Paul Kalosona, Singh Jayakant
School of Development Studies, Tata Institute of Social Sciences, Opp. Deonar Depot, Mumbai, 400088, India.
School of Health Systems Studies, Tata Institute of Social Sciences, Opp. Deonar Depot, Mumbai, 400088, India.
J Health Popul Nutr. 2017 Aug 9;36(1):32. doi: 10.1186/s41043-017-0109-x.
India is rapidly undergoing an epidemiological transition with a sudden change in the disease profile of its population. It is important to understand the changing nature of the burden of disease across the states of India for adequate policy intervention.
We analyzed the trend and pattern of self-reported morbidity across states of India using three rounds of (52nd, 60th and 71st) National Sample Survey Organization (NSSO) data. Descriptive analysis was carried out to understand the prevalence of self-reported morbidity variation over a period of two decades (1995-2014) and multivariate analysis was performed to identify the significant determinants of various types of self-reported morbidities.
The results indicated an increasing trend of infectious disease, Cardio Vascular Diseases (CVDs) and Non-Communicable Diseases (NCDs) over the last two decades (1995-2014). CVDs increased by a whopping eight-fold and the NCDs increased by three times during this period. A higher prevalence of self-reported morbidity was observed among the elderly and female, particularly in the urban locality. The growing incidence of CVDs and NCDs, especially among the elderly were reported from Kerala, Tamil Nadu, Punjab and West Bengal.
The already constrained public health system in India is likely to face serious challenges with a double burden of communicable and non-communicable diseases. An effective and responsive public health system needs to be in place to make health care services available for NCDs and CVDs at the primary level. In order to ameliorate caregiving, the involvement of family will be critical. Informing the people inculcate healthy habits may be an effective health promotion measure.
印度正迅速经历流行病学转变，其人口的疾病谱突然发生变化。了解印度各邦疾病负担的变化性质对于进行适当的政策干预至关重要。
我们使用三轮（第52轮、第60轮和第71轮）国家抽样调查组织（NSSO）的数据，分析了印度各邦自我报告发病率的趋势和模式。进行描述性分析以了解二十年间（1995 - 2014年）自我报告发病率变化的流行情况，并进行多变量分析以确定各类自我报告疾病的重要决定因素。
结果表明，在过去二十年（1995 - 2014年）中，传染病、心血管疾病（CVDs）和非传染性疾病（NCDs）呈上升趋势。在此期间，心血管疾病增加了八倍，非传染性疾病增加了两倍。在老年人和女性中，尤其是在城市地区，自我报告发病率较高。喀拉拉邦、泰米尔纳德邦、旁遮普邦和西孟加拉邦报告称，心血管疾病和非传染性疾病的发病率不断上升，尤其是在老年人中。
印度本就捉襟见肘的公共卫生系统可能因传染病和非传染性疾病的双重负担而面临严峻挑战。需要建立一个有效且反应迅速的公共卫生系统，以便在基层提供针对非传染性疾病和心血管疾病的医疗服务。为了改善护理情况，家庭的参与将至关重要。向民众宣传并灌输健康习惯可能是一项有效的健康促进措施。
