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Article(id=1241022943132709689, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1241022939957621542, articleNumber=null, orderNo=null, doi=10.20043/j.cnki.MPM.202411511, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1732550400000, receivedDateStr=2024-11-26, revisedDate=null, revisedDateStr=null, acceptedDate=null, acceptedDateStr=null, onlineDate=1773812526734, onlineDateStr=2026-03-18, pubDate=1742832000000, pubDateStr=2025-03-25, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1773812526734, onlineIssueDateStr=2026-03-18, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1773812526734, creator=13701087609, updateTime=1773812526734, updator=13701087609, issue=Issue{id=1241022939957621542, tenantId=1146029695717560320, journalId=1227665162245664772, year='2025', volume='52', issue='6', pageStart='961', pageEnd='1152', issueExtLink='null', onlineDate='null', pubDate='null', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=null, createTime=1773812525976, creator=13701087609, updateTime=1773815469296, updator=13701087609, preIssue=null, nextIssue=null, ext={EN=IssueExt(id=1241035285174219432, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1241022939957621542, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1241035285174219433, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1241022939957621542, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null}, startPage=1006, endPage=1011, ext={EN=ArticleExt(id=1241022943896073038, articleId=1241022943132709689, tenantId=1146029695717560320, journalId=1227665162245664772, language=EN, title=Trend and forecast of dengue disease burden in China based on GBD2021 database, 1990-2021, columnId=1228016567443718970, journalTitle=Modern Preventive Medicine, columnName=Epidemiology and Statistical Methods Advances, runingTitle=null, highlight=null, articleAbstract=
Objective

To describe and analyze the disease burden of dengue fever in China from 1990 to 2021, and to provide evidence for the prevention and control of the disease.

Methods

Using the open data of the Global Burden of Disease (GBD) database from 1990 to 2021, this study analyzed the trend of dengue disease burden. The Joinpoint regression model was used to reflect the change trend of dengue burden, and the ARIMA time series model was used to predict the dengue disease burden in China in the next ten years.

Results

The incidence and prevalence of dengue fever in China increased from 0.37/100 000 and 0.02/100 000 in 1990 to 1.88/100 000 and 0.11/100 000 in 2021, and the DALYs rate decreased from 0.30/100 000 in 1990 to 0.04/100 000 in 2021. From 1990 to 2021, the age-standardized incidence and prevalence of dengue fever in China increased from 0.38/100 000 and 0.02/100 000 to 2.01/100 000 and 0.12/100 000, and the age-standardized DALYs rate decreased from 0.32/100 000 to 0.05/100 000. The Joinpoint regression model showed that, the age-standardized incidence rate (AAPC=5.59%, P<0.05) and age-standardized prevalence rate (AAPC=5.57%, P<0.05) of dengue fever in China from 1990 to 2021 showed an increasing trend, while the age-standardized DALYs rate (AAPC=-5.84%, P<0.05) showed a decreasing trend. The ARIMA forecast model showed a small decline in the burden of dengue in China from 2022 to 2031.

Conclusion

In China, the incidence and prevalence of dengue fever and its age-standardized rate showed an increasing trend, while the DALYs rate and age-standardized DALYs rate showed a decreasing trend. The burden of dengue fever in China is still relatively heavy, so preliminary screening and health education of dengue fever should be strengthened, and corresponding preventive measures should be formulated according to the characteristics of dengue disease burden.

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目的

本研究旨在描述并分析1990年至 2021年中国登革热的疾病负担，为疾病的防治提供依据。

方法

本研究利用1990年至2021年全球疾病负担（GBD）数据库的开放数据，分析了中国登革热疾病负担的趋势，采用Joinpoint回归模型反映登革热负担的变化趋势，应用ARIMA时间序列模型对未来十年中国登革热疾病负担状况进行了预测。

结果

中国登革热发病率和患病率从1990年的0.37/10万、0.02/10万上升至2021年的1.88/10万、0.11/10万，DALYs率从1990年的0.30/10万下降至2021年的0.04/10万。1990—2021年中国登革热年龄标化发病率和年龄标化患病率从0.38/10万、0.02/10万上升到2.01/10万、0.12/10万，年龄标化DALYs率从0.32／10万下降至0.05／10万， Joinpoint回归模型显示，1990—2021年中国登革热年龄标化发病率（AAPC=5.59%，P<0.05）和年龄标化患病率（AAPC=5.57%，P<0.05）均呈现上升趋势，年龄标化DALYs率（AAPC=-5.84%，P<0.05）呈现下降趋势；ARIMA预测模型显示2022—2031年中国登革热疾病负担将出现小幅度下降。

结论

中国登革热发病率和患病率及其年龄标化率呈现上升趋势，DALYs率和年龄标化DALYs率呈现下降趋势。中国登革热负担仍然较重，应加强登革热的初步筛查和健康教育，根据登革热疾病负担特征，制定相应的针对性的预防措施。

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李宝珠，E-mail:
, copyrightStatement=本刊刊出的所有文章不代表中华预防医学会和本刊编委会的观点，除非特别声明。, copyrightOwner=中华预防医学会和四川大学华西公共卫生学院, extLink=null, articleAbsUrl=null, sourceXml=/SNvtIuENNhs1DyKgteHrw==, magXml=zp0BljFzIhHFls3RWQoFbQ==, pdfUrl=null, pdf=mCbgat4TqtwE49Pej6+55Q==, pdfFileSize=875923, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=QglTzw8NqJutwpgh1EDN0w==, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=C0HlQ8zC8gqHs74/gp3CuQ==, mapNumber=null, authorCompany=null, fund=null, authors=

曹阳光（2000—），男，硕士在读，研究方向：风湿病与肌肉骨骼疾病流行病学

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曹阳光（2000—），男，硕士在读，研究方向：风湿病与肌肉骨骼疾病流行病学

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Tropical Medicine and Infectious Disease, 2022, 7(8): 180., articleTitle=Dengue incidence trends and its burden in major endemic regions from 1990 to 2019, refAbstract=null), Reference(id=1241022957468840572, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241022943132709689, doi=null, pmid=null, pmcid=null, year=2024, volume=60, issue=3, pageStart=425, pageEnd=null, url=null, language=null, rfNumber=[19], rfOrder=26, authorNames=Ilic I, Ilic M, journalName=Medicina (Kaunas, Lithuania), refType=null, unstructuredReference=Ilic I, Ilic M. Global patterns of trends in incidence and mortality of dengue, 1990-2019: an analysis based on the global burden of disease study[J]. Medicina (Kaunas, Lithuania), 2024, 60(3): 425., articleTitle=Global patterns of trends in incidence and mortality of dengue, 1990-2019: an analysis based on the global burden of disease study, refAbstract=null), Reference(id=1241022957573698184, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241022943132709689, doi=null, pmid=null, pmcid=null, year=2019, volume=10, issue=2, pageStart=31, pageEnd=38, url=null, language=null, rfNumber=[20], rfOrder=27, authorNames=Getahun A, Batikawai A, Nand D, journalName=Western Pacific Surveillance and Response Journal: WPSAR, refType=null, unstructuredReference=Getahun A, Batikawai A, Nand D, et al. Dengue in Fiji: epidemiology of the 2014 DENV-3 outbreak[J]. Western Pacific Surveillance and Response Journal: WPSAR, 2019, 10(2): 31-38., articleTitle=Dengue in Fiji: epidemiology of the 2014 DENV-3 outbreak, refAbstract=null), Reference(id=1241022957728887445, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241022943132709689, doi=null, pmid=null, pmcid=null, year=2013, volume=31, issue=5, pageStart=783, pageEnd=787, url=null, language=null, rfNumber=[21], rfOrder=28, authorNames=Lee CC, Hsu HC, Chang CM, journalName=The American Journal of Emergency Medicine, refType=null, unstructuredReference=Lee CC, Hsu HC, Chang CM, et al. Atypical presentations of dengue disease in the elderly visiting the ED[J]. The American Journal of Emergency Medicine, 2013, 31(5): 783-787., articleTitle=Atypical presentations of dengue disease in the elderly visiting the ED, refAbstract=null), Reference(id=1241022957909242535, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241022943132709689, doi=null, pmid=null, pmcid=null, year=2024, volume=37, issue=2, pageStart=126, pageEnd=135, url=null, language=null, rfNumber=[22], rfOrder=29, authorNames=B A Seixas J, Giovanni Luz K, Pinto Junior V, journalName=Acta Medica Portuguesa, refType=null, unstructuredReference=B A Seixas J, Giovanni Luz K, Pinto Junior V. [Clinical update on diagnosis, treatment and prevention of dengue] [J]. Acta Medica Portuguesa, 2024, 37(2): 126-135., articleTitle=Clinical update on diagnosis, treatment and prevention of dengue], refAbstract=null), Reference(id=1241022958022488754, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241022943132709689, doi=null, pmid=null, pmcid=null, year=2024, volume=40, issue=6, pageStart=489, pageEnd=497, url=null, language=null, rfNumber=[23], rfOrder=30, authorNames=中华医学会热带病与寄生虫学分会, 中华预防医学会媒介生物学及控制分会, 中国疫苗行业协会基础研究专业委员会, journalName=中国人兽共患病学报, refType=null, unstructuredReference=中华医学会热带病与寄生虫学分会，中华预防医学会媒介生物学及控制分会，中国疫苗行业协会基础研究专业委员会，等．登革热疾病负担及预防控制策略中国专家共识[J].中国人兽共患病学报，2024, 40(6): 489-497., articleTitle=登革热疾病负担及预防控制策略中国专家共识, refAbstract=null), Reference(id=1241022958118957755, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241022943132709689, doi=null, pmid=null, pmcid=null, year=2024, volume=40, issue=6, pageStart=489, pageEnd=497, url=null, language=null, rfNumber=[23], rfOrder=31, authorNames=Tropical Diseases and Parasites Branch of Chinese Medical Association, Vector Biology and Control Branch of Chinese Preventive Medical Association, Basic Research Professional Committee of China Vaccine Industry Association, journalName=Chinese Journal of Zoonoses, refType=null, unstructuredReference=Tropical Diseases and Parasites Branch of Chinese Medical Association, Vector Biology and Control Branch of Chinese Preventive Medical Association, Basic Research Professional Committee of China Vaccine Industry Association, et al. Expert consensus on the disease burden and strategies of dengue prevention and control in China[J]. Chinese Journal of Zoonoses, 2024, 40(6): 489-497. (In Chinese), articleTitle=Expert consensus on the disease burden and strategies of dengue prevention and control in China, refAbstract=null), Reference(id=1241022958232203972, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241022943132709689, doi=null, pmid=null, pmcid=null, year=2024, volume=39, issue=8, pageStart=806, pageEnd=812, url=null, language=null, rfNumber=[24], rfOrder=32, authorNames=胡守财, 陶堰成, 马浩天, journalName=中国循环杂志, refType=null, unstructuredReference=胡守财，陶堰成，马浩天，等．1990—2019年中国非风湿性瓣膜性心脏病疾病负担及变化趋势分析[J].中国循环杂志，2024, 39(8): 806-812., articleTitle=1990—2019年中国非风湿性瓣膜性心脏病疾病负担及变化趋势分析, refAbstract=null), Reference(id=1241022958332867277, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241022943132709689, doi=null, pmid=null, pmcid=null, year=2024, volume=39, issue=8, pageStart=806, pageEnd=812, url=null, language=null, rfNumber=[24], rfOrder=33, authorNames=Hu SC, Tao YC, Ma HT, journalName=Chinese Circulation Journal, refType=null, unstructuredReference=Hu SC, Tao YC, Ma HT, et al. Disease burden and changing trend of non-rheumatic valvular heart disease from 1990 to 2019 in China[J]. Chinese Circulation Journal, 2024, 39(8): 806-812. (In Chinese), articleTitle=Disease burden and changing trend of non-rheumatic valvular heart disease from 1990 to 2019 in China, refAbstract=null), Reference(id=1241022958420947673, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241022943132709689, doi=null, pmid=null, pmcid=null, year=2021, volume=28, issue=8, pageStart=null, pageEnd=null, url=null, language=null, rfNumber=[25], rfOrder=34, authorNames=Yang XR, Quam MBM, Zhang TC, journalName=Journal of Travel Medicine, refType=null, unstructuredReference=Yang XR, Quam MBM, Zhang TC, et al. Global burden for dengue and the evolving pattern in the past 30 years[J]. Journal of Travel Medicine, 2021, 28(8): taab146., articleTitle=Global burden for dengue and the evolving pattern in the past 30 years, refAbstract=null)], funds=[Fund(id=1241022952561504571, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241022943132709689, awardId=JKS2022023, language=CN, fundingSource=合肥大健康研究院健康大数据与群体医学研究所项目(JKS2022023), fundOrder=null, country=null)], companyList=[AuthorCompany(id=1241022944898511757, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241022943132709689, xref=null, ext=[AuthorCompanyExt(id=1241022944911094670, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241022943132709689, companyId=1241022944898511757, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=Department of Epidemiology and Health Statistics， School of Public Health, Anhui Medical University, Center for Big Data and Population Health of IHM， Hefei， Anhui 230032， China), AuthorCompanyExt(id=1241022944927871888, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241022943132709689, companyId=1241022944898511757, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=安徽医科大学公共卫生学院流行病与卫生统计学系，合肥大健康研究院健康大数据与群体医学研究所，安徽　合肥　230032)])], figs=[ArticleFig(id=1241022949398999202, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241022943132709689, language=EN, label=Fig.1, caption=The incidence, prevalence and DALYs rate of dengue fever in different age groups in China in 1990 and 2021, figureFileSmall=PkDC6Dgv4ZnQ1V9RsOUw5w==, figureFileBig=QglTzw8NqJutwpgh1EDN0w==, tableContent=null), ArticleFig(id=1241022949499662509, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241022943132709689, language=CN, label=图1, caption=1990年与2021年中国登革热不同年龄段发病率、患病率和DALYs率趋势图

注：A：中国不同年龄段发病率；B：中国不同年龄段患病率；C：中国不同年龄段DALYs率。

, figureFileSmall=PkDC6Dgv4ZnQ1V9RsOUw5w==, figureFileBig=QglTzw8NqJutwpgh1EDN0w==, tableContent=null), ArticleFig(id=1241022951160606923, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241022943132709689, language=EN, label=Fig.2, caption=Map of differences in dengue disease burden between men and women of different age groups in China, 1990 and 2021, figureFileSmall=plUKaWP8zMAIRuXbJQaRtQ==, figureFileBig=p0ZsqLEhPrJRCo6fADRvPQ==, tableContent=null), ArticleFig(id=1241022951286436051, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241022943132709689, language=CN, label=图2, caption=1990年与2021年中国不同年龄组男性和女性登革热疾病负担差异图

注：A：1990年中国不同年龄组男性和女性登革热发病人数；B：2021年中国不同年龄组男性和女性登革热发病人数；C：1990年中国不同年龄组男性和女性登革热患病人数；D：2021年中国不同年龄组男性和女性登革热患病人数；E：1990年中国不同年龄组男性和女性登革热DALYs人年数；F：2021年中国不同年龄组男性和女性登革热DALYs人年数。

, figureFileSmall=plUKaWP8zMAIRuXbJQaRtQ==, figureFileBig=p0ZsqLEhPrJRCo6fADRvPQ==, tableContent=null), ArticleFig(id=1241022951387099357, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241022943132709689, language=EN, label=Table 1, caption=

Dengue fever prevalence and disease burden in China, 1990 and 2021

, figureFileSmall=null, figureFileBig=null, tableContent=
年份类别发病人数发病率/10万年龄标化发病率/10万患病人数患病率/10万年龄标化患病率/10万DALYs人年数DALYs率/10万年龄标化DALYs率/10万
1990年全部4 3640.370.382560.020.023 5680.300.32
男性2 0850.340.351220.020.022 3560.390.41
女性2 2790.400.411340.020.021 2120.210.23
2021年全部26 7481.882.011 5790.110.126220.040.05
男性13 1071.801.927760.110.113840.050.06
女性13 6411.962.118030.120.122380.030.04
), ArticleFig(id=1241022951680700649, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241022943132709689, language=CN, label=表1, caption=

1990年和2021年中国登革热流行和疾病负担现状

, figureFileSmall=null, figureFileBig=null, tableContent=
年份类别发病人数发病率/10万年龄标化发病率/10万患病人数患病率/10万年龄标化患病率/10万DALYs人年数DALYs率/10万年龄标化DALYs率/10万
1990年全部4 3640.370.382560.020.023 5680.300.32
男性2 0850.340.351220.020.022 3560.390.41
女性2 2790.400.411340.020.021 2120.210.23
2021年全部26 7481.882.011 5790.110.126220.040.05
男性13 1071.801.927760.110.113840.050.06
女性13 6411.962.118030.120.122380.030.04
), ArticleFig(id=1241022951785558255, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241022943132709689, language=EN, label=Table 2, caption=

Joinpoint regression analysis of dengue disease burden in China from 1990 to 2021

, figureFileSmall=null, figureFileBig=null, tableContent=
指标总体男性
年份（年）APC（%）AAPCb（%）年份（年）APC（%）AAPCb（%）
年龄标化发病率1990—19945.21a1990—19944.58a
1994—20101.25a1994—20101.61a
2010—201423.43a2010—201424.37a
2014—20178.45a2014—20216.11a
2017—20215.09a
1990—20215.59a（5.39～5.79）1990—20215.71a（5.60～5.82）
年龄标化患病率1990-19954.48a1990-19954.06a
1995—20101.11a1995—20101.48a
2010—201423.92a2010—201424.94a
2014—20178.52a2014—20215.99a
2017—20214.93a
1990—20215.57a（5.38～5.76）1990—20215.70（5.59～5.81）
年龄标化DALYs率1990—19921.761990—1992-0.97
1992—1995-17.62a1992-1996-23.22a
1995—1998-11.75a1996-1999-11.96a
1998—20023.381999—200210.80
2002—2012-7.75a2002—2012-5.11a
2012—2021-3.15a2012—2021-2.65a
1990—2021-5.84a（-7.10～-4.56）1990—2021-6.00a（-7.61～-4.35）
指标女性
年份（年）APC（%）AAPCb（%）
年龄标化发病率1990-19954.75a
1995—20100.84a
2010—201423.28a
2014—20198.79a
2019—20211.16
1990—20215.43a（5.25～5.61）
年龄标化患病率1990-19954.91a
1995—20100.78a
2010—201423.54a
2014—20198.93a
2019—20210.78
1990—20215.45a（5.29～5.60）
年龄标化DALYs率1990-19931.67
1993—1998-7.86a
1998—20021.73
2002—2012-10.44a
2012—2021-4.19a
1990—2021-5.58a（-6.37～-4.77）
), ArticleFig(id=1241022951974301952, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241022943132709689, language=CN, label=表2, caption=

1990年至2021年中国登革热疾病负担Joinpoint回归分析

, figureFileSmall=null, figureFileBig=null, tableContent=
指标总体男性
年份（年）APC（%）AAPCb（%）年份（年）APC（%）AAPCb（%）
年龄标化发病率1990—19945.21a1990—19944.58a
1994—20101.25a1994—20101.61a
2010—201423.43a2010—201424.37a
2014—20178.45a2014—20216.11a
2017—20215.09a
1990—20215.59a（5.39～5.79）1990—20215.71a（5.60～5.82）
年龄标化患病率1990-19954.48a1990-19954.06a
1995—20101.11a1995—20101.48a
2010—201423.92a2010—201424.94a
2014—20178.52a2014—20215.99a
2017—20214.93a
1990—20215.57a（5.38～5.76）1990—20215.70（5.59～5.81）
年龄标化DALYs率1990—19921.761990—1992-0.97
1992—1995-17.62a1992-1996-23.22a
1995—1998-11.75a1996-1999-11.96a
1998—20023.381999—200210.80
2002—2012-7.75a2002—2012-5.11a
2012—2021-3.15a2012—2021-2.65a
1990—2021-5.84a（-7.10～-4.56）1990—2021-6.00a（-7.61～-4.35）
指标女性
年份（年）APC（%）AAPCb（%）
年龄标化发病率1990-19954.75a
1995—20100.84a
2010—201423.28a
2014—20198.79a
2019—20211.16
1990—20215.43a（5.25～5.61）
年龄标化患病率1990-19954.91a
1995—20100.78a
2010—201423.54a
2014—20198.93a
2019—20210.78
1990—20215.45a（5.29～5.60）
年龄标化DALYs率1990-19931.67
1993—1998-7.86a
1998—20021.73
2002—2012-10.44a
2012—2021-4.19a
1990—2021-5.58a（-6.37～-4.77）
), ArticleFig(id=1241022952087548168, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241022943132709689, language=EN, label=Table 3, caption=

Evaluation of fitting effect of ARIMA（2，2，0）model

, figureFileSmall=null, figureFileBig=null, tableContent=
指标RMSEMAEMAPE
年龄标化发病率0.021 30.009 70.913 4
年龄标化患病率0.001 30.000 60.934 3
年龄标化DALYs率0.039 70.025 521.358 1
), ArticleFig(id=1241022952179822865, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241022943132709689, language=CN, label=表3, caption=

ARIMA（2，2，0）模型拟合效果评价

, figureFileSmall=null, figureFileBig=null, tableContent=
指标RMSEMAEMAPE
年龄标化发病率0.021 30.009 70.913 4
年龄标化患病率0.001 30.000 60.934 3
年龄标化DALYs率0.039 70.025 521.358 1
), ArticleFig(id=1241022952297263392, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241022943132709689, language=EN, label=Table 4, caption=

Forecast of dengue burden in China from 2022 to 2031

, figureFileSmall=null, figureFileBig=null, tableContent=
年份年龄标化发病率（/10万）a年龄标化患病率（/10万）a
2022年1.979 0（1.934 3~2.023 6）0.116 6（0.113 8~0.119 3）
2023年1.915 5（1.775 9~2.055 0）0.112 5（0.104 1~0.121 0）
2024年1.866 3（1.592 8~2.139 8）0.109 3（0.092 7~0.125 8）
2025年1.847 4（1.420 1~2.274 8）0.107 8（0.081 9~0.133 7）
2026年1.849 4（1.261 8~2.437 1）0.107 5（0.071 9~0.143 1）
2027年1.854 0（1.103 9~2.604 2）0.107 4（0.061 8~0.152 9）
2028年1.849 1（0.931 6~2.766 0）0.106 7（0.050 9~0.162 6）
2029年1.833 6（0.739 3~2.927 8）0.105 5（0.038 8~0.172 2）
2030年1.813 3（0.529 9~3.096 7）0.104 0（0.025 8~0.182 3）
2031年1.794 6（0.309 4~3.279 8）0.102 6（0.012 0~0.193 2）
), ArticleFig(id=1241022952406315307, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241022943132709689, language=CN, label=表4, caption=

2022—2031年中国登革热负担预测情况

, figureFileSmall=null, figureFileBig=null, tableContent=
年份年龄标化发病率（/10万）a年龄标化患病率（/10万）a
2022年1.979 0（1.934 3~2.023 6）0.116 6（0.113 8~0.119 3）
2023年1.915 5（1.775 9~2.055 0）0.112 5（0.104 1~0.121 0）
2024年1.866 3（1.592 8~2.139 8）0.109 3（0.092 7~0.125 8）
2025年1.847 4（1.420 1~2.274 8）0.107 8（0.081 9~0.133 7）
2026年1.849 4（1.261 8~2.437 1）0.107 5（0.071 9~0.143 1）
2027年1.854 0（1.103 9~2.604 2）0.107 4（0.061 8~0.152 9）
2028年1.849 1（0.931 6~2.766 0）0.106 7（0.050 9~0.162 6）
2029年1.833 6（0.739 3~2.927 8）0.105 5（0.038 8~0.172 2）
2030年1.813 3（0.529 9~3.096 7）0.104 0（0.025 8~0.182 3）
2031年1.794 6（0.309 4~3.279 8）0.102 6（0.012 0~0.193 2）
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基于GBD2021数据库分析1990—2021年中国登革热疾病负担趋势与预测
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曹阳光 , 王竞 , 周倩倩 , 陆张伟 , 王驿远 , 李宝珠
现代预防医学 | 流行病与统计方法 2025,52(6): 1006-1011
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现代预防医学 | 流行病与统计方法 2025, 52(6): 1006-1011
基于GBD2021数据库分析1990—2021年中国登革热疾病负担趋势与预测
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曹阳光, 王竞, 周倩倩, 陆张伟, 王驿远, 李宝珠
作者信息
  • 安徽医科大学公共卫生学院流行病与卫生统计学系，合肥大健康研究院健康大数据与群体医学研究所，安徽　合肥　230032

    • 曹阳光（2000—），男，硕士在读，研究方向：风湿病与肌肉骨骼疾病流行病学

通讯作者:

李宝珠，E-mail:
Trend and forecast of dengue disease burden in China based on GBD2021 database, 1990-2021
Yang-guang CAO, Jing WANG, Qian-qian ZHOU, Zhang-wei LU, Yi-yuan WANG, Bao-zhu LI
Affiliations
  • Department of Epidemiology and Health Statistics， School of Public Health, Anhui Medical University, Center for Big Data and Population Health of IHM， Hefei， Anhui 230032， China
出版时间: 2025-03-25 doi: 10.20043/j.cnki.MPM.202411511
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摘要
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目的

本研究旨在描述并分析1990年至 2021年中国登革热的疾病负担，为疾病的防治提供依据。

方法

本研究利用1990年至2021年全球疾病负担（GBD）数据库的开放数据，分析了中国登革热疾病负担的趋势，采用Joinpoint回归模型反映登革热负担的变化趋势，应用ARIMA时间序列模型对未来十年中国登革热疾病负担状况进行了预测。

结果

中国登革热发病率和患病率从1990年的0.37/10万、0.02/10万上升至2021年的1.88/10万、0.11/10万，DALYs率从1990年的0.30/10万下降至2021年的0.04/10万。1990—2021年中国登革热年龄标化发病率和年龄标化患病率从0.38/10万、0.02/10万上升到2.01/10万、0.12/10万，年龄标化DALYs率从0.32／10万下降至0.05／10万， Joinpoint回归模型显示，1990—2021年中国登革热年龄标化发病率（AAPC=5.59%，P<0.05）和年龄标化患病率（AAPC=5.57%，P<0.05）均呈现上升趋势，年龄标化DALYs率（AAPC=-5.84%，P<0.05）呈现下降趋势；ARIMA预测模型显示2022—2031年中国登革热疾病负担将出现小幅度下降。

结论

中国登革热发病率和患病率及其年龄标化率呈现上升趋势，DALYs率和年龄标化DALYs率呈现下降趋势。中国登革热负担仍然较重，应加强登革热的初步筛查和健康教育，根据登革热疾病负担特征，制定相应的针对性的预防措施。

登革热  /  疾病负担  /  预测  /  回归模型
Objective

To describe and analyze the disease burden of dengue fever in China from 1990 to 2021, and to provide evidence for the prevention and control of the disease.

Methods

Using the open data of the Global Burden of Disease (GBD) database from 1990 to 2021, this study analyzed the trend of dengue disease burden. The Joinpoint regression model was used to reflect the change trend of dengue burden, and the ARIMA time series model was used to predict the dengue disease burden in China in the next ten years.

Results

The incidence and prevalence of dengue fever in China increased from 0.37/100 000 and 0.02/100 000 in 1990 to 1.88/100 000 and 0.11/100 000 in 2021, and the DALYs rate decreased from 0.30/100 000 in 1990 to 0.04/100 000 in 2021. From 1990 to 2021, the age-standardized incidence and prevalence of dengue fever in China increased from 0.38/100 000 and 0.02/100 000 to 2.01/100 000 and 0.12/100 000, and the age-standardized DALYs rate decreased from 0.32/100 000 to 0.05/100 000. The Joinpoint regression model showed that, the age-standardized incidence rate (AAPC=5.59%, P<0.05) and age-standardized prevalence rate (AAPC=5.57%, P<0.05) of dengue fever in China from 1990 to 2021 showed an increasing trend, while the age-standardized DALYs rate (AAPC=-5.84%, P<0.05) showed a decreasing trend. The ARIMA forecast model showed a small decline in the burden of dengue in China from 2022 to 2031.

Conclusion

In China, the incidence and prevalence of dengue fever and its age-standardized rate showed an increasing trend, while the DALYs rate and age-standardized DALYs rate showed a decreasing trend. The burden of dengue fever in China is still relatively heavy, so preliminary screening and health education of dengue fever should be strengthened, and corresponding preventive measures should be formulated according to the characteristics of dengue disease burden.

Dengue fever  /  Disease burden  /  Forecast  /  Regression model
曹阳光, 王竞, 周倩倩, 陆张伟, 王驿远, 李宝珠. 基于GBD2021数据库分析1990—2021年中国登革热疾病负担趋势与预测. 现代预防医学, 2025 , 52 (6) : 1006 -1011 . DOI: 10.20043/j.cnki.MPM.202411511
Yang-guang CAO, Jing WANG, Qian-qian ZHOU, Zhang-wei LU, Yi-yuan WANG, Bao-zhu LI. Trend and forecast of dengue disease burden in China based on GBD2021 database, 1990-2021[J]. Modern Preventive Medicine, 2025 , 52 (6) : 1006 -1011 . DOI: 10.20043/j.cnki.MPM.202411511
正文
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1　背景
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登革热是由登革热病毒引起的一种蚊媒传染病，该疾病主要集中在热带和亚热带地区[1]。登革热感染每年影响全球 3.9 亿人，并导致多达 36 000 人死亡[2]。中国从 1978 年到 2019 年，发生了不同规模的登革热疫情，共出现747 417 例病例和造成622人死亡[3]。在中国登革热属于法定乙类传染病，中国登革热病例主要为境外输入病例，由输入性病例引起的本地传播疫情多分布在广东、云南、福建、广西等省区[4]。
目前全球疾病负担数据库（Global Burden of Disease Study 2021，GBD）研究中关于登革热负担的报告主要集中在全球和区域层面的宏观评估，在中国使用GBD数据库分析登革热的报告较为鲜有。而登革热一直是中国面临的重大公共卫生挑战，在全球变暖、频繁的国际旅行以及城市规模和人口流动增加的城市化背景下，这一点尤为重要[5]。因此，本研究基于最新的GBD数据，对1990年至2021年中国登革热负担进行了全面的分析和比较，其目的是为决策者评估中国登革热的总体负担提供有价值的见解，并促进其制定有针对性的预防策略。
2　资料与方法
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2.1　数据来源
本研究中使用的数据摘自GBD 2021数据集。GBD 2021包括具有全国代表性的调查、人口普查和荟萃分析结果，并提供了对 371种疾病和伤害以及88种风险因素的流行病学评估，涵盖 1990年至2021年的21个GBD地区和204个国家和地区[6]。
2.2　分析指标
本研究筛选了GBD2021数据库中的中国登革热发病率、患病率和伤残调整寿命年（DALYs）及其年龄标化率来评价登革热疾病负担情况。使用Joinpoint软件计算平均年度百分比变化（average annual percentage change，AAPC）和年度变化百分比（average percent change，APC）和相应的95%置信区间（95% CI）以确定疾病的负担趋势，应用自回归滑动平均混合模型（autoregressive integrated moving average model, ARIMA）预测2022年至2031年中国登革热年龄标化发病率和患病率。
2.3　统计学方法
使用R统计软件程序（版本4.4.1）和Excel 2019表格软件对全球登革热数据进行处理。使用Joinpoint软件程序（版本5.2.0）进行时间趋势分析，计算出APC，AAPC及其95% CI值。如果相应95% CI值>0, 则年龄标准化指标显示增加趋势;如果95% CI值< 0，则显示下降趋势;如果它包含0，则表示稳定的趋势[7]。ARIMA模型是一种典型的时间序列模型，特点是根据历史数据的特征来预测序列自身未来的发展趋势，对于理解疾病趋势及其可能的变化尤为有用[8]，并且由于其具有结构简单、适用性强、能够解读数据集等优点，在医疗卫生领域已经广泛成功应用[9]。采用ARIMA模型对2022—2031年的年龄标化发病率和年龄标化患病率进行预测。使用白噪声检验对模型进行评价，检验水准为α=0.05，当通过白噪声检验，可用于外推预测，用均方根误差（root mean square error，RMSE）、平均绝对误差（mean absolute error，MAE）、平均绝对百分误差（mean absolute percentage error，MAPE）评价模型预测效果，数值越小，模型预测效果越好[10]。
3　结果
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3.1　1990—2021年中国登革热疾病负担
1990—2021年中国登革热发病率和患病率呈现上升趋势，DALYs率呈现下降趋势，发病率和患病率从1990年的0.37/10万、0.02/10万上升至2021年的1.88/10万、0.11/10万，分别增长了408.11%、450.00%，DALYs率从1990年的0.30/10万下降至2021年的0.04/10万，降幅为86.67%；年龄标化发病率和年龄标化患病率从1990年的0.38/10万、0.02/10万上升到2021年的2.01/10万、0.12/10万，累计上升了428.95%、500.00%，年龄标化DALYs率从1990年的0.32/10万下降至2021年的0.05/10万，降幅为84.38%。1990—2021年男性和女性发病率和患病率呈现上升趋势，且女性高于男性，而男性和女性DALYs率均呈现下降趋势，见表1。
3.2　1990年与2021年中国不同年龄段登革热疾病负担趋势变化
2021年各年龄段登革热发病率和患病率均大于1990年，1990年和2021年中国登革热在65~95+岁发病率、患病率逐渐上升，2021年登革热发病率和患病率在35~59岁逐渐下降。1990年中国登革热DALYs率在<5岁最高，在<5~24岁DALYs率逐渐下降，2021年中国登革热DALYs率在<5~19岁逐渐下降，见图1。
3.3　中国不同年龄、不同性别的登革热疾病负担
1990年男性和女性登革热发病人数高峰为5~9岁，5~39岁女性发病人数高于男性，2021年30~34岁男性和女性发病人数最高，在15~34岁男性发病人数高于女性；从患病人数来看，1990年登革热男性和女性患病人数最多的年龄段均为5~9岁，0~39岁女性患病人数高于男性，2021年中国登革热男性和女性患病人数最多的年龄段为30~34岁，在35~95+岁年龄段，女性患病人数高于男性；1990和2021年中国登革热男性和女性DALYs人年数最高的年龄段均是<5岁，并且在<5岁年龄段男性DALYs人年数高于女性，见图2。
3.4　中国登革热疾病负担的Joinpoint回归分析
Joinpoint回归分析显示，1990—2021年中国登革热年龄标化发病率（AAPC=5.59%，P<0.05）和年龄标化患病率（AAPC=5.57%，P<0.05）均呈现上升趋势，年龄标化DALYs率（AAPC=-5.84%，P<0.05）呈现下降趋势，年龄标化发病率（APC=23.43%，P<0.05）和年龄标化患病率（APC=23.92%，P<0.05）在2010—2014年上升速度最快，年龄标化DALYs率（APC=-17.62%，P<0.05）在1992—1995年下降速度最快。1990—2021年中国登革热男性的年龄标化发病率、年龄标化患病率、年龄标化DALYs率的AAPC值分别为5.71%、5.70%和-6.00%；女性的年龄标化发病率、年龄标化患病率、年龄标化DALYs率的AAPC值分别为5.43%、5.45%和-5.58%，变化趋势均具有统计学意义（P<0.05），见表2。
3.5　2021—2031中国和全球登革热患病和DALYs情况预测
本研究应用ARIMA模型预测2022—2031年中国登革热负担情况，因年龄标化DALYs率拟合效果不佳，故只分析并预测了年龄标化发病率和年龄标化患病率，结果显示，2022—2031年中国年龄标化发病率和年龄标化患病率整体上均呈下降趋势。到2031年，中国年龄标化发病率约为1.79/10万，下降了10.95%，中国年龄标化患病率约为0.10/10万，下降了16.67%，见表4。
4　讨论
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本研究利用GBD2021最新数据库，对中国过去近三十年登革热的负担趋势做了全面分析。研究显示，1990—2021年中国患病率和发病率及其年龄标化率呈上升趋势，这或许与输入性病例增加有很大关系。在中国输入性病例常年可见，东南亚国家是我国登革热的主要输入来源，2005—2019年输入性登革热病例数快速上升[11]。2019 年达到5 813例，占该一年输入性病例总数的 45.8%[12]。防控登革热，输入性病例是关键。商业贸易往来是目前导致登革热输入的主要原因之一，加强境外发病人员入关时的检查发现及人员入境后的健康监测均具有十分重要的意义[13]。及时发现输入或早期病例，对病例实施防蚊隔离管理[14]。输入性病例在伊蚊密度高峰期输入极易造成本地传播，降低媒介伊蚊密度，切断传播途径，也是控制输入性登革热疫情的关键[15]。不同于1990—2010年的平稳状态，2010年后登革热发病率和患病率开始逐年上升。除了与输入病例的增加有关外，还可能与检出率的上升有关，核酸检测技术在登革热病毒早期检测方面具有独特的优势，包括PCR技术、核酸杂交技术等方法[16]。例如，RT-PCR检出率为97.0%，敏感性及特异性分别为91.4%和95.4%[17]。随着检测技术的进步，检出率的提高可能使得更多的病例被及时发现和报告，从而影响了发病率和患病率的统计数据。1990—2021年中国登革热DALYs率和年龄标化DALYs率呈现下降趋势，这可能与中国社会经济增长、人民健康素养提高、监测和诊断系统以及医疗卫生资源的不断优化相关[18]。除此之外，本研究还观察到中国登革热女性发病率和患病率普遍高于男性，Ilic等人研究发现，在全球范围内，2019年所有年龄组的女性登革热年龄别发病率均高于男性[19]。性别差异可能与性别相关的生物学差异以及暴露、职业和社会经济地位的差异有关，而没有关于登革热病毒传播方式取决于性别的发现[20]。
老年人更易感染登革热，2007年在台南急诊科就诊的 193例成人登革热病例的前瞻性病例对照研究中报告了类似的发现，与65岁以下的患者相比，65岁以上的患者更容易出现登革热出血[21]。本研究分析了1990和2021年中国不同年龄段登革热发病率和患病率，结果表明在65~95+岁发病率和患病率迅速上升，这可能与老年人口免疫功能下降和抵抗力减弱有关，导致对登革热易感性增加，针对老年人群需要建立更加完善的疾病监测系统，尽早诊断并提供有效的治疗。
病媒控制措施和疫苗开发一直是目前预防登革热的主要策略[22]。而中国登革热防治的总体目标是及时发现和控制输入病例、防止本土传播，预防控制登革热续发病例，避免出现较大规模暴发或流行[23]。本研究根据ARIMA模型预测未来十年中国登革热年龄标化发病率和年龄标化患病率将会有小幅度下降，但到2031年仍处于较高水平，仍需要重视对登革热的防控。
此外，本研究也存在一定的局限性。首先，GBD数据库利用各种数学模型来估算疾病负担及其变动趋势，这可能与现实中的情形存在出入[24]；其次，登革热症状易与疟疾和其他病毒感染混淆或误诊[25]，因为它们的临床表现相似，从而低估或者高估了实际疾病负担；最后，没有对中国各省和地区之间的差别进行详尽的探讨。
综上所述，中国登革热负担仍然较重，应制定针对性的防治输入性病例的措施，同时对于老年人适当分配更多的医疗资源，完善医疗保障制度，降低登革热负担。
基金
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  • 合肥大健康研究院健康大数据与群体医学研究所项目(JKS2022023)
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2025年第52卷第6期
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doi: 10.20043/j.cnki.MPM.202411511
  • 接收时间：2024-11-26
  • 首发时间：2026-03-18
  • 出版时间：2025-03-25
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  • 收稿日期：2024-11-26
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合肥大健康研究院健康大数据与群体医学研究所项目(JKS2022023)
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    安徽医科大学公共卫生学院流行病与卫生统计学系，合肥大健康研究院健康大数据与群体医学研究所，安徽　合肥　230032

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Number of
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species		 占总种数比例
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total species (%)		 属
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鹅膏菌科Amanitaceae 2 11 5.26 鹅膏菌属 Amanita 10 4.78
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