Namusisi Olivia, Sekandi Juliet N, Kasasa Simon, Wasswa Peter, Kamara Nicholas T, Bitekyerezo Medard, Mihayo Placid, Gitta Sheba N, Mukanga David
African Field Epidemiology Network, Kampala, Uganda.
Pan Afr Med J. 2011;10:47. Epub 2011 Nov 29.
Despite an increasing recognition of non- communicable diseases (NCDs) in sub-Saharan Africa, there is lack of well established surveillance systems for these diseases. In an effort to understand burden of NCDs in low-resource settings, the African Field Epidemiology Network launched a pilot project in 2009 to routinely capture patient data in the diabetes clinic of Mbarara Regional Referral Hospital. The objective of this study was to determine the prevalence and, the gender- and age- specific distributions of common NCD risk factors among diabetic patients attending a referral hospital in rural Uganda.
A relational Access database was designed to collect information on NCD risk factors. These included smoking, alcohol use, family history of diabetes, hypertension and body mass index. Univariate analyses were done and differences in proportions tested using chi-square P-values in STATA version 10.0.
A total of 1,383 patient records were analyzed, with 61% being female and mean age of 39.6 years (SD 15.8). About 24% had a family history of diabetes. Smoking and alcohol use were more prevalent among males (16.6% vs. 8.3%; p<0.0001) and (30.7 vs. 13%; p<0.0001) respectively. Overweight, obesity and hypertension were more prevalent in women (18.6% vs. 9.7%, 8.6% vs. 2.6%; p<0.0001, and 40.3% vs. 33%, p=0.018) respectively.
This pilot project shows that use of hospital-based data is a valuable initial step in setting up surveillance systems for NCDs in Uganda. Risk factors for NCDs were both age and gender-specific and predominantly related to lifestyle. This suggests the need to design gender-sensitive prevention interventions that target lifestyle modification in this setting.
尽管撒哈拉以南非洲地区对非传染性疾病（NCDs）的认识日益提高，但针对这些疾病的完善监测系统却很缺乏。为了了解资源匮乏地区非传染性疾病的负担，非洲现场流行病学网络于2009年启动了一个试点项目，以定期收集姆巴拉拉地区转诊医院糖尿病诊所的患者数据。本研究的目的是确定乌干达农村一家转诊医院糖尿病患者中常见非传染性疾病风险因素的患病率以及性别和年龄特异性分布。
设计了一个关系型Access数据库来收集非传染性疾病风险因素的信息。这些因素包括吸烟、饮酒、糖尿病家族史、高血压和体重指数。进行了单变量分析，并在STATA 10.0版本中使用卡方P值检验比例差异。
共分析了1383份患者记录，其中61%为女性，平均年龄39.6岁（标准差15.8）。约24%有糖尿病家族史。吸烟和饮酒在男性中更为普遍（分别为16.6%对8.3%；p<0.0001）和（30.7%对13%；p<0.0001）。超重、肥胖和高血压在女性中更为普遍（分别为18.6%对9.7%，8.6%对2.6%；p<0.0001，以及40.3%对33%，p=0.018）。
该试点项目表明，利用医院数据是在乌干达建立非传染性疾病监测系统的重要第一步。非传染性疾病的风险因素具有年龄和性别特异性，且主要与生活方式有关。这表明有必要设计针对该环境中生活方式改变的性别敏感预防干预措施。
