北京市食源性胃肠炎的疾病负担
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摘要
目的 了解北京市食源性胃肠炎的疾病负担,为食源性疾病的防治提供依据。方法 采用多阶段分层随机抽样方法,选取北京市6个监测地区内9885人,进行入户面对面调查,了解其过去4周急性胃肠炎的发病、就诊情况以及因急性胃肠炎产生的各类费用,计算急性胃肠炎的疾病负担;根据文献报道的急性胃肠炎的食源性比例,推算食源性胃肠炎疾病负担。结果 急性胃肠炎的年发病率为0.15次/人年(95%CI 0.13～0.16),估算调查期间北京市食源性胃肠炎发病人数为911 975人次。每年约有290 190人次就诊,9120人住院。北京市食源性胃肠炎的总经济负担为1.47亿元,约占全市年生产总值的0.07‰;其中直接费用1.07亿元(医疗费用0.94亿元,非医疗费用0.12亿元),间接费用0.40亿元。结论 北京市人群食源性胃肠炎的疾病负担不容忽视,应进一步完善食源性疾病主动监测体系,更准确地评估食源性疾病对社会和健康造成的影响。
OBJECTIVE To estimate the burden of foodborne acute gastrointestinal illness(AGI) in community residents, and to provide the basis for prevention and control of foodborne diseases. METHODS Muli-stage stratified random cluster sampling was used to select samples in community population. A retrospective cross-sectional face-to-face household interviews were conducted over a 12-month period.Respondents were asked questions about vomiting and diarrhea within the 28 days prior to the interviews, healthcare seeking behavior and the related cost due to AGI. RESULTS There were 0.15(95%CI 0.13-0.16)AGI episodes per person-year, foodboren infection resulted in 911975 AGI cases. About 290 190 cases sought healthcare, resulting in 9120 hospitallizations. The overall economic burden of foodborne AGI was 147 million Yuan per year, accounting for 0.07‰ of the GDP.The direct cost of medical care was 107 million Yuan(medical costs and non-medical cost were 9.4 million and 1.2 million), and the direct cost was 4 million Yuan. CONCLUSION The burden of foodborne AGI in Beijing should not be ignored.It is necessary to improve the foodborne disease surveillance system to more accurately assess the impact of foodborne disease on society and health.
OBJECTIVE To estimate the burden of foodborne acute gastrointestinal illness(AGI) in community residents, and to provide the basis for prevention and control of foodborne diseases. METHODS Muli-stage stratified random cluster sampling was used to select samples in community population. A retrospective cross-sectional face-to-face household interviews were conducted over a 12-month period.Respondents were asked questions about vomiting and diarrhea within the 28 days prior to the interviews, healthcare seeking behavior and the related cost due to AGI. RESULTS There were 0.15(95%CI 0.13-0.16)AGI episodes per person-year, foodboren infection resulted in 911975 AGI cases. About 290 190 cases sought healthcare, resulting in 9120 hospitallizations. The overall economic burden of foodborne AGI was 147 million Yuan per year, accounting for 0.07‰ of the GDP.The direct cost of medical care was 107 million Yuan(medical costs and non-medical cost were 9.4 million and 1.2 million), and the direct cost was 4 million Yuan. CONCLUSION The burden of foodborne AGI in Beijing should not be ignored.It is necessary to improve the foodborne disease surveillance system to more accurately assess the impact of foodborne disease on society and health.
引文
[1] HAVELAAR A H,KIRK M D,TORGERSON P R,et al.World health organization global estimates and regional comparisons of the burden of foodborne disease in 2010[J].PLoS Med,2015,12(12):e1001923.
[2] THOMAS M K,MURRAY R,FLOCKHART L,et al.Estimates of the burden of foodborne illness in Canada for 30 specified pathogens and unspecified agents,Circa 2006[J].Foodborne Pathog Dis,2015,12(10):820-827.
[3] KIRK M,FORD L,GLASS K,et al.Foodborne illness,Australia,Circa 2000 and Circa 2010[J].Emerg Infect Dis,2014,20(11):1857-1864.
[4] KIRK M,FORD L,GLASS K,et al.Preliminary incidence and trends of infections with pathogens transmitted commonly through food-foodborne diseases active surveillance network,10 U.S.sites,2006-2017[J].MMWR,2018,67(11):324-328.
[5] 李茜瑶,周莹,黄辉,等.疾病负担研究进展[J].中国公共卫生,2018,34 (5):777-780.
[6] THOMAS M K,MURRAY R,NESBITT A,et al.The incidence of acute gastrointestinal illness in Canada,foodbook survey 2014-2015[J].Can J Infect Dis Med Microbiol,2017:5956148.
[7] 宋文磊,梁晓军,孙强.2013—2014年江苏省昆山市急性胃肠炎负担研究[J].疾病监测,2015,30(4):305-309.
[8] MEAD P S,SLUTSKER L,DIETZ V,et al.Food-related illness and death in the United States[J].Emerg Infect Dis,1999,5:607-625.
[9] HALL G,KIRK M D,BECKER N,et al.Estimating foodborne gastroenteritis,Australia[J].Emerg Infect Dis,2005,11(8):1257-1264.
[10] ADAK G K1,LONG S M,O′BRIEN S J,et al.Trends in indigenous foodborne disease and deaths,England and Wales:1992 to 2000[J].2002,51(6):832-841.
[11] CHEN Y,YAN W X,ZHOU Y J,et al.Burden of self-reported acute gastrointestinal illness in China:a population-based survey [J].BMC Public Health,2013,13:456.
[12] ZHOU Y J,DAI Y,YUAN B J,et al.Population-based estimate of the burden of acute gastrointestinal illness in Jiangsu province,China,2010-2011[J].Epidemiol Infect,2013,141(5):944-952.
[13] 刘爽,李骏,龚晨睿,等.湖北省急性胃肠炎疾病人群负担评估[J].中国公共卫生,2016 (4):554-557.
[14] 世界卫生组织.全球食源性疾病负担的估算报告[EB/OL].(2015-12-14)[2018-10-10].http://www.who.int/mediacentre/news/releases/2015/foodborne-disease-estimates/zh/.
[15] 杜田,杨梅,蒋立新,等.深圳市福田区社区食源性疾病经济负担调查[J].现代预防医学,2016(12):2175-2179.
[16] 刘璐,白光大,邢扬,等.吉林省食源性疾病患者就诊情况及疾病经济负担的评估[J].吉林大学学报(医学版),2015,41(2):410-415.
[2] THOMAS M K,MURRAY R,FLOCKHART L,et al.Estimates of the burden of foodborne illness in Canada for 30 specified pathogens and unspecified agents,Circa 2006[J].Foodborne Pathog Dis,2015,12(10):820-827.
[3] KIRK M,FORD L,GLASS K,et al.Foodborne illness,Australia,Circa 2000 and Circa 2010[J].Emerg Infect Dis,2014,20(11):1857-1864.
[4] KIRK M,FORD L,GLASS K,et al.Preliminary incidence and trends of infections with pathogens transmitted commonly through food-foodborne diseases active surveillance network,10 U.S.sites,2006-2017[J].MMWR,2018,67(11):324-328.
[5] 李茜瑶,周莹,黄辉,等.疾病负担研究进展[J].中国公共卫生,2018,34 (5):777-780.
[6] THOMAS M K,MURRAY R,NESBITT A,et al.The incidence of acute gastrointestinal illness in Canada,foodbook survey 2014-2015[J].Can J Infect Dis Med Microbiol,2017:5956148.
[7] 宋文磊,梁晓军,孙强.2013—2014年江苏省昆山市急性胃肠炎负担研究[J].疾病监测,2015,30(4):305-309.
[8] MEAD P S,SLUTSKER L,DIETZ V,et al.Food-related illness and death in the United States[J].Emerg Infect Dis,1999,5:607-625.
[9] HALL G,KIRK M D,BECKER N,et al.Estimating foodborne gastroenteritis,Australia[J].Emerg Infect Dis,2005,11(8):1257-1264.
[10] ADAK G K1,LONG S M,O′BRIEN S J,et al.Trends in indigenous foodborne disease and deaths,England and Wales:1992 to 2000[J].2002,51(6):832-841.
[11] CHEN Y,YAN W X,ZHOU Y J,et al.Burden of self-reported acute gastrointestinal illness in China:a population-based survey [J].BMC Public Health,2013,13:456.
[12] ZHOU Y J,DAI Y,YUAN B J,et al.Population-based estimate of the burden of acute gastrointestinal illness in Jiangsu province,China,2010-2011[J].Epidemiol Infect,2013,141(5):944-952.
[13] 刘爽,李骏,龚晨睿,等.湖北省急性胃肠炎疾病人群负担评估[J].中国公共卫生,2016 (4):554-557.
[14] 世界卫生组织.全球食源性疾病负担的估算报告[EB/OL].(2015-12-14)[2018-10-10].http://www.who.int/mediacentre/news/releases/2015/foodborne-disease-estimates/zh/.
[15] 杜田,杨梅,蒋立新,等.深圳市福田区社区食源性疾病经济负担调查[J].现代预防医学,2016(12):2175-2179.
[16] 刘璐,白光大,邢扬,等.吉林省食源性疾病患者就诊情况及疾病经济负担的评估[J].吉林大学学报(医学版),2015,41(2):410-415.