Epidemiological features of and changes in incidence of infectious diseases in China in the first decade after the SARS outbreak: an observational trend study
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Auteurs : Shigui Yang [République populaire de Chine] ; Jie Wu [République populaire de Chine] ; Cheng Ding [République populaire de Chine] ; Yuanxia Cui [République populaire de Chine] ; Yuqing Zhou [République populaire de Chine] ; Yiping Li [République populaire de Chine] ; Min Deng [République populaire de Chine] ; Chencheng Wang [République populaire de Chine] ; Kaijin Xu [République populaire de Chine] ; Jingjing Ren [République populaire de Chine] ; Bing Ruan [République populaire de Chine] ; Lanjuan Li [République populaire de Chine]Source :
- The Lancet. Infectious Diseases [ 1473-3099 ] ; 2017.
Abstract
The model of infectious disease prevention and control changed significantly in China after the outbreak in 2003 of severe acute respiratory syndrome (SARS), but trends and epidemiological features of infectious diseases are rarely studied. In this study, we aimed to assess specific incidence and mortality trends of 45 notifiable infectious diseases from 2004 to 2013 in China and to investigate the overall effectiveness of current prevention and control strategies.
Incidence and mortality data for 45 notifiable infectious diseases were extracted from a WChinese public health science data centre from 2004 to 2013, which covers 31 provinces in mainland China. We estimated the annual percentage change in incidence of each infectious disease using joinpoint regression.
Between January, 2004, and December, 2013, 54 984 661 cases of 45 infectious diseases were reported (average yearly incidence 417·98 per 100 000). The infectious diseases with the highest yearly incidence were hand, foot, and mouth disease (114·48 per 100 000), hepatitis B (81·57 per 100 000), and tuberculosis (80·33 per 100 000). 132 681 deaths were reported among the 54 984 661 cases (average yearly mortality 1·01 deaths per 100 000; average case fatality 2·4 per 1000). Overall yearly incidence of infectious disease was higher among males than females and was highest among children younger than 10 years. Overall yearly mortality was higher among males than females older than 20 years and highest among individuals older than 80 years. Average yearly incidence rose from 300·54 per 100 000 in 2004 to 483·63 per 100 000 in 2013 (annual percentage change 5·9%); hydatid disease (echinococcosis), hepatitis C, and syphilis showed the fastest growth. The overall increasing trend changed after 2009, and the annual percentage change in incidence of infectious disease in 2009–13 (2·3%) was significantly lower than in 2004–08 (6·2%).
Although the overall incidence of infectious diseases was increasing from 2004, the rate levelled off after 2009. Effective prevention and control strategies are needed for diseases with the highest incidence—including hand, foot, and mouth disease, hepatitis B, and tuberculosis—and those with the fastest rates of increase (including hydatid disease, hepatitis C, and syphilis).
Chinese Ministry of Science and Technology, National Natural Science Foundation (China).
Url:
DOI: 10.1016/S1473-3099(17)30227-X
PubMed: 28412150
PubMed Central: 7164789
Affiliations:
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Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China</nlm:aff><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou</wicri:regionArea><placeName><settlement type="city">Hangzhou</settlement><region type="province">Zhejiang</region></placeName><orgName type="university">Université de Zhejiang</orgName></affiliation></author><author><name sortKey="Wu, Jie" sort="Wu, Jie" uniqKey="Wu J" first="Jie" last="Wu">Jie Wu</name><affiliation wicri:level="4"><nlm:aff id="aff1">State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China</nlm:aff><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou</wicri:regionArea><placeName><settlement type="city">Hangzhou</settlement><region type="province">Zhejiang</region></placeName><orgName type="university">Université de Zhejiang</orgName></affiliation></author><author><name sortKey="Ding, Cheng" sort="Ding, Cheng" uniqKey="Ding C" first="Cheng" last="Ding">Cheng Ding</name><affiliation wicri:level="4"><nlm:aff id="aff1">State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China</nlm:aff><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou</wicri:regionArea><placeName><settlement type="city">Hangzhou</settlement><region type="province">Zhejiang</region></placeName><orgName type="university">Université de Zhejiang</orgName></affiliation></author><author><name sortKey="Cui, Yuanxia" sort="Cui, Yuanxia" uniqKey="Cui Y" first="Yuanxia" last="Cui">Yuanxia Cui</name><affiliation wicri:level="4"><nlm:aff id="aff1">State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China</nlm:aff><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou</wicri:regionArea><placeName><settlement type="city">Hangzhou</settlement><region type="province">Zhejiang</region></placeName><orgName type="university">Université de Zhejiang</orgName></affiliation></author><author><name sortKey="Zhou, Yuqing" sort="Zhou, Yuqing" uniqKey="Zhou Y" first="Yuqing" last="Zhou">Yuqing Zhou</name><affiliation wicri:level="4"><nlm:aff id="aff1">State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China</nlm:aff><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou</wicri:regionArea><placeName><settlement type="city">Hangzhou</settlement><region type="province">Zhejiang</region></placeName><orgName type="university">Université de Zhejiang</orgName></affiliation></author><author><name sortKey="Li, Yiping" sort="Li, Yiping" uniqKey="Li Y" first="Yiping" last="Li">Yiping Li</name><affiliation wicri:level="3"><nlm:aff id="aff2">Zhejiang Institute of Medical-care Information Technology, Hangzhou, China</nlm:aff><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>Zhejiang Institute of Medical-care Information Technology, Hangzhou</wicri:regionArea><placeName><settlement type="city">Hangzhou</settlement><region type="province">Zhejiang</region></placeName></affiliation></author><author><name sortKey="Deng, Min" sort="Deng, Min" uniqKey="Deng M" first="Min" last="Deng">Min Deng</name><affiliation wicri:level="4"><nlm:aff id="aff1">State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China</nlm:aff><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou</wicri:regionArea><placeName><settlement type="city">Hangzhou</settlement><region type="province">Zhejiang</region></placeName><orgName type="university">Université de Zhejiang</orgName></affiliation></author><author><name sortKey="Wang, Chencheng" sort="Wang, Chencheng" uniqKey="Wang C" first="Chencheng" last="Wang">Chencheng Wang</name><affiliation wicri:level="4"><nlm:aff id="aff1">State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China</nlm:aff><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou</wicri:regionArea><placeName><settlement type="city">Hangzhou</settlement><region type="province">Zhejiang</region></placeName><orgName type="university">Université de Zhejiang</orgName></affiliation></author><author><name sortKey="Xu, Kaijin" sort="Xu, Kaijin" uniqKey="Xu K" first="Kaijin" last="Xu">Kaijin Xu</name><affiliation wicri:level="4"><nlm:aff id="aff1">State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China</nlm:aff><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou</wicri:regionArea><placeName><settlement type="city">Hangzhou</settlement><region type="province">Zhejiang</region></placeName><orgName type="university">Université de Zhejiang</orgName></affiliation></author><author><name sortKey="Ren, Jingjing" sort="Ren, Jingjing" uniqKey="Ren J" first="Jingjing" last="Ren">Jingjing Ren</name><affiliation wicri:level="4"><nlm:aff id="aff1">State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China</nlm:aff><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou</wicri:regionArea><placeName><settlement type="city">Hangzhou</settlement><region type="province">Zhejiang</region></placeName><orgName type="university">Université de Zhejiang</orgName></affiliation></author><author><name sortKey="Ruan, Bing" sort="Ruan, Bing" uniqKey="Ruan B" first="Bing" last="Ruan">Bing Ruan</name><affiliation wicri:level="4"><nlm:aff id="aff1">State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China</nlm:aff><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou</wicri:regionArea><placeName><settlement type="city">Hangzhou</settlement><region type="province">Zhejiang</region></placeName><orgName type="university">Université de Zhejiang</orgName></affiliation></author><author><name sortKey="Li, Lanjuan" sort="Li, Lanjuan" uniqKey="Li L" first="Lanjuan" last="Li">Lanjuan Li</name><affiliation wicri:level="4"><nlm:aff id="aff1">State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China</nlm:aff><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou</wicri:regionArea><placeName><settlement type="city">Hangzhou</settlement><region type="province">Zhejiang</region></placeName><orgName type="university">Université de Zhejiang</orgName></affiliation></author></analytic><series><title level="j">The Lancet. Infectious Diseases</title><idno type="ISSN">1473-3099</idno><idno type="eISSN">1474-4457</idno><imprint><date when="2017">2017</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><title>Summary</title><sec><title>Background</title><p>The model of infectious disease prevention and control changed significantly in China after the outbreak in 2003 of severe acute respiratory syndrome (SARS), but trends and epidemiological features of infectious diseases are rarely studied. In this study, we aimed to assess specific incidence and mortality trends of 45 notifiable infectious diseases from 2004 to 2013 in China and to investigate the overall effectiveness of current prevention and control strategies.</p></sec><sec><title>Methods</title><p>Incidence and mortality data for 45 notifiable infectious diseases were extracted from a WChinese public health science data centre from 2004 to 2013, which covers 31 provinces in mainland China. We estimated the annual percentage change in incidence of each infectious disease using joinpoint regression.</p></sec><sec><title>Findings</title><p>Between January, 2004, and December, 2013, 54 984 661 cases of 45 infectious diseases were reported (average yearly incidence 417·98 per 100 000). The infectious diseases with the highest yearly incidence were hand, foot, and mouth disease (114·48 per 100 000), hepatitis B (81·57 per 100 000), and tuberculosis (80·33 per 100 000). 132 681 deaths were reported among the 54 984 661 cases (average yearly mortality 1·01 deaths per 100 000; average case fatality 2·4 per 1000). Overall yearly incidence of infectious disease was higher among males than females and was highest among children younger than 10 years. Overall yearly mortality was higher among males than females older than 20 years and highest among individuals older than 80 years. Average yearly incidence rose from 300·54 per 100 000 in 2004 to 483·63 per 100 000 in 2013 (annual percentage change 5·9%); hydatid disease (echinococcosis), hepatitis C, and syphilis showed the fastest growth. The overall increasing trend changed after 2009, and the annual percentage change in incidence of infectious disease in 2009–13 (2·3%) was significantly lower than in 2004–08 (6·2%).</p></sec><sec><title>Interpretation</title><p>Although the overall incidence of infectious diseases was increasing from 2004, the rate levelled off after 2009. Effective prevention and control strategies are needed for diseases with the highest incidence—including hand, foot, and mouth disease, hepatitis B, and tuberculosis—and those with the fastest rates of increase (including hydatid disease, hepatitis C, and syphilis).</p></sec><sec><title>Funding</title><p>Chinese Ministry of Science and Technology, National Natural Science Foundation (China).</p></sec></div></front><back><div1 type="bibliography"><listBibl><biblStruct></biblStruct><biblStruct><analytic><author><name sortKey="Heesterbeek, H" uniqKey="Heesterbeek H">H Heesterbeek</name></author><author><name sortKey="Anderson, Rm" uniqKey="Anderson R">RM Anderson</name></author><author><name sortKey="Andreasen, V" uniqKey="Andreasen V">V Andreasen</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Wang, L" uniqKey="Wang L">L Wang</name></author><author><name sortKey="Wang, Y" uniqKey="Wang Y">Y Wang</name></author><author><name sortKey="Jin, S" 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name="République populaire de Chine"><region name="Zhejiang"><name sortKey="Yang, Shigui" sort="Yang, Shigui" uniqKey="Yang S" first="Shigui" last="Yang">Shigui Yang</name></region><name sortKey="Cui, Yuanxia" sort="Cui, Yuanxia" uniqKey="Cui Y" first="Yuanxia" last="Cui">Yuanxia Cui</name><name sortKey="Deng, Min" sort="Deng, Min" uniqKey="Deng M" first="Min" last="Deng">Min Deng</name><name sortKey="Ding, Cheng" sort="Ding, Cheng" uniqKey="Ding C" first="Cheng" last="Ding">Cheng Ding</name><name sortKey="Li, Lanjuan" sort="Li, Lanjuan" uniqKey="Li L" first="Lanjuan" last="Li">Lanjuan Li</name><name sortKey="Li, Yiping" sort="Li, Yiping" uniqKey="Li Y" first="Yiping" last="Li">Yiping Li</name><name sortKey="Ren, Jingjing" sort="Ren, Jingjing" uniqKey="Ren J" first="Jingjing" last="Ren">Jingjing Ren</name><name sortKey="Ruan, Bing" sort="Ruan, Bing" uniqKey="Ruan B" first="Bing" last="Ruan">Bing Ruan</name><name sortKey="Wang, Chencheng" sort="Wang, Chencheng" uniqKey="Wang C" first="Chencheng" last="Wang">Chencheng Wang</name><name sortKey="Wu, Jie" sort="Wu, Jie" uniqKey="Wu J" first="Jie" last="Wu">Jie Wu</name><name sortKey="Xu, Kaijin" sort="Xu, Kaijin" uniqKey="Xu K" first="Kaijin" last="Xu">Kaijin Xu</name><name sortKey="Zhou, Yuqing" sort="Zhou, Yuqing" uniqKey="Zhou Y" first="Yuqing" last="Zhou">Yuqing Zhou</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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