Disease burden of stroke in rural South Africa: an estimate of incidence, mortality and disability adjusted life years.
Disease burden of stroke in rural South Africa: an estimate of incidence, mortality and disability adjusted life years.
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南非农村中风的疾病负担：估计发病率，死亡率和残疾调整的终身年份。
DOI：
10.1186/s12883-015-0311-7
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发表时间：
2015-04-12
期刊：
影响因子：
2.6
通讯作者：
Tollman SM
中科院分区：
文献类型：
--
作者：
Maredza M;Bertram MY;Tollman SM
在南非流行病学转变的背景下，心血管疾病正在增加，对中风负担，特别是农村人群的发病率知之甚少。中风的危险因素很高，高血压患病率超过50%。准确、最新的疾病负担信息对于规划卒中管理的卫生服务至关重要。本研究使用发病率、死亡率和残疾调整生命年（DALY）指标的流行病学参数估计了南非农村的卒中负担，DALY指标是一种基于时间的测量方法，包括死亡率和发病率。使用来自Agincourt健康和社会人口监测系统的数据计算2007-2011年期间的卒中死亡率。Dismod是一个发病率-患病率-死亡率模型，用于估计南非阿金库尔分区和“大部分农村”城市残疾的发病率和持续时间。使用这些值，疾病负担的损失寿命年（YLL），年生活在残疾（YLD）和残疾人计算的Agincourt分区。5年来，估计在阿金库尔分区有842例中风病例，粗中风发病率为每10万人年244例。我们估计每年有1,070名残疾人因中风而死亡。其中，YLD贡献了8.7%（敏感性分析中为3.5 - 10.5%）。2007-11年，阿金库尔分区的粗中风死亡率为每10万人年114人。在南非的整个农村地区，中风的负担很高，大约有1300万人口，2011年估计有33500人中风。这项研究提供了南非农村地区中风发病率和残疾负担的第一个估计。农村人口中的高YLL和DALLS损失需要采取紧急措施预防和减轻中风的影响。纵向监测站点提供了一个平台，通过该平台可以监测南非农村地区不断变化的中风负担。本文的在线版本（doi：10.1186/s12883-015-0311-7）包含补充材料，可供授权用户使用。
In the context of an epidemiologic transition in South Africa, in which cardiovascular disease is increasing, little is known about the stroke burden, particularly morbidity in rural populations. Risk factors for stroke are high, with hypertension prevalence of more than 50%. Accurate, up-to-date information on disease burden is essential in planning health services for stroke management. This study estimates the burden of stroke in rural South Africa using the epidemiological parameters of incidence, mortality and disability adjusted life year (DALY) metric, a time-based measure that incorporates both mortality and morbidity. Data from the Agincourt health and socio-demographic surveillance system was utilised to calculate stroke mortality for the period 2007–2011. Dismod, an incidence-prevalence-mortality model, was used to estimate incidence and duration of disability in Agincourt sub-district and ‘mostly rural’ municipalities of South Africa. Using these values, burden of disease in years of life lost (YLL), years lived with disability (YLD) and DALYs was calculated for Agincourt sub-district. Over 5 years, there were an estimated 842 incident cases of stroke in Agincourt sub-district, a crude stroke incidence rate of 244 per 100,000 person years. We estimate that 1,070 DALYs are lost due to stroke yearly. Of this, YLDs contributed 8.7% (3.5 – 10.5%) in sensitivity analysis). Crude stroke mortality was 114 per 100,000 person-years in 2007–11 in Agincourt sub-district. Burden of stroke in entire rural South Africa, a population of some 13,000,000 people, was high, with an estimated 33, 500 strokes occurring in 2011. This study provides the first estimates of stroke burden in terms of incidence, and disability in rural South Africa. High YLL and DALYs lost amongst the rural populations demand urgent measures for preventing and mitigating impacts of stroke. Longitudinal surveillance sites provide a platform through which a changing stroke burden can be monitored in rural South Africa. The online version of this article (doi:10.1186/s12883-015-0311-7) contains supplementary material, which is available to authorized users.
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通讯作者：
Tollman SM