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印度南部偏远农村地区基于社区的心血管疾病风险因素筛查的可行性与结果:Chunampet农村心血管健康评估与管理项目

Feasibility and outcome of community-based screening for cardiovascular disease risk factors in a remote rural area of South India: The Chunampet rural-Cardiovascular health assessment and management program.

作者信息

Newtonraj Ariarathinam, Selvaraj Kalaiselvi, Purty Anil J, Nanda Sunil K, Arokiaraj Mark C, Vincent Antony, Manikandan Mani

机构信息

Department of Community Medicine, Pondicherry Institute of Medical Sciences, Puducherry, India.

Department of Community Medicine, All India Institute of Medical Sciences, Nagpur, Maharashtra, India.

出版信息

Indian J Endocrinol Metab. 2019 Nov-Dec;23(6):628-634. doi: 10.4103/ijem.IJEM_528_19.

Abstract

BACKGROUND

As committed by India in Global Action Plan, Sustainable Development Goals and National Health Policy 2017, India has the responsibility to provide accessible, affordable noncommunicable disease care to the people. Our study aimed to find out the burden of cardiovascular risk factors among hypertension and diabetic patients, through a community-based screening, in a remote rural area of South India.

METHODS

A special program named "Chunampet Rural-Cardiovascular Health Assessment and Management Program" (CR-CHAMP) was launched in August and September 2017 in a Rural Health Training Center (RHTC), functioning under a private medical college in South India. In this program, participants with hypertension (HT) and diabetes (DM) were line listed from 10 remote villages, and then history, initial biochemical, hormonal, and hematological screenings were done to assess the cardiovascular diseases (CVDs) risk factors among these patients, following which special consultation was offered in RHTC.

RESULTS

Out of 415 eligible patients with HT and DM, 389 were approached; among them, 328 were willing to participate and were screened initially; among them, 235 were attended special consultation. Higher CVD risk was found in 21%. Prevalence of chronic kidney disease was 14%, deranged lipid profile was more than 50%, metabolic syndrome was 49%, anemia was 68%, abnormal waist-hip ratio was 56%, abdominal obesity was 59%, and overweight and obesity using body mass index (BMI) was 59%. Females' participation was more in our community-based screening procedure (66%) than male participation (34%).

CONCLUSION

CR-CHAMP demonstrated feasibility and value of implementing a screening program for high-risk individuals with HT and DM for CVD risk through existing primary care in a remote rural area of South India. This will help the National Program and policymakers to plan for interventions in the remote rural area in future.

摘要

背景

正如印度在《全球行动计划》《可持续发展目标》及《2017年国家卫生政策》中所承诺的,印度有责任为民众提供可及、可负担的非传染性疾病护理。我们的研究旨在通过在印度南部一个偏远农村地区开展的社区筛查,了解高血压和糖尿病患者中心血管危险因素的负担情况。

方法

2017年8月和9月,在印度南部一所私立医学院下属的农村卫生培训中心启动了一项名为“Chunampet农村心血管健康评估与管理项目”(CR-CHAMP)的特别项目。在该项目中,从10个偏远村庄列出高血压(HT)和糖尿病(DM)患者名单,然后进行病史、初始生化、激素和血液学筛查,以评估这些患者的心血管疾病(CVDs)危险因素,之后在农村卫生培训中心提供特别咨询。

结果

在415名符合条件的HT和DM患者中,389人被接触;其中,328人愿意参与并接受了初步筛查;其中,235人接受了特别咨询。发现21%的患者心血管疾病风险较高。慢性肾脏病患病率为14%,血脂异常超过50%,代谢综合征为49%,贫血为68%,腰臀比异常为56%,腹型肥胖为59%,使用体重指数(BMI)评估的超重和肥胖为59%。在我们基于社区的筛查程序中,女性参与率(66%)高于男性参与率(34%)。

结论

CR-CHAMP证明了通过印度南部偏远农村地区现有的初级保健,为HT和DM高危个体实施心血管疾病风险筛查项目的可行性和价值。这将有助于国家项目和政策制定者未来规划在偏远农村地区的干预措施。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8410/6987782/66b986fd15ca/IJEM-23-628-g001.jpg

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