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.) teh
etjük 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 talá
lható 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 fő
bb 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 Z
imbabvéban 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 mértékbenAz Altavista-ban a popul*, project*, ta
ble 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/htm2.
www.sote.hu/aok/int/közeg/saját/MAGYAR/fel2.htm3.
www.altavizsla.matav.hu4.
www.altavista.com5.
www.undp.org/popin6.
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
Year or |
Instant |
Low |
Low- |
Medium |
High- |
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
Population Division
Department of Economic and Social Affairs
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.
(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
Population Division
Department of Economic and Social Affairs
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 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 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 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)