Objective:To understand the epidemic situation of HIV/AIDS and its change trend in the Belt and Road countries and provide evidence for the improvement of prevention and control of the cross-border transmission of HIV/AIDS.Methods:The 145 countries that have signed the cooperation document of the Belt and Road initiative with China were selected in our study. Age-standardized incidence rate and prevalence rate of HIV/AIDS in the 145 countries from 2013 to 2019 were downloaded from the Global Burden of Disease Study 2019. Age-standardized incidence rate and prevalence rate of HIV/AIDS in 2019 were used to describe the HIV/AIDS epidemics in 145 countries, and the estimated annual percentage change (EAPC) of incidence was calculated to analyze the trend of HIV/AIDS incidence from 2013 to 2019.Results:In 2019, Africa had the highest proportion of countries with HIV/AIDS incidence exceeding 40.00 per 100 000 (56.86%, 29/51), and Asia had the lowest proportion (5.41%, 2/37). The countries with the prevalence rate of HIV/AIDS exceeding 100.00 per 10 000 were almost distributed in Africa, accounting for 20.69% (30/145). From 2013 to 2019, the incidence rate of HIV/AIDS increased in 50 countries, accounting for 34.48% (50/145). The incidence rate of HIV/AIDS showed downward trends in 69 countries (47.59%, 69/145), and showed no significant change in 26 countries (17.93%, 26/145). The most obvious increase of incidence rate of HIV/AIDS was observed in Comoros (EAPC=15.60, 95% CI: 5.84-26.26) and the most obvious decrease was observed in Burundi (EAPC=-14.27, 95% CI: -15.21 to -13.31). Conclusions:In the Belt and Road countries, the most severe disease burden of HIV/AIDS was observed in countries in Africa, and the incidences of HIV/AIDS increased rapidly in some European countries, which means the risk of cross-border transmission still exists. Hence, the prevention and control of HIV/AIDS in China should be further strengthened in the future.

Objective:To analyze the epidemic situation of multidrug-resistant tuberculosis in 2019 and the incidence trends from 2013 to 2019 in the Belt and Road countries.Methods:The 145 countries that have signed cooperation documents of the Belt and Road Initiative with China were selected. Age-standardized incidence and prevalence rate of multidrug-resistant tuberculosis from the Global Burden of Disease Study were used to describe the epidemic situation of multidrug-resistant tuberculosis in 2019. The annual percentage changes of the age-standardized incidence rate were calculated to assess incidence trends of multidrug-resistant tuberculosis from 2013 to 2019.Results:In 2019, of the 145 countries, Somalia had the highest incidence rate (30.42 per 100 000) and prevalence rate (48.86 per 100 000) of multidrug-resistant tuberculosis, while Slovenia had the lowest incidence rate (0.01 per 100 000) and prevalence rate (0.01 per 100 000). The incidence trends of multidrug-resistant tuberculosis in six continents from 2013 to 2019 were as follows: multidrug-resistant tuberculosis incidence rates showed increasing trends in 14 countries (27.45%) and decreasing trends in 22 countries (43.14%) in Africa, showed increasing trends in 2 countries (18.18%) and decreasing trends in 3 countries (27.27%) in North America and showed increasing trends in 2 countries (5.41%) and decreasing trends in 23 countries (62.16%) in Asia. The increasing trends were observed in Europe, Oceania, and South America, but it was found that 26 countries (96.30%) in Europe, 2 countries (18.18%) in Oceania, and 1 country (12.50%) in South America had decreasing trends of multidrug-resistant tuberculosis incidence rates.Conclusion:Multidrug-resistant tuberculosis is endemic in 145 Belt and Road countries with the prevalence increasing year by year in some countries in central and southern Africa and decreasing in European countries except Ukraine.

Objective:To analyze epidemic situation of dengue fever in 2019 and the incidence trends from 2013 to 2019 in the Belt and Road countries.Methods:We used age-standardized incidence rate (ASR) which was from Global Burden of Disease Study 2019 to describe the epidemic situation of dengue fever in 2019. The estimated annual percentage change(EAPC) of the ASR was calculated to assess dengue fever incidence trends from 2013 to 2019.Results:The 2019 GBD dengue fever incidence records showed that in 145 Belt and Road countries, 93 (64.14%) countries had dengue fever epidemics. In 2019, there were 11 countries with the incidence >3 000.00 per 100 000, including 9 countries in Oceania; 16 countries with the incidence of 1 000.00 per 100 000-2 999.99 per 100 000, including 10 countries in Asia. The incidence rates in most countries in Africa (58.14%,25/43), North America (72.73%,8/11) and South America (66.67%,4/6) ranged from 500.00 per 100 000 to 999.99 per 100 000. The incidence rates of dengue fever in 90.00% (9/10) of countries in Oceania showed increasing trend, and the increasing trend in Fiji was most obvious (EAPC=18.22,95% CI:12.91-23.77), and the incidence rates of dengue fever in 18.18% (4/22) of countries in Asia showed increasing trend, the increasing trend in the Philippines was most obvious (EAPC=3.09,95% CI:1.74-4.45), and the incidence rates of dengue fever in 4.65% (2/43) of countries in Africa showed increasing trend, and the increasing trend in Seychelles was most obvious (EAPC=18.20,95% CI:7.82-29.58). The incidence rates of dengue fever showed no increasing trend in countries in South America and North America. Conclusions:In 2019, more than 60% of the Belt and Road countries had dengue fever epidemics. The incidences of dengue fever were high and showed increasing trends in most Oceanian countries, but the dengue fever epidemics in the countries in Asia, Africa and Americas were relatively mild.

Objective:To understand the epidemic situation of malaria and its change trend in the Belt and Road countries.Methods:The 145 countries with which China has signed cooperation documents on the Belt and Road Initiative were selected for this study, and their malaria incidence data were collected from the Global Burden of Disease 2019. The age-standardized incidence rate (ASR) was used to describe the epidemic situation of malaria in 2019. The estimated annual percentage change (EAPC) of the ASR was calculated to assess the incidence trend of malaria from 2013 to 2019.Results:Among the 145 countries, 74 (51.03%) countries had malaria epidemics, mainly in Africa (60.81%, 45/74) and Asia (22.97%, 17/74). The countries with malaria incidence of ≥10 000 per 100 000 in 2019 were mainly distributed in Africa (96.15%, 25/26). From 2013 to 2019, the incidence rates of malaria showed decreasing trends in 32 countries (43.24%), and the incidence rates of malaria in 23 countries (31.08%) showed no significant change, while the incidence rates of malaria in 19 countries (25.68%) showed increasing trends. The obvious increasing trends were observed in Cape Verde (EAPC=151.46, 95% CI: 47.15-329.71), South Africa (EAPC=98.61, 95% CI: 32.11-198.58) and Namibia (EAPC=78.03, 95% CI: 54.30-105.42). Conclusion:About half of the Belt and Road countries had malaria epidemics in 2019, in which 1/4 had increased incidence of malaria. China should continue to strengthen the prevention and control of malaria, especially imported malaria, to maintain the achievements of malaria elimination