Epidemiológiai előrejelzések az Interneten

Lakatos László

 

Hol keressünk, hogyan keressünk epidemiológiai témájú előrejelzéseket az Interneten?

A célom az volt, hogy a népegészségtan tárgykörébe tartozó cikkeket találjak ábrákkal, táblázatokkal, grafikonokkal. A világ és Magyarország népességének változására vonatkozó prognózisra, illetve az AIDS-nek erre gyakorolt hatására voltam kíváncsi.

Ha a SZOTE-n tanul az ember, kézenfekvő, hogy a SZOTE saját honlapján néz legelőször is körül.(cím 1.) Az Intézetek szóra klikkelve megtaláljuk ugyan a Népegészségtan Intézet honlapját, de az 1997 óta nincs frissítve. Ez a hosszú idő is valószínűsíti, hogy valamilyen anyagnak fel kell kerülnie – reméljük, a fenti témában is.

Az Internetes Ajánlatok közül választhatjuk a Hazai Intézetek címszót, de csak a SOTE Népegészségtan Intézete jelentkezik saját honlappal.(cím 2.) Itt ugyan nem találtam a témához kapcsolódó cikket, de választhattam egy listából, sőt egy Internetes címlistát is kaptam népegészségtani témában.

Szintén az Internetes Ajánlatoknál található meg a Medline (ez sajnos november elején nem működött), ahol témakörönként keresgélhetünk.

A Martindle egy észak-amerikai honlap (ez novemberben szintén nem volt elérhető), itt könyvtárszerűen helyezkednek el a témák. A public health szóra kattintva az AIDS terjedéséről szóló ismertetést találtam csak. Ez nem volt igazán prognózisnak mondható és grafikonokat, táblázatokat sem mellékeltek.

Több keresőprogramot ajánl fel még a SZOTE honlapja, ezekből tetszőlegesen választhatunk.

A keresők és a cikkek legtöbbje természetszerűleg angol nyelvű. Magyar nyelvű anyag kereséséhez használható az Altavizsla (cím 3.) nevű program, ahol a részletes keresés funkcióban logikai műveletekkel (AND, OR, EOR, stb.) tehetjük pontosabbá szempontjainkat.

Ezzel a programmal nem értem el sikert, nem találtam epidemiológiai előrejelzést.

Az Altavista (cím 4.) szintén alkalmas a magyar nyelvű keresésre, bár az eredmény itt sem lett kedvezőbb. Magyar nyelvű anyag tehát nem található az Interneten a témában.

Angol nyelvű kereséssel sikerült megtalálni a WHO honlapját (cím 5.). Itt találtam a világ össznépességére vonatkozó táblázatot. (1. sz. melléklet) Ebből látható, hogy közepes növekedési rátával számolva (tehát a jelenlegi főbb populációs paramétereket megtartva) pl. 2050.-ben 8,9 milliárdnyian leszünk a Földön.

Az egyes országok között megtalálhatjuk a Magyarországra vonatkozó becslést is(cím 6.). (2. sz. melléklet). Ez is 2050.-re vonatkozik. Láthatjuk, hogy alig 7,5 milliónyian élnek majd Magyarországon ekkor.

Az AIDS hatásait a népességre a következő címen találtam: www.popin.org/pop1998/6.htm.

Megfigyelhetjük az AIDS hatását a lakosság összlétszámának alakulására egyes afrikai országokban. (3. sz. melléklet) A 9 legfertőzöttebb országban 16 évvel esik vissza a születéskor várható élettartam, Botswanában pedig 29-cel. A magas reprodukciós ráta miatt ennek ellenére még mindig növekvő tendenciát fog mutatni a népesség – bár közel 20 százalékkal kevesebbet. Hasonló a helyzet Zimbabvéban is. A járvány csak később érte el az észak afrikai országokat, így náluk mind a születéskor várható élettartam visszaesése, mind a növekedési ráta csökkenése később fog bekövetkezni – bár hasonló mértékben

Az Altavista-ban a popul*, project*, table szűkítő szempontokat megadva célszerű keresni. Itt több, főleg amerikai prognózist találtam. Ezek kisebb területekre, államokra (USA), városokra vonatkoztak és egyszerű népesedési előrejelzéseket tartalmaznak. Magyarország népességének változása és az AIDS kapcsolatáról szintén nem sikerült eddig adatokat, becsléseket találnom.

Mindent összevéve kevés megfelelő anyagot találtam. Sok időt igényel az adekvát információ megtalálása.

Címek: 1. www.szote.u-szeged.hu./puhe/puhe/htm

2. www.sote.hu/aok/int/közeg/saját/MAGYAR/fel2.htm

3. www.altavizsla.matav.hu

4. www.altavista.com

5. www.undp.org/popin

6. www.popin.org/pop1998/3.htm

 

 

 

 

1. sz. melléklet

 

Population Division
Department of Economic and Social Affairs
United Nations

Long-Range World Population Projections:
Based on the 1998 Revision

Table 1. World population according to various projection scenarios, 1995-2150

Projection scenario

Year or
period

Instant
replacement

    Low    

Low-
Medium

Medium

High-
Medium

High

Constant

Population (millions)

1995

5,666

5,666

5,666

5,666

5,666

5,666

5,666

2000

5,962

6,028

6,028

6,055

6,082

6,082

6,113

2025

7,424

7,275

7,275

7,824

8,379

8,379

9,069

2050

8,310

7,343

7,547

8,909

10,409

10,674

14,421

2075

8,663

6,402

7,024

9,319

12,026

13,149

26,048

2100

8,924

5,153

6,324

9,459

13,430

16,178

52,508

2125

9,142

4,074

5,779

9,573

14,735

19,986

113,302

2150

9,349

3,236

5,329

9,746

16,218

24,834

255,846

Growth Rates (per year)

1995-2000

1.02

1.24

1.24

1.33

1.42

1.42

1.52

2020-2025

0.71

0.50

0.50

0.84

1.17

1.17

1.65

2045-2050

0.29

-0.23

-0.07

0.34

0.69

0.87

2.02

2070-2075

0.13

-0.73

-0.39

0.11

0.51

0.83

2.57

2095-2100

0.11

-0.92

-0.40

0.04

0.40

0.83

2.93

2120-2125

0.09

-0.93

-0.34

0.06

0.37

0.86

3.16

2145-2150

0.09

-0.92

-0.32

0.08

0.39

0.87

3.32

 
Source: Values for 1995-2050 for the Low, Medium, High and Constant scenarios are obtained from World Population Prospects: 1998 Revision, Volume I, Part One (United Nations, 1999a). All other values are the result of the long-range projections. More details can be found in: Population Division of the Department of Economic and Social Affairs of the United Nations Secretariat, Long-Range Population Projections: Based on the 1998 Revision (ESA/P/WP.153), 1999.
Note: Values for 1995 are estimates rather than projections and are therefore the same for all scenarios. Projected numbers for the world are the sum of projected numbers for the eight major world areas based on the assumptions for each scenario.
 
(Return to POPIN Home Page)
Copyright © 1999 United Nations

 

2. sz. melléklet

 

United Nations Nations Unies

Population Division
Department of Economic and Social Affairs

Population (in thousands) for the countries of the world: 2050
Medium variant projection

World total

8,909,095

Afghanistan

61,004

Albania

4,322

Algeria

57,731

American Samoa

201

Andorra

165

Angola

36,901

Anguilla

13

Antigua and Barbuda

79

Argentina

54,522

Armenia

3,996

Aruba

347

Australia (http://www.popin.org/pop1998/3.htm - 11)

25,761

Austria

7,094

Azerbaijan

9,981

Bahamas

485

Bahrain

992

Bangladesh

212,495

Barbados

288

Belarus

8,330

Belgium

8,918

Belize

477

Benin

15,620

Bermuda

82

Bhutan

5,687

Bolivia

16,967

Bosnia and Herzegovina

3,767

Botswana

2,798

Brazil

244,230

British Virgin Islands

46

Brunei Darussalam

528

Bulgaria

5,673

Burkina Faso

35,491

Burundi

15,571

Cambodia

20,700

Cameroon

37,290

Canada

42,311

Cape Verde

869

Cayman Islands

102

Central African Republic

7,689

Chad

19,693

Channel Islands

173

Chile

22,215

China

1,477,730

China, Hong Kong SAR

6,664

Colombia

71,550

Comoros

1,577

Congo

8,597

Cook Islands

28

Costa Rica

7,195

Côte d'Ivoire

30,470

Croatia

3,673

Cuba

11,095

Cyprus

913

Czech Republic

7,829

Dem. People's Rep. of Korea

30,770

Dem. Republic of the Congo

160,360

Denmark

4,793

Djibouti

1,346

Dominica

79

Dominican Republic

12,265

East Timor

1,387

Ecuador

21,190

Egypt

114,844

El Salvador

11,237

Equatorial Guinea

1,122

Eritrea

9,085

Estonia

927

Ethiopia

169,446

Faeroe Islands

34

Falkland Islands (Malvinas)

3

Fiji

1,310

Finland

4,898

France

59,883

French Guiana

581

French Polynesia

388

Gabon

2,682

Gambia

2,773

Gaza Strip

4,772

Georgia

5,180

Germany

73,303

Ghana

51,802

Gibraltar

18

Greece

8,233

Greenland

63

Grenada

115

Guadeloupe

601

Guam

266

Guatemala

27,165

Guinea

16,348

Guinea-Bissau

2,685

Guyana

1,166

Haiti

15,174

Holy See

1

Honduras

13,920

Hungary

7,488

Iceland

341

India

1,528,853

Indonesia

311,857

Iran (Islamic Republic of)

114,947

Iraq

54,916

Ireland

4,710

Isle of Man

104

Israel

9,440

Italy

41,197

Jamaica

3,801

Japan

104,921

Jordan

16,547

Kazakstan

18,665

Kenya

51,034

Kiribati

155

Kuwait

3,527

Kyrgyzstan

7,375

Lao People's Dem. Republic

13,344

Latvia

1,628

Lebanon

5,169

Lesotho

4,766

Liberia

10,010

Libyan Arab Jamahiriya

11,005

Liechtenstein

42

Lithuania

2,967

Luxembourg

430

Macau

488

Madagascar

40,438

Malawi

29,008

Malaysia

36,989

Maldives

680

Mali

31,353

Malta

421

Marshall Islands

182

Martinique

457

Mauritania

6,585

Mauritius (http://www.popin.org/pop1998/3.htm - 22)

1,440

Mexico

146,645

Micronesia, (Fed. States of)

254

Monaco

41

Mongolia

4,398

Montserrat

11

Morocco

45,434

Mozambique

42,923

Myanmar

64,890

Namibia

3,023

Nauru

24

Nepal

49,320

Netherlands

14,156

Netherlands Antilles

267

New Caledonia

332

New Zealand

5,248

Nicaragua

11,600

Niger

32,029

Nigeria

244,311

Niue

2

Northern Mariana Islands

402

Norway

4,758

Oman

8,310

Pakistan

345,484

Palau

45

Panama

4,263

Papua New Guinea

9,515

Paraguay

12,565

Peru

42,292

Philippines

130,893

Pitcairn (http://www.popin.org/pop1998/3.htm - 33)

 

Poland

36,256

Portugal

8,137

Puerto Rico

4,710

Qatar

844

Republic of Korea

51,275

Republic of Moldova

4,506

Reunion

959

Romania

16,419

Russian Federation

121,256

Rwanda

16,008

Saint Helena (http://www.popin.org/pop1998/3.htm - 44)

10

Saint Kitts and Nevis

36

Saint Lucia

242

Saint Pierre and Miquelon

8

Saint Vincent and Grenadines

140

Samoa

351

San Marino

30

Sao Tome and Principe

297

Saudi Arabia

54,461

Senegal

23,135

Seychelles

115

Sierra Leone

10,994

Singapore

4,015

Slovakia

4,836

Slovenia

1,487

Solomon Islands

1,130

Somalia

31,835

South Africa

52,514

Spain

30,226

Sri Lanka

25,923

Sudan

59,176

Suriname

588

Swaziland

2,436

Sweden

8,661

Switzerland

6,745

Syrian Arab Republic

34,490

Tajikistan

11,293

TFYR Macedonia (http://www.popin.org/pop1998/3.htm - 55)

2,302

Thailand

74,188

Togo

12,104

Tokelau

2

Tonga

110

Trinidad and Tobago

1,543

Tunisia

14,983

Turkey

100,664

Turkmenistan

7,715

Turks and Caicos Islands

44

Tuvalu

28

Uganda

64,850

Ukraine

39,302

United Arab Emirates

3,615

United Kingdom

56,667

United Rep. of Tanzania

80,584

United States of America

349,318

United States Virgin Islands

86

Uruguay

4,362

Uzbekistan

40,565

Vanuatu

428

Venezuela

42,152

Viet Nam

126,793

Wallis and Futuna Islands

21

Western Sahara

591

Yemen

58,801

Yugoslavia

10,548

Zambia

21,204

Zimbabwe

18,139

Source: United Nations Population Division, World Population Prospects: The 1998 Revision, forthcoming.
 
 

Notes:

(1) Including Christmas Islands, Cocos (Keeling) Islands and Norfolk Island.
(return to table)
(2) Including Agalega, Rodrigues and St. Brandon.
(return to table)
(3) The Population of Pitcairn is 47 persons in 2050.
(return to table)
(4) Including Ascension and Tristan da Cunha.
(return to table)
(5) The former Yugoslav Republic of Macedonia.
(return to table)
(Return to United Nations 1998 Revision World Population Estimates and Projections Table of Contents)

 

3. sz. melléklet

United Nations Nations Unies

Population Division
Department of Economic and Social Affairs

The Demographic Impact of HIV/AIDS

As part of its research work programme, the United Nations Population Division studies the demographic impact of AIDS in the world. In its 1998 Revision of world population estimates and projections, special attention is given to those developing countries which are hardest-hit (population of 1 million or more and an adult HIV prevalence of 2 per cent or more) or, because of their large population size, exhibit a large share of the developing world's HIV infections.
Among those countries, 29 are in Sub-Sahara Africa (Benin, Botswana, Burundi, Burkina Faso, Cameroon, Central Republic of Africa, Chad, Congo, Côte d'Ivoire, Democratic Republic of Congo, Eritrea, Ethiopia, Gabon, Guinea Bissau, Kenya, Lesotho, Liberia, Malawi, Mozambique, Namibia, Nigeria, Rwanda, Sierra Leone, South Africa, Togo, Uganda, United Republic of Tanzania, Zambia, Zimbabwe), 3 in Asia (Cambodia, India and Thailand), and 2 in Latin America and the Caribbean (Brazil and Haiti). Of the 30 million persons in the world currently infected by HIV (UNAIDS, 1997), 26 million (85 per cent) reside in these 34 countries. In addition, 91 per cent of all AIDS deaths in the world have occurred in these 34 countries.
The 1998 Revision shows a devastating toll from AIDS with respect to mortality and population loss. In the 29 hard-hit African countries that are studied, life expectancy at birth is currently estimated at 47 years, 7 years less than what could have been expected in the absence of AIDS (Figure 1). The demographic impact of AIDS is even more dramatic when one focuses only on the hardest hit countries. For example, the average life expectancy at birth in the 9 countries with an adult HIV prevalence of 10 per cent or more is projected to reach 48 years in 1995-2000 whereas it would have reached 58 years in the absence of AIDS, a loss of 10 years. This group includes Botswana, Kenya, Malawi, Mozambique, Namibia, Rwanda, South Africa, Zambia and Zimbabwe. Yet, the demographic impact of HIV/AIDS is expected to intensify in the future. By 2010-2015, the average life expectancy at birth in these countries could be only 47 years (Figure 2). In the absence of AIDS, it would have been expected to reach 63 years. This represents 16 years lost to AIDS. However, in none of the 34 countries, is the population expected to decline because of the AIDS epidemic.
 
 

Figure I. Life Expectancy at Birth in 29 African Countries With and Without AIDS Between 1985-1990 and 2010-2015

Source: United Nations Population Division, World Population Prospects: The 1998 Revision, forthcoming.

 

Figure II. Life Expectancy at Birth in the Seven Hardest Hit Countries Between 1985-1990 and 2010-2015

Source: United Nations Population Division, World Population Prospects: The 1998 Revision, forthcoming.

In Botswana, the hardest-hit country, one of every 4 adults is infected by HIV. Life expectancy at birth is expected to drop from 61 years in 1990-1995 to 47 years in 1995-2000. In the absence of HIV/AIDS, it would have been expected to reach 65 years in 1990-1995 and 67 years in 1995-2000. Due to the impact of AIDS, life expectancy is projected to further fall to 41 years by 2000-2005; this is 29 years less than expected in the absence of HIV/AIDS. Mainly due to the mortality impact, population growth in Botswana has been significantly reduced. The average annual population growth rate of 3.5 per cent per year in 1980-1985 has fallen to 2.9 per cent in 1990-1995 and will likely further fall to 1.9 per cent in 1995-2000 and 1.2 per cent in 2000-2005 (Figure 3). In the absence of AIDS, Botswana's population would have experienced growth above 2.5 throughout the 1990-2005 period. Because of the mortality impact of AIDS, Botswana's population by 2015 is expected to be 20 per cent smaller than it would have been in he absence of AIDS. Nevertheless, because of high fertility, Botswana's population is still expected to nearly double between 1995 and 2050.

Figure III. Annual Population Growth Rates With and Without AIDS Between 1985-1990 and 2010-2015
Botswana

Source: United Nations Population Division, World Population Prospects: The 1998 Revision, forthcoming.

In Zimbabwe, the second hardest hit country, one of every five adults is infected. Life expectancy at birth was estimated at 52 years in 1990-1995 whereas it would have been 61 years in the absence of AIDS. It is projected to further decrease to 44 years in 1995-2000 and 41 years in 2000-2005. In the absence of AIDS, it would have been expected to rise to 66 years by 2000-2005. As in Botswana, the demographic impact on population growth in Zimbabwe has been staggering. Estimated at 3.3 per cent in 1980-1985, the annual growth rate fell to near 2 per cent in 1990-1995 and will likely further fall to 1.4 per cent in 1995-2000 and under 1 per cent in 2000-2005. In the absence of AIDS, Zimbabwe would have experienced growth of 2.4 per cent per year in 1995-2000 and probably still be at 2 per cent per year in 2000-2005 (Figure 4). Because of the heavy toll on human lives, Zimbabwe's population in 2015 is expected to be 19 per cent lower than it would have been in the absence of the AIDS epidemic.
 
 

Figure IV. Annual Population Growth Rates With and Without AIDS Between 1985-1990 and 2010-2015
Zimbabwe

Source: United Nations Population Division, World Population Prospects: The 1998 Revision, forthcoming.

The South African epidemic began later than in Zimbabwe. One of every 8 adults was infected by the virus in 1997. Due to the later start, the demographic impact is yet to come. By 1990-1995, life expectancy at birth (estimated at 59 years) was barely affected by HIV/AIDS. However, projections show that by 2005-2010, 21 years of life expectancy at birth will be lost to AIDS: the level of life expectancy is expected to be just 45 years against 66 years in the absence of AIDS. Population growth, while remaining positive, is also expected to decrease faster because of the AIDS epidemic. South Africa’s annual growth rate is expected to decrease from 1.9 per cent in 1990-1995 to 0.3 per cent by 2005-2010; in the absence of HIV/AIDS, the population growth rate in 2005-2010 would have been around 1.5 per cent (Figure 5). By 2015, South Africa’s population is expected to be 16 per cent lower than it would have been in the absence of the AIDS epidemic.
 
 

Figure V. Annual Population Growth Rates With and Without AIDS Between 1985-1990 and 2010-2015
South Africa

Source: United Nations Population Division, World Population Prospects: The 1998 Revision, forthcoming.

(Return to United Nations 1998 Revision World Population Estimates and Projections Table of Contents)