Ichiho Henry M, Shomour Moria, Marar Julio, Lippwe Kipier, Aitaoto Nia
Pacific Chronic Disease Coalition, Atlanta, GA, USA.
Hawaii J Med Public Health. 2013 May;72(5 Suppl 1):30-8.
Non-communicable diseases (NCD) have been identified as a health emergency in the US-affiliated Pacific Islands (USAPI).1 This assessment, funded by the National Institutes of Health, was conducted in the Federated States of Micronesia, State of Chuuk and describes the burdens due to selected NCDs (diabetes, heart disease, hypertension, stroke, chronic kidney disease); and assesses the system of service capacity and current activities for service delivery, data collection and reporting as well as identifying the issues that need to be addressed. There has been a 9.2% decline in the total population between 2000 and 2010. Findings of medical and health data reveal that diabetes, myocardial infarction, and septicemia are the leading causes of death and lower limb surgical procedures and amputations was a major problem that was addressed with a foot care education program to prevent amputations. No data were available on the prevalence of diabetes among the population of Chuuk. Other findings show significant gaps in the system of administrative, clinical, data, and support services to address these NCDs. There is a lack of policy and procedure manuals, coordination among providers, and common standards of care. There is no functional data system to identify and track patients with diabetes and other chronic diseases. Priority issues and problems were identified for the clinical, administrative, and data systems.
非传染性疾病（NCD）已被认定为美属太平洋岛屿（USAPI）的一项卫生紧急情况。1 这项由美国国立卫生研究院资助的评估在密克罗尼西亚联邦楚克州开展，描述了特定非传染性疾病（糖尿病、心脏病、高血压、中风、慢性肾病）造成的负担；评估了服务能力体系以及当前在服务提供、数据收集与报告方面的活动，并确定了需要解决的问题。2000年至2010年间，总人口下降了9.2%。医疗卫生数据的调查结果显示，糖尿病、心肌梗死和败血症是主要死因，下肢外科手术和截肢是一个主要问题，为此开展了足部护理教育项目以预防截肢。楚克州人群中的糖尿病患病率尚无数据。其他调查结果表明，在应对这些非传染性疾病的行政、临床、数据和支持服务体系方面存在重大差距。缺乏政策和程序手册，医疗服务提供者之间缺乏协调，也没有统一的护理标准。没有能识别和跟踪糖尿病及其他慢性病患者的实用数据系统。确定了临床、行政和数据系统的优先问题和难题。
