按人体免疫缺陷病毒状况绘制肯尼亚当前和未来非传染性疾病负担图:模型研究。

Mikaela Smit, Pablo N Perez-Guzman, Kennedy K Mutai, Rachel Cassidy, Joseph Kibachio, Nduku Kilonzo, Timothy B Hallett
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引用次数: 0

摘要

背景:肯尼亚的非传染性疾病 (NCD) 负担还没有得到很好的描述,尽管需要进行估算以确定未来的健康优先事项。我们的目的是根据人体免疫缺陷病毒(HIV)状况量化肯尼亚当前和未来的非传染性疾病负担:方法:我们对肯尼亚心血管疾病(CVD)、慢性肾病、抑郁症、糖尿病、高总胆固醇、高血压、人类乳头瘤病毒感染以及相关癌前病变阶段的流行率/发病率进行了原创性系统综述和荟萃分析。开发了一个基于个人的模型,模拟出生、死亡、艾滋病毒疾病和治疗、上述非传染性疾病和癌症。该模型使用系统回顾和流行病学国家和地区监测数据进行参数化。根据成人的艾滋病毒感染状况,对 2018-2035 年的非传染性疾病负担进行了量化:系统综述确定了除缺血性心脏病以外的每种非传染性疾病的流行率/发病率数据。该模型估计,目前有 51% 的肯尼亚成年人罹患≥1 种 NCD,与非 HIV 感染者相比,HIV 感染者的负担更高(62% 对 51%),这是因为他们的年龄更高,而且部分原因是与 HIV 相关的 NCD 风险。高血压和高总胆固醇是非传染性疾病的主要诱因(成人发病率分别为 20.5% [530 万] 和 9.0% [230 万]),心血管疾病和癌症是主要死因。预计到 2035 年,这一负担将加重(非艾滋病毒感染者的负担将增加 56%;艾滋病毒感染者的负担将增加 71%),到 2035 年,人口增长将使需要服务的人数增加一倍(从 1,540 万增加到 2,810 万):肯尼亚需要扩大非传染性疾病服务。肯尼亚的指导方针已经支持在普通人群和艾滋病毒感染者中提供这些服务;但是,覆盖率仍然很低。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Mapping the Current and Future Noncommunicable Disease Burden in Kenya by Human Immunodeficiency Virus Status: A Modeling Study.

Background: The noncommunicable disease (NCD) burden in Kenya is not well characterized, despite estimates needed to identify future health priorities. We aimed to quantify current and future NCD burden in Kenya by human immunodeficiency virus (HIV) status.

Methods: Original systematic reviews and meta-analyses of prevalence/incidence of cardiovascular disease (CVD), chronic kidney disease, depression, diabetes, high total cholesterol, hypertension, human papillomavirus infection, and related precancerous stages in Kenya were carried out. An individual-based model was developed, simulating births, deaths, HIV disease and treatment, aforementioned NCDs, and cancers. The model was parameterized using systematic reviews and epidemiological national and regional surveillance data. NCD burden was quantified for 2018-2035 by HIV status among adults.

Results: Systematic reviews identified prevalence/incidence data for each NCD except ischemic heart disease. The model estimates that 51% of Kenyan adults currently suffer from ≥1 NCD, with a higher burden in people living with HIV (PLWH) compared to persons not living with HIV (62% vs 51%), driven by their higher age profile and partly by HIV-related risk for NCDs. Hypertension and high total cholesterol are the main NCD drivers (adult prevalence of 20.5% [5.3 million] and 9.0% [2.3 million]), with CVD and cancers the main causes of death. The burden is projected to increase by 2035 (56% in persons not living with HIV; 71% in PLWH), with population growth doubling the number of people needing services (15.4 million to 28.1 million) by 2035.

Conclusions: NCD services will need to be expanded in Kenya. Guidelines in Kenya already support provision of these among both the general and populations living with HIV; however, coverage remains low.

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