| Objective: This study aimed to understand the incidence and disease burden of brucellosis in Inner Mongolia from 2010 to 2020,analyzed the disease burden and economic burden of brucellosis in this area,and explored the socio-economic influencing factors of the disease burden in this area,so as to provide a theoretical basis for further optimizing the prevention and control strategy of brucellosis and rational allocation of medical resources.Methods: This study based on monitoring data of brucellosis in Inner Mongolia from2010 to 2020.The incidence rates,standardized incidence rates,years of life lost with disability(YLD),standardized YLD rate and indirect economic burden were used to analysis the change of the disease burden.Joinpoint Regression model was used to analyze the time change trend and the age change trend.Generalized linear model was used to explore the social influencing factors of disease burden.Results:(1)The average incidence rate was 48.52/100,000 of Inner Mongolia in2010～2020,the incidence rate of the disease decreased first and then increased.The peak incidence was mainly in March,April,May and June,they count for 10.23%,11.30%,11.31% and 11.73% of the annual cases respectively.(2)The incidence rate in eastern and central regions was higher,55.30/10 and 62.09/10 respectively.Tongliao City,Xing’an League,Hulunbuir City,Xilin Gol League,Chifeng City and Ulanqab City reported the most cases.(3)The incidence of male was higher than women,the proportion of farmers was the highest.And the standardized incidence rates of different genders show a downward trend at first and then an upward trend.The standardized incidence rate decreased in 2010～2015,annual percent change was-17.39% and-16.68%,and the standardized incidence rate in 2016～2020 rate of increase(APC=27.52%,APC=-29.43%).(4)45-59 years old had the largest number of cases,the peak incidence in 2010～2011 was 55 years old,the peak incidence in 2012～2018 was 60 years old,and the peak incidence in 2019～2020 was 65 years old,the peak incidence shifted with time.(5)From 2010 ～2020,a total of 4054.96 person-years of YLD were lost of brucellosis in Inner Mongolia,the male YLD was 2832.32 personyears,and the female YLD was 1222.62 person-years.The YLD rate of males(0.209‰)was higher than that of females(0.097‰)and the eastern and central regions were higher.(6)Male had the highest YLD rate in the age group of 55-59(0.329‰),and females had the highest YLD rate in the 50-54 age group(0.217‰).The ratio of YLD rates in the elderly and middle-aged and young people first increased and then decreased with time.(7)Joinpoint trend regression analysis showed that overall YLD rate of brucellosis first decreased and then increased;the age trend analysis showed that the overall YLD rate increased with age,average annual percent change was 2.0%,P<0.05.The sub-segment results showed that the rate of YLD increased the fastest in the age group 10-29(APC=10.40%,P<0.001),increasing slowly in the age group 30-59(APC=2.53%,P=0.003),and decreasing fastest in the age group ≥ 60 years(APC=-9.74%,P=0.006).the male YLD rate increased rapidly in the 10-24 age group(APC=16.81%,P=0.022);the YLD rate in the central region increased with age.(8)The indirect economic burden of Inner Mongolia showed a first decreased and then increased.The indirect economic burden of people over 15 years old and the central and eastern regions was heavier,and it gradually shifted to the western region.(9)The analysis of the influencing factors of disease burden showed that the number of medical institutions,health manpower,rural per capita disposable income,mutton output,beef output,and milk output were the influencing factors of disease burden.Conclusion: The incidence of brucellosis in Inner Mongolia from 2010 to 2020 is still at a relatively high level in the country,and its incidence first decreased and then increased.The overall YLD rate trend was consistent with the incidence trend.In the central and eastern regions,males,and young and middle-aged populations have higher incidence rates and higher disease burdens.The indirect economic burden of people over 15 years old and the central and eastern regions was heavier,and the economic burden of the western region is gradually increasing.The number of medical institutions,health manpower,rural per capita disposable income,mutton production,beef production,and milk production affect the level of disease burden.It is suggested that relevant regions should continue to strengthen the level of protection and quarantine,reasonably allocate medical resources and public health infrastructure,and reduce the disease burden of brucellosis in Inner Mongolia. |
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