Chronic Noncommunicable Diseases in 6 Low-and Middle-Income Countries: Findings From Wave 1 of the World Health Organization's Study on Global Ageing and Adult Health (SAGE)

作者:Arokiasamy, Perianayagam; Uttamacharya; Kowal, Paul; Capistrant, Benjamin D.; Gildner, Theresa E.; Thiele, Elizabeth; Biritwum, Richard B.; Yawson, Alfred E.; Mensah, George; Maximova, Tamara; Wu, Fan; Guo, Yanfei; Zheng, Yang; Kalula, Sebastiana Zimba; Rodriguez, Aaron Salinas; Espinoza, Betty Manrique; Liebert, Melissa A.; Eick, Geeta; Sterner, Kirstin N.; Barrett, Tyler M.; Duedu, Kwabena; Gonzales, Ernest; Ng, Nawi; Negin, Joel; Jiang, Yong; Byles, Julie; Madurai, Savathree Lorna
来源:American Journal of Epidemiology, 2017, 185(6): 414-428.
DOI:10.1093/aje/kww125

摘要

In this paper, we examine patterns of self-reported diagnosis of noncommunicable diseases (NCDs) and prevalences of algorithm/measured test-based, undiagnosed, and untreated NCDs in China, Ghana, India, Mexico, Russia, and South Africa. Nationally representative samples of older adults aged >= 50 years were analyzed from wave 1 of the World Health Organization's Study on Global Ageing and Adult Health (2007-2010; n = 34,149). Analyses focused on 6 conditions: angina, arthritis, asthma, chronic lung disease, depression, and hypertension. Outcomes for these NCDs were: 1) self-reported disease, 2) algorithm/measured test-based disease, 3) undiagnosed disease, and 4) untreated disease. Algorithm/measured test-based prevalence of NCDs was much higher than self-reported prevalence in all 6 countries, indicating underestimation of NCD prevalence in low-and middle-income countries. Undiagnosed prevalence of NCDs was highest for hypertension, ranging from 19.7% (95% confidence interval (CI): 18.1, 21.3) in India to 49.6% (95% CI: 46.2, 53.0) in South Africa. The proportion untreated among all diseases was highest for depression, ranging from 69.5% (95% CI: 57.1, 81.9) in South Africa to 93.2% (95% CI: 90.1, 95.7) in India. Higher levels of education and wealth significantly reduced the odds of an undiagnosed condition and untreated morbidity. A high prevalence of undiagnosed NCDs and an even higher proportion of untreated NCDs highlights the inadequacies in diagnosis and management of NCDs in local health-care systems.