Грузева Татьяна С, Дуфинец Василий А, Замкевич Виктория Б
Национальный Медицинский Университет Имени А.А. Богомольца, ул. Политехническая, 25/29, 01001 Киев, Украина тел. 236-42-33 , 236-01-22
Национальный Медицинский Университет Имени А.А. Богомольца, Киев, Украина
Wiad Lek. 2016;69(2 Pt 2):183-9.
Harmful alcohol consumption constitutes a significant cause of the global burden of disease, causing more than 200 different diseases, 5.9% of all deaths worldwide, causing substantial medical and social costs, major economic loss, slowing progress towards the strategic goals of human development.
to substantiate approaches to the formation of a national strategy to combat the harmful use of alcohol in Ukraine based on the analysis of the prevalence of alcohol consumption and related health and social problems and international experience and recommendations of WHO.
The study was based on analysis of the extent and patterns of alcohol consumption in Ukraine, levels, structure and dynamics of morbidity and mortality from diseases associated with alcohol abuse; investigation of preventive activities in primary healthcare, the existing problems and doctors' needs for prevention alcohol abuse, national and international experience on this problem.This work usesbibliosemantic, medical, statistical, sociological, epidemiological methods. The information base are: European Health for All Database (HFA-DB)for 2000-2012,Center of Medical Statistics, Ministry of Health of Ukraine for 2000-2015, questionnaire survey of physicians in primary care, strategic and policy documents of WHO, WHO Regional Office for Europe.
In Ukraine, as in most countries in the WHO European Region prevalence of alcohol is high. In the ranking of the WHO European Region Ukraine ranks fifth in alcohol consumption per capita. The structure of consumption of alcoholic drinks is dominated by strong spirits (48%). There has been a negative trend for this indicator from 5.4 liters in 2002 to 15.6 liters in 2012.The dominant pattern of alcohol consumption is characterized by early onset of alcohol consumption, significant frequency, large doses, mostly strong alcohol beverages, with significant share of low-quality alcohol. This factor contributes to high levels of morbidity. A total of546.3 thousandpeople with mental and behavioral disorders due to use of psychoactive substances wereregistered in health care facilities in 2014. Standardized mortality rate from causes related to alcohol in Ukraine (185.4 per 100 thousand.) is one of the largest in Europe, with only Kazakhstan (308.4) and Belarus (187.9) being behind. Regular work aiming at prevention of alcohol abuse is carried out by 49.4% of primary care professionals; 21.3% of physiciansinsist on reducing alcohol use on occasion.
Alcohol abuse is a major factor of morbidity, epidemic of noncommunicable diseases in Ukraine, causing significant medical and social costs and economic losts.Ukraine ranks fifth in alcohol consumption per capita among WHO European Region countries. High level and unhealthy patterns of alcohol consumption in the population causes high morbidity and mortality from noncommunicable diseases, accidents, exceeding pan-European indices and indicators in the European Union. Primary health care facility staff has insufficient knowledge, skills and gaps in professional training regarding the prevention of harmful use of alcohol.There is a high need for effective strategies to reduce the prevalence of this risk factor in Ukraine. In developing the National Action Plan to reduce the harmful use of alcohol, a national context and WHO recommendationsshould be considered, including improving the efficiency of health services, high-quality prevention and effective treatment of disorders caused by alcohol, countermeasures on driving drunk, limiting the sale and availability of alcohol, prevention the spread of manufacturing and marketing of alcoholbeverages produced illegally, including falsification, the revitalization of local communities, weakening the impact of marketing of alcohol beverages.
有害饮酒是全球疾病负担的一个重要成因,可引发200多种不同疾病,占全球所有死亡人数的5.9%,造成了巨大的医疗和社会成本、重大经济损失,减缓了人类发展战略目标的推进进程。
基于对乌克兰酒精消费流行情况、相关健康和社会问题以及国际经验和世界卫生组织建议的分析,论证制定乌克兰国家战略以应对有害饮酒问题的方法。
该研究基于对乌克兰酒精消费的程度和模式、与酒精滥用相关疾病的发病率、死亡率水平、结构和动态变化的分析;对初级医疗保健中的预防活动、存在的问题以及医生预防酒精滥用的需求进行调查,以及关于此问题的国家和国际经验。这项工作采用文献语义学、医学、统计学、社会学、流行病学方法。信息来源包括:2000 - 2012年欧洲全民健康数据库(HFA - DB)、乌克兰卫生部医学统计中心2000 - 2015年的数据、对初级医疗保健医生的问卷调查、世界卫生组织的战略和政策文件、世界卫生组织欧洲区域办事处的文件。
与世界卫生组织欧洲区域的大多数国家一样,乌克兰的酒精消费流行率很高。在世界卫生组织欧洲区域的排名中,乌克兰人均酒精消费量位居第五。酒精饮料消费结构中烈酒占主导(48%)。该指标呈负面趋势,从2002年的5.4升降至2012年的15.6升。酒精消费的主要模式特点是饮酒开始时间早、频率高、剂量大,主要是烈酒饮料,且劣质酒精占很大比例。这一因素导致了高发病率。2014年,医疗保健机构共登记了54.63万因使用精神活性物质导致精神和行为障碍的人。乌克兰与酒精相关病因的标准化死亡率(每10万人中有185.4人)是欧洲最高的之一,仅次于哈萨克斯坦(308.4)和白俄罗斯(187.9)。49.4%的初级医疗保健专业人员开展了旨在预防酒精滥用的常规工作;21.3%的医生偶尔会坚持减少酒精使用。
酒精滥用是乌克兰发病和非传染性疾病流行的主要因素,造成了巨大的医疗和社会成本以及经济损失。在世界卫生组织欧洲区域国家中,乌克兰人均酒精消费量位居第五。民众高水平且不健康的酒精消费模式导致非传染性疾病、事故的高发病率和高死亡率,超过了泛欧指标以及欧盟的指标。初级医疗保健机构工作人员在预防有害饮酒方面知识、技能不足,专业培训存在差距。乌克兰迫切需要有效的战略来降低这一风险因素的流行率。在制定减少有害饮酒的国家行动计划时,应考虑国家背景和世界卫生组织的建议,包括提高卫生服务效率、高质量预防和有效治疗酒精所致障碍、应对酒后驾车的对策、限制酒精销售和可得性、防止非法生产和销售酒精饮料(包括造假)蔓延、振兴当地社区、削弱酒精饮料营销的影响。