Prynn Josephine E, Dube Albert, Mwaiyeghele Elenaus, Mwiba Oddie, Geis Steffen, Koole Olivier, Nyirenda Moffat, Kuper Hannah, Crampin Amelia C
Malawi Epidemiology and Intervention Research Unit (MEIRU), Lilongwe, Malawi.
University College London, London, UK.
Wellcome Open Res. 2021 Aug 27;4:90. doi: 10.12688/wellcomeopenres.15196.5. eCollection 2019.
Disability is a complex concept involving physical impairment, activity limitation, and participation restriction. The Washington Group developed a set of questions on six functional domains (seeing, hearing, walking, remembering, self-care, and communicating) to allow collection of comparable data on disability. We aimed to improve understanding of prevalence and correlates of disability in this low-income setting in Malawi. This study is nested in the Karonga Health and Demographic Surveillance Site in Malawi; the Washington Group questions were added to the annual survey in 2014. We used cross-sectional data from the 2014 survey to estimate the current prevalence of disability and examine associations of disability with certain chronic conditions. We then reviewed the incidence and resolution of disability over time using panel data from the 2015 survey. Of 10,863 participants, 9.6% (95% CI 9.0-10.1%) reported disability in at least one domain. Prevalence was higher among women and increased with age. Diabetes and obesity were associated with disability among women, and diabetes was also associated with disability among men. Neither hypertension nor HIV were associated with disability. Participants reporting "no difficulty" or "can't do at all" for any domain were likely to report the same status one year later, whereas there was considerable movement between people describing "some difficulty" and "a lot of difficulty". Disability prevalence is high and likely to increase over time. Further research into the situation of this population is crucial to ensure inclusive policies are created and sustainable development goals are met.
残疾是一个复杂的概念，涉及身体损伤、活动受限和参与受限。华盛顿小组针对六个功能领域（视力、听力、行走、记忆、自我护理和沟通）设计了一组问题，以便收集有关残疾的可比数据。我们旨在增进对马拉维这个低收入地区残疾患病率及其相关因素的了解。本研究嵌套于马拉维的卡龙加健康与人口监测点；华盛顿小组的问题于2014年被添加到年度调查中。我们使用2014年调查的横断面数据来估计当前的残疾患病率，并研究残疾与某些慢性病之间的关联。然后，我们利用2015年调查的面板数据回顾了残疾随时间的发生情况和缓解情况。在10,863名参与者中，9.6%（95%置信区间9.0 - 10.1%）报告在至少一个领域存在残疾。女性中的患病率更高，且随年龄增长而上升。糖尿病和肥胖与女性残疾相关，糖尿病也与男性残疾相关。高血压和艾滋病毒均与残疾无关。在任何领域报告“无困难”或“完全不能做”的参与者一年后可能报告相同状态，而在描述“有些困难”和“困难很大”的人群之间有相当大的变化。残疾患病率很高，且可能随时间增加。对这一人群状况的进一步研究对于确保制定包容性政策和实现可持续发展目标至关重要。
