Background:Understanding the global burden of enteric infections is crucial for prioritizing control strategies for foodborne and waterborne diseases.This study aimed to assess the global burden of enteric infections ...Background:Understanding the global burden of enteric infections is crucial for prioritizing control strategies for foodborne and waterborne diseases.This study aimed to assess the global burden of enteric infections in 2021 and identify risk factors from One Health aspects.Methods:Leveraging the Global Burden of Disease(GBD)2021 database,the incidence,disability-adjusted life years(DALYs),and deaths of enteric infections and the subtypes were estimated,including diarrheal diseases,typhoid and paratyphoid fever,invasive non-typhoidal Salmonella(iNTS)infections,and other intestinal infectious diseases.The estimates were quantified by absolute number,age-standardized incidence rate(ASIR),agestandardized mortality rate(ASMR)and age-standardized DALY rate with 95%uncertainty intervals(UIs).Thirteen pathogens and three risk factors associated with diarrheal diseases were analyzed.Results:In 2021,the global age-standardized DALY rate of enteric infections was 1020.15 per 100,000 popultion(95%UI:822.70-1259.39 per 100,000 population)with an estimated annual percentage change(EAPC)of-4.11%(95%confidence interval:-4.31%to-3.90%)in 1990-2021.A larger burden was observed in regions with lower socio-demographic index(SDI)levels.Diarrheal disease was the most serious subtype with Western Sub-Saharan Africa exhibiting the highest age-standardized DALY rate(2769.81 per 100,000 population,95%UI:1976.80-3674.41 per 100,000 population).Children under 5 and adults over 65 years suffered more from diarrheal diseases with the former experiencing the highest global age-standardized DALY rate(9382.46 per 100,000 population,95%UI:6771.76-13,075.12 per 100,000 population).Rotavirus remained the leading cause of diarrheal diseases despite a cross-year decline in the observed age-standardized DALY rate.Unsafe water,sanitation,and handwashing contributed most to the disease burden.Conclusion:The reduced burden of enteric infections suggested the effectiveness of previous control strategies;however,more efforts should be made in vulnerable regions and populations through a One Health approach.展开更多
Background:In the 21st century,as globalization accelerates and global public health crises occur,the One Health approach,guided by the holistic thinking of human-animal-environment and emphasizing interdisciplinary c...Background:In the 21st century,as globalization accelerates and global public health crises occur,the One Health approach,guided by the holistic thinking of human-animal-environment and emphasizing interdisciplinary collaboration to address global health issues,has been strongly advocated by the international community.An immediate requirement exists for the creation of an assessment tool to foster One Health initiatives on both global and national scales.Methods:Built upon extensive expert consultations and dialogues,this follow-up study enhances the 2022 global One Health index(GOHI)indicator system.The GOHI framework is enriched by covering three indices,e.g.external drivers index(EDI),intrinsic drivers index(IDI),and core drivers index(CDI).The comprehensive indicator system incorporates 13 key indicators,50 indicators,and 170 sub I-indicators,utilizing a fuzzy analytic hierarchy process to ascertain the weight for each indicator.Weighted and summed,the EDI,IDI,and CDI scores contribute to the computation of the overall GOHI 2022 score.By comparing the ranking and the overall scores among the seven regions and across 160 countries/territories,we have not only derived an overall profile of the GOHI 2022 scores,but also assessed the GOHI framework.We also compared rankings of indicators and sub Iindicators to provide greater clarity on the strengths and weaknesses of each region within the One Health domains.Results:The GOHI 2022 performance reveals significant disparities between countries/territories ranged from 39.03 to 70.61.The global average score of the GOHI 2022 is 54.82.The average score for EDI,IDI,and CDI are 46.57,58.01,and 57.25,respectively.In terms of global rankings,countries from North America,Europe and Central Asia,East Asia and Pacific present higher scores.In terms of One Health domains of CDI,the lowest scores are observed in antimicrobial resistance(median:43.09),followed by food security(median:53.78),governance(median:54.77),climate change(median:64.12)and zoonotic diseases(median:69.23).Globally,the scores of GOHI vary spatially,with the highest score in North America while lowest in sub-Saharan Africa.In addition,evidence shows associations between the socio-demographic profile of countries/territories and their GOHI performance in certain One Health scenarios.Conclusion:The objective of GOHI is to guide impactful strategies for enhancing capacity building in One Health.With advanced technology and an annually updated database,intensifying efforts to refine GOHI's data-mining methodologies become imperative.The goal is to offer profound insights into disparities and progressions in practical One Health implementation,particularly in anticipation of future pandemics.展开更多
The potential for dengue fever epidemic due to climate change remains uncertain in tropical areas.This study aims to assess the impact of climate change on dengue fever transmission in four South and Southeast Asian s...The potential for dengue fever epidemic due to climate change remains uncertain in tropical areas.This study aims to assess the impact of climate change on dengue fever transmission in four South and Southeast Asian settings.We collected weekly data of dengue fever incidence,daily mean temperature and rainfall from 2012 to 2020 in Singapore,Colombo,Selangor,and Chiang Mai.Projections for temperature and rainfall were drawn for three Shared Socioeconomic Pathways(SSP126,SSP245,and SSP585)scenarios.Using a disease transmission model,we projected the dengue fever epidemics until 2090s and determined the changes in annual peak incidence,peak time,epidemic size,and outbreak duration.A total of 684,639 dengue fever cases were reported in the four locations between 2012 and 2020.The projected change in dengue fever transmission would be most significant under the SSP585 scenario.In comparison to the 2030s,the peak incidence would rise by 1.29 times in Singapore,2.25 times in Colombo,1.36 times in Selangor,and>10 times in Chiang Mai in the 2090s under SSP585.Additionally,the peak time was projected to be earlier in Singapore,Colombo,and Selangor,but be later in Chiang Mai under the SSP585 scenario.Even in a milder emission scenario of SSP126,the epidemic size was projected to increase by 5.94%,10.81%,12.95%,and 69.60%from the 2030se2090s in Singapore,Colombo,Selangor,and Chiang Mai,respectively.The outbreak durations in the four settings were projected to be prolonged over this century under SSP126 and SSP245,while a slight decrease is expected in 2090s under SSP585.The results indicate that climate change is expected to increase the risk of dengue fever transmission in tropical areas of South and Southeast Asia.Limiting greenhouse gas emissions could be crucial in reducing the transmission of dengue fever in the future.展开更多
Background Rare infectious diseases of poverty(rIDPs)involve more than hundreds of tropical diseases,which domi-nantly affect people living in impoverished and marginalized regions and fail to be prioritized in the gl...Background Rare infectious diseases of poverty(rIDPs)involve more than hundreds of tropical diseases,which domi-nantly affect people living in impoverished and marginalized regions and fail to be prioritized in the global health agenda.The neglect of rIDPs could impede the progress toward sustainable development.This study aimed to esti-mate the disease burden of rIDPs in 2021,which would be pivotal for setting intervention priorities and mobilizing resources globally.Methods Leveraging data from the Global Burden of Disease Study 2021,the study reported both numbers and age-standardized rates of prevalence,mortality,disability-adjusted life-years(DALYs),years lived with disability,and years of life lost of rIDPs with corresponding 95%uncertainty intervals(Uls)at global,regional,and national levels.The temporal trends between 1990 and 2021 were assessed by the joinpoint regression analysis.A Bayesian age-period-cohort model was used to project the disease burden for 2050.Results In 2021,there were 103.76 million(95%Ul:102.13,105.44 million)global population suffered from rIDPs with an age-standardized DALY rate of 58.44 per 100,000 population(95%Ul:42.92,77.26 per 100,000 population).From 1990 to 2021,the age-standardized DALY rates showed an average annual percentage change of-0.16%(95%confidence interval:-0.22,-0.11%).Higher age-standardized DALY rates were dominated in sub-Saharan Africa(126.35 per 100,000 population,95%Ul:91.04,161.73 per 100,000 population),South Asia(80.80 per 100,000 popula-tion,95%Ul:57.31,114.10 per 100,000 population),and countries with a low socio-demographic index.There was age heterogeneity in the DALY rates of rIDPs,with the population aged under 15 years being the most predominant.Females aged 15-49 years had four-times higher age-standardized DALY rates of rIDPs than males in the same age.The projections indicated a slight reduction in the disease burden of rIDPs by 2050.Conclusions There has been a slight reduction in the disease burden of rIDPs over the past three decades.Given that rIDPs mainly affect populations in impoverished regions,targeted health strategies and resource allocation are in great demand for these populations to further control rIDPs and end poverty in all its forms everywhere.展开更多
基金supported by Bill&Melinda Gates Foundation[grant number OPP1152504]International Joint Laboratory on Tropical Diseases Control in Greater Mekong Subregion[grant number 21410750200]+3 种基金National Natural Science Foundation of China[grant number 82304102]Natural Science Foundation of Shanghai[grant number 23ZR1436200]Shanghai Science and Technology Development Foundation[grant number 22YF1421100]Shanghai Science and Technology Development Foundation[grant number 23YF1421200].
文摘Background:Understanding the global burden of enteric infections is crucial for prioritizing control strategies for foodborne and waterborne diseases.This study aimed to assess the global burden of enteric infections in 2021 and identify risk factors from One Health aspects.Methods:Leveraging the Global Burden of Disease(GBD)2021 database,the incidence,disability-adjusted life years(DALYs),and deaths of enteric infections and the subtypes were estimated,including diarrheal diseases,typhoid and paratyphoid fever,invasive non-typhoidal Salmonella(iNTS)infections,and other intestinal infectious diseases.The estimates were quantified by absolute number,age-standardized incidence rate(ASIR),agestandardized mortality rate(ASMR)and age-standardized DALY rate with 95%uncertainty intervals(UIs).Thirteen pathogens and three risk factors associated with diarrheal diseases were analyzed.Results:In 2021,the global age-standardized DALY rate of enteric infections was 1020.15 per 100,000 popultion(95%UI:822.70-1259.39 per 100,000 population)with an estimated annual percentage change(EAPC)of-4.11%(95%confidence interval:-4.31%to-3.90%)in 1990-2021.A larger burden was observed in regions with lower socio-demographic index(SDI)levels.Diarrheal disease was the most serious subtype with Western Sub-Saharan Africa exhibiting the highest age-standardized DALY rate(2769.81 per 100,000 population,95%UI:1976.80-3674.41 per 100,000 population).Children under 5 and adults over 65 years suffered more from diarrheal diseases with the former experiencing the highest global age-standardized DALY rate(9382.46 per 100,000 population,95%UI:6771.76-13,075.12 per 100,000 population).Rotavirus remained the leading cause of diarrheal diseases despite a cross-year decline in the observed age-standardized DALY rate.Unsafe water,sanitation,and handwashing contributed most to the disease burden.Conclusion:The reduced burden of enteric infections suggested the effectiveness of previous control strategies;however,more efforts should be made in vulnerable regions and populations through a One Health approach.
基金supported by China Medical Board[No.20–365]Bill&Melinda Gates Foundation[No.INV-046218]the National Natural Science Foundation of China[No.72204160].
文摘Background:In the 21st century,as globalization accelerates and global public health crises occur,the One Health approach,guided by the holistic thinking of human-animal-environment and emphasizing interdisciplinary collaboration to address global health issues,has been strongly advocated by the international community.An immediate requirement exists for the creation of an assessment tool to foster One Health initiatives on both global and national scales.Methods:Built upon extensive expert consultations and dialogues,this follow-up study enhances the 2022 global One Health index(GOHI)indicator system.The GOHI framework is enriched by covering three indices,e.g.external drivers index(EDI),intrinsic drivers index(IDI),and core drivers index(CDI).The comprehensive indicator system incorporates 13 key indicators,50 indicators,and 170 sub I-indicators,utilizing a fuzzy analytic hierarchy process to ascertain the weight for each indicator.Weighted and summed,the EDI,IDI,and CDI scores contribute to the computation of the overall GOHI 2022 score.By comparing the ranking and the overall scores among the seven regions and across 160 countries/territories,we have not only derived an overall profile of the GOHI 2022 scores,but also assessed the GOHI framework.We also compared rankings of indicators and sub Iindicators to provide greater clarity on the strengths and weaknesses of each region within the One Health domains.Results:The GOHI 2022 performance reveals significant disparities between countries/territories ranged from 39.03 to 70.61.The global average score of the GOHI 2022 is 54.82.The average score for EDI,IDI,and CDI are 46.57,58.01,and 57.25,respectively.In terms of global rankings,countries from North America,Europe and Central Asia,East Asia and Pacific present higher scores.In terms of One Health domains of CDI,the lowest scores are observed in antimicrobial resistance(median:43.09),followed by food security(median:53.78),governance(median:54.77),climate change(median:64.12)and zoonotic diseases(median:69.23).Globally,the scores of GOHI vary spatially,with the highest score in North America while lowest in sub-Saharan Africa.In addition,evidence shows associations between the socio-demographic profile of countries/territories and their GOHI performance in certain One Health scenarios.Conclusion:The objective of GOHI is to guide impactful strategies for enhancing capacity building in One Health.With advanced technology and an annually updated database,intensifying efforts to refine GOHI's data-mining methodologies become imperative.The goal is to offer profound insights into disparities and progressions in practical One Health implementation,particularly in anticipation of future pandemics.
基金supported by the National Natural Science Foundation of China(grant numbers 71974165)partially supported by Health and Medical Research Fund(grant numbers INF-CUHK-1).
文摘The potential for dengue fever epidemic due to climate change remains uncertain in tropical areas.This study aims to assess the impact of climate change on dengue fever transmission in four South and Southeast Asian settings.We collected weekly data of dengue fever incidence,daily mean temperature and rainfall from 2012 to 2020 in Singapore,Colombo,Selangor,and Chiang Mai.Projections for temperature and rainfall were drawn for three Shared Socioeconomic Pathways(SSP126,SSP245,and SSP585)scenarios.Using a disease transmission model,we projected the dengue fever epidemics until 2090s and determined the changes in annual peak incidence,peak time,epidemic size,and outbreak duration.A total of 684,639 dengue fever cases were reported in the four locations between 2012 and 2020.The projected change in dengue fever transmission would be most significant under the SSP585 scenario.In comparison to the 2030s,the peak incidence would rise by 1.29 times in Singapore,2.25 times in Colombo,1.36 times in Selangor,and>10 times in Chiang Mai in the 2090s under SSP585.Additionally,the peak time was projected to be earlier in Singapore,Colombo,and Selangor,but be later in Chiang Mai under the SSP585 scenario.Even in a milder emission scenario of SSP126,the epidemic size was projected to increase by 5.94%,10.81%,12.95%,and 69.60%from the 2030se2090s in Singapore,Colombo,Selangor,and Chiang Mai,respectively.The outbreak durations in the four settings were projected to be prolonged over this century under SSP126 and SSP245,while a slight decrease is expected in 2090s under SSP585.The results indicate that climate change is expected to increase the risk of dengue fever transmission in tropical areas of South and Southeast Asia.Limiting greenhouse gas emissions could be crucial in reducing the transmission of dengue fever in the future.
基金supported by International Joint Laboratory on Tropical Diseases Control in Greater Mekong Subregion(21410750200)National Natural Science Foundation of China(82304102)+2 种基金Natural Science Foundation of Shanghai(23ZR1436200)Shanghai Science and Technology Development Foundation(22YF1421100,23YF1421200)the Bill&Melinda Gates Foundation.The Funders had no role in the study design or in the collection,analysis,and interpretation of the data,writing of the report,or decision to submit the article for publication.
文摘Background Rare infectious diseases of poverty(rIDPs)involve more than hundreds of tropical diseases,which domi-nantly affect people living in impoverished and marginalized regions and fail to be prioritized in the global health agenda.The neglect of rIDPs could impede the progress toward sustainable development.This study aimed to esti-mate the disease burden of rIDPs in 2021,which would be pivotal for setting intervention priorities and mobilizing resources globally.Methods Leveraging data from the Global Burden of Disease Study 2021,the study reported both numbers and age-standardized rates of prevalence,mortality,disability-adjusted life-years(DALYs),years lived with disability,and years of life lost of rIDPs with corresponding 95%uncertainty intervals(Uls)at global,regional,and national levels.The temporal trends between 1990 and 2021 were assessed by the joinpoint regression analysis.A Bayesian age-period-cohort model was used to project the disease burden for 2050.Results In 2021,there were 103.76 million(95%Ul:102.13,105.44 million)global population suffered from rIDPs with an age-standardized DALY rate of 58.44 per 100,000 population(95%Ul:42.92,77.26 per 100,000 population).From 1990 to 2021,the age-standardized DALY rates showed an average annual percentage change of-0.16%(95%confidence interval:-0.22,-0.11%).Higher age-standardized DALY rates were dominated in sub-Saharan Africa(126.35 per 100,000 population,95%Ul:91.04,161.73 per 100,000 population),South Asia(80.80 per 100,000 popula-tion,95%Ul:57.31,114.10 per 100,000 population),and countries with a low socio-demographic index.There was age heterogeneity in the DALY rates of rIDPs,with the population aged under 15 years being the most predominant.Females aged 15-49 years had four-times higher age-standardized DALY rates of rIDPs than males in the same age.The projections indicated a slight reduction in the disease burden of rIDPs by 2050.Conclusions There has been a slight reduction in the disease burden of rIDPs over the past three decades.Given that rIDPs mainly affect populations in impoverished regions,targeted health strategies and resource allocation are in great demand for these populations to further control rIDPs and end poverty in all its forms everywhere.
