Global and Regional Patterns in Noncommunicable Diseases and Dietary Factors across National Income Levels

Background: Noncommunicable diseases (NCDs) are the leading global cause of death and share common risk factors. Little quantitative data are available on the patterns of each NCDs death and dietary factors by national income level and region. We aimed to identify the trend of NCDs deaths and dietary factors with other health-related behaviors across national income levels and geographical regions. Methods: Three databases were collected, including the World Health Organization, Food and Agriculture Organization, and World Bank in 2014. These were analyzed to describe the trend for NCDs deaths and dietary factors with health-related behaviors across national income levels (high income, upper-middle income, lower-middle income, and low income) from 151 countries using variance-weighted least-squares linear regression. Results: Lower-middle-income and low-income countries in Africa and Asia had higher death rates of NCDs. More than 30% of the population had raised blood pressure with higher carbohydrate intake and lower protein and fat intake compared to high-income European countries in 2014. High-income countries had the highest prevalence of raised total cholesterol, overweight, and obesity, the highest total energy, fat, and protein intake, and the highest supplies of animal fat, stimulants, sugar and sweetener, vegetable oil, and milk, as well as insufficient activity with an increasing trend (p for trend < 0.001). Conclusion: There were differences in NCDs risk factors and dietary factors by national income and region. Accordingly, measures should be taken to suit the situation in each country. Our findings have significance for health workers and health policies preventing and controlling the rise of NCDs.     

Estimating Quality-Adjusted Life-Year Loss Due to Noncommunicable Diseases in Korean Adults through to the Year 2040

ObjectivesTo estimate the loss in quality-adjusted life-years (QALYs) in Korean adults due to 13 noncommunicable diseases (NCDs) in 2010 and predict changes in QALY loss through to the year 2040.MethodsThirteen NCDs (hypertension, diabetes mellitus, hyperlipidemia, stroke, myocardial infarction, angina, arthritis, osteoporosis, asthma, allergic rhinitis, atopic dermatitis, cataract, and depression) were selected from the Korean Community Health Survey 2010. The EuroQol five-dimensional questionnaire index from the Korean Community Health Survey 2010 and the Korean valuation set were used to estimate utility weights according to sex, age, and disease. Morbidity data were also obtained from the Korean Community Health Survey 2010. Mortality data according to disease and life expectancy were retrieved from the Korean Statistical Information Service. To predict future QALY loss, future population projection data from the Korean Statistical Information Service were used as substitutes for 2010 population size.ResultsAmong the assessed 13 NCDs, the largest total QALY loss was for hypertension (513,113 QALYs; units are omitted hereafter), followed by arthritis (509,317) and stroke (431,049). The largest QALY loss due to mortality was stroke (306,733), whereas the largest QALY loss due to morbidity was arthritis (502,513). By applying the middle estimate of future population, the largest increase in total QALY loss between 2010 and 2040 was for hypertension (840,582), followed by stroke (719,076) and diabetes mellitus (474,607).ConclusionsHypertension, arthritis, and stroke are important in terms of total QALY loss, which will continuous to increase because of aging. These results could be used to develop cost-effective interventions that reduce the burden of NCDs.     

团体标准 − 高质量发展的动力引擎

T/CPMA 033 — 2023《成人慢性病行为危险因素监测基本数据集标准》由中华预防医学会于2023年10月20日发布并正式实施。该标准规定了成人慢性病行为危险因素监测数据集的元数据属性和数据元属性。适用于卫生健康行政部门、疾病预防控制机构、基层医疗卫生机构、健康体检和管理机构及科研院所开展慢性病行为危险因素监测、调查、干预和评估等相关数据的采集。该文对标准的要点内容进行解读,为医疗卫生机构及专业人员深入理解和推广应用该标准提供指导。

     

Applications of Systems Science in Biomedical Research Regarding Obesity and Noncommunicable Chronic Diseases: Opportunities,Promise, and Challenges

Interest in the application of systems science (SS) in biomedical research, particularly regarding obesity and noncommunicable chronic disease (NCD) research, has been growing rapidly over the past decade. SS is a broad term referring to a family of research approaches that include modeling. As an emerging approach being adopted in public health, SS focuses on the complex dynamic interaction between agents (e.g., people) and subsystems defined at different levels. SS provides a conceptual framework for interdisciplinary and transdisciplinary approaches that address complex problems. SS has unique advantages for studying obesity and NCD problems in comparison to the traditional analytic approaches. The application of SS in biomedical research dates back to the 1960s with the development of computing capacity and simulation software. In recent decades, SS has been applied to addressing the growing global obesity epidemic. There is growing appreciation and support for using SS in the public health field, with many promising opportunities. There are also many challenges and uncertainties, including methodologic, funding, and institutional barriers. Integrated efforts by stakeholders that address these challenges are critical for the successful application of SS in the future.     

成人慢性病行为危险因素监测基本数据集标准 (T/CPMA 033 — 2023)

《成人慢性病行为危险因素监测基本数据集标准》（T/CPMA 033 — 2023）由中华预防医学会于2023年10月20日发布并正式实施。该标准规定了成人慢性病行为危险因素监测数据集的元数据属性和数据元属性。适用于卫生健康行政部门、疾病预防控制机构、基层医疗卫生机构、健康体检和管理机构及科研院所开展慢性病行为危险因素监测、调查、干预和评估等相关数据的采集。

     

甘肃省疾控系统慢性病监测能力调查

目的全面了解甘肃省各级疾病预防控制中心（CDC）系统开展慢性病监测能力现状,为建立健全全省慢性病监测与干预体系以及制定相关政策、措施提供参考依据。方法统一采用《2010年甘肃省慢性病预防控制能力调查问卷》,开展定性访谈和网络填报,总结和分析全省CDC系统主要慢性病及其相关危险因素的监测能力。结果此次调查共回收有效调查问卷和网络填报问卷各101份,回收率为100.00%。全省总计有25.74%的CDC开展了针对主要慢性病和主要危险因素的监测工作,其中有28个CDC开展了主要慢性病的监测工作,有24个CDC开展了主要慢性病相关危险因素的监测工作。各级CDC对慢性病及其危险因素监测的覆盖范围非常有限,缺乏连续系统的监测数据,慢性病及其危险因素的监测工作尚未成为CDC常规的工作任务。结论应加大政府和卫生行政部门对慢性病监测的政策支持力度和增加资金投入,建立健全慢性病综合监测系统,为制定相关政策和慢性病防控工作提供技术支撑。     

光明新区社区慢性非传染性疾病及相关危险因素调查分析

目的为了尽快完善深圳市光明新区慢性非传染性疾病(下简称慢性病)综合防治体系,推动社区生服务与慢性病防治相结合的综合防治,并为制定深圳市光明新区慢性病防治对策提供参考依据。方法通过随机抽样对光明新区4个社区587名15岁以上的居民进行慢性病患病率及相关危险因素调查。结果样本人群慢性病患病率为20.97%,男女慢性病患病率均随年龄增长而上升;吸烟、饮酒、缺乏运动和不合理膳食等是社区慢性病的主要危险因素。结论社区慢性病患病率较高,且35岁以上各年龄组人群高血压患病率处于较高水平。因此,加强对高危人群的体格检查以及慢性病及其各种并发症的筛查是非常必要的,对探索建立社区慢性病综合防治体系有积极的推动作用。     

2005-2009广元市年食源性疾病危险因素监测结果分析

目的了解和掌握广元市食品污染状况和危险因数;了解和掌握广元市食品中致病菌血清型分布、耐药状况;为预防和控制食源性疾病提供科学依据。方法对全市食源性疾病相关样品依据流行病学调查进行理化或微生物相关项目检测,市售主要食品进行理化污染物及致病菌检测,溯源追踪可疑食品。现场或问卷调查危险因素。结果 2005~2009年共检测各类样品1 003份,监测散发和暴发食源性疾病49起,其中细菌性20起,化学性6起,蕈类及植物性8起,原因不明15起。共检出致病菌89株,其中沙门菌37株,志贺菌51株,致泻大肠埃希菌1株。市内主要皮蛋加工厂生产环境良好,生产工艺为新工艺。本地蛋鸭养殖户养殖过程安全有序。居民食用皮蛋卫生习惯良好。结论广元市食源性疾病主要发生在夏秋季,场所主要为学校食堂、家庭聚餐、农村坝坝宴。致病原因,细菌性41%,化学性12%,原因不明31%,其他16%。食物存在不同程度的致病菌污染,尤以熟肉卤制品、皮蛋、不洁水源为重。细菌主要血清型为肠炎沙门菌,宋内志贺菌,并且对12种抗生素出现不同程度的耐药。     

宁波口岸6194名入出境人员疾病监测体检结果分析

本文报道了宁波口岸1994年1月至1995年7月对6194名入出境人员传染病监测体检结果．其中HBsAg阳性364例，阳性率方5．88%．出国劳务人员中HBsAg阳性率略偏高，为6．24%；乙型肝炎10例；SGPT异常5例；隐性梅毒感染者5例；肺结核1例；未检出HIV抗体阳性者．并对监测结果进行了分析，为今后更好地开展疾病监测体检工作提供了参考依据。     

四川省疾病预防控制系统慢性病防控机构基础配置现状及公平性研究

目的了解四川省疾病预防控制系统慢性病防控部门、人力、财力等基础配置资源的现状及其人口分布和地理分布的公平性。方法采用问卷调查方法,收集四川省市(州)和县(区)级所有疾病预防控制中心(CDC)慢性病防控的部门设置、人力资源和经费配置等信息。同时,收集各市(州)2009年人口数和地理面积,利用洛伦茨曲线和基尼系数测算公平性。结果部门设置:市(州)级和县(区)级CDC设有专门慢性病防控科所的比例分别为14.29%和1.65%,设置以慢性病防控为主要职责的科所比例分别为9.52%和4.40%。人力资源:全省慢性病防控人数、专职慢性病防控人数占CDC总人数的比例分别为3.88%和1.23%;33.9%的慢性病防控工作人员接受过本科及以上教育;94.2%的人员具有医学背景;9.7%的人员有高级职称;76.1%的人员从事慢性病防控工作年限在5年以下;85.8%的慢性病防控工作人员所在部门不以承担慢病防控为主要职责,仅承担本单位慢病防控相关工作。经费配置:市(州)级和县(区)级CDC慢病防控经费占同级CDC总业务工作经费的比例分别为1.14%和0.91%。资源公平性:慢病防控科所、慢病防控人员、专职慢病防控人员和慢病防控经费按人口配置的基尼系数分别为0.646、0.287、0.355和0.421,按地理面积配置的基尼系数分别为0.902、0.551、0.733和0.761。结论四川省疾控系统慢性病防控专职部门所占比例较少,人员数量不多,经费投入不足,基础配置仅部分考虑到了人口公平性,地理面积配置方面存在严重不公平状态。     

三明市慢性病综合防治示范点居民健康状况与行为危险因素调查

「目的」了解慢性病的患病情况、易感人群和主要危险因素。「方法」采用随机分层抽样对３０岁以上常住人口进行入户调查。「结果」高血压、高血脂、冠心病的现患率分别为１０．１％、７．９％、５．５％;吸烟、咸食、缺少体育锻炼、肥胖与超重的比例分别为３３．２％、２１．５％、５１．３％、３１．３％。「结论」高血压、高经等是三明市城镇居民的主要慢性病;吸烟、缺少体育锻炼等是主要危险因素。加强健康教育、开展控烟与防治     

上海松江岳阳社区居民慢性病患病现状及行为危险因素分析

[目的]了解上海市松江区岳阳社区居民慢性非传染性疾病的流行现状及行为危险因素。[方法]采用分层随机抽样的方法，按国家卫生部“中国成人慢性病危险因素调查”的要求，抽取在该社区居住满1年的18～69岁常住居民1984名，进行问卷调查和体格检查。[结果]72．1％的样本人群具有≥1种危险因素，33．1％的样本人群患有≥1种慢性病。吸烟率、饮酒率、超重率、肥胖率分别为24．1％、21．5％、27．5％、6．6％；样本人群中，34．7％缺乏体力活动，49．1％钙质摄入不足，6．9％维生素B、C摄入不足，45．3％蛋白质摄入不足，9．7％嗜腌制品（苯丙胺类致癌物质及高钠食品）；高血压和糖尿病的患病率分别为26．6％、5．5％。Logistic回归分析显示：高血压、糖尿病的共同危险因素为40岁以上人群、高血脂、肥胖。[结论]行为危险因素的持续存在，已导致慢性病的高发。大力开展社区健康教育与健康促进，应采取综合性干预措施，遏止慢性病流行。     

宁波市区居民慢性病相关因素分析

目的了解宁波市慢性病的患病率及相关危险因素.方法采用多级分层随机抽样的方法,抽取宁波市区35～74周岁的常住(5年及5年以上)居民6 589人,进行一般状况、生活方式及行为、家族史的调查和相关的体格检查,采用Logistic回归分析筛选相关因素.结果高血压、冠心病、糖尿病、脑血管病等慢性病的相关危险因素有年龄、家族史、膳食因素、体育锻炼及体力活动减少、腹部肥胖.结论宁波市慢性病有随年龄增高的趋势,有必要在社区采取综合防治措施,以减少慢性病的患病率.     

苏州口岸外籍人员传染病监测结果分析

目的了解苏州口岸外籍人员传染病感染情况,为有效的开展口岸传染病监测和防控工作提供科学依据。方法对2005-2009年苏州口岸35006名外籍入境人员的传染病监测结果进行统计学分析。结果共检出传染病3203例,检出率9.15%。传染病的检出率,在地区分布、人员类别、性别及年龄组分布上,有显著差别;各年度传染病发生率,较为平稳。结论外籍人员传染病防工作,要重点关注亚洲地区、男性青壮年劳务及商务人员,建立入境人员传染病流行的风险防范机制,防止传染病通过国境口岸进行传播。     

接触有毒有害作业工人的职业健康监护结果分析

目的对深圳市宝安区内从事有毒有害作业工人进行职业健康监护,调查分析存在的主要职业病危害因素。方法按照职业健康监护技术规范GBZ 188-2007,根据劳动者接触职业病危害因素种类选择健康监护项目,对上岗前、在岗期间、离岗时共计11 647名劳动者进行健康检查。结果辖区内主要职业病危害因素包括苯系物、粉尘、噪声、三氯乙烯、正己烷、铅、强酸强碱。上岗前健康检查2 126人,查出职业禁忌证168人;在岗期间健康检查9 268人,查出职业禁忌证231人,疑似职业病14人;离岗时健康检查253人,查出疑似职业病6人。结论部分企业仍然存在明显的职业病危害因素,对劳动者健康产生一定的影响,企业必须采取有效的职业病防治措施,预防控制职业病发生。     

Potential Gains in Health-Adjusted Life Expectancy by Reducing Burden of Noncommunicable Diseases in 188 Countries: A Population-Based Study

ObjectivesThis article quantifies the potential gains in health-adjusted life expectancy for people aged 30 to 70 years (HALE_[30-70]) by examining the reductions in disability in addition to premature mortality from noncommunicable diseases (NCDs).MethodsWe extracted data from the Global Burden of Disease Study 2019 for 4 major NCDs (cancers, cardiovascular diseases, chronic respiratory diseases, and diabetes mellitus) in 188 countries from 2010 to 2019. Estimates of the potential gains in HALE_[30-70] were based on a counterfactual analysis involving 3 alternative future scenarios: (1) achieve Sustainable Development Goals target 3.4 but do not make any progress on disability reduction, (2) achieve Sustainable Development Goals target 3.4 and eliminate NCD-related disability, and (3) eliminate all NCD-related mortality and disability.ResultsIn all scenarios, the high-income group has the greatest potential gains in HALE_[30-70], above the global average. For all specific causes, potential gains in HALE_[30-70] decrease as income levels fall. Across these 3 scenarios, the potential gains in HALE_[30-70] globally of reducing premature mortality for 4 major NCDs are 3.13 years, 4.53 years, and 7.32 years, respectively. In scenario A, all income groups have the greatest potential gains in HALE_[30-70] from diabetes and chronic respiratory diseases. In scenarios B and C, the high-income group has the greatest potential gains in HALE_[30-70] from cancer intervention, and the other income groups have the greatest potential gains in HALE_[30-70] from cardiovascular diseases intervention.ConclusionReducing premature death and disability from 4 major NCDs at once and attaching equal importance to each lead to a sizable improvement in HALE_[30-70].     

Noncommunicable Diseases: Current Status of Major Modifiable Risk Factors in Korea

A noncommunicable disease (NCD) is a medical condition or disease that is by definition non-infectious and non-transmissible among people. Currently, NCDs are the leading causes of death and disease burden worldwide. The four main types of NCDs, including cardiovascular disease, cancer, chronic lung disease, and diabetes, result in more than 30 million deaths annually. To reduce the burden of NCDs on global health, current public health actions stress the importance of preventing, detecting, and correcting modifiable risk factors; controlling major modifiable risk factors has been shown to effectively reduce NCD mortality. The World Health Organization''s World Health Report 2002 identified tobacco use, alcohol consumption, overweight, physical inactivity, high blood pressure, and high cholesterol as the most important risk factors for NCDs. Accordingly, the present report set out to review the prevalence and trends of these modifiable risk factors in the Korean population. Over the past few decades, we observed significant risk factor modifications of improved blood pressure control and decreased smoking rate. However, hypertension and cigarette smoking remained the most contributable factors of NCDs in the Korean population. Moreover, other major modifiable risk factors show no improvement or even worsened. The current status and trends in major modifiable risk factors reinforce the importance of prevention, detection, and treatment of risk factors in reducing the burden of NCDs on individuals and society.     

珠海市学校传染病症状监测系统建立和分析

目的探讨建立本地区学校传染病症状监测系统及应用。方法以网络技术、浏览器/服务器技术(B/S)为基础,进行系统集成。定义发热等7个症状数据及聚集性事件监测标准,利用时间序列建模预警预测,Spearman相关分析进行数据源分析。结果开发建设了"珠海市学校突发卫生事件症状监测系统",温特斯法对学生就诊ILI%跟踪和拟合性好。结论学校症状监测系统运行良好,能较准确的预测、预警,对学校传染病防控及其他突发公共卫生事件有积极预防作用,适宜推广。     

2013年苏州市相城区慢性非传染性疾病行为危险因素调查分析

目的 了解苏州市相城区居民慢性病相关行为危险因素分布情况和发生水平,为制定有效的防治策略提供依据.方法 采取随机抽样方法,抽取相城区10个社区2 979例18～69岁常住居民进行问卷调查和体格检查.结果 相城区居民慢性病相关行为危险因素流行率较高,其中吸烟率为26.8％,饮酒率为38.5％,超重和肥胖率为34.0％.高血压、糖尿病和高血脂的健康知识知晓率不高.结论 慢性病的各种主要行为危险因素在相城区居民中普遍存在,且发生率较高,应积极采取相应的行为干预措施,建立科学的生活方式与健康行为习惯,降低慢性病发病率.     

10种疾病病人住院医疗费用的因子分析

目的:探讨影响10种疾病病人住院医疗费用的主要支配因子,为控制住院医疗费用的过度增长提供理论依据。方法:以随机抽取的2002—2005年间在胜利石油管理局中心医院和胜利医院住院的10种疾病病人2238例为样本,采用因子分析的方法,对出院病人的各项医疗费用进行分析。结果:诊疗、床位、药物与化验因子、手术及麻醉因子、输血及护理因子、输氧及材料因子、检查因子和治疗因子是支配病人住院费用的6个公因子。结论:控制医疗费用的过度增长,应着力降低药费、化验费和治疗费。