Programas Governamentais, Instituto Israelita de Responsabilidade Social, Hospital Israelita Albert Einstein, São Paulo, São Paulo, Brasil.
Departamento de Medicina Preventiva, Faculdade de Medicina, Universidade de São Paulo, São Paulo, São Paulo, Brasil.
PLoS One. 2019 Mar 15;14(3):e0213998. doi: 10.1371/journal.pone.0213998. eCollection 2019.
Noncommunicable diseases (NCDs) were responsible for 72.3% of global deaths in 2016, with cardiovascular diseases accounting for almost half of those deaths and low- and middle-income countries carrying the biggest burden. As a result, the prevention and control of NCDs is recognized as urgent, while better surveillance at the country level could result in more effective policies. Hence, the objective of this study was to obtain more detailed information on the distribution of the prevalence of hypertension and diabetes among the population of two large districts of the city of São Paulo in Brazil, and to compare these findings to the results of a citywide health survey.
This cross-sectional study used primary health care (PHC) routinely-collected data. The study population included 187,110 individuals 20 years of age or older registered in 13 public PHC facilities at two districts of the city of São Paulo in 2015. Data extracted from SIAB, a primary care database, was used to calculate age and sex directly standardized prevalences for diabetes and hypertension for each PHC facility. The prevalence of hypertension among women was significantly higher than the prevalence among men in the entire study population, and in every PHC facility. There was great variation among PHC facilities that was more pronounced among women. The prevalence of diabetes among women was significantly higher than the prevalence among men in the entire study population, and in every PHC facility, but there was little variation among PHC facilities.
This study provided information that could help with policy planning and allocation of resources, and demonstrated the use of PHC routinely-collected data to generate important insights that if replicated could have a substantial impact given the broad coverage of the national public PHC program in Brazil.
2016 年,非传染性疾病(NCDs)导致全球 72.3%的死亡,其中心血管疾病占这些死亡人数的近一半,中低收入国家的负担最重。因此,预防和控制非传染性疾病已被视为当务之急,而在国家层面进行更好的监测则可能会制定出更有效的政策。因此,本研究的目的是获取巴西圣保罗市两个大区人群中高血压和糖尿病流行率的更详细分布信息,并将这些发现与全市范围的健康调查结果进行比较。
这是一项使用初级卫生保健(PHC)常规收集数据的横断面研究。研究人群包括 2015 年在圣保罗市两个区的 13 个公共 PHC 机构登记的 187110 名 20 岁及以上的个体。从初级保健数据库 SIAB 中提取的数据用于计算每个 PHC 机构的糖尿病和高血压的年龄和性别直接标准化患病率。在整个研究人群中,女性高血压患病率明显高于男性,而且在每个 PHC 机构中也是如此。PHC 机构之间存在很大差异,女性差异更为明显。在整个研究人群中,女性糖尿病患病率明显高于男性,而且在每个 PHC 机构中也是如此,但 PHC 机构之间的差异很小。
本研究提供了有助于政策规划和资源分配的信息,并展示了使用 PHC 常规收集的数据生成重要见解的方法,如果在巴西全国性的公共 PHC 计划中得到复制,可能会产生重大影响。