High diabetes risk among asylum seekers in the Netherlands
High diabetes risk among asylum seekers in the Netherlands
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DOI：
10.1111/dme.12510
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发表时间：
2014-12-01
影响因子：
3.5
通讯作者：
Kunst, A. E.
中科院分区：
文献类型：
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作者：
Goosen, S.;Middelkoop, B.;Kunst, A. E.
目的根据人口因素和在东道国的停留时间绘制寻求庇护者中记录在案的糖尿病患病率和发病率图。方法我们使用来自寻求庇护者社区卫生服务的全国数据库。研究人群包括所有在2000年至2008年间抵达荷兰的年龄在20-79岁之间的寻求庇护者。病例分配基于国际初级保健分类代码。采用一般实践注册表获取参考数据。计算标准化患病率和发病率，并用Cox回归分析其与住院时间的关系。结果共纳入59 380名寻求庇护者，其中糖尿病患者1227例。与参考人群相比，男性（标准化患病率=1.85,95% CI 1.71-1.91）和女性（标准化患病率=2.26,95% CI 2.08-2.45）寻求庇护者中记录的糖尿病患病率均较高。来自索马里、苏丹和斯里兰卡的寻求庇护者的标准化患病率最高。30岁寻求庇护者的标准化患病率较高。在所有的住院时间间隔内，发病率都高于参考人群。结论：与荷兰的普通人群相比，来自大多数原籍国的寻求庇护者患糖尿病的风险更高。来自索马里的寻求庇护者处境尤其危险。这一新出现的公共卫生问题需要决策者和保健提供者予以关注。
Aims To map the prevalence and incidence of recorded diabetes among asylum seekers according to demographic factors and length of stay in the host country.Methods We used a nationwide database from the Community Health Services for Asylum Seekers. The study population included all asylum seekers aged 20-79 years who arrived in the Netherlands between 2000 and 2008. Case allocation was based on International Classification of Primary Care codes. A general practice registry was used to obtain reference data. Standardized prevalence and incidence ratios were calculated and their association with length of stay was explored with Cox regression.Results The study included 59 380 asylum seekers among whom there were 1227 recorded cases of diabetes. The prevalence of recorded diabetes was higher among asylum seekers compared with the reference population for both men (standardized prevalence ratio=1.85, 95% CI 1.71-1.91) and women (standardized prevalence ratio=2.26, 95% CI 2.08-2.45). The highest standardized prevalence ratios were found for asylum seekers from Somalia, Sudan and Sri Lanka. The standardized prevalence ratio was higher in asylum seekers aged >= 30 years. Incidence rates were higher compared with the reference population for all length-of-stay intervals.Conclusions Asylum seekers from the majority of countries of origin were at higher risk of diabetes compared with the general population in the Netherlands. Asylum seekers from Somalia were particularly at risk. This emerging public health issue requires attention from policy-makers and care providers.