Department of Social and Preventive Medicine, University of Montreal, Montreal, Canada.
BMC Public Health. 2012 Jan 10;12:24. doi: 10.1186/1471-2458-12-24.
WHO estimates suggest that age-specific death rates from non-communicable diseases are higher in sub-Saharan Africa than in high-income countries. The objectives of this study were to examine, in Burkina Faso, the prevalence of non-communicable disease symptoms by age, gender, socioeconomic group and setting (rural/urban), and to assess gender and socioeconomic inequalities in the prevalence of these symptoms.
We obtained data from the Burkina Faso World Health Survey, which was conducted in an adult population (18 years and over) with a high response rate (4822/4880 selected individuals). The survey used a multi-stage stratified random cluster sampling strategy to identify participants. The survey collected information on socio-demographic and economic characteristics, as well as data on symptoms of a variety of health conditions. Our study focused on joint disease, back pain, angina pectoris, and asthma. We estimated prevalence correcting for the sampling design. We used multiple Poisson regression to estimate associations between non-communicable disease symptoms, gender, socioeconomic status and setting.
The overall crude prevalence and 95% confidence intervals (CI) were: 16.2% [13.5; 19.2] for joint disease, 24% [21.5; 26.6] for back pain, 17.9% [15.8; 20.2] for angina pectoris, and 11.6% [9.5; 14.2] for asthma. Consistent relationships between age and the prevalence of non-communicable disease symptoms were observed in both men and women from rural and urban settings. There was markedly high prevalence in all conditions studied, starting with young adults. Women presented higher prevalence rates of symptoms than men for all conditions: prevalence ratios and 95% CIs were 1.20 [1.01; 1.43] for joint disease, 1.42 [1.21; 1.66] for back pain, 1.68 [1.39; 2.04] for angina pectoris, and 1.28 [0.99; 1.65] for asthma. Housewives and unemployed women had the highest prevalence rates of non-communicable disease symptoms.
Our work suggests that social inequality extends into the distribution of non-communicable diseases among social groups and supports the thesis of a differential vulnerability in Burkinabè women. It raises the possibility of an abnormally high rate of premature morbidity that could manifest as a form of premature aging in the adult population. Increased prevention, screening and treatment are needed in Burkina Faso to address high prevalence and gender inequalities in non-communicable diseases.
世界卫生组织的估计表明，撒哈拉以南非洲的特定年龄组非传染性疾病死亡率高于高收入国家。本研究的目的是在布基纳法索检查非传染性疾病症状的流行率按年龄、性别、社会经济群体和环境（农村/城市）划分，并评估这些症状的性别和社会经济不平等。
我们从布基纳法索世界卫生调查中获取了数据，该调查针对的是成年人（18 岁及以上），响应率很高（4822/4880 名选定的个体）。该调查采用多阶段分层随机聚类抽样策略来确定参与者。该调查收集了社会人口统计学和经济特征信息，以及各种健康状况症状的数据。我们的研究集中在关节疾病、背痛、心绞痛和哮喘上。我们对抽样设计进行了校正，以估计发病率。我们使用多泊松回归来估计非传染性疾病症状、性别、社会经济地位和环境之间的关联。
总体粗发病率和 95%置信区间（CI）为：关节疾病 16.2%[13.5;19.2]，背痛 24%[21.5;26.6]，心绞痛 17.9%[15.8;20.2]，哮喘 11.6%[9.5;14.2]。农村和城市环境中的男性和女性都观察到年龄与非传染性疾病症状流行率之间存在一致的关系。所有研究条件下的发病率都很高，从年轻成年人开始。女性的所有症状发病率都高于男性：发病率比和 95%CI 分别为关节疾病 1.20[1.01;1.43]，背痛 1.42[1.21;1.66]，心绞痛 1.68[1.39;2.04]，哮喘 1.28[0.99;1.65]。家庭主妇和失业妇女的非传染性疾病症状发病率最高。
我们的工作表明，社会不平等延伸到社会群体中非传染性疾病的分布，支持布基纳法索妇女易受伤害的论点。这提出了过早发病率异常高的可能性，这可能表现为成年人口的过早衰老形式。布基纳法索需要增加预防、筛查和治疗，以解决非传染性疾病的高发病率和性别不平等问题。
