Background:Tuberculosis(TB),caused by Mycobacterium tuberculosis,remains the second leading cause of death from a single infectious disease globally and poses a significant economic and clinical burden in the world in...Background:Tuberculosis(TB),caused by Mycobacterium tuberculosis,remains the second leading cause of death from a single infectious disease globally and poses a significant economic and clinical burden in the world in 2022.Of particular concern is the emergence of drug-resistant TB,accounting for 15%-20%of TB deaths.It is imperative to delve into the global trends of incidence and death rate for multidrug-resistant tuberculosis(MDRTB)and extensively drug-resistant tuberculosis(XDR-TB),drawing upon the comprehensive Global Burden of Disease(GBD)2021 drug-resistant tuberculosis dataset.Methods:From the GBD 2021,data on incidence,prevalence,disability-adjusted life years(DALYs),and death of MDR-TB and XDR-TB from 1990 to 2021 were collected.We calculated the estimated annual percentage changes in age standardized incidence rate(ASIR)and age-standardized death rate(ASDR),segmented by age,sex,and socio-demographic index(SDI).The impacts of various risk factors on MDR-TB and XDR-TB were also analyzed.Results:In 2021,there were an estimated 443,680(95%uncertainty interval[UI]:259,196-766,545)incident cases of MDR-TB,and an estimated 106,818(95%UI:41,612-211,854)death cases of MDR-TB,while there were an estimated 24,036(95%UI:17,144-34,587)incident cases of XDR-TB and 7,946(95%UI:3,326-14,859)death cases of XDR-TB.The incidence and death cases of MDR-TB were lowest in high SDI regions,whereas the incidence rates of XDR-TB in high-middle SDI regions were higher than those in middle SDI and high SDI regions.Conclusion:This study reported the disease burden of drug-resistant TB from 1990 to 2021.Until 2021,drugresistant TB is still a serious problem in low SDI countries,especially for high-risk age populations with highrisk factors.Controlling drug-resistant TB requires effective control strategies and healthcare systems.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
Background:Antimicrobial resistance(AMR)is one of the top ten global public health challenges.However,given the lack of a comprehensive assessment of worldwide AMR status,our objective is to develop a One Health-based...Background:Antimicrobial resistance(AMR)is one of the top ten global public health challenges.However,given the lack of a comprehensive assessment of worldwide AMR status,our objective is to develop a One Health-based system-wide evaluation tool on global AMR.Methods:We have further developed the three-hierarchical Global One Health Index(GOHI)-AMR indicator scheme,which consists of five key indicators,17 indicators,and 49 sub-indicators,by incorporating 146 countries'data from diverse authoritative databases,including WHO's Global Antimicrobial Resistance and Use Surveillance System(GLASS)and the European CDC.We investigated the overall-or sub-rankings of GOHI-AMR at the international/regional/national levels for data preprocessing and score calculation utilizing the existing GOHI methodology.Additionally,a correlation analysis was conducted between the GOHI-AMR and other socioeconomic factors.Results:The average GOHI-AMR score for 146 countries is 38.45.As expected,high-income countries(HICs)outperform the other three income groups on overall rankings and all five key indicators of GOHI-AMR,whereas lowincome countries unexpectedly outperform upper-middle-income countries and lower-middle-income countries on the antibiotics-resistant key indicator(ARR)and ARR-subordinate indicators,including carbapenem-,β-lactam-,and quinolone resistance,and even HICs on aminoglycoside resistance.There were no significant differences among the four groups on the environmental-monitoring indicator(P>0.05).GOHI-AMR was positively correlated with gross domestic product,life expectancy,and AMR-related publications,but negatively with natural growth rate and chronic respiratory disease.In contrast to Cyprus,the remarkably lower prevalence of"ESKAPE pathogens"in high-scoring Sweden and Denmark highlights Europe's huge gaps.China and Russia outperformed the other three BRICS countries on all key indicators,particularly India's ARR and Brazil's AMR laboratory network and coordination capacity.Furthermore,significant internal disparities in carbapenem-resistant Klebsiella pneumoniae(CRKP)and methicillin-resistant Staphylococcus aureus(MRSA)prevalence were observed between China and the USA,with MRSA prevalence both gradually declining,whereas CRKP prevalence has been declining in the USA but increasing in China,consistent with higher carbapenems-related indicator'performance in USA.Conclusions:GOHI-AMR is the most comprehensive tool currently available for the assessment of AMR status worldwide.We discovered unique features impacting AMR in each country and offered precise recommendations to improve the capacity to tackle AMR in low-ranking countries.展开更多
Background Certain infectious diseases are caused by specific bacterial pathogens,including syphilis,gonorrhea,typhoid and paratyphoid fever,diphtheria,pertussis,tetanus,leprosy,and tuberculosis.These diseases signifi...Background Certain infectious diseases are caused by specific bacterial pathogens,including syphilis,gonorrhea,typhoid and paratyphoid fever,diphtheria,pertussis,tetanus,leprosy,and tuberculosis.These diseases significantly impact global health,contributing heavily to the disease burden.The study aims to thoroughly evaluate the global burden of syphilis,gonorrhea,typhoid and paratyphoid fever,diphtheria,pertussis,tetanus,and leprosy.Methods Leveraging the Global Burden of Disease(GBD)study 2021,age-specific and Socio-demographic Index(SDI)-specific incidence,disability-adjusted life-years(DALYs),and death for eight specific bacterial infections across 204 countries and territories from 1990 to 2021 were analyzed.Percentage changes in age-standardized incidence rate(ASIR),DALY rate,and mortality rate(ASMR)were also examined,with a focus on disease distribution across different regions,age groups,genders,and SDI.Results By 2021,among the eight diseases,gonococcal infection had the highest global ASIR[1096.58 per 100,000 population,95%uncertainty interval(UI):838.70,1385.47 per 100,000 population],and syphilis had the highest global age-standardized DALY rate(107.13 per 100,000 population,95%UI:41.77,212.12 per 100,000 population).Except for syphilis and gonococcal infection,the age-standardized DALY rate of the remaining diseases decreased by at least 55%compared to 1990,with tetanus showing the largest decrease by at least 90%.Globally,significant declines in the ASIR,age-standardized DALY rate,and ASMR for these eight bacterial infections have been observed in association with increases in the SDI.Regions with lower SDI,such as sub-Saharan Africa,experienced a relatively higher burden of these eight bacterial infections.Conclusions Although there has been an overall decline in these eight diseases,they continue to pose significant public health challenges,particularly in low SDI regions.To further reduce this burden in these areas,targeted intervention strategies are essential,including multi-sectoral collaboration,policy support,improved WASH management,and enhanced research efforts.展开更多
Background The zoonotic infectious diseases of poverty(zIDPs)are a group of diseases contributing to global pov-erty,with significant impacts on a substantial population.This study aims to describe the global,regional...Background The zoonotic infectious diseases of poverty(zIDPs)are a group of diseases contributing to global pov-erty,with significant impacts on a substantial population.This study aims to describe the global,regional,and national burden of zIDPs-schistosomiasis,cystic echinococcosis,cysticercosis,and food-borne trematodiases(FBTs)—to sup-port policy making and resource allocation for their control and elimination.Methods Data of zIDPs from the Global Burden of Diseases,Injuries,and Risk Factors Study(GBD)2021 were retrieved from 1990 to 2021.The age-standardized prevalence rate(ASPR),age-standardized mortality rate(ASMR),and age-standardized disability-adjusted life-year(DALY)rate were described and the estimated annual percentage changes(EAPCs)were calculated to quantify their burden and temporal trends.Spearman correlation analysis was conducted to examine the relationship between age-standardized rates and Socio-demographic Index(SDI).Results In 2021,these zIDPs exhibited a certain level of ASPRs and age-standardized DALY rates,while maintaining relatively low ASMRs.Noticeably,schistosomiasis presented the highest ASPR of 1914.299(95%Ul:1378.920,2510.853 per 100,000 population)and an age-standardized DALY rate of 21.895(95%UI:12.937,37.278 per 100,000 popula-tion)among the zIDPs.The tapestry of burden-woven predominantly through low and lower-middle SDI regions-stretched across Africa,Latin America,and parts of Asia.From 1990 to 2021,a kaleidoscopic shift was observed globally as ASPRs,ASMRs,and age-standardized DALY rates declined significantly,as reflected by the EAPC values.Negative correlations were observed between the ASPRs,ASMRs,age-standardized DALY rates of schistosomiasis(r val ue=-0.610,-0.622 and-0.610),cystic echinococcosis(-0.676 of ASMR,-0.550 of age-standardized DALYs),cysticer-cosis(-0.420,-0.797 and-0.591)and the SDI.In contrast,a slight positive correlation was noted between the ASPR,age-standardized DALY rates of FBTs and SDI with rvalue of0.221 and 0.213,respectively.Conclusion The burden of zIDPs declined across almost all endemic regions from 1990 to 2021,yet still predomi-nated in low and low-middle SDI regions.Substantial challenges exist to achieve the goal of control and elimination of zIDPs,and integrated approaches based on One Health need to be strengthened to improve health outcomes.展开更多
基金supported by International Joint Laboratory on Tropical Diseases Control in Greater Mekong Subregion(grant number 21410750200)from Shanghai Municipality Government.
文摘Background:Tuberculosis(TB),caused by Mycobacterium tuberculosis,remains the second leading cause of death from a single infectious disease globally and poses a significant economic and clinical burden in the world in 2022.Of particular concern is the emergence of drug-resistant TB,accounting for 15%-20%of TB deaths.It is imperative to delve into the global trends of incidence and death rate for multidrug-resistant tuberculosis(MDRTB)and extensively drug-resistant tuberculosis(XDR-TB),drawing upon the comprehensive Global Burden of Disease(GBD)2021 drug-resistant tuberculosis dataset.Methods:From the GBD 2021,data on incidence,prevalence,disability-adjusted life years(DALYs),and death of MDR-TB and XDR-TB from 1990 to 2021 were collected.We calculated the estimated annual percentage changes in age standardized incidence rate(ASIR)and age-standardized death rate(ASDR),segmented by age,sex,and socio-demographic index(SDI).The impacts of various risk factors on MDR-TB and XDR-TB were also analyzed.Results:In 2021,there were an estimated 443,680(95%uncertainty interval[UI]:259,196-766,545)incident cases of MDR-TB,and an estimated 106,818(95%UI:41,612-211,854)death cases of MDR-TB,while there were an estimated 24,036(95%UI:17,144-34,587)incident cases of XDR-TB and 7,946(95%UI:3,326-14,859)death cases of XDR-TB.The incidence and death cases of MDR-TB were lowest in high SDI regions,whereas the incidence rates of XDR-TB in high-middle SDI regions were higher than those in middle SDI and high SDI regions.Conclusion:This study reported the disease burden of drug-resistant TB from 1990 to 2021.Until 2021,drugresistant TB is still a serious problem in low SDI countries,especially for high-risk age populations with highrisk factors.Controlling drug-resistant TB requires effective control strategies and healthcare systems.
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.
文摘Background:Antimicrobial resistance(AMR)is one of the top ten global public health challenges.However,given the lack of a comprehensive assessment of worldwide AMR status,our objective is to develop a One Health-based system-wide evaluation tool on global AMR.Methods:We have further developed the three-hierarchical Global One Health Index(GOHI)-AMR indicator scheme,which consists of five key indicators,17 indicators,and 49 sub-indicators,by incorporating 146 countries'data from diverse authoritative databases,including WHO's Global Antimicrobial Resistance and Use Surveillance System(GLASS)and the European CDC.We investigated the overall-or sub-rankings of GOHI-AMR at the international/regional/national levels for data preprocessing and score calculation utilizing the existing GOHI methodology.Additionally,a correlation analysis was conducted between the GOHI-AMR and other socioeconomic factors.Results:The average GOHI-AMR score for 146 countries is 38.45.As expected,high-income countries(HICs)outperform the other three income groups on overall rankings and all five key indicators of GOHI-AMR,whereas lowincome countries unexpectedly outperform upper-middle-income countries and lower-middle-income countries on the antibiotics-resistant key indicator(ARR)and ARR-subordinate indicators,including carbapenem-,β-lactam-,and quinolone resistance,and even HICs on aminoglycoside resistance.There were no significant differences among the four groups on the environmental-monitoring indicator(P>0.05).GOHI-AMR was positively correlated with gross domestic product,life expectancy,and AMR-related publications,but negatively with natural growth rate and chronic respiratory disease.In contrast to Cyprus,the remarkably lower prevalence of"ESKAPE pathogens"in high-scoring Sweden and Denmark highlights Europe's huge gaps.China and Russia outperformed the other three BRICS countries on all key indicators,particularly India's ARR and Brazil's AMR laboratory network and coordination capacity.Furthermore,significant internal disparities in carbapenem-resistant Klebsiella pneumoniae(CRKP)and methicillin-resistant Staphylococcus aureus(MRSA)prevalence were observed between China and the USA,with MRSA prevalence both gradually declining,whereas CRKP prevalence has been declining in the USA but increasing in China,consistent with higher carbapenems-related indicator'performance in USA.Conclusions:GOHI-AMR is the most comprehensive tool currently available for the assessment of AMR status worldwide.We discovered unique features impacting AMR in each country and offered precise recommendations to improve the capacity to tackle AMR in low-ranking countries.
文摘Background Certain infectious diseases are caused by specific bacterial pathogens,including syphilis,gonorrhea,typhoid and paratyphoid fever,diphtheria,pertussis,tetanus,leprosy,and tuberculosis.These diseases significantly impact global health,contributing heavily to the disease burden.The study aims to thoroughly evaluate the global burden of syphilis,gonorrhea,typhoid and paratyphoid fever,diphtheria,pertussis,tetanus,and leprosy.Methods Leveraging the Global Burden of Disease(GBD)study 2021,age-specific and Socio-demographic Index(SDI)-specific incidence,disability-adjusted life-years(DALYs),and death for eight specific bacterial infections across 204 countries and territories from 1990 to 2021 were analyzed.Percentage changes in age-standardized incidence rate(ASIR),DALY rate,and mortality rate(ASMR)were also examined,with a focus on disease distribution across different regions,age groups,genders,and SDI.Results By 2021,among the eight diseases,gonococcal infection had the highest global ASIR[1096.58 per 100,000 population,95%uncertainty interval(UI):838.70,1385.47 per 100,000 population],and syphilis had the highest global age-standardized DALY rate(107.13 per 100,000 population,95%UI:41.77,212.12 per 100,000 population).Except for syphilis and gonococcal infection,the age-standardized DALY rate of the remaining diseases decreased by at least 55%compared to 1990,with tetanus showing the largest decrease by at least 90%.Globally,significant declines in the ASIR,age-standardized DALY rate,and ASMR for these eight bacterial infections have been observed in association with increases in the SDI.Regions with lower SDI,such as sub-Saharan Africa,experienced a relatively higher burden of these eight bacterial infections.Conclusions Although there has been an overall decline in these eight diseases,they continue to pose significant public health challenges,particularly in low SDI regions.To further reduce this burden in these areas,targeted intervention strategies are essential,including multi-sectoral collaboration,policy support,improved WASH management,and enhanced research efforts.
基金supported by the National Science and Technology Major Project of China(No.2018ZX10101002-002)National Key Research and Development Program of China(No.2021YFC2300800,2021YFC2300804)+1 种基金International Joint Laboratory on Tropical Diseases Control in Greater Mekong Subregion(no.21410750200)from Shanghai Municipality Governmentthe Scientifc research project of Shanghai Health Commission(20204Y0050).
文摘Background The zoonotic infectious diseases of poverty(zIDPs)are a group of diseases contributing to global pov-erty,with significant impacts on a substantial population.This study aims to describe the global,regional,and national burden of zIDPs-schistosomiasis,cystic echinococcosis,cysticercosis,and food-borne trematodiases(FBTs)—to sup-port policy making and resource allocation for their control and elimination.Methods Data of zIDPs from the Global Burden of Diseases,Injuries,and Risk Factors Study(GBD)2021 were retrieved from 1990 to 2021.The age-standardized prevalence rate(ASPR),age-standardized mortality rate(ASMR),and age-standardized disability-adjusted life-year(DALY)rate were described and the estimated annual percentage changes(EAPCs)were calculated to quantify their burden and temporal trends.Spearman correlation analysis was conducted to examine the relationship between age-standardized rates and Socio-demographic Index(SDI).Results In 2021,these zIDPs exhibited a certain level of ASPRs and age-standardized DALY rates,while maintaining relatively low ASMRs.Noticeably,schistosomiasis presented the highest ASPR of 1914.299(95%Ul:1378.920,2510.853 per 100,000 population)and an age-standardized DALY rate of 21.895(95%UI:12.937,37.278 per 100,000 popula-tion)among the zIDPs.The tapestry of burden-woven predominantly through low and lower-middle SDI regions-stretched across Africa,Latin America,and parts of Asia.From 1990 to 2021,a kaleidoscopic shift was observed globally as ASPRs,ASMRs,and age-standardized DALY rates declined significantly,as reflected by the EAPC values.Negative correlations were observed between the ASPRs,ASMRs,age-standardized DALY rates of schistosomiasis(r val ue=-0.610,-0.622 and-0.610),cystic echinococcosis(-0.676 of ASMR,-0.550 of age-standardized DALYs),cysticer-cosis(-0.420,-0.797 and-0.591)and the SDI.In contrast,a slight positive correlation was noted between the ASPR,age-standardized DALY rates of FBTs and SDI with rvalue of0.221 and 0.213,respectively.Conclusion The burden of zIDPs declined across almost all endemic regions from 1990 to 2021,yet still predomi-nated in low and low-middle SDI regions.Substantial challenges exist to achieve the goal of control and elimination of zIDPs,and integrated approaches based on One Health need to be strengthened to improve health outcomes.
