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越南的贫血负担和病因:来自全球疾病负担数据的见解。

Burden and causes of anemia in Vietnam: insights from the global burden of disease data.

机构信息

Department of Economics and Finance, The Business School, RMIT University Vietnam, Ho Chi Minh, 700000, Vietnam.

Asian Development Bank Institute (ADBI), Tokyo, 100-6008, Japan.

出版信息

BMC Public Health. 2024 Oct 31;24(1):3026. doi: 10.1186/s12889-024-20497-7.

Abstract

BACKGROUND

Anemia is a significant global health issue, impacting 1.92 billion people and ranking as a leading cause of disability. It is marked by low hemoglobin levels, which hinder oxygen delivery to vital organs and result from causes such as nutritional deficiencies and chronic diseases. Despite some progress, anemia remains a major concern in Southeast Asia, including Vietnam. Although the country has reduced its anemia rates, the progress is insufficient to achieve the WHO's 2030 targets for anemia reduction among women of reproductive age. This study explores anemia trends and socio-economic determinants in Vietnam, with a focus on age and gender differences, to inform targeted interventions and policy development.

METHODS

This study used the Global Burden of Diseases, Injuries, and Risk Factors (GBD) dataset to explore the burden of anemia and its causes in Vietnam from 1990 to 2021. The GBD study provides data on anemia prevalence and years lived with disability (YLD) by age, sex, and 37 causes across 204 countries and territories. Further, this study employed a regression model to examine how the anemia burden (i.e., prevalence rate and YLD rate) relates to socio-economic factors such as the Human Development Index (HDI), gender disparities in human development achievement, and gender-based inequalities in reproductive health, empowerment, and economic status in Vietnam over this period.

RESULTS

In 1990, there were 16.30 million anemia cases in Vietnam, decreasing slightly to 16.05 million by 2021. Male prevalence dropped from 34.90 to 26.58%, while female prevalence increased from 65.10 to 73.42%. Iron deficiency was the main cause, affecting 68.35% of cases in 1990 and 68.84% in 2021, with 24.96% in males and 75.04% in females in 2021. While anemia has decreased among infants, young children, and adolescents due to improved healthcare, it has increased among middle-aged and older adults, especially females. Regression analysis shows that higher human development and gender equality reduce anemia prevalence and disability, whereas gender inequality worsens the issue.

CONCLUSIONS

The study underscores that anemia remains a major health concern in Vietnam, marked by significant gender and age disparities. Despite a decrease in overall anemia rates and the effectiveness of specific interventions like iron-folic acid supplementation, females, particularly those of reproductive age and older adults, continue to face higher rates. Socio-economic improvements, including higher income and better human development, are linked to lower anemia rates, though the impact differs by gender. The persistent gender disparity and the shift in burden to older adults highlight the need for more comprehensive, gender-sensitive interventions. Future efforts should integrate nutritional support with broader socio-economic enhancements to effectively address anemia and improve public health in Vietnam.

摘要

背景

贫血是一个重大的全球健康问题,影响着 19.2 亿人,是导致残疾的主要原因之一。它的特点是血红蛋白水平低,这会阻碍氧气输送到重要器官,其原因包括营养缺乏和慢性疾病等。尽管取得了一些进展,但贫血仍然是东南亚(包括越南)的一个主要问题。尽管该国已经降低了贫血率,但进展不足以实现世界卫生组织(WHO)到 2030 年降低育龄妇女贫血率的目标。本研究旨在探讨越南的贫血趋势和社会经济决定因素,重点关注年龄和性别差异,以为有针对性的干预措施和政策制定提供信息。

方法

本研究使用全球疾病、伤害和风险因素研究(GBD)数据集,探讨了 1990 年至 2021 年期间越南的贫血负担及其原因。GBD 研究提供了 204 个国家和地区的年龄、性别和 37 个病因的贫血流行率和残疾生活年(YLD)数据。此外,本研究还采用回归模型,探讨了贫血负担(即流行率和 YLD 率)与社会经济因素之间的关系,这些因素包括人类发展指数(HDI)、人类发展成就方面的性别差距以及越南在这一时期在生殖健康、赋权和经济地位方面的性别不平等。

结果

1990 年,越南有 1630 万例贫血病例,到 2021 年略有减少至 1605 万例。男性的患病率从 34.90%下降到 26.58%,而女性的患病率从 65.10%上升到 73.42%。缺铁是主要原因,1990 年影响了 68.35%的病例,2021 年影响了 68.84%,其中男性占 24.96%,女性占 75.04%。虽然由于医疗保健的改善,婴儿、幼儿和青少年的贫血症有所减少,但中年和老年成年人的贫血症有所增加,尤其是女性。回归分析表明,较高的人类发展和性别平等会降低贫血的流行率和残疾程度,而性别不平等则会使问题恶化。

结论

本研究强调,贫血仍然是越南的一个主要健康问题,其特点是存在显著的性别和年龄差异。尽管总体贫血率有所下降,而且铁叶酸补充等特定干预措施有效,但女性,尤其是育龄和老年女性,贫血率仍然较高。社会经济的改善,包括收入的提高和人类发展的提高,与较低的贫血率有关,但性别差异会影响这种关系。持续存在的性别差距以及负担向老年人转移,突显了需要采取更全面、对性别敏感的干预措施。未来的努力应将营养支持与更广泛的社会经济增强结合起来,以有效解决贫血问题,改善越南的公共卫生状况。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7fb5/11529559/710675b1227d/12889_2024_20497_Fig1_HTML.jpg

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