数据采集。
BACKGROUND: Thalassemia represents a significant public health challenge globally. However, the global burden of thalassemia and the disparities associated with it remain poorly understood. Our study aims to uncover the long-term spatial and temporal trends in thalassemia at global, regional, and national levels, analyze the impacts of age, time periods, and birth cohorts, and pinpoint the global disparities in thalassemia burden.
METHODS: We extracted data on the thalassemia burden from the Global Burden of Disease Study (GBD) 2019. We employed a joinpoint regression model to assess temporal trends in thalassemia burden and an age-period-cohort model to evaluate the effects of age, period, and cohort on thalassemia mortality.
RESULTS: From 1990 to 2019, the number of thalassemia incident cases, prevalent cases, mortality cases, and disability-adjusted life years (DALYs) decreased by 20.9%, 3.1%, 38.6%, and 43.1%, respectively. Age-standardized rates of incidence, prevalence, mortality, and DALY declined across regions with high, high-middle, middle, and low-middle sociodemographic index (SDI), yet remained the highest in regions with low SDI and low-middle SDI as well as in Southeast Asia, peaking among children under five years of age. The global prevalence rate was higher in males than in females. The global mortality rate showed a consistent decrease with increasing age.
CONCLUSIONS: The global burden of thalassemia has significantly declined, yet notable disparities exist in terms of gender, age groups, periods, birth cohorts, SDI regions, and GBD regions. Systemic interventions that include early screening, genetic counseling, premarital health examinations, and prenatal diagnosis should be prioritized in regions with low, and low-middle SDI, particularly in Southeast Asia. Future population-based studies should focus specifically on thalassemia subtypes and transfusion requirements, and national registries should enhance data capture through newborn screening.