对慢性病认识的社会人口差异:对南非东北部农村老年人的观察研究

Daniel Ohene-Kwofie, Carlos Riumallo-Herl, C. Kabudula, F. Gómez-Olivé
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摘要

慢性病在老年人口中的发病率很高。对这些疾病的认识是开始治疗、控制和预防进一步并发症的重要前提。本研究评估了南非农村地区 40 岁及以上人群对慢性病认识的社会人口差异:我们对南非 INDEPTH 社区健康与老龄化纵向研究的基线调查数据进行了分析,以估计 40 岁及以上人群对艾滋病毒、高血压、糖尿病和血脂异常等慢性病的认识水平。我们将自我报告的认知度与客观测量结果进行了比较,并进行了逻辑回归,以评估慢性病认知度的社会人口决定因素。我们发现,80% 的人至少患有一种慢性病--艾滋病毒、糖尿病、高血压和/或血脂异常。在至少患有一种慢性病的人群中,对慢性病的认知率相对较高,但不同病症和性别的认知率有所不同:艾滋病毒(女性为 83%,男性为 84%)、高血压(女性为 88%,男性为 81%)、糖尿病(女性为 76%,男性为 75%)、血脂异常(女性和男性均为 10%)。我们观察到个人、家庭和社区因素之间的差异。一般来说,女性更了解自己的病情;随着年龄的增长,对病情的了解程度也在增加,但艾滋病毒除外;来自人均消费高的家庭、与一人或多人生活在一起以及居住地离医疗机构较近的人更有可能了解自己的病情。然而,仍有一部分人不了解自己的病情,因此缺乏必要的信息来启动治疗和实施行为改变以控制病情。我们的研究结果可以指导政策制定者按社会人口/社会经济亚群体开展有针对性的宣传活动。
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Sociodemographic disparities in awareness of chronic conditions: an observational study among older persons in rural north-east of South Africa
The prevalence of chronic diseases is high among the older population. Awareness of these conditions is a crucial prerequisite to initiate treatment, control and prevent further complications. This study evaluates sociodemographic disparities in awareness of chronic diseases among people 40 years and over in rural South Africa.Data from the baseline survey of the Health and Aging in Africa: A Longitudinal Study of an INDEPTH Community in South Africa were analysed to estimate the level of awareness of chronic conditions such as HIV, hypertension, diabetes and dyslipidaemia among the population 40+ years. We compare self-reported awareness with objective measurements and conduct logistic regressions to evaluate sociodemographic determinants of awareness of chronic conditions.We find that 80% of individuals have at least one chronic condition—HIV, diabetes, hypertension and/or dyslipidaemia. Awareness rates were relatively high among those with at least one chronic condition but varied across conditions and genders: HIV (83% for women, 84% for men), hypertension (88% of women, 81% of men); diabetes (76% for women, 75% for men); dyslipidaemia (10% for both women and men). We observe differences across individual, household and community factors. Generally, women are more aware of their condition; awareness increases with age except for HIV; persons from high consumption per capita households, living with one or more persons and living closer to a health facility are more likely to be aware of their conditions.Older adults in rural South Africa are generally aware of their chronic conditions, though there are important differences by age, gender and socioeconomic status. However, there is still a fraction unaware of their conditions and, therefore, lacking the necessary information to initiate treatment and implement behavioural changes to control them. Our findings may guide policy-makers directing the required efforts to promote targeted awareness campaigns by sociodemographic/socioeconomic subgroups.
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