Analysis Of Major Health Problems In Aging Countries Along The "Belt And Road" In Asia

Objective: To describe the prevalence of the main communicable diseases,chronic non-communicable diseases,and injuries in the aging countries in Asia along the “Belt and Road” since the 21 st century.And to explore the influencing factors of these diseases.In order to provide scientific basis for dealing with major health problems and to promote the development of health in Asia countries.Methods: Based on the WHO’s basic classification framework for human diseases,namely communicable diseases,chronic non-communicable diseases,and injuries,comprehensively collect the data about Asian aging countries along the “Belt and Road”(China(CHN),Korea(KOR),Singapore(SGP),Kazakhstan(KAZ),Israel(ISR),Armenia(ARM),Georgia(GEO),Lebanon(LBN))published by the official online database since 2000.Ecological study methods were used to explore the prevalence of major communicable diseases such as AIDS,tuberculosis,important chronic non-communicable diseases such as cardiovascular disease,malignant tumors and injuries.Furthermore,the generalized estimating equation model was used to explore the ecological correlation between these major health problems and the social factors like social economy,education,population,et al.Results: 1.Among the Asian aging countries along the “Belt and Road”,the HIV infection rates of SGP,KAZ,ARM,GEO and LBN all showed an upward trend in2000-2017(P<0.05).The HIV infection rate of CHN showed an upward trend in2011-2017(P<0.05).The HIV infection rate of CHN and LBN has been below 0.5‰.From 2000 to 2017,the new HIV infection rate of SGP and ARM showed a downward trend(P<0.05),and the new HIV infection rate of KAZ and GEO showed an upward trend(P<0.05).The new HIV infection rate of CHN showed an upward trend in 2004-2016(P<0.05),but the new HIV infection rate has been below 0.10‰.In 2010-2017,the coverage of ART treatment for HIV carriers in SGP,KAZ,ARM,GEO,and LBN showed an upward trend(P<0.05).In 2017,the HIV detection rate of HIV infection in SGP was 91%,the rate of ART treatment was 85% in diagnosed HIV-infected patients,and the rate of successful suppression of HIV in patientsreceiving ART was 94%.The values of these indicators in SGP are higher than those of other countries in the same period.The incidence of tuberculosis in 2000-2016 showed a decreasing trend in CHN,KAZ,ISR,and GEO(P<0.05).In addition to LBN,tuberculosis mortality rates in all countries showed a decreasing trend(P<0.05).The double infection rate of TB/HIV in 2000-2016 showed a downward trend in CHN,SGP,ISR and GEO(P<0.05),and increased in KOR,KAZ,ARM and LBN(P<0.05).After 2009,the coverage rate of tuberculosis treatment in all countries reached more than 80%.The success rate of new and recurrent tuberculosis treatments remained about 90% in CHN,but there were significant fluctuations in other countries.2.Among the aging countries in Asia along the “Belt and Road”,the mortality rate of non-communicable diseases showed a downward trend except for the increase of6.36% in GEO in 2000-2016(P<0.05).The mortality rate of cardiovascular disease during the 17 years showed a downward trend in CHN,KOR,SGP,KAZ and ISR(P<0.05).During the 17 years,the male’s mortality rate of cardiovascular disease in all countries was higher than that of females(P<0.05).Ischemic heart disease and stroke are the top two diseases of cardiovascular disease in various countries,accounting for 72.87% ~ 94.53% of cardiovascular deaths.The mortality rate of malignant tumors in CHN,KOR,SGP and LBN decreased in these years(P<0.05).During the years,the male’s mortality rate of malignant tumors in all countries was higher than that of females(P<0.05).During the 17 years,the top five malignant tumors deaths in the eight countries in the cumulative sequence were lung cancer,stomach cancer,colorectal cancer,liver cancer,and prostate cancer in male;and breast cancer,lung cancer,colorectal cancer,stomach cancer,and other malignant tumors in female.3.Among the Asian aging countries along the “Belt and Road”,mortality rates of injury in SGP,ISR and ARM in 2000-2015 showed a declining trend(P<0.05).During the 16 years,the males’ injury mortality rate was higher than that of females(P<0.05).In the past 16 years,the top three injury deaths in the eight countries were traffic accidents,suicides,and falls.The mortality rate of the elderly in 2000-2015 showed a downward trend in SGP,KAZ,ISR,and ARM(P<0.05).In the past 16 years,the mortality rate of the elderly was higher in men than in women(P<0.05);the death rate in the group aged ≥70 years was higher than that in the group aged 60-69years(P<0.05).In the past 16 years,the top three injury death of the elderly in the eight countries in the cumulative sequence were traffic accidents,suicides,and falls.4.Multi-factor ecological correlation analysis results showed that in Asian agingcountries along the “Belt and Road”,Per capita GDP,GGHE-D ratio,population density,and number of arrivals were negatively correlated with HIV infection;years,the proportion of urban population,the proportion of old population aged ≥65 years,and primary school enrollment rate were positively correlated with HIV infection.Years,the proportion of urban population,population density,primary school enrollment rate were negatively correlated with tuberculosis incidence;the proportion of old population aged ≥65 years was positively correlated with tuberculosis incidence.Per capita GDP,the proportion of old population aged ≥65 years was negatively correlated with cardiovascular death.The proportion of old population aged ≥65 years was negatively correlated with malignant tumor death.Year,the proportion of urban population,the proportion of old population aged ≥65 years,primary school enrollment rate were negatively correlated with injury death.Per capita GDP is positively correlated with injury death.All the above statistical test results were applicable to P < 0.05.Conclusion: 1.Since 2000,the prevention and control work of representative major communicable diseases,chronic non-communicable diseases and injuries in 8Asian countries along the "Belt and Road" has been continuously improved.2.The HIV detection rate,AIDS ART treatment coverage and ART success treatment rate in all countries still need to be improved.China’s success rate of treatment for recurrent tuberculosis has steadily increased.In all countries,ischemic heart disease and stroke death are more important in chronic non-communicable diseases,lung cancer is the most important type of tumor as the leading cause of cancer death.Traffic accidents,suicides and falls are the main types of fatal injuries among the whole population and the elderly population in all countries.3.The Asian aging countries along the “Belt and Road” need to be wary of the intricate effects on health which is caused by the social development and aging.Countries need to further strengthen exchanges and cooperation,learn from each other’s successful experiences in disease prevention and control,and promote the construction of the destiny community and healthy community of the "Belt and Road".