Ben Romdhane Habiba, Haouala Habib, Belhani Ali, Drissa H, Kafsi Nacer, Boujnah Rachid, Mechmèche Rachid, Slimane Mohamed Lotfi, Achour N, Nacef Taoufik, Gueddiche Mohamed
Institut National de Santé Publique.
Tunis Med. 2005 May;83 Suppl 5:1-7.
We aim at analysing the increase of CVDs in the Tunisian hospitals in order to assess the burden of NCDs in the transitional context.
Data are recorded through the Tunisian National Morbidity and Mortality Survey (TNMMS). In order to assess the CVDs (CHDs vs RHDs) trend, two representative samples of Cardiology Departements patients were compared one is selected from the TNMMS and the second from the hospitalisations recorded in 1992. Causes, stay duration, status at the end of the hospitalisation, transfer to another hospital and patients socio-demographic characteristics are recorded and compared for the two periods. All the diagnosis are coded referring to the DMC 10. To analyze the determinant of the epidemiological transition, we have elaborated the CVD causal pattern and we have documented all their determinants.
CHD rate has dramatically increased, while RHD has decreased especially on men. In 1992, 39.2% of men and 11.8% of women were admitted for CHD. In 2002, these rate are respectivly 58.8% and 38.2% while RHD rates were, in 1992, 11.8% on men and 25.3% on women vs 4.4% and 11.7% respectively.
This study has confirmed that so far controlling transmitted diseases seems to be successful, Tunisian people are about to face a new problems as hypertension, obesity, diabetes and tobacco smoking. The new challenge with the burden of diseases requires the implementation of a national strategy relevant to the epidemiological, social and economical transition. Population needs and cost effectiveness of interventions assessment is crucial to set the national priorities.
我们旨在分析突尼斯医院中心血管疾病（CVDs）的增加情况，以评估转型背景下非传染性疾病（NCDs）的负担。
数据通过突尼斯国家发病率和死亡率调查（TNMMS）记录。为了评估心血管疾病（冠心病与风湿性心脏病）的趋势，比较了心脏病科患者的两个代表性样本，一个选自TNMMS，另一个选自1992年记录的住院病例。记录并比较了两个时期的病因、住院时间、住院结束时的状态、转至另一家医院的情况以及患者的社会人口学特征。所有诊断均参照国际疾病分类第10版（DMC 10）进行编码。为了分析流行病学转变的决定因素，我们制定了心血管疾病因果模式，并记录了其所有决定因素。
冠心病发病率大幅上升，而风湿性心脏病发病率下降，尤其是男性。1992年，因冠心病入院的男性占39.2%，女性占11.8%。2002年，这些比例分别为58.8%和38.2%，而1992年风湿性心脏病发病率男性为11.8%，女性为25.3%，2002年分别为4.4%和11.7%。
本研究证实，到目前为止，控制传染病似乎取得了成功，突尼斯人民即将面临高血压、肥胖、糖尿病和吸烟等新问题。疾病负担带来的新挑战需要实施一项与流行病学、社会和经济转型相关的国家战略。评估人群需求和干预措施的成本效益对于确定国家优先事项至关重要。
