The epidemiological transition in Papua New Guinea: new evidence from verbal autopsy studies
The epidemiological transition in Papua New Guinea: new evidence from verbal autopsy studies
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DOI：
10.1093/ije/dyz018
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发表时间：
2019-06-01
影响因子：
7.7
通讯作者：
Riley, Ian D.
中科院分区：
文献类型：
--
作者：
Gouda, Hebe N.;Hazard, Riley H.;Riley, Ian D.
背景资料：巴布亚新几内亚（巴布亚新几内亚）最近的经济增长表明，该国可能正在经历一个流行病转型期，其特点是传染病减少，非传染性疾病的负担日益加重。然而，在巴布亚新几内亚的具体原因死亡率的数据是非常稀疏的，在该国的过渡程度知之甚少。方法：死亡率监测建立在四个小人口在巴布亚新几内亚：西希里在中央省，阿萨罗谷在东部高地省，隐藏在海拉省和卡卡尔岛在马当省。对查明的所有死亡进行了口头尸检，SmartVA确定了死亡原因，并将其分为五大疾病类别：地方性非传染性疾病;新出现的非传染性疾病;地方性感染;新出现的感染;以及伤害。从以前的巴布亚新几内亚VA研究，使用不同的VA方法，跨越1970年至2001年的结果，也呈现在here.Results：共868青少年和成年人的死亡被确定和分配的死因。非传染性疾病占所有死亡人数的大多数（40.4%），慢性呼吸道疾病的地方性非传染性疾病占死亡人数的最大比例（10.5%），其次是新出现的糖尿病非传染性疾病（6.2%）。新发传染病多于地方性传染病（11.9%对9.5%）。这四个地点的死因分布各不相同，在社会经济最发达的西希里，新出现的非传染性疾病和新出现的感染最多。比较1970-2001年VA系列与本研究表明，地方性infections.Conclusions的大幅下降：我们的研究结果表明，卫生服务规划和加强重要的登记系统，更有效地服务于卫生优先事项设置的需求，立即优先事项。
Background: Recent economic growth in Papua New Guinea (PNG) would suggest that the country may be experiencing an epidemiological transition, characterized by a reduction in infectious diseases and a growing burden from non-communicable diseases (NCDs). However, data on cause-specific mortality in PNG are very sparse, and the extent of the transition within the country is poorly understood.Methods: Mortality surveillance was established in four small populations across PNG: West Hiri in Central Province, Asaro Valley in Eastern Highlands Province, Hides in Hela Province and Karkar Island in Madang Province. Verbal autopsies (VAs) were conducted on all deaths identified, and causes of death were assigned by SmartVA and classified into five broad disease categories: endemic NCDs; emerging NCDs; endemic infections; emerging infections; and injuries. Results from previous PNG VA studies, using different VA methods and spanning the years 1970 to 2001, are also presented here.Results: A total of 868 deaths among adolescents and adults were identified and assigned a cause of death. NCDs made up the majority of all deaths (40.4%), with the endemic NCD of chronic respiratory disease responsible for the largest proportion of deaths (10.5%), followed by the emerging NCD of diabetes (6.2%). Emerging infectious diseases outnumbered endemic infectious diseases (11.9% versus 9.5%). The distribution of causes of death differed across the four sites, with emerging NCDs and emerging infections highest at the site that is most socioeconomically developed, West Hiri. Comparing the 1970-2001 VA series with the present study suggests a large decrease in endemic infections.Conclusions: Our results indicate immediate priorities for health service planning and for strengthening of vital registration systems, to more usefully serve the needs of health priority setting.