Burden of disease in adults admitted to hospital in a rural region of coastal Kenya: an analysis of data from linked clinical and demographic surveillance systems
Burden of disease in adults admitted to hospital in a rural region of coastal Kenya: an analysis of data from linked clinical and demographic surveillance systems
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DOI：
10.1016/s2214-109x(14)70023-3
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发表时间：
2014-04-01
影响因子：
34.3
通讯作者：
Scott, J. Anthony G.
中科院分区：
文献类型：
--
作者：
Etyang, Anthony O.;Munge, Kenneth;Scott, J. Anthony G.
对撒哈拉以南非洲成年人疾病负担的估计在很大程度上依赖于稀疏数据模型。我们的目的是衡量疾病负担的成年人生活在农村地区的沿海Kenya与使用相关联的临床和人口监测data.Methods我们使用的数据从18712成人入院基利菲区医院（肯尼亚基利菲）在2007年1月1日至2012年12月31日期间，与基利菲卫生和人口监测系统内790 635人-年的观察相联系，以确定入院率和主要原因。这些数据也被用来模拟特定疾病的残疾调整寿命年损失的人口。我们使用地理绘图软件来计算从hospital.Findings距离分层入院率入院的主要原因在5公里内的医院生活的妇女是传染病和寄生虫病（每100 000人-年观察303例），妊娠相关疾病（每100 000人年观察239例）和循环系统疾病（每100 000人年观察105例）。居住在医院5公里范围内的男性住院的主要原因是传染病和寄生虫病（每10万人-年观察169例）、伤害（每10万人-年观察135例）和消化系统疾病（每10万人-年观察112例）。艾滋病毒相关疾病是残疾调整生命年损失的主要原因（每10万人观察年2050人），其次是非传染性疾病（每10万人观察年741人）。与医院的距离每增加5公里，男性全因入院率下降11%（95%CI 7-14），女性下降20%（17-23）。这种下降的幅度是最高的女性内分泌疾病（35%; 95%CI 22-46）和男性肿瘤（30%; 9-45）。解释肯尼亚农村的成年人面临着传染病，妊娠相关疾病，心血管疾病和伤害的综合负担。基于医院数据的疾病负担估计数受医院距离的影响，疾病负担低估的程度因疾病和性别而异。
Background Estimates of the burden of disease in adults in sub-Saharan Africa largely rely on models of sparse data. We aimed to measure the burden of disease in adults living in a rural area of coastal Kenya with use of linked clinical and demographic surveillance data.Methods We used data from 18 712 adults admitted to Kilifi District Hospital (Kilifi, Kenya) between Jan 1, 2007, and Dec 31, 2012, linked to 790 635 person-years of observation within the Kilifi Health and Demographic Surveillance System, to establish the rates and major causes of admission to hospital. These data were also used to model disease-specific disability-adjusted life-years lost in the population. We used geographical mapping software to calculate admission rates stratified by distance from the hospital.Findings The main causes of admission to hospital in women living within 5 km of the hospital were infectious and parasitic diseases (303 per 100 000 person-years of observation), pregnancy-related disorders (239 per 100 000 person-years of observation), and circulatory illnesses (105 per 100 000 person-years of observation). Leading causes of hospital admission in men living within 5 km of the hospital were infectious and parasitic diseases (169 per 100 000 person-years of observation), injuries (135 per 100 000 person-years of observation), and digestive system disorders (112 per 100 000 person-years of observation). HIV-related diseases were the leading cause of disability-adjusted life-years lost (2050 per 100 000 person-years of observation), followed by non-communicable diseases (741 per 100 000 person-years of observation). For every 5 km increase in distance from the hospital, all-cause admission rates decreased by 11% (95% CI 7-14) in men and 20% (17-23) in women. The magnitude of this decline was highest for endocrine disorders in women (35%; 95% CI 22-46) and neoplasms in men (30%; 9-45).Interpretation Adults in rural Kenya face a combined burden of infectious diseases, pregnancy-related disorders, cardiovascular illnesses, and injuries. Disease burden estimates based on hospital data are affected by distance from the hospital, and the amount of underestimation of disease burden differs by both disease and sex.