Department of Biostatistics and Demography,Faculty of Graduate Studies for Statistical Research, Cairo University, Cairo, Egypt.
Faculty of Computers and Artificial Intelligence, Cairo University, Cairo, Egypt.
PLoS One. 2021 Aug 10;16(8):e0245642. doi: 10.1371/journal.pone.0245642. eCollection 2021.
The study aimed to model and quantify the health burden induced by four non-communicable diseases (NCDs) in Egypt, the first to be conducted in the context of a less developing county. The study used the State-Space model and adopted two Bayesian methods: Particle Filter and Particle Independent Metropolis-Hastings to model and estimate the NCDs' health burden trajectories. We drew on time-series data of the International Health Metric Evaluation, the Central Agency for Public Mobilization and Statistics (CAPMAS) Annual Bulletin of Health Services Statistics, the World Bank, and WHO data. Both Bayesian methods showed that the burden trajectories are on the rise. Most of the findings agreed with our assumptions and are in line with the literature. Previous year burden strongly predicts the burden of the current year. High prevalence of the risk factors, disease prevalence, and the disease's severity level all increase illness burden. Years of life lost due to death has high loadings in most of the diseases. Contrary to the study assumption, results found a negative relationship between disease burden and health services utilization which can be attributed to the lack of full health insurance coverage and the pattern of health care seeking behavior in Egypt. Our study highlights that Particle Independent Metropolis-Hastings is sufficient in estimating the parameters of the study model, in the case of time-constant parameters. The study recommends using state Space models with Bayesian estimation approaches with time-series data in public health and epidemiology research.
本研究旨在对埃及四种非传染性疾病(NCDs)造成的健康负担进行建模和量化,这是首次在欠发达国家进行的研究。该研究使用状态空间模型,并采用两种贝叶斯方法:粒子滤波和粒子独立 metropolis-hastings 来对 NCDs 的健康负担轨迹进行建模和估计。我们利用了国际健康指标评估、中央公共动员和统计机构(CAPMAS)年度卫生服务统计通报、世界银行和世界卫生组织的数据的时间序列数据。两种贝叶斯方法都表明,负担轨迹呈上升趋势。大多数研究结果与我们的假设一致,与文献相符。前一年的负担强烈预测当前年份的负担。危险因素、疾病流行率和疾病严重程度的高患病率都会增加疾病负担。由于死亡而导致的生命损失年数在大多数疾病中都有很高的负荷。与研究假设相反,研究结果发现疾病负担与卫生服务利用之间存在负相关关系,这可能归因于埃及缺乏全面的健康保险覆盖范围和卫生保健寻求行为模式。我们的研究强调,在时间常数参数的情况下,粒子独立 metropolis-hastings 足以估计研究模型的参数。该研究建议在公共卫生和流行病学研究中使用具有时间序列数据的状态空间模型和贝叶斯估计方法。