Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
Methods and Implementation Support for Clinical and Health research Hub (MISCH), Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, Victoria, Australia.
BMJ Open. 2022 Dec 8;12(12):e065318. doi: 10.1136/bmjopen-2022-065318.
This study aimed to map the national, regional and local prevalence of hypertension and diabetes in Ethiopia.
Nationwide cross-sectional survey in Ethiopia combined with georeferenced ecological level data from publicly available sources.
9801 participants aged between 15 and 69 years.
Prevalence of hypertension and diabetes were collected using the WHO's STEPS survey approach. Bayesian model-based geostatistical techniques were used to estimate hypertension and diabetes prevalence at national, regional and pixel levels (1×1 km) with corresponding 95% credible intervals (95% CrIs).
The national prevalence was 19.2% (95% CI: 18.4 to 20.0) for hypertension and 2.8% (95% CI: 2.4 to 3.1) for diabetes. Substantial variation was observed in the prevalence of these diseases at subnational levels, with the highest prevalence of hypertension observed in Addis Ababa (30.6%) and diabetes in Somali region (8.7%). Spatial overlap of high hypertension and diabetes prevalence was observed in some regions such as the Southern Nations, Nationalities and People's region and Addis Ababa. Population density (number of people/km) was positively associated with the prevalence of hypertension (β: 0.015; 95% CrI: 0.003-0.027) and diabetes (β: 0.046; 95% CrI: 0.020-0.069); whereas altitude in kilometres was negatively associated with the prevalence of diabetes (β: -0.374; 95% CrI: -0.711 to -0.044).
Spatial clustering of hypertension and diabetes was observed at subnational and local levels in Ethiopia, which was significantly associated with population density and altitude. The variation at the subnational level illustrates the need to include environmental drivers in future NCDs burden estimation. Thus, targeted and integrated interventions in high-risk areas might reduce the burden of hypertension and diabetes in Ethiopia.
本研究旨在绘制埃塞俄比亚全国、地区和局部高血压和糖尿病的流行情况。
在埃塞俄比亚进行全国性横断面调查，并结合来自公开来源的地理参考生态水平数据。
年龄在 15 至 69 岁之间的 9801 名参与者。
使用世卫组织的 STEPS 调查方法收集高血压和糖尿病的患病率。采用基于贝叶斯模型的地质统计技术，在国家、地区和像素（1×1km）层面上估计高血压和糖尿病的患病率，并给出相应的 95%可信区间（95%CrI）。
全国高血压的患病率为 19.2%（95%CI：18.4 至 20.0），糖尿病的患病率为 2.8%（95%CI：2.4 至 3.1）。在国家以下各级，这些疾病的患病率存在很大差异，其中高血压的患病率最高的是亚的斯亚贝巴（30.6%），糖尿病的患病率最高的是索马里地区（8.7%）。在一些地区，如南部各州、民族和人民地区以及亚的斯亚贝巴，高血压和糖尿病的高患病率存在空间重叠。人口密度（每平方公里人数）与高血压的患病率呈正相关（β：0.015；95%CrI：0.003-0.027），与糖尿病的患病率呈正相关（β：0.046；95%CrI：0.020-0.069）；而海拔高度（公里）与糖尿病的患病率呈负相关（β：-0.374；95%CrI：-0.711 至-0.044）。
在埃塞俄比亚，高血压和糖尿病在国家以下和地方一级存在空间聚集，这与人口密度和海拔高度显著相关。国家以下各级的差异表明，在未来非传染性疾病负担估计中需要纳入环境驱动因素。因此，在高风险地区采取有针对性和综合性的干预措施，可能会降低埃塞俄比亚高血压和糖尿病的负担。
