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古巴自我报告的急性胃肠疾病负担。

Burden of self-reported acute gastrointestinal illness in Cuba.

作者信息

Aguiar Prieto Pablo, Finley Rita L, Muchaal P K, Guerin Michele T, Isaacs Sandy, Domínguez Arnaldo Castro, Coutín Marie Gisele, Perez Enrique

机构信息

National Environmental Health Unit, Ministry of Health, Ciudad de La Habana, CP 10 400, Cuba.

出版信息

J Health Popul Nutr. 2009 Jun;27(3):345-57. doi: 10.3329/jhpn.v27i3.3377.

Abstract

Acute gastrointestinal illness is an important public-health issue worldwide. Burden-of-illness studies have not previously been conducted in Cuba. The objective of the study was to determine the magnitude, distribution, and burden of self-reported acute gastrointestinal illness in Cuba. A retrospective, cross-sectional survey was conducted in three sentinel sites during June-July 2005 (rainy season) and during November 2005-January 2006 (dry season). Households were randomly selected from a list maintained by the medical offices in each site. One individual per household was selected to complete a questionnaire in a face-to-face interview. The case definition was three or more bouts of loose stools in a 24-hour period within the last 30 days. In total, 97.3% of 6,576 interviews were completed. The overall prevalence of acute gastrointestinal illness was 10.6%. The risk of acute gastrointestinal illness was higher during the rainy season (odds ratio [OR]=3.85, 95% confidence interval [CI] 3.18-4.66) in children (OR=3.12, 95% CI 2.24-4.36) and teens (OR=2.27, 95% CI 1.51-3.41) compared to people aged 25-54 years, in males (OR=1.24, 95% CI 1.04-1.47), and in the municipality of Santiago de Cuba (OR=1.33, 95% CI 1.11-1.61). Of 680 cases, 17.1-38.1% visited a physician, depending on sentinel site. Of the cases who visited a physician, 33.3-53.9% were requested to submit a stool sample, and of those, 72.7-100.0% complied. Of the cases who sought medical care, 16.7-61.5% and 0-31.6% were treated with antidiarrhoeals and antibiotics respectively. Acute gastrointestinal illness represented a substantial burden of health compared to developed countries. Targeting the identified risk factors when allocating resources for education, food safety, and infrastructure might lower the morbidity associated with acute gastrointestinal illness.

摘要

急性胃肠疾病是全球重要的公共卫生问题。此前古巴尚未开展疾病负担研究。本研究的目的是确定古巴自我报告的急性胃肠疾病的严重程度、分布情况和负担。于2005年6月至7月(雨季)以及2005年11月至2006年1月(旱季)在三个哨点开展了一项回顾性横断面调查。从每个哨点医务室保存的名单中随机抽取家庭。每户选取一人在面对面访谈中完成一份问卷。病例定义为过去30天内24小时内出现三次或更多次稀便。总共6576份访谈中有97.3%完成。急性胃肠疾病的总体患病率为10.6%。与25至54岁人群相比,雨季儿童(优势比[OR]=3.85,95%置信区间[CI] 3.18 - 4.66)、青少年(OR=3.12,95% CI 2.24 - 4.36)、男性(OR=1.24,95% CI 1.04 - 1.47)以及古巴圣地亚哥市(OR=1.33,95% CI 1.11 - 1.61)患急性胃肠疾病的风险更高。在680例病例中,根据哨点不同,17.1% - 38.1%的患者就医。在就医的病例中,33.3% - 53.9%被要求提交粪便样本,其中72.7% - 100.0%的患者照做。在寻求医疗护理的病例中,分别有16.7% - 61.5%和0 - 31.6%的患者接受了止泻药和抗生素治疗。与发达国家相比,急性胃肠疾病造成了相当大的健康负担。在为教育、食品安全和基础设施分配资源时针对已确定的风险因素,可能会降低与急性胃肠疾病相关的发病率。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5923/2761793/53f503271157/jhpn0027-0345_f01.jpg

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