大多数词典会把morbidity翻译成发病率，有的会翻译成患病率或病态，我自己之前也经常把incidence和morbidity混用，但自从看见一个研究的标题写着“incidence of morbidity”后整个人就开始怀疑人生了，难道以前都用错了？经过一番探究，我对Morbidity这个词有了新的感悟……
个人感觉，Morbidity是个自由度很大的词，中文翻译可以五花八门，我们来举具体案例说明。
1. 标题：Prevalence of ocular morbidity in school going children in West Uttar Pradesh【1】.（患病率prevalence和morbidity一起出现了哦！）
具体描述：The prevalence of ocular morbidity was 29.35% (28.65% urban, 30.05% rural). Refractive error (17.36%) was the major cause of ocular morbidity followed by convergence insufficiency (2.79%), blepharitis (2.11%), Vitamin A deficiency (2.09%), allergic conjunctivitis (1.92%), bacterial conjunctivitis (0.95%), amblyopia (0.41%), stye (0.31%) and squint (0.27%).
说明：从描述可以看出，ocular morbidity实际上在这里是一系列眼部疾病的合集，虽然文章想表达患病率的意思，但已经征用了prevalence这个词，所以morbidity在此仅翻译为“疾病”。
2. 标题: Incidence and determinants of severe morbidity among HIV-infected patients from Rio de Janeiro, Brazil, 2000-2010[2].（发病率incidence 和morbidity同时出现了哦！）
具体描述：Over the years, annual incidence rate of severe morbid events, AIDS-related events, non-AIDS-related events, and deaths significantly decreased from, respectively, 36.6, 12.9, 23.7 and 3.2 per 100 PY in 2000 to 25.3, 7.9, 17.4 and 1.9 per 100 PY in 2010.
说明：这里文中实际上给出了morbidity的同义词morbid events，由于本文morbid events可以是艾滋病导致的，也可以不是由艾滋病导致的，因此用汉语意会的话，这种语境下可以翻译为“合并症”。具体合并症有哪些可以参见文中给出的下表。
3. 标题：Severe Maternal Morbidity During Delivery Hospitalizations [3].
具体描述：A total of 995,179 delivery hospitalizations occurred among Wisconsin women between 2000 and 2014. Of those, 7,999 were identified with severe maternal morbidity (overall rate=80.4 per 10,000 delivery hospitalizations, 95% CI=78.6, 82.2).
说明：这种情况下，morbidity翻译为产后“并发症”，其实和co-morbidity一个意思，包含一系列症状和情况，比如在这个研究里，定义为如下表。
标题：Morbidity and mortality of very low birth weight infants in Taiwan-Changes in 15 years: A population-based study [4]. (mortality和morbidity也是经常弄混的一对词哦！)
具体描述：Incidence of some morbidities increased, such as respiratory distress syndrome and patent ductus arteriosus; in contrast, incidence of others decreased, such as sepsis, necrotizing enterocolitis, intraventricular hemorrhage, and chronic lung disease. However, retinopathy of prematurity (ROP) incidence remained constant.
说明：这也是一个翻译为“并发症”的案例，后文实际上也讲明了“极低体重儿并发症”包括了呼吸窘迫综合征、动脉导管未闭等情况。在这里作者实际上想表达发病率的意思，但是他征用了incidence这个词。
4. 标题：Mortality and morbidity among hospitalized adult patients with neurological diseases in Cameroon [5].
具体描述：Among the 2225 neurological admissions of adults, death from neurological disease was recorded in 423 patients (19.01%), and disability in 819 of the survivors (53.6%). Among the 819 disabled survivors, 314 (38.34%) patients had mild-moderate dependence (need for help with Activities of Daily Life-dressing, feeding, bathing-but could do most things by themselves) and 275 patients (33.58%) patients were fully dependent
说明：根据描述中给出的同义词disability和语境，这里的morbidity可以意会成“致残率”。
5. 标题：Distinct trends in tuberculosis morbidity among foreign-born and US-born persons in New Jersey, 1986 through 1995 [6].
具体描述：The overall TB incidence rate in New Jersey declined 15% from 1992 to 1995 after 7 years of increase. However, the incidence rate of TB in foreign-born persons increased 75% from 1986 through 1995. CONCLUSIONS: TB morbidity among foreign-born persons has continued to increase, despite the decline in overall TB morbidity since 1992.
说明：在这篇1998年的老文里，标题的morbidity和描述里的incidence是一个意思，可以翻译为发病率，两者可以相互替换。
总的来说，发病率、致残率、疾病、合并症、并发症、甚至有可能是后遗症……别看中文翻译这么多，我觉得主要原因还是汉语博大精深……经我揣摩，在英语里morbidity实际上就一个意思，就是”疾病本身及转归的非正常的状态”……
但我在Pubmed里检索morbidity的时候有个感觉，只有在很老的文章里incidence和morbidity才会互相替换，越是近的文章morbidity越贴近“合并症”或“并发症”的意思，即使要表达率也会带上一个专门表达率的词。或许这是个趋势吧。Anyway，理解就行，理解万岁。
参考文献：
1. Singh V, Malik KPS, Malik VK, et al. Prevalence of ocular morbidity in school going children in West Uttar Pradesh. Indian J Ophthalmol. 2017 Jun;65(6):500-508.
2. Ribeiro SR, Luz PM, Campos DP, et al. Incidence and determinants of severe morbidity among HIV-infected patients from Rio de Janeiro, Brazil, 2000-2010. Antivir Ther. 2014;19(4):387-97.
3. Gibson C, Rohan AM, Gillespie KH. Severe Maternal Morbidity During Delivery Hospitalizations. WMJ. 2017 Dec;116(5):215-220.
4. Su YY, Wang SH, Chou HC, et al. Morbidity and mortality of very low birth weight infants in Taiwan-Changes in 15 years: A population based study. J Formos Med Assoc. 2016 Dec;115(12):1039-1045.
5. Kompoliti K, Doumbe J, Mapoure YN, et al. Mortality and morbidity among hospitalized adult patients with neurological diseases in Cameroon. J Neurol Sci. 2017 Oct 15;381:165-168.
6. Liu Z, Shilkret KL, Tranotti J, et al. Distinct trends in tuberculosis morbidity among foreign-born and US-born persons in New Jersey, 1986 through 1995. Am J Public Health. 1998 Jul;88(7):1064-7.
