OBJECTIVES: Nasopharyngeal carcinoma is often diagnosed at a late stage due to its concealed location and exhibits marked regional clustering, posing a significant public health challenge in China. This study aims to analyze the disease burden of nasopharyngeal carcinoma in China using the latest 2021 Global Burden of Diseases (GBD) database, providing epidemiological evidence for precise prevention and control of nasopharyngeal carcinoma. METHODS: Age-standardized incidence rate (ASIR), mortality rate, and disability-adjusted life year (DALY) rate were used as indicators of disease burden. Stratified analyses were conducted by age, sex, socio-demographic index (SDI), and relevant risk factors. The autoregressive integrated moving average (ARIMA) model and Bayesian age-period-cohort (BAPC) model were employed to project ASIR trends through 2050. RESULTS: In 2021, China's age-standardized incidence, mortality, and DALY rates of nasopharyngeal carcinoma were 3.4/100 000, 1.5/100 000, and 48.7/100 000, respectively, all higher than the global average. Across all age groups, Chinese males exhibited higher ASIR, mortality, and DALY rates than females. From 1990 to 2021, the disease burden of nasopharyngeal carcinoma in China decreased gradually with rising SDI. The proportion of nasopharyngeal carcinoma burden attributed to alcohol consumption, smoking, and occupational formaldehyde exposure in China exceeded global levels, especially among males. Projections from both models indicate a rising trend in ASIR for males, females, and the general population in China and globally from 2022 to 2050. CONCLUSIONS Over the past 30 years, the disease burden of nasopharyngeal carcinoma in China has decreased with the increasing SDI values but remains higher than the global average. Furthermore, ASIR is projected to increase over the next 30 years. It is imperative for China to enhance healthcare resource allocation for nasopharyngeal carcinoma prevention, diagnosis, and treatment, particularly among high-risk male populations.
Humans ; China/epidemiology* ; Male ; Nasopharyngeal Carcinoma/mortality* ; Female ; Middle Aged ; Nasopharyngeal Neoplasms/mortality* ; Adult ; Incidence ; Global Burden of Disease ; Disability-Adjusted Life Years ; Aged ; Risk Factors ; Adolescent ; Databases, Factual ; Young Adult ; Cost of Illness ; Child ; Bayes Theorem

OBJECTIVES: Near vision loss (NVL) is one of the leading causes of visual impairment worldwide, exerting a profound impact on individual quality of life and socio-economic development. This study aims to analyze the burden of NVL in China by sex and age groups from 1990 to 2021 and to project trends over the next 15 years. METHODS: Using data from the Global Burden of Disease (GBD) 2021 database, we conducted descriptive analyses of NVL prevalence in China, calculated age-standardized prevalence rates (ASPR) and age-standardized disability-adjusted life years rates (ASDR) to compare burden differences between sexes and age groups, and applied an autoregressive integrated moving average (ARIMA) model to predict NVL trends for the next 15 years. The model selection was based on best-fit criteria to ensure reliable projections. RESULTS: From 1990 to 2021, China's ASPR of NVL rose from 10 096.24/100 000 to 15 624.54/100 000, and ASDR increased from 101.75/100 000 to 158.75/100 000. In 2021, ASPR (16 551.70/100 000) and ASDR (167.69/100 000) were higher among females than males (14 686.21/100 000 and 149.76/100 000, respectively). China ranked highest globally in both NVL cases and disability-adjusted life years (DALYs), with female burden significantly exceeding male burden. Projections indicated this trend and sex gap will persist until 2036. Compared with 1990, the prevalence cases and DALYs increased by 239.20% and 238.82%, respectively in 2021, with the highest burden among females and the 55-59 age group. The ARIMA model predicted continued increases in prevalence and DALYs by 2036, with females maintaining a higher burden than males. CONCLUSIONS This study reveals a marked increase in the NVL burden in China and predicts continued growth in the coming years. Public health policies should prioritize NVL prevention and control, with special attention to women and middle-aged populations to mitigate long-term societal and health impacts.
Humans ; China/epidemiology* ; Male ; Female ; Prevalence ; Middle Aged ; Disability-Adjusted Life Years ; Adult ; Global Burden of Disease ; Adolescent ; Quality-Adjusted Life Years ; Aged ; Sex Factors ; Child ; Young Adult ; Child, Preschool ; Cost of Illness ; Infant ; Aged, 80 and over ; Vision Disorders/epidemiology*

OBJECTIVES: With the accelerating aging of the population and the rising prevalence of chronic diseases, the number of patients with pressure injuries (PIs) has increased markedly, prolonging the period of disease-related care. Informal caregivers play a critical role in the daily care of patients with pressure injuries, and their care burden has become increasingly prominent. This study aims to investigate the current status and influencing factors of care burden among informal caregivers of patients with PIs, providing evidence for targeted intervention strategies. METHODS: A total of 170 informal caregivers of patients with PIs were selected by convenience sampling from the Third Xiangya Hospital of Central South University. General demographic and clinical data of both patients and caregivers were collected. The Zarit Caregiver Burden Inventory (ZBI), Knowledge-Attitude-Practice Scale for Informal Caregivers of Patients with PIs, General Self-Efficacy Scale (GSES), and Family Caregiver Task Inventory (FCTI) were used to assess caregiving burden, knowledge-attitude-practice level, self-efficacy, and caregiving ability, respectively. Pearson correlation analysis was conducted to evaluate relationships among ZBI, Knowledge-Attitude-Practice Scale for Informal Caregivers of Patients with PIs, GSES, and FCTI scores. Stepwise multiple linear regression analysis was used to identify factors influencing caregiving. RESULTS: Among the 170 patients with pressure injuries, the age was (65.52±15.88) years; 118 (69.41%) were male and 52 (30.59%) were female. The duration of PIs was less than 1 month in 108 (63.53%) cases and 1 to 6 months in 40 cases (23.53%). Stage II injuries were predominant (135 cases, 79.41%). A total of 193 pressure injury sites were recorded, most commonly located at the sacrococcygeal region (127 sites, 65.80%), followed by the head (3 sites, 1.55%), shoulder and back (9 sites, 4.66%), feet (24 sites, 12.44%), and other regions (30 sites, 15.55%). Informal caregivers were 48.82% aged 46 to 59 years, 54.71% female, 41.77% primarily spouses and 47.06% children of the patients, and 77.06% lived with the patients. Caregivers who received assistance from others or had higher family per-capita monthly income reported significantly lower caregiver burden scores than those without assistance or with lower income (all P<0.001). The total ZBI score was 50.89±14.95, indicating a moderate burden. The total scores of the Knowledge-Attitude-Practice Scale for Informal Caregivers, GSES, and FCTI were 50.61±7.22, 26.03±7.11, and 14.76±8.70, respectively. Pearson correlation analysis revealed that ZBI scores were correlated with scores on the Knowledge-Attitude-Practice Scale for Informal Caregivers of Patients with PIs (r=-0.543, P<0.001), GSES scores (r=-0.545, P<0.001), and FCTI scores (r=0.800, P<0.001). The scores on Knowledge-Attitude-Practice Scale for Informal Caregivers of patients with PIs were correlated with GSES scores (r=0.500, P<0.001) and FCTI scores (r=-0.461, P<0.001); GSES scores was negatively correlated with FCTI scores (r=-0.415, P<0.001). Stepwise multiple linear regression analysis showed that assistance availability, family per-capita monthly income, total scores on the Knowledge-Attitude-Practice Scale for Informal Caregivers of Patients with PIs, total GSES score, and total FCTI score were the main influencing factors of caregiver burden, jointly explaining 79.38% of its variance. CONCLUSIONS The main factors influencing the caregiving burden of informal caregivers of patients with PIs include the availability of assistance, family per-capita monthly income, total score on the Knowledge-Attitude-Practice Scale for Informal Caregivers of PI patients, total score on the GSES, and total score on the FCTI. Developing targeted intervention strategies addressing these factors may help alleviate the caregiving burden among informal caregivers of patients with PIs.
Humans ; Caregivers/psychology* ; Pressure Ulcer/nursing* ; Female ; Male ; Middle Aged ; Cost of Illness ; Adult ; Aged ; Surveys and Questionnaires ; Health Knowledge, Attitudes, Practice ; Self Efficacy ; Caregiver Burden ; China

BACKGROUND

The World Health Organization (WHO) estimates that in 2015, approximately 325 million or 4.4% of the global population were living with chronic hepatitis B or hepatitis C infection. In the same year, around 1.34 million died from this disease.

This study aimed to estimate the burden of hepatitis B in the Philippines and to determine the costeffectiveness of possible interventions.

This study utilized the Center for Disease Analysis Foundation’s (CDAF’s) mathematical disease burden model of hepatitis B. Model inputs were collected using literature review, key informant interviews, expert panel interviews, and records review, and were validated through a series of round table discussions with experts.

Results show that in 2017, the prevalence of chronic hepatitis B infection in the Philippines was 9.7%, equivalent to 10 million infected individuals. Although the model projects a decreasing trend in chronic hepatitis B virus (HBV) infections, liver-related mortality and morbidity due to these viruses are expected to rise if the status quo is maintained. Results show that substantial increase in government subsidy for WHO elimination scenarios would be required to achieve cost-effective outcomes.

Hepatitis B remains a huge problem in the Philippines. The HBV modelling exercise reveal that it will be worthwhile and cost-effective to adhere to the WHO elimination targets. A substantial financial investment will be necessary to do so, specifically a significant scale up in the screening, diagnosis, treatment, and monitoring of patients with HBV. While this modelling exercise does not yield burden of disease as accurate as a prevalence survey, experts consulted in the round table discussions agreed with the modelling inputs.

BACKGROUND: Without timely and effective rehabilitation, hearing loss may profoundly affect human life quality. China has a large population of hearing-impaired individuals, which imposes a heavy health burden on society. Moreover, this population is projected to increase rapidly owing to China's aging society. METHODS: We used data from a population-representative epidemiological investigation of hearing loss and ear diseases in four Chinese provinces. We estimated the national prevalence using multiple linear regression of the age-group proportions and prevalence in 31 provinces with clustering analysis. We used years lived with disability (YLDs) to analyze the disease burden and forecasted the prevalence of hearing loss by 2060 in China. RESULTS: An estimated 115 million people had moderate-to-complete hearing loss in 2015 across the 31 provinces of China (8.4% of 1.37 billion people). Of these, 85.7% were older than age 50 years (99 million people) and 2.4% were younger than 20 years old (2.8 million people). Of all YLDs attributable to hearing loss, 68.9% were attributable to moderate-to-complete cases. By 2060, a projected 242 million people in China will have moderate-to-complete hearing loss, a 110.0% increase from 2015. CONCLUSIONS The hearing loss prevalence in China is high. Population aging and socioeconomic factors substantially affect the prevalence and severity of hearing loss and the disease burden. The prevalence and severity of hearing loss are unevenly distributed across different provinces. Future public health policies should take these trends and regional variations into account.
Humans ; China/epidemiology* ; Hearing Loss/epidemiology* ; Prevalence ; Middle Aged ; Male ; Female ; Adult ; Aged ; Adolescent ; Young Adult ; Child ; Child, Preschool ; Infant ; Aged, 80 and over ; Cost of Illness

BACKGROUND: Parkinson's disease (PD) is a leading cause of death and disability worldwide, and is associated with a significant Global Burden of Disease (GBD). We analyzed the trends in PD incidence, mortality, and disability-adjusted life year (DALY) burden in China, and compared them with global data. METHODS: Estimates and 95% uncertainty intervals (UIs) for incidence, mortality, DALYs, years lived with disability (YLDs), and years of life lost (YLLs) for PD were extracted from the GBD, Injuries, and Risk Factors Study 2021. We describe the epidemiology of PD at global and Chinese levels, analyze trends in incidence and mortality from 1990 to 2021 by joinpoint regression models, and decompose PD burden according to population size, age structure, and epidemiological changes. RESULTS: GBD 2021 estimated 508,378 (95% UI: 430,499-592,748) incident cases of PD, 92,035 (95% UI: 75,908-108,133) deaths, and 2,159,514 (95% UI: 1,826,196-2,521,344) DALYs in China, with the higher age-standardized rate (ASR) in incidence, mortality and DALYs than the global levels. The DALY burden of PD in China increased slightly from 1990 to 2021, consistent with the global upward trend. Joinpoint regression analysis indicated that the ASR of incidence in China increased faster than the global average, while the ASR of mortality decreased, with the fastest decline in 2004-2014. Decomposition analysis revealed that men and the middle sociodemographic index (SDI) quintile (32.82%) were responsible for the most significant DALYs, whose changes were primarily driven by population growth and aging. CONCLUSIONS The burden of PD showed an overall increasing trend from 1990 to 2021, which was primarily driven by population growth and aging. This study highlights the significant challenges in controlling and managing PD, including the increase in cases and gender differences, which may provide guidance for comprehensive strategies to address the changing profiles of PD in China.
Humans ; Parkinson Disease/mortality* ; China/epidemiology* ; Global Burden of Disease ; Male ; Incidence ; Female ; Disability-Adjusted Life Years ; Middle Aged ; Aged ; Adult ; Quality-Adjusted Life Years ; Aged, 80 and over ; Cost of Illness ; Adolescent ; Pattern Analysis, Machine

OBJECTIVE: To analyze the current status and temporal trends of the disease burden of spinal fractures in China from 1990 to 2021 based on data from the Global Burden of Disease Study 2021 (GBD 2021), aiming to provide evidence for developing prevention and treatment strategies. METHODS: Epidemiological data on spinal fractures in China, the United States of America (USA), and globally were extracted from the GBD 2021 database. Joinpoint regression models were applied to analyze temporal trends. Age-standardized incidence, prevalence, and disability-adjusted life years (DALYs) rates were calculated, with comparisons of gender- and age-group disparities. RESULTS: In 2021, the number of incident cases, prevalent cases, and DALYs of spinal fractures in China increased by 52.28%, 113.68%, and 106.98%, respectively, compared to 1990. The age-standardized incidence, prevalence, and DALYs rates rose by 11.80%, 16.11%, and 14.79%, respectively. The disease burden escalated significantly with age, peaking in individuals aged ≥75 years. Males exhibited higher age-standardized incidence and DALYs rates than females. Comparative analysis revealed that the age-standardized DALYs rate in China (4.19/100 000) was lower than that in globally (6.62/100 000) and USA (15.92/100 000). However, China showed an upward trend [annual average percentage change (AAPC)=0.19%], contrasting with a declining trend in the USA (AAPC=-0.08%). CONCLUSION The escalating disease burden of spinal fractures in China is closely linked to population aging, gender disparities, and insufficient targeted prevention policies. Future strategies should integrate age- and gender-specific interventions, including strengthened osteoporosis prevention, trauma risk control, and big data-driven precision measures, to mitigate this burden.
Humans ; China/epidemiology* ; Global Burden of Disease/trends* ; Male ; Female ; Spinal Fractures/epidemiology* ; Middle Aged ; Aged ; Disability-Adjusted Life Years ; Prevalence ; Incidence ; Adult ; Young Adult ; Adolescent ; Aged, 80 and over ; United States/epidemiology* ; Cost of Illness ; Quality-Adjusted Life Years ; Child

OBJECTIVE:  To estimate the population attributable disease burden (PAD) of low bone mineral density (LBMD) related fractures (fragility fractures) among Chinese people over 50 years old from 1990 to 2023, using data from the Global Burden of Disease Study 2023 (GBD 2023), and to provide evidence for prevention strategies and health resource allocation. METHODS:   Based on the GBD 2023, the LBMD summary exposure values (SEV), fracture incidence, years lived with disability (YLDs), and LBMD-related falls YLDs of Chinese people over 50 years old from 1990 to 2023 were extracted. PAD was calculated with population attributable fraction (PAF), and an entropy-weight method was applied to evaluate the contribution of individual fracture sites. Temporal trends and sex differences were examined with Joinpoint regression. RESULTS:  From 1990 to 2023, the age-standardized SEV of LBMD in people over 50 years old showed an overall decline [average annual percent change (AAPC)=-0.564%]. Age-standardized fracture incidence, fracture YLDs rate, and LBMD-related falls YLDs rate all exhibited W-shaped upward trends (AAPC=1.045%, 0.296%, and 0.724%, respectively). PAF-based estimates indicated that LBMD-attributable fracture incidence likewise increased in a "W-shaped" manner (AAPC=0.558%), whereas the corresponding YLDs rate showed an overall W-shaped decline (AAPC=-0.193%). In international comparison, China and the global average displayed broadly concordant directions of change, with greater volatility in China and a progressive narrowing of the gap after 2015. Regarding sex differences, fracture YLDs rates were consistently higher in the males, whereas the other burden indicators were higher in the females; the temporal patterns were similar in both sexes. Entropy weight method identified hip fractures as contributing most to incidence (weight 0.133), and pelvic fractures as the largest contributor to YLDs rate (weight 0.115). CONCLUSION Since 1990, the LBMD attributable fracture burden in China's older population has risen, with female and hip or pelvic fractures bearing the heaviest load. Strengthened osteoporosis screening, improved insurance coverage, and targeted health education are urgently needed to curb further increases in disease burden.
Humans ; China/epidemiology* ; Middle Aged ; Female ; Male ; Bone Density ; Aged ; Incidence ; Osteoporotic Fractures/epidemiology* ; Aged, 80 and over ; Accidental Falls/statistics & numerical data* ; Cost of Illness ; Global Burden of Disease ; Osteoporosis/complications* ; Disability-Adjusted Life Years ; Fractures, Bone/epidemiology*

OBJECTIVE: To analyze the disease burden of pelvic fractures at the global, regional, and national levels from 1990 to 2023 using data from the 2023 Global Burden of Disease Study (GBD), and to predict the disease burden through 2050. METHODS: Leveraging data from the GBD 2023, this study investigated the disease burden of pelvic fractures across 204 countries and regions. Assessment indicators included incidence rate, prevalence rate, and years lived with disability (YLDs). The Joinpoint regression model was employed to analyze trends in pelvic fracture burden from 1990 to 2023, while the average annual percentage change (AAPC) was used to quantify this temporal trend. The relationship between the socio-demographic index and pelvic fracture burden was evaluated. Furthermore, the long short-term memory (LSTM) model was applied to predict trends in pelvic fracture burden through 2050. RESULTS: In 2023, the estimated number of new pelvic fracture cases globally was 7 479 884 [95% uncertainty interval ( UI): 5 293 401-10 611 876], representing a 42.74% increase from 1990. In the same year, the number of prevalent pelvic fracture cases and YLDs were 23 007 508 (95% UI: 21 021 518-25 327 165) and 3 909 228 person-years (95% UI: 2 725 498-5 194 385), respectively. Additionally, age-standardized rates exhibited an opposing downward trend. Significant disparities in the disease burden of pelvic fractures were identified across different age groups, genders, and social contexts. According to predictions from the LSTM model, the global age-standardized incidence rate (ASIR) of pelvic fractures will be approximately 88.44 per 100 000 persons by 2050, while the total number of incident cases will rise to 8 547 095. CONCLUSION Although the overall incidence rate, prevalence rate, and YLDs of pelvic fractures have exhibited an upward trend over the past three decades, the ASIR, age-standardized prevalence rate (ASPR), and age-standardized years of life lost rate (ASYR) have shown a downward trend. It is predicted that over the upcoming 26-year period, the age-standardized rate of disease burden due to pelvic fractures will further decrease, while the number of incident cases and prevalent cases will continue to exhibit an upward trend. Formulating more targeted disease prevention strategies is critical to addressing disparities across genders, regions, and other dimensions, and to mitigating the burden of pelvic fractures.
Humans ; Fractures, Bone/epidemiology* ; Pelvic Bones/injuries* ; Male ; Female ; Middle Aged ; Adult ; Incidence ; Prevalence ; Aged ; Global Burden of Disease/trends* ; Global Health ; Adolescent ; Cost of Illness ; Young Adult ; Forecasting ; Disability-Adjusted Life Years ; Memory, Short-Term

OBJECTIVE: To analyze the current status and trends of the disease burden of knee osteoarthritis (KOA) in China from 1990 to 2023, and to examine the epidemiological characteristics of age, gender differences, and attribution to high body mass index (BMI), in order to provide a basis for formulating prevention and treatment strategies to reduce the disease burden of KOA in China. METHODS: Based on the 2023 Global Burden of Disease Study (GBD) database, data on the number, rate, and age-standardized rate of incidence, prevalence, disability-adjusted life years (DALYs) for KOA, and DALYs for KOA attributable to high BMI in the Chinese population from 1990 to 2023 were integrated. The Joinpoint 5.4.0.0 software was used to analyze the age and gender differences in KOA and the epidemiological characteristics attributable to high BMI. RESULTS: The standardized incidence, prevalence, and DALYs rates of KOA in China in 2023 increased by 6.46%, 6.43%, and 6.93%, respectively, compared with 1990. In terms of age, the disease burden of KOA in China was lowest in the age group of 30-34 years, with the highest incidence rate in the age group of 50-54 years, whereas the prevalence rate and DALYs rate continued to increase with age, and both were highest in the age group of ≥70 years. In terms of gender, all disease burden standardized rate indicators were higher in females than in males, and the difference widened with age. The rate of BMI-attributable DALYs increased at an annual average rate of 1.57% (95% CI: 1.55, 1.59) from 1990 to 2023, again with significant age and gender differences. CONCLUSION The continued growth of the KOA disease burden and significant population differences characterizing China call for focused attention on the female middle-aged and elderly population, enhanced weight management, and implementation of targeted preventive and control measures.
Humans ; Osteoarthritis, Knee/epidemiology* ; China/epidemiology* ; Male ; Female ; Middle Aged ; Incidence ; Aged ; Adult ; Prevalence ; Body Mass Index ; Disability-Adjusted Life Years ; Cost of Illness ; Aged, 80 and over ; Sex Factors ; Global Burden of Disease ; Age Factors ; Young Adult ; Quality-Adjusted Life Years