Objective: To compare the approaches used for the assessment of disability adjust life years (DALYs) for advanced schistosomiasis japonica, so as to provide scientific evidence for accurate assessment of the burden of advanced schistosomiasis japonica.
Methods: The patients with advanced schistosomiasis japonica receiving treatment and assistance programs in Hunan Province in 2017 were enrolled, and the years lived with disability (YLD) for the patients with advanced schistosomiasis japonica was calculated using the common global burden of disease (GBD) estimation method, the modified GBD method with addition of common syndromes of advanced schistosomiasis japonica, and the quality of life assessment method.
Results: The YLDs of patients with advanced schistosomiasis japonica, the mean YLDs per capita, and the percentages of YLD were 673.94, 728.77 person-years and 1 761.99 person-years; 0.181, 0.196 person-years and 0.474 person-years; and 10.61, 11.48 person-years per 100 thousand persons and 27.75 person-years per 100 thousand persons with the common GBD method, modified GBD method and the quality of life method, respectively. The YLDs of the patients with advanced schistosomiasis japonica in Hunan Province estimated with the modified GBD method and the quality of life method were 8.14% and 2.61 times higher than that with the common GBD method. Of the major symptoms included in the calculation, the 5 symptoms with the greatest contribution to the burden of advanced schistosomiasis japonica included ascites, moderate anemia, severe anemia, diarrhea and hematochezia.
Conclusions: The quality of life method may more comprehensively assess the YLDs in patients with advanced schistosomiasis japonica than the common and modified GBD methods.
[摘要] 目的 比较晚期血吸虫病 (晚血) 伤残调整寿命年 (Disability-adjusted life year, DALY) 的评价方法, 为准确评价 晚血疾病负担提供依据。方法 以 2017 年湖南省晚血救助病例为研究对象, 分别采用全球疾病负担 (The global burden of disease and injury, GBD) 通用症状法、增加晚血常见症状后的改良 GBD 法和基于患者生命质量评价的生命质量法, 计 算晚血患者健康寿命损失年 (Years lived with disability, YLDs)。结果 GBD 通用症状法计算得出湖南省晚血患者 YLDs 为 673.94 人·年, 人均 YLDs 为 0.181 人·年, YLDs 率为 10.61 人·年/10万人; 改良 GBD 法计算得出晚血患者 YLDs 为 728.77 人·年, 人均 YLDs 为 0.196 人·年, YLDs 率为 11.48 人·年/10万人; 生命质量法计算得出晚血患者 YLDs 为 1 761.99 人·年, 人均 YLDs 为 0.474 人·年, YLDs 率为 27.75 人·年/10万人。改良 GBD 法计算所得湖南省晚血患者 YLDs 较 GBD 通用症状 法高 8.14%, 生命质量法计算所得 YLDs 是 GBD 通用症状法的 2.61 倍。在纳入计算的各种主要晚血症状中, 按照对晚血 疾病负担贡献的高低排序, 依次为腹水、中度贫血、重度贫血、腹泻和便血。结论 与 GBD 通用症状法、改良 GBD 法相 比, 生命质量法能更全面地评估晚血患者的 YLDs。.
Keywords: Advanced schistosomiasis japonica; Assessment approach; Disease burden; Quality of life; Years lived with disability.