Kirigia Joses M, Sambo Hama B, Sambo Luis G, Barry Saidou P
World Health Organization Regional Office for Africa, Brazzaville, Congo.
BMC Int Health Hum Rights. 2009 Mar 31;9:6. doi: 10.1186/1472-698X-9-6.
In 2000, the prevalence of diabetes among the 46 countries of the WHO African Region was estimated at 7.02 million people. Evidence from North America, Europe, Asia, Latin America and the Caribbean indicates that diabetes exerts a heavy health and economic burden on society. Unfortunately, there is a dearth of such evidence in the WHO African Region. The objective of this study was to estimate the economic burden associated with diabetes mellitus in the countries in the African Region.
Drawing information from various secondary sources, this study used standard cost-of-illness methods to estimate: (a) the direct costs, i.e. those borne by the health systems and the families in directly addressing the problem; and (b) the indirect costs, i.e. the losses in productivity attributable to premature mortality, permanent disability and temporary disability caused by the disease. Prevalence estimates of diabetes for the year 2000 were used to calculate direct and indirect costs of diabetes mellitus. A discount rate of 3% was used to convert future earnings lost into their present values. The economic burden analysis was done for three groups of countries, i.e. 6 countries whose gross national income (GNI) per capita was greater than 8000 international dollars (i.e. in purchasing power parity), 6 countries with Int$2000-7999 and 33 countries with less than Int$2000. GNI for Zimbabwe was missing.
The 7.02 million cases of diabetes recorded by countries of the African Region in 2000 resulted in a total economic loss of Int$25.51 billion (PPP). Approximately 43.65%, 10.03% and 46.32% of that loss was incurred by groups 1, 2 and 3 countries, respectively. This translated into grand total economic loss of Int$11,431.6, Int$4,770.6 and Int$ 2,144.3 per diabetes case per year in the three groups respectively.
In spite of data limitations, the estimates reported here show that diabetes imposes a substantial economic burden on countries of the WHO African Region. That heavy burden underscores the urgent need for increased investments in the prevention and management of diabetes.
2000年,据估计世界卫生组织非洲区域46个国家的糖尿病患者人数达702万。来自北美、欧洲、亚洲、拉丁美洲和加勒比地区的证据表明,糖尿病给社会带来了沉重的健康和经济负担。不幸的是,世界卫生组织非洲区域缺乏此类证据。本研究的目的是估计非洲区域各国与糖尿病相关的经济负担。
本研究从各种二手资料中获取信息,采用标准疾病成本法进行估计:(a) 直接成本,即卫生系统和家庭直接应对该问题所承担的成本;(b) 间接成本,即因该疾病导致的过早死亡、永久性残疾和临时性残疾造成的生产力损失。利用2000年糖尿病患病率估计值来计算糖尿病的直接和间接成本。采用3%的贴现率将未来损失的收入换算为现值。对三组国家进行了经济负担分析,即人均国民总收入(GNI)高于8000国际美元(按购买力平价计算)的6个国家、人均国民总收入在2000 - 7999国际美元的6个国家以及人均国民总收入低于2000国际美元的33个国家。津巴布韦的国民总收入数据缺失。
2000年非洲区域各国记录的702万例糖尿病病例导致总计255.1亿美元(购买力平价)的经济损失。其中,第1组、第2组和第3组国家分别承担了约43.65%、10.03%和46.32%的损失。这意味着三组国家中每例糖尿病病例每年的总经济损失分别为11431.6美元、4770.6美元和2144.3美元。
尽管存在数据限制,但此处报告的估计结果表明,糖尿病给世界卫生组织非洲区域各国带来了巨大的经济负担。这一沉重负担凸显了迫切需要增加对糖尿病预防和管理的投资。