Tshikuka Jose Gaby, Okenge Léon, Lukuka Albert, Mengema Bibi, Mafuta Jacqueline, Itetya Jerry, Ne-Kimole Kimole, Eloko Gérard
Department of Health Science, National Pedagogic University, Kinshasa ; Department of Community Health, University School of Medical Technology ( ISTM ), Kinshasa.
Department of Community Health, University School of Medical Technology ( ISTM ), Kinshasa.
Ethiop J Health Sci. 2014 Oct;24(4):299-306. doi: 10.4314/ejhs.v24i4.4.
For the past decades, developing countries have received considerable support to fight infectious illnesses in their homelands. This global effort has tremendously reduced case fatality rates associated with illnesses such as HIV/AIDS, tuberculosis and malaria in many countries. However, this information is still missing in some developing countries, hindering international effort for control programs; we designed this study in effort to close this gap.
Data on 23,487 inpatients from Kinshasa hospitals were gathered and analyzed using EpiData and SPSS. Major illnesses affecting inpatients were identified; mortality and case fatality rates associated with each such illness were estimated. Case fatality rates associated with each illness were compared between consecutive years. Socio demographic and economic factors associated with mortality due to HIV/AIDS, TB and malaria were investigated using logistic regression.
The outstanding findings were that case fatality rates associated with major illnesses were relatively higher in 2008 than in the previous year; inpatients hospitalized for HIV/AIDS, TB and malaria in 2008 were more likely to die than those hospitalized in the previous year. Low socioeconomic status inpatients hospitalized for malaria, HIV/AIDS or TB were more likely to die than high socioeconomic status inpatients (AOR 0.29, 95% CI 0.22-0.40; AOR 0.20, 95%CI0.12-0.33; AOR 0.33, 95%CI 0.21-0.53), even though both groups presumably had access to free life-saving treatment and care.
These results indicate that while improvement in health indicators greatly depends on funds availability and sustainability, these alone might not be enough in resource poor developing countries. Other factors, i.e., population SES also need to be addressed before needed changes may occur.
在过去几十年里，发展中国家在抗击本土传染病方面获得了大量支持。这一全球努力在许多国家极大地降低了与艾滋病毒/艾滋病、结核病和疟疾等疾病相关的病死率。然而，一些发展中国家仍缺乏此类信息，这阻碍了控制项目的国际努力；我们开展本研究以填补这一空白。
收集了金沙萨各医院23487名住院患者的数据，并使用EpiData和SPSS进行分析。确定影响住院患者的主要疾病；估算与每种此类疾病相关的死亡率和病死率。比较连续年份中与每种疾病相关的病死率。使用逻辑回归研究与艾滋病毒/艾滋病、结核病和疟疾导致的死亡相关的社会人口学和经济因素。
突出的发现是，2008年与主要疾病相关的病死率高于上一年；2008年因艾滋病毒/艾滋病、结核病和疟疾住院的患者比上一年住院的患者更有可能死亡。因疟疾、艾滋病毒/艾滋病或结核病住院的社会经济地位低的患者比社会经济地位高的患者更有可能死亡（比值比0.29，95%置信区间0.22 - 0.40；比值比0.20，95%置信区间0.12 - 0.33；比值比0.33，95%置信区间0.21 - 0.53），尽管两组患者可能都能获得免费的救命治疗和护理。
这些结果表明，虽然健康指标的改善很大程度上取决于资金的可获得性和可持续性，但在资源匮乏的发展中国家，仅靠这些可能还不够。在可能发生所需变化之前，还需要解决其他因素，即人群的社会经济地位。
