Enhancing regional disease burden estimates: insights from the comparison of Global Burden of Disease and China's notifiable infectious diseases data with policy implications (2010-2020).

Abstract

Background: The Global Burden of Disease (GBD) study offers influential Disability-Adjusted Life Years (DALYs) estimates for various diseases. However, discrepancies with national surveillance data raise concerns about accuracy. This study aims to promote the deep integration of the GBD model with localized data and facilitate the development of region-specific models.

Methods: Data for 14 notifiable infectious diseases (NIDs), grouped into intestinal infectious diseases, respiratory infectious diseases, and sexually transmitted and blood-borne infections, were obtained from the Data-center of China Public Health Science. DALYs based on national surveillance data (2010-2020) were calculated using DALY formulas, and discrepancies with GBD estimates were quantified through ratio comparisons. A historical timeline map highlighted key infectious disease control policies and certified disease elimination events in China.

Results: National surveillance data show a decrease in DALYs for 14 NIDs in China, from 6,529,124.62 person-years in 2010 to 6,326,497.18 person-years in 2020. Among them, sexually transmitted and blood-borne infections have the highest burden, with 78% of DALYs attributed to hepatitis B (4,864,028.29 person-years). Respiratory infectious diseases follow, with 99% of DALYs from TB (394,927.70 person-years). Intestinal infectious diseases have the relative lightest burden, with 45% of DALYs from hepatitis E (496.49 person-years). Over 11 years, 9 of the 14 NIDs showed a downward trend. Comparisons reveal that DALYs based on national surveillance data are lower than GBD 2021 estimates.

Conclusions: Considerable differences exist between the GBD estimates and national surveillance data regarding the burden of 14 NIDs in China. Therefore, strengthening national reporting systems and integrating localized data with the GBD model is essential for more accurate disease burden assessments and effective response strategies. Despite significant progress in infectious disease control, China still faces substantial challenges in domestic disease elimination.