Chest Research Foundation, Pune, India.
Chest Research Foundation, Pune, India.
Lancet Glob Health. 2015 Dec;3(12):e776-84. doi: 10.1016/S2214-109X(15)00152-7.
India has one of the highest disease burdens in the world. A better understanding of what ails India will help policy makers plan appropriate health-care services and infrastructure development, design medical education curricula, and identify health research priorities that are relevant to the needs of the country. The POSEIDON study aimed to record the prevalence of symptoms and medical conditions for which patients visit a primary health-care practitioner in India.
We randomly selected 12 000 general practitioners, general physicians, and paediatricians from 880 cities and towns and invited them to record demographic details, symptoms, and medical conditions for every patient they saw on Feb 1, 2011. A further 1225 practitioners volunteered to participate and their responses were included. We did simple descriptive analyses of prevalence rates and used χ(2) tests to study comorbid associations. Through application of systems biology methods, we visualised inter-relations between organ involvement of diseases and symptoms and deciphered how these associations change with age and gender.
We included responses from 7400 health-care practitioners, which represented data for 204 912 patients, who presented with 554 146 reasons for visit. Fever (35·5%) was the most common presenting symptom. More than half of all patients presented with respiratory symptoms across all age groups and regions of India. Other common presentations were digestive system symptoms (25%), circulatory symptoms (12·5%), skin complaints (9%), and endocrine disorders (6·6%). Hypertension (14·52%), obstructive airways diseases (14·51%), and upper respiratory tract infections (12·9%) were the most common diagnoses reported. Of note was that 21·4% of all patients with hypertension reported by the primary health-care practitioners were younger than 40 years. Anaemia was the fourth most common disease reported by these health-care practitioners and was most common in women of menstrual age living outside metro cities.
The POSEIDON study provides insight into the reasons that patients visit primary health-care practitioners in India; our results highlight important social and medical challenges in the developing world.
Chest Research Foundation, Council of Scientific and Industrial Research-Institute of Genomics and Integrated Biology (CSIR-IGIB), and Cipla Ltd.
印度是全球疾病负担最重的国家之一。深入了解印度的健康问题，将有助于决策者规划适当的医疗服务和基础设施建设，设计医学教育课程，并确定与国家需求相关的卫生研究重点。POSEIDON 研究旨在记录印度初级保健医生就诊患者的症状和疾病流行情况。
我们从 880 个城市中随机选择了 12000 名全科医生、普通内科医生和儿科医生，并邀请他们记录 2011 年 2 月 1 日每位就诊患者的人口统计学数据、症状和疾病情况。另外有 1225 名医生自愿参与并提供了相关信息。我们对流行率进行了简单的描述性分析，并使用卡方检验研究了合并症之间的关联。通过应用系统生物学方法，我们可以观察到疾病和症状的器官受累之间的相互关系，并揭示这些关联如何随年龄和性别而变化。
我们共纳入了 7400 名医生的回复，这些回复代表了 204912 名患者的数据，他们就诊的原因共计 554146 个。发热（35.5%）是最常见的就诊症状。在印度所有年龄组和地区，超过一半的患者都有呼吸道症状。其他常见的就诊原因包括消化系统症状（25%）、循环系统症状（12.5%）、皮肤投诉（9%）和内分泌紊乱（6.6%）。高血压（14.52%）、气道阻塞性疾病（14.51%）和上呼吸道感染（12.9%）是医生报告的最常见诊断。值得注意的是，初级保健医生报告的所有高血压患者中，21.4%的年龄小于 40 岁。贫血是这些医生报告的第四大常见疾病，在非大都市地区的育龄女性中最为常见。
POSEIDON 研究提供了对印度患者就诊初级保健医生的原因的深入了解；我们的结果突出了发展中国家存在的重要社会和医疗挑战。
印度胸科基金会、印度科学与工业研究理事会-基因组与综合生物学研究所（CSIR-IGIB）和西普拉有限公司。
