Huong Dao Lan, Minh Hoang Van, Vos Theo, Janlert Urban, Van Do Duc, Byass Peter
Health Strategy and Policy Institute, Ministry of Health, Vietnam.
Popul Health Metr. 2006 Aug 8;4:9. doi: 10.1186/1478-7954-4-9.
Assessing the burden of disease contributes towards evidence-based allocation of limited health resources. However, such measures are not yet commonly available in Vietnam. Taking advantage of the FilaBavi Demographic Surveillance Site (FilaBavi DSS) in Vietnam, this study aimed to establish the feasibility of applying the Years of Life Lost (YLL) technique in the context of a defined DSS, and to estimate the importance of the principal causes of premature mortality in a rural area of Vietnam between 1999 and 2003.
Global Burden of Disease methods were applied. Causes of death were ascertained by verbal autopsy.
In five years, 1,240 deaths occurred and for 1,220 cases cause of death information from verbal autopsy was available. Life expectancy at birth was 71.0 (95% confidence interval 69.9-72.1) in males and 80.9 (79.9-81.9) in females. The discounted, but not age weighted YLL per 1,000 population was 85 and 55 for males and females, respectively. The leading causes of YLL and death counts were cardiovascular diseases, malignant neoplasms, unintentional injuries, and neonatal causes. Males contributed 54% of total deaths and 59% of YLL. Males experienced higher YLL than women across all causes. Filabavi mortality estimates are considerably lower than 2002 WHO country estimates for Vietnam. Also the FilaBavi cause distribution varies considerably from the WHO result.
The combination of localised demographic surveillance, verbal autopsy and the application of YLL methods enable new insights into the magnitude and importance of significant public health issues in settings where evidence for planning is otherwise scarce. Local mortality data vary considerably from the WHO model-based estimates.
评估疾病负担有助于为有限的卫生资源进行循证分配。然而，此类措施在越南尚不普遍。本研究利用越南的菲拉巴维人口监测点（FilaBavi DSS），旨在确定在特定的人口监测点背景下应用寿命损失年（YLL）技术的可行性，并估计1999年至2003年越南农村地区过早死亡主要原因的重要性。
应用全球疾病负担方法。通过死因推断确定死亡原因。
五年内共发生1240例死亡，其中1220例通过死因推断获得了死亡原因信息。男性出生时预期寿命为71.0岁（95%置信区间69.9 - 72.1），女性为80.9岁（79.9 - 81.9）。每1000人口中经贴现但未加权的YLL，男性为85，女性为55。YLL和死亡数的主要原因是心血管疾病、恶性肿瘤、意外伤害和新生儿病因。男性占总死亡人数的54%，占YLL的59%。所有病因导致的男性YLL均高于女性。菲拉巴维的死亡率估计值远低于2002年世卫组织对越南的国家估计值。而且菲拉巴维的死因分布与世卫组织的结果有很大差异。
局部人口监测、死因推断和YLL方法的结合，能够在规划证据匮乏的环境中，为重大公共卫生问题的规模和重要性提供新的见解。当地死亡率数据与基于世卫组织模型的估计值有很大差异。
