Universidad Peruana de Ciencias Aplicadas, Lima, Peru.
Centro de Excelencia en Investigaciones Económicas y Sociales en Salud, Vicerrectorado de Investigación, Universidad San Ignacio de Loyola, Lima, Peru.
PLoS One. 2022 Sep 16;17(9):e0274697. doi: 10.1371/journal.pone.0274697. eCollection 2022.
To investigate the prevalence, associated factors and socioeconomic inequalities in chronic disease relapses (CDR) during 2020 in Peru.
A secondary analysis was made of the National Household Survey on Living Conditions and Poverty (ENAHO) 2020. Participants older than 18 years who suffered from a chronic disease and with information about the occurrence of a CDR in the last 4 weeks prior to the survey were included. Adjusted prevalence ratios (aPRs) were estimated to determine the associated factors. Socioeconomic inequality in CDR was estimated using concentration curves (CC) and the Erreygers concentration index (ECI).
Data from 38,662 participants were analyzed; the prevalence of CDR in the last 4 weeks prior to the survey was 16.5% (95% CI: 15.8-17.2). Being female (aPR 1.29; 95% CI: 1.21-1.37), with regards to being male; being 30-39 (aPR 1.22; 95% CI: 1.05-1.42), 40-49 (aPR 1.29; 95% CI: 1.12-1.48), 50-59 (aPR 1.60; 95% CI: 1.41-1.82), and 60 years or older (aPR 1.80; 95% CI: 1.58-2.04), compared to 18-29; reaching up to primary (aPR 1.18; 95% CI: 1.07-1.31), or secondary education (aPR 1.13; 95% CI: 1.02-1.24), in contrast to tertiary education; presenting some physical, psychological or cognitive limitation (aPR 1.33; 95% CI: 1.21-1.46), with respect to experiencing no limitations; and being affiliated to a health insurance (aPR 1.18; CI 95%: 1.09-1.29), opposed to not having health insurance; were associated with a higher probability of CDR. Residing in the natural region of the coastal area (aPR 0.83; 95% CI: 0.74-0.92) was associated with a lower probability of relapse compared to residing in the jungle area. In people with limitations and residents of the jungle areas, the prevalence of CDR was concentrated in those with higher per capita spending.
Approximately 1 in 6 Peruvians with chronic diseases had a relapse within the last 4 weeks prior to the survey of 2020 and certain geographic and sociodemographic factors were found to be associated with CDR. It was also found that a higher concentration of CDR was observed in the population with the highest per capita spending with some limitations, as well as in residents of the jungle, implying the need for appropriate policy interventions that address CDR with a special focus on these populations.
调查 2020 年秘鲁慢性疾病复发（CDR）的流行率、相关因素和社会经济不平等情况。
对 2020 年全国家庭生活条件和贫困状况调查（ENAHO）进行二次分析。纳入年龄大于 18 岁、患有慢性疾病且在调查前四周内有 CDR 发作信息的参与者。采用调整后的患病率比（aPR）来确定相关因素。采用集中曲线（CC）和 Erreygers 集中指数（ECI）来评估 CDR 的社会经济不平等情况。
共分析了 38662 名参与者的数据；调查前四周内 CDR 的患病率为 16.5%（95%CI：15.8-17.2）。与男性相比，女性（aPR 1.29；95%CI：1.21-1.37）、30-39 岁（aPR 1.22；95%CI：1.05-1.42）、40-49 岁（aPR 1.29；95%CI：1.12-1.48）、50-59 岁（aPR 1.60；95%CI：1.41-1.82）和 60 岁及以上（aPR 1.80；95%CI：1.58-2.04）的 CDR 复发可能性更高；达到小学（aPR 1.18；95%CI：1.07-1.31）或中学（aPR 1.13；95%CI：1.02-1.24）教育水平，而非高等教育水平；存在某些身体、心理或认知障碍（aPR 1.33；95%CI：1.21-1.46），而没有任何障碍；以及参加健康保险（aPR 1.18；95%CI：1.09-1.29），而非没有健康保险；与更高的 CDR 可能性相关。与丛林地区相比，沿海自然地区（aPR 0.83；95%CI：0.74-0.92）的居民复发率较低。在有身体限制和居住在丛林地区的人群中，CDR 的流行率集中在人均支出较高的人群中。
在 2020 年调查前的四周内，大约每 6 名秘鲁慢性疾病患者中就有 1 名复发，并且发现某些地理和社会人口因素与 CDR 相关。还发现，在有身体限制的人群和丛林地区的居民中，CDR 的集中程度较高，这表明需要采取适当的政策干预措施，特别关注这些人群的 CDR 问题。
