ObjectiveTo systematically review the disease burden and epidemiological characteristics of diabetes mellitus in Chinese population, and to provide references for health resources allocation and health policy making. MethodsDatabases such as PubMed, EMbase, CNKI, VIP and WanFang Data were searched for studies investigating disease burden of diabetes mellitus in Chinese population up to January 1st, 2014. According to the inclusion and exclusion criteria, two researchers screened literature, exacted data, and assessed methodological quality of included studies. Statistical analysis was performed with the data of diabetes associated population, mortality and disease burden were analyzed. ResultsA total of 39 studies were included, one of which was not included for further qualitative analysis due to low quality. The results of qualitative analysis involving 38 studies showed that, since 1980, the prevalence of diabetes increased rapidly in China, especially in the younger age group. The disease burden of woman was higher than that of man; it was slightly higher in the city than in the countryside; but the gap between urban and rural areas was gradually narrowed. Disease burdens in Eastern, Central and Western regions orderly decreased, all of which were all at high levels. ConclusionThe disease burden of diabetes mellitus in China is seriously high and the prevention and control work is very hard. It is necessary to rationally and effectively allocate health resources based on different health demands in different regions among urban-rural and age groups; to reduce the burden in the elderly; and to pay more attention to the young age population at the same time. Besides, the emphasis of prevention should be placed on suppressing the increase of prevalence of diabetes mellitus and reducing disease burden due to its complications.
ObjectivesTo systematically review the disease burden and epidemiological characteristics of tuberculosis in the Chinese population, and to provide reference for health resources allocation and health policy making.MethodsDatabases such as PubMed, EMbase, CNKI, VIP and WanFang Data were searched for studies investigating disease burden of tuberculosis in Chinese population from inception to August 1st, 2017. Two researchers independently screened literature, exacted data and assessed methodological quality of included studies. Statistical analysis was performed on data of tuberculosis associated population, mortality and disease burden.ResultsA total of 40 studies were included. The results of qualitative analysis showed that, since 1990, the prevalence of tuberculosis and its disease burden in China decreased year by year. However, the disease burden per patient and the total economic burden in China showed an increasing trend, and the economical disease burden increased 1.6 times from 1993 to 2003. The disease burden of men was higher than that of women, and it was higher in the countryside than in the city. In 2004, the ratio of YLL per thousand people in rural and urban areas was 2.18, and the ratio was 1.29 in 2014. Additionally, the disease burden decreased gradually in western, central and eastern regions. In 2014, compared with 2004, YLL decreased by 1.11, while the central and eastern regions were 0.48 and 0.25, respectively. The gap between the gender, the urban and rural areas and the regions was not as significant as in previous.ConclusionsThe disease burden of tuberculosis in China is seriously high and the tuberculosis prevention and control work should take into consideration the epidemiological characteristics of tuberculosis and the trends of the disease burden. It is necessary to rationally and effectively implement health intervention programs and allocate health resources based on different health demands in different regions and age groups to reduce the morbidity and mortality, and to pay more attention to drug-resistant tuberculosis. Besides, the emphasis of prevention should be placed on reducing disease burden in the elderly and strengthening prevention in the young population.
Objective To systematically review the epidemic trend and disease burden of ischemic stroke in the Chinese population and to provide references for formulating reasonable prevention and treatment measures and allocating health resources. Methods Based on Global Burden of Disease (GBD) data, we analyzed the morbidity, mortality, disability-adjusted life year (DALY) and normalized rates for ischemic stroke in China from 1990 to 2019 and evaluated the changes in the disease burden by sex and age group. Meanwhile, joinpoint regression model was constructed to analyze the time trend change in each stage during the study period. Results Compared with 1990, the incidence, mortality and DALY rate of ischemic stroke in China increased by 171.68%, 125.60% and 98.60% in 2019, among which the incidence, mortality and DALY rate of males increased by 184.29%, 148.96% and 115.16%, respectively; the morbidity, mortality and DALY rates of females increased by 160.9%, 101.32% and 81.44%, respectively. The age-standardized incidence increased by 34.70%, while the age-standardized mortality and age-standardized DALY rate decreased by 3.33% and 4.02%, respectively; the age-standardized incidence, mortality and DALY rates of males increased by 39.52%, 8.03% and 3.68%, respectively; the age-standardized incidence rate of females increased by 31.40%, while the age-standardized mortality rate and age-standardized DALY rate decreased by 14.02% and 11.53%, respectively. In 2019, both the mortality rate and DALY rate due to ischemic stroke increased with age, and the highest rate was found in the population over 85 years old. Males over 60 years old were significantly than females. In the 55-84 age group, the incidence of ischemic stroke in females was higher than that in males, while in the 85 and above age group, the incidence of ischemic stroke in females was lower than that in males. The AAPC of age-standardized incidence, age-standardized mortality, and age-standardized DALY rates due to ischemic stroke from 1990 to 2019 were 1.06% (95%CI 1.00% to 1.11%), 0.01% (95%CI −0.45% to 0.48%) and −0.16% (95%CI −0.53% to 0.22%), respectively. All indicators of the AAPC for males were higher than those for females. ConclusionThe curvent age-standardized mortality and DALY rate of ischemic stroke in China have decreased slightly compared with 1990. The crude mortality, morbidity and disease burden have significantly increased. All indicators of the AAPC for males were higher than those for females. To reduce the epidemic trend and disease burden of ischemic stroke, reasonable prevention and treatment measures and rational allocation of health resources should be made according to sex and age.