Quantifying the impact of disease severity changes on the burden of blindness: A global decomposition analysis.

IF 4.5 3区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Journal of Global Health Pub Date : 2024-11-01 DOI:10.7189/jogh.14.04248
Jianqi Chen, Xiaohong Chen, Yingting Zhu, Zhidong Li, Xuhao Chen, Xu Cao, Yangyang Li, Yuwen Wen, Liyan Liu, Yue Xiao, Jinan Zhan, Haishun Huang, Yingfeng Zheng, Yiqing Li, Yantao Wei, Yehong Zhuo
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Abstract

Background: Despite the significant impact of blindness on the affected individuals' quality of life, its burden has not been assessed according to temporal cause-specific changes in severity, impeding our ability to evaluate the impact of blindness on population health accurately. Therefore, we aimed to comprehensively quantify the changes in cause-specific blindness burden according to changes in disease severity for 18 causes of blindness.

Methods: For this cross-sectional population-based study, we derived data on prevalence, disability-adjusted life-years (DALYs), and population size between 1990 and 2019 from the Global Burden of Disease 2019 study. Using the decomposition method, we attributed changes in total DALYs to population growth, population ageing, and changes in prevalence rate and disease severity between 1990 and each subsequent year globally, regionally, nationally, and by sex, cause, and sociodemographic index (SDI). The absolute and relative contributions to the variation in blindness-related DALYs between 1990 and each year from 1991 to 2019 then served as a measure of changes in disease severity.

Results: Changes in disease severity from 1990 to 2019 were associated with 15 165.11 DALYs in men and 20 639.32 DALYs in women. We observed disease severity increases in most countries/territories, with attributable DALY proportions ranging from -0.07% to 1.30% in men and from -0.06% to 1.73% in women. Notably, both attributable proportions and DALYs were greater in women than men. The largest increases in attributable DALYs were observed for cataracts, refraction disorders, and glaucoma globally; age-related macular degeneration in high-SDI countries; and trachoma and retinopathy of prematurity in lower-SDI countries.

Conclusions: Growth in the burden of cause-specific blindness due to increased disease severity reflects the lag of healthy vision life behind increasing life expectancy, necessitating the implementation of preventive and long-term therapeutic measures focussed on improving visual outcomes.

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量化疾病严重程度变化对失明负担的影响:全球分解分析。
背景:尽管失明对患者的生活质量有很大影响,但目前还没有根据失明严重程度的时间性变化对失明负担进行评估,这阻碍了我们准确评估失明对人口健康影响的能力。因此,我们旨在根据 18 种致盲原因的疾病严重程度的变化,全面量化特定原因致盲负担的变化:在这项基于人群的横断面研究中,我们从《2019 年全球疾病负担》研究中获取了 1990 年至 2019 年间的患病率、残疾调整生命年(DALYs)和人口数量数据。利用分解法,我们将总残疾调整寿命年数的变化归因于 1990 年及其后每年全球、地区、国家以及性别、病因和社会人口指数(SDI)的人口增长、人口老龄化以及患病率和疾病严重程度的变化。然后,1990 年与 1991 年至 2019 年期间每年与失明相关的残疾调整寿命年数变化的绝对值和相对值可作为疾病严重程度变化的衡量标准:结果:从 1990 年到 2019 年,疾病严重程度的变化与男性 15 165.11 DALYs 和女性 20 639.32 DALYs 有关。我们在大多数国家/地区观察到疾病严重程度的增加,男性的可归因残疾调整寿命年数比例从-0.07%到1.30%不等,女性的可归因残疾调整寿命年数比例从-0.06%到1.73%不等。值得注意的是,女性的可归因残疾调整寿命年数比例和残疾调整寿命年数都高于男性。在全球范围内,白内障、屈光障碍和青光眼的可归因残疾调整寿命年数增幅最大;在高 SDI 国家,与年龄相关的黄斑变性;在低 SDI 国家,沙眼和早产儿视网膜病变:结论:因疾病严重程度增加而导致的特定原因失明负担的增长反映了健康视力寿命落后于预期寿命的增长,因此有必要实施预防和长期治疗措施,重点改善视觉结果。
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来源期刊
Journal of Global Health
Journal of Global Health PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH -
CiteScore
6.10
自引率
2.80%
发文量
240
审稿时长
6 weeks
期刊介绍: Journal of Global Health is a peer-reviewed journal published by the Edinburgh University Global Health Society, a not-for-profit organization registered in the UK. We publish editorials, news, viewpoints, original research and review articles in two issues per year.
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