Malik Muhammad Ashar, Batool Rahat, Ahmed Muhammad, Abbasi Imran Naeem, Fatmi Zafar Ahmed, Saleem Sarah, Siddiqui Sameen
Department of Community Health Sciences, Aga Khan University, Karachi, Pakistan.
Faculty of Arts and Sciences, Aga Khan University, Karachi, Pakistan.
PLoS One. 2025 Jan 31;20(1):e0293790. doi: 10.1371/journal.pone.0293790. eCollection 2025.
Self-reported illnesses (SRI) surveys are widely used as a low-cost substitute for weak Disease Surveillance Systems in low- and low-middle-income countries. In this paper, we report findings of a district-level disease prevalence survey of all types of illnesses including chronic, infectious, injuries and accidents, and maternal and child health in a rural district in Pakistan.
A district-level survey was conducted in Thatta in 2019 with a population-representative sample of all ages (n = 7811) a. Survey included questions on demographics and SRIs from the respondents. Prevalence was estimated for all SRIs categorized into six major and 16 minor illnesses. The influence of important socio-demographic covariates on the illnesses and multiple comorbidities was explored by estimating prevalence ratios with a Generalized Linear Model of the Poisson family and by Zero-Inflated Poison Distribution respectively.
36.57% of the respondents to the survey reported at least one SRI. Prevalence of communicable illnesses was 20.7%, followed by non-communicable illnesses (4.8%), Gastrointestinal disorders (4.4%), and injuries/disabilities (1.9%). Urban inhabitants were more likely to have Chronic Obstructive Pulmonary Disorders (3.34%) and Diabetes (1.62%). Females were most likely to have injuries (1.20,), disabilities (1.59), and Musculoskeletal Disorders (1.25). Children aged < 1 year (0.80) and elderly >65 years (0.78) were more likely to have comorbidities.
Our estimated prevalence of SRI is quite higher than the prevalence of unknown SRIs in national-level surveys in Pakistan. This research's findings serve as an example of aiding evidence-based priority settings within the health sector. Our findings on gender, and young and old age as positive predictors of SRI are consistent with similar surveys in a few LMICs.
We provide evidence of a complete disease profile of a district that is otherwise unavailable in the country. This study can reshape the existing health surveys and to aid evidence-based priority settings in the health sector. We, however, support strengthening the Disease Surveillance System as a reliable source of disease prevalence data.
自我报告疾病（SRI）调查在低收入和中低收入国家被广泛用作低成本的手段，以替代薄弱的疾病监测系统。在本文中，我们报告了巴基斯坦一个农村地区针对包括慢性疾病、传染病、伤害与事故以及母婴健康在内的各类疾病进行的县级疾病患病率调查结果。
2019年在塔塔进行了一项县级调查，样本具有各年龄段的人口代表性（n = 7811）。调查包括向受访者询问人口统计学和自我报告疾病方面的问题。对所有自我报告疾病进行了患病率估计，这些疾病被分为六大类和16种小类疾病。通过使用泊松族广义线性模型估计患病率比以及分别使用零膨胀泊松分布，探讨了重要的社会人口统计学协变量对疾病和多种合并症的影响。
调查的受访者中有36.57%报告至少患有一种自我报告疾病。传染病的患病率为20.7%，其次是非传染病（4.8%）、胃肠道疾病（4.4%）以及伤害/残疾（1.9%）。城市居民更易患慢性阻塞性肺疾病（3.34%）和糖尿病（1.62%）。女性最易出现伤害（1.20）、残疾（1.59）以及肌肉骨骼疾病（1.25）。1岁以下儿童（0.80）和65岁以上老年人（0.78）更易患有合并症。
我们估计的自我报告疾病患病率远高于巴基斯坦国家级调查中未知自我报告疾病的患病率。本研究结果为卫生部门基于证据的优先事项设定提供了一个实例。我们关于性别以及年龄在自我报告疾病方面作为积极预测因素的研究结果与一些中低收入国家的类似调查一致。
我们提供了一个地区完整疾病概况的证据，而该国其他地方无法获取这些信息。本研究可以重塑现有的健康调查，并有助于卫生部门基于证据的优先事项设定。然而，我们支持加强疾病监测系统，使其成为疾病患病率数据的可靠来源。
