1990—2021年中国0~14岁儿童呼吸道合胞病毒相关下呼吸道感染的疾病负担及预测

顾信佳; 周晓芳; 刘太祥

doi:10.19428/j.cnki.sjpm.2026.250231

1990—2021年中国0~14岁儿童呼吸道合胞病毒相关下呼吸道感染的疾病负担及预测

Disease burden and prediction of respiratory syncytial virus-associated lower respiratory tract infections in Chinese children aged 0 to 14 years from 1990 to 2021

摘要

摘要:
目的分析1990—2021年中国0~14岁儿童呼吸道合胞病毒相关下呼吸道感染（RSV⁃LRTIs）的疾病负担变化趋势，并预测2022— 2030年的疾病负担。
方法基于全球疾病负担研究（GBD）2021年数据库，提取中国0~14岁儿童RSV⁃LRTIs的死亡数、死亡率、伤残调整寿命年（DALYs）、DALYs率等数据。采用疾病建模元回归工具DisMod⁃MR 2.1进行数据建模，估计RSV⁃LRTIs死亡率和DALYs率及其95%不确定性区间（UI）。采用Joinpoint回归分析计算年度变化百分比（APC）、平均年度变化百分比（AAPC）及其95%置信区间（CI），分析1990—2021年RSV⁃LRTIs死亡率和DALYs率随时间变化趋势。采用贝叶斯年龄-时期-队列（BAPC）模型预测2022—2030年的疾病负担。
结果 1990—2021年，中国0~14岁儿童RSV⁃LRTIs死亡数从24 738例降至400例，死亡率从7.8/10万降至0.2/10万；DALYs从2 211 155人年降至35 958人年，DALYs率从694.5/10万降至13.8/10万。男童死亡数、死亡率、DALYs及DALYs率均高于女童。2021年，1~5月龄儿童的死亡数和DALYs最高，新生儿（<28 d）的死亡率和DALYs率最高。Joinpoint回归分析显示，1990—1993、1993—2002、2002—2019及2019—2021年的死亡率和DALYs率均下降（P<0.001），2019—2021年降幅最大。据预测，2022—2030年中国0~14岁儿童年龄标化死亡率将降至0.000 9/10万（95%CI：0.000 2~0.001 7）。
结论 1990—2021年中国0~14岁儿童RSV⁃LRTIs疾病负担下降，男童的疾病负担高于女童。5岁以下儿童，尤其是6个月以下婴儿和新生儿（<28 d）是高风险人群。2022—2030年年龄标化死亡率仍将呈下降趋势，需持续加强婴幼儿人群的监测与防控。

Abstract:
Objective To analyze trends in the disease burden of respiratory syncytial virus-associated lower respiratory tract infections (RSV-LRTIs) among children aged 0 to 14 years old in China from 1990 to 2021, and to predict the disease burden for the period of 2022 to 2030.
Methods Based on the Global Burden of Disease (GBD) 2021 database, data on deaths, mortality rates, disability-adjusted life years (DALYs), and DALYs rates for RSV-LRTIs among Chinese children aged 0 to 14 years old were extracted. The disease modelling meta-regression tool—DisMod-MR 2.1 was employed for data modelling to estimate RSV-LRTIs mortality rates and DALYs rates, along with their 95% uncertainty intervals (UI). Joinpoint regression analyses were employed to calculate annual percentage change (APC), average annual percentage change (AAPC), and their 95% confidence intervals (CI), in order to analyze trends in mortality and DALYs rates over time from 1990 to 2021. A Bayesian age-period-cohort (BAPC) model was employed to predict the disease burden for 2022 to 2030.
Results From 1990 to 2021, the number of deaths from RSV-LRTIs among children aged 0 to 14 years old in China decreased from 24 738 to 400, with the mortality rate falling from 7.8/100 000 to 0.2/100 000; DALYs decreased from 2 211 155 person-years to 35 958 person-years, with the DALYs rate falling from 694.5/100 000 to 13.8/100 000. The number of deaths, mortality rates, DALYs, and DALYs rates were all higher in boys than in girls. In 2021, the highest number of deaths and DALYs occurred among infants aged 1 to 5 months, while the highest mortality rates and DALYs rates were observed among newborns (<28 days). Joinpoint regression analyses indicated significant reductions in mortality rates and DALYs rates across all three periods: 1990‒1993, 1993‒2002, 2002‒2019, and 2019‒2021 (P<0.001), with the most pronounced decline occurring from 2019 to 2021. Prodictions indicate that the age-standardized mortality rate for children aged 0 to 14 years old in China will decrease to 0.000 9/100 000 (95%CI: 0.000 2‒0.001 7) from 2022 to 2030.
Conclusion The disease burden of RSV-LRTIs among Chinese children aged 0 to 14 years old declined from 1990 to 2021. The disease burden was higher in boys than in girls. Children under 5 years of age, particularly infants under six months and newborns (<28 days), constituted high-risk groups. Age-standardized mortality rate is predicted to continue decreasing from 2022 to 2030. Sustained efforts to strengthen surveillance and prevention measures for infants and young children remain essential.

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