Chronic Diseases: Chronic Diseases and Development 5 Monitoring and surveillance of chronic non-communicable diseases: progress and capacity in high-burden countries
Chronic Diseases: Chronic Diseases and Development 5 Monitoring and surveillance of chronic non-communicable diseases: progress and capacity in high-burden countries
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DOI：
10.1016/s0140-6736(10)61853-3
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发表时间：
2010-11-01
期刊：
影响因子：
168.9
通讯作者：
Bettcher, Douglas
中科院分区：
文献类型：
--
作者：
Alwan, Ala;MacLean, David R.;Bettcher, Douglas
低收入和中等收入国家的慢性非传染性疾病负担正在增加。我们概述了监测这些疾病的框架，并审查了死亡率负担和各国应对这些疾病的能力。我们展示了来自世卫组织数据来源和已发表工作的数据，这些数据涉及23个低收入和中等收入非传染性疾病负担高的国家的烟草使用流行率、超重和死因特异性死亡率。国家慢性病预防和控制能力的数据来自2009-10年在世卫组织成员国进行的全球评估。虽然关于特定原因死亡率的可靠数据很少，但在我们分析的23个国家中，非传染性疾病估计造成2340万人死亡（占总数的64%），其中47%发生在70岁以下的人群中。烟草使用和超重在我们研究的大多数国家和人群中很常见，但降低这些风险因素的成本效益干预措施的覆盖率很低。预防和控制非传染性疾病的能力，包括国家监测和监督行动能力不足。监测框架，包括一套涵盖风险和结果的最低限度指标，对于政策制定和评估以及监测疾病趋势至关重要。技术、人力和财政资源的限制是建立有效的预防和控制方案的主要障碍。尽管对慢性病的认识和承诺有所提高，但全球合作伙伴在规划和实施具有成本效益的干预措施方面的具体行动还不够。
The burden of chronic, non-communicable diseases in low-income and middle-income countries is increasing. We outline a framework for monitoring of such diseases and review the mortality burden and the capacity of countries to respond to them. We show data from WHO data sources and published work for prevalence of tobacco use, overweight, and cause-specific mortality in 23 low-income and middle-income countries with a high burden of non-communicable disease. Data for national capacity for chronic disease prevention and control were generated from a global assessment that was done in WHO member states in 2009-10. Although reliable data for cause-specific mortality are scarce, non-communicable diseases were estimated to be responsible for 23.4 million (or 64% of the total) deaths in the 23 countries that we analysed, with 47% occurring in people who were younger than 70 years. Tobacco use and overweight are common in most of the countries and populations we examined, but coverage of cost-effective interventions to reduce these risk factors is low. Capacity for prevention and control of non-communicable diseases, including monitoring and surveillance operations nationally, is inadequate. A surveillance framework, including a minimum set of indicators covering exposures and outcomes, is essential for policy development and assessment and for monitoring of trends in disease. Technical, human, and fiscal resource constraints are major impediments to the establishment of effective prevention and control programmes. Despite increasing awareness and commitment to address chronic disease, concrete actions by global partners to plan and implement cost-effective interventions are inadequate.