Age-Period-Cohort Analysis on the Time Trend of Hepatitis B Incidence in Four Prefectures of Southern Xinjiang, China from 2005 to 2017

Trends and age-period-cohort effect on incidence of hepatitis B from 2008 to 2022 in Guangzhou, China

Hepatitis B virus (HBV) infection is highly prevalent in Guangzhou, China. This study aimed to examine the long-term trend of HB incidence from 2008 to 2022 and the independent impacts of age, period, and cohort on the trends. HBV data were collected from the China Information System for Disease Control and Prevention. Joinpoint regression was utilized to examine temporal trends, and an age-period-cohort model was employed to estimate the effects of age, period, and cohort. A total of 327,585 HBV cases were included in this study. The incidence of chronic and acute HB showed a decreasing trend in Guangzhou over the past 15 years, with an average annual percent change of - 4.31% and - 16.87%, respectively. Age, period, and cohort all exerted significant effects. The incidence of HB was higher in males than in females and non-central areas compared to central areas. Age groups of 0-4 years and 15-24 years were identified as high-risk groups. The period relative risks for chronic HB incidence decreased initially and then stabilized. Cohorts born later had lower risks. Chronic HB incidences remain high in Guangzhou, especially among males, younger individuals, and residents of non-central areas. More efforts are still needed to achieve hepatitis elimination targets.

Multiple change point analysis of hepatitis B reports in Xinjiang, China from 2006 to 2021

Objective

Hepatitis B (HB) is a major global challenge, but there has been a lack of epidemiological studies on HB incidence in Xinjiang from a change-point perspective. This study aims to bridge this gap by identifying significant change points and trends.

Method

The datasets were obtained from the Xinjiang Information System for Disease Control and Prevention. Change points were identified using binary segmentation for full datasets and a segmented regression model for five age groups.

Results

The results showed four change points for the quarterly HB time series, with the period between the first change point (March 2007) and the second change point (March 2010) having the highest mean number of HB reports. In the subsequent segments, there was a clear downward trend in reported cases. The segmented regression model showed different numbers of change points for each age group, with the 30-50, 51-80, and 15-29 age groups having higher growth rates.

Conclusion

Change point analysis has valuable applications in epidemiology. These findings provide important information for future epidemiological studies and early warning systems for HB.

Trends in disease burden of hepatitis B infection in Jiangsu Province, China, 1990-2021

Background

The incidence of hepatitis B virus (HBV) has decreased year by year in China after the expansion of vaccination, but there is still a high disease burden in Jiangsu Province of China.

Methods

The year-by-year incidence data of HBV in Jiangsu Province from 1990 to 2021 were collected. The incidence rates of males and females age groups were clustered by systematic clustering, and the incidence rates of each age group were analyzed and studied by using Joinpoint regression model and age-period-cohort effect model (APC).

Results

Joinpoint regression model and APC model showed a general decrease in HBV prevalence in both males and females. In addition, the results of the APC model showed that the age, period, and cohort effects of patients all affected the incidence of HBV, and the incidence was higher in males than in females. The incidence is highest in the population between the ages of 15 and 30 years (mean: 21.76/100,000), especially in males (mean: 31.53/100,000) than in females (mean:11.67/100,000). Another high-risk group is those over 60 years of age (mean: 21.40/100,000), especially males (mean: 31.17/100,000) than females (mean: 11.63/100,000). The period effect of the APC model suggests that HBV vaccination is effective in reducing the incidence of HBV in the population.

Conclusions

The incidence of HBV in Jiangsu Province showed a gradual downward trend, but the disease burden in males was higher than that in females. The incidence is higher and increasing rapidly in the population between the ages of 15 and 30 years and people over 60 years of age. More targeted prevention and control measures should be implemented for males and the elderly.

The Description and Prediction of Incidence, Prevalence, Mortality, Disability-Adjusted Life Years Cases, and Corresponding Age-Standardized Rates for Global Diabetes

OBJECTIVE

Diabetes is a life-long disease that poses a serious threat to safety and health. We aimed to assess the disease burden attributable to diabetes globally and by different subgroups, and to predict future disease burden using statistical models.

METHODS

This study was divided into three stages. Firstly, we evaluated the disease burden attributable to diabetes globally and by different subgroups in 2019. Second, we assessed the trends from 1990 to 2019. We estimated the annual percentage change of disease burden by applying a linear regression model. Finally, the age-period-cohort model was used to predict the disease burden from 2020 to 2044. Sensitivity analysis was performed with time-series models.

RESULTS

In 2019, the number of incidence cases of diabetes globally was 22239396 (95% uncertainty interval (UI): 20599519-24058945). The number of prevalence cases was 459875371 (95% UI 423474244-497980624) the number of deaths cases was 1551170 (95% UI 1445555-1650675) and the number of disability-adjusted life years cases was 70880155 (95% UI 59707574-84174005). The disease burden was lower in females than males and increased with age. The disease burden associated with type 2 diabetes mellitus was greater than that with type 1; the burden also varied across different socio-demographic index regions and different countries. The global disease burden of diabetes increased significantly over the past 30 years and will continue to increase in the future.

CONCLUSION

The disease burden of diabetes contributed significantly to the global disease burden. It is important to improve treatment and diagnosis to halt the growth in disease burden.

Spatial age-period-cohort analysis of hepatitis B risk in Xinjiang from 2006 to 2019

Objective

The objective of this study was to investigate the spatio-temporal distribution and epidemiological characteristics of hepatitis B in 96 districts and counties of Xinjiang and to give useful information for hepatitis B prevention and treatment.

Methods

Based on the incidence data of hepatitis B in 96 districts and counties of Xinjiang from 2006 to 2019, the global trend analysis method was used to characterize the spatial variability of the disease, and the spatial autocorrelation and spatio-temporal aggregation analysis were used to explore the spatial clustering of hepatitis B and to identify high-risk areas and periods. The Integrated Nested Laplace Approximation (INLA)-based spatial age-period-cohort model was established to further explore the influence of age, period, birth queue effect, and spatial distribution on the incidence risk of hepatitis B, and sum-to-zero constraint was adopted to avoid the issue of model unrecognition.

Results

The risk of hepatitis B in Xinjiang is increasing from west to east and from north to south, with spatial heterogeneity and spatio-temporal scanning statistics yielding five clustering areas. The spatial age-period-cohort model showed two peaks in the average risk of hepatitis B, at [25,30) years old and [50,55) years old, respectively. The mean risk of hepatitis B incidence fluctuated up and down around 1 with time, and the average risk of disease by birth cohort displayed an increasing-decreasing-stabilizing trend. Taking age, period, and cohort effect into consideration, it was found that the areas with a high risk of hepatitis B are Tianshan District, Xinshi District, Shuimogou District, Changji City, Aksu City, Kashi City, Korla City, Qiemo County and Yopurga County in Xinjiang. According to the spatio-temporal effect item, it was found that there are unobserved variables affecting the incidence of hepatitis B in some districts and counties of Xinjiang.

Conclusion

The spatio-temporal characteristics of hepatitis B and the high-risk population needed to be taken into attention. It is suggested that the relevant disease prevention and control centers should strengthen the prevention and control of hepatitis B among young people while paying attention to middle-aged and older adult people, and strengthening the prevention and monitoring of high-risk areas.

Changing trends in the air pollution-related disease burden from 1990 to 2019 and its predicted level in 25 years

In the twenty-first century, exposure to air pollution has become a threat to human health worldwide due to industrial development. Timely, comprehensive, and reliable assessment and prediction of disease burden can help mitigate the health hazards of air pollution. This study conducted a two-stage analysis. First, we reported the air pollution-related disease burden globally and for different subgroups like socio-demographic index (SDI), sex, and age. We analyzed the trend of the disease burden from 1990 to 2019. In addition, we explored whether and how some national indicators modified the disease burden. Second, we predicted the number and the age-standardized rates of death and disability-adjusted life years (DALYs) attributable to air pollution from 2020 to 2044 by the autoregressive integrated moving average (ARIMA) model and exponential smoothing model. The age-period-cohort (APC) model in the maximum likelihood framework and the Bayesian APC model integrated nested Laplace approximations (INLAs) were further applied to perform sensitivity analysis. In 2019, air pollution accounted for 11.62% of death and 0.84% of DALY worldwide. The corresponding age-standardized rate was 85.62 (95% uncertainty interval (UI): 75.71, 96.07) and 2791.08 (95% UI: 2468.81, 3141.39) per 100,000 population. From 1990 to 2019, the number of death attributable to air pollution remained stable, and the number of DALY exhibited a downward trend. The corresponding age-standardized rates both declined. In some countries with larger population densities, higher proportions of elders, and lower proportions of females, the disease burden attributable to air pollution was lower. The predicted results showed that the number of air pollution-related death and DALY would increase. This study comprehensively assessed and predicted the air pollution-related disease burden worldwide. The results indicated that the disease burden would remain very serious in the future. Hence, some relevant policies should be developed to prevent and manage air pollution.

An analysis on the trend of AIDS/HIV incidence in Chongqing and Shenzhen, China from 2005-2015 based on Age-Period-Cohort model

This paper elucidates that the AIDS/HIV incidence rate differences exist among different population and regions, especially among the old and college students. Due to the effect of age, the AIDS incidence peak in males aged 20-35 years and 50 years old both in Chongqing and Shenzhen, and the incidence rate and increasing spread in males was higher than that of females under period effect. In the local population in Chongqing and Shenzhen, the incidence rate of males in over 40, below and in the whole age groups are predicted to increase sharply in the future six years, while in females, the incidence rates among over 40-year-old and the whole age groups were predicted to increase as well. The incidence rate among homosexually transmitted patients reaches the peak in the 20-35, the incidence rate of patients transmitted through heterosexual reaches the peak around 50-year-old. Under the effect of period, AIDS/HIV incidence rate of patients transmitted through sexual routes showed an upward trend both in Chongqing and Shenzhen. The incidence rate of patients aged between 41 and 70 years old presents with an upward trend in the future six years. The results show great differences exist in the AIDS/HIV incidence between males and females, therefore it is necessary to take specific measures respectively.