2000-2021年世界卫生组织非洲区域血红蛋白病和溶血性贫血负担:《2021年全球疾病负担》研究结果

IF 2.5
PLOS global public health Pub Date : 2025-09-22 eCollection Date: 2025-01-01 DOI:10.1371/journal.pgph.0005197
Temitope T Ojo, Prince M Amegbor, Farha Islam, Joyce Gyamfi, Andi Mai, Carly M Malburg, Deborah B Adenikinju, Nicholas J Kassebaum, Shimelis Tadesse Abebe, Richard Gyan Aboagye, Ganiyu Adeniyi Amusa, Seth Christopher Yaw Appiah, Haftu Asmerom Asmerom, Isaac Sunday Chukwu, Tadesse Asmamaw Dejenie, Fitsum Wolde Demisse, Gashaw Dessie, Mengistie Diress, Christopher Imokhuede Esezobor, Habitu Birhan Eshetu, Adeniyi Francis Fagbamigbe, Sefineh Fenta, Teferi Gebru Gebremeskel, Segun Emmanuel Ibitoye, Robel Hussen Kabthymer, Woldeteklehaymanot Dagne Kassahun, Biruk Getahun Kibret, Osaretin Christabel Okonji, Prof Mayowa O Owolabi, Prof Léon Muepu M Tshilolo, Berhanu Woldu, Emmanuel K Peprah
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引用次数: 0

摘要

血红蛋白病和溶血性贫血(HHA)是与多种临床并发症相关的遗传性血液疾病,全球约有21亿人受到影响。世界卫生组织(世卫组织)非洲区域约有4.258亿人,占全球HHA患病率的20%,但缺乏对这一负担的全面评估。我们利用2021年全球疾病负担(GBD)研究的数据,首次对世卫组织非洲区域2000-2021年卫生保健机构负担进行了系统分析。我们以5年为间隔估计了地区、性别和年龄特定的死亡率(每10万人)、出生发生率和残疾生活年数(YLDs)。死亡率估计使用死亡原因集合模型(CODEm)生成,并辅以时空高斯过程回归。使用贝叶斯元回归工具dismod - mr2.1估计出生时的发病率,而通过将患病率乘以反映严重程度和持续时间的残疾权重来计算YLDs。2000年至2021年期间,世卫组织非洲区域卫生保健的年龄标准化死亡率持续高于全球水平,尽管该区域死亡率在此期间有所下降。镰状细胞病(SCD)是主要致病因素,死亡率最高[每10万人中有3.68人死亡(95% UI 2.04-6.29)],残疾负担最高[41.08 YLDs (95% UI 26.09-58.61)],而地中海贫血的致病因素最少。残疾调整生命年(DALYs)集中在撒哈拉以南非洲西部,占该区域负担的71.3%。按年龄分列的估计数显示,五岁以下儿童在死亡率和致残率中所占比例过高。尽管死亡率总体下降,但世卫组织非洲区域继续承担着不成比例的卫生保健全球负担,特别是影响到幼儿。这些发现强调迫切需要加强新生儿筛查、早期治疗和卫生系统干预,以减少可预防的死亡和残疾。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Burden of hemoglobinopathies and hemolytic anemias in the World Health Organization African region, 2000-2021: Findings from the Global Burden of Disease 2021 study.

Hemoglobinopathies and hemolytic anemias (HHA) are genetic blood disorders associated with diverse clinical complications, affecting an estimated 2.1 billion people worldwide. The World Health Organization (WHO) African Region accounts for approximately 425.8 million individuals, or 20% of the global HHA prevalence, yet comprehensive assessments of this burden have been lacking. We present the first systematic analysis of HHA burden in the WHO African Region from 2000-2021 using data from the Global Burden of Disease (GBD) 2021 study. We estimated regional, sex-, and age-specific rates (per 100,000 population) of mortality, incidence at birth, and years lived with disability (YLDs) in five-year intervals. Mortality estimates were generated using the Cause of Death Ensemble model (CODEm), supplemented with spatiotemporal Gaussian process regression. Incidence at birth was estimated using DisMod-MR 2.1, a Bayesian meta-regression tool, while YLDs were calculated by multiplying prevalence by disability weights reflecting severity and duration. Between 2000 and 2021, the WHO African Region experienced persistently higher age-standardized death rates from HHA compared to global levels, although regional mortality declined over the period. Sickle cell disorder (SCD) was the predominant contributor, with the highest mortality [3.68 deaths (95% UI 2.04-6.29) per 100,000] and disability burden [41.08 YLDs (95% UI 26.09-58.61)], while thalassemias contributed the least. Disability-adjusted life years (DALYs) were concentrated in western sub-Saharan Africa, accounting for 71.3% of the regional burden. Age-specific estimates revealed that children under five years faced a disproportionate share of mortality and disability. Despite overall declines in mortality, the WHO African Region continues to bear a disproportionate global burden of HHA, particularly affecting young children. These findings underscore the urgent need for strengthened newborn screening, early treatment, and health system interventions to reduce preventable deaths and disability.

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