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东南亚和非洲地区糖尿病和高血压负担日益加重:初级卫生保健环境中预防和控制有效策略的必要性。

The rising burden of diabetes and hypertension in southeast asian and african regions: need for effective strategies for prevention and control in primary health care settings.

作者信息

Mohan Viswanathan, Seedat Yackoob K, Pradeepa Rajendra

机构信息

Madras Diabetes Research Foundation and Dr. Mohan's Diabetes Specialities Centre, WHO Collaborating Centre for Noncommunicable Diseases Prevention and Control, IDF Centre for Education, 4 Conran Smith Road, Gopalapuram, Chennai 600 086, India.

出版信息

Int J Hypertens. 2013;2013:409083. doi: 10.1155/2013/409083. Epub 2013 Mar 14.

Abstract

Aim. To review the available literature on burden of diabetes mellitus (DM) and hypertension (HTN) and its coexistence in Southeast Asian (SEA) and the African (AFR) regions and to suggest strategies to improve DM and HTN prevention and control in primary health care (PHC) in the two regions. Methods. A systematic review of the papers published on DM, HTN, and prevention/control of chronic diseases in SEA and AFR regions between 1980 and December 2012 was included. Results. In the year 2011, SEA region had the second largest number of people with DM (71.4 million), while the AFR region had the smallest number (14.7 million). Screening studies identified high proportions (>50%) of individuals with previously undiagnosed HTN and DM in both of the SEA and AFR regions. Studies from both regions have shown that DM and HTN coexist in type 2 DM ranging from 20.6% in India to 78.4% in Thailand in the SEA region and ranging from 9.7% in Nigeria to 70.4% in Morocco in the AFR region. There is evidence that by lifestyle modification both DM and HTN can be prevented. Conclusion. To meet the twin challenge of DM and HTN in developing countries, PHCs will have to be strengthened with a concerted and multipronged effort to provide promotive, preventive, curative, and rehabilitative services.

摘要

目的。回顾关于东南亚(SEA)和非洲(AFR)地区糖尿病(DM)和高血压(HTN)负担及其共存情况的现有文献,并提出改善这两个地区初级卫生保健(PHC)中DM和HTN预防与控制的策略。方法。纳入对1980年至2012年12月期间在SEA和AFR地区发表的关于DM、HTN及慢性病预防/控制的论文的系统评价。结果。2011年,SEA地区DM患者数量位居世界第二(7140万),而AFR地区患者数量最少(1470万)。筛查研究发现,SEA和AFR地区均有高比例(>50%)的个体患有先前未诊断出的HTN和DM。两个地区的研究均表明,2型糖尿病中DM和HTN共存的情况在SEA地区从印度的20.6%到泰国的78.4%不等,在AFR地区从尼日利亚的9.7%到摩洛哥的70.4%不等。有证据表明,通过改变生活方式,DM和HTN均可得到预防。结论。为应对发展中国家DM和HTN的双重挑战,必须通过协调一致的多方面努力加强初级卫生保健,以提供促进、预防、治疗和康复服务。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a40d/3612479/73ac91072959/IJHT2013-409083.001.jpg

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