학술논문

Incorporating selected non-communicable diseases into facility-based surveillance systems from a resource-limited setting in Africa
Document Type
article
Source
BMC Public Health. 19(1)
Subject
Health Services and Systems
Health Sciences
Brain Disorders
Prevention
Clinical Research
Health Services
Cardiovascular
Metabolic and endocrine
Respiratory
Good Health and Well Being
Adolescent
Adult
Aged
Child
Child
Preschool
Female
Health Resources
Hospitals
Urban
Humans
Infant
Infant
Newborn
Male
Middle Aged
Mozambique
Noncommunicable Diseases
Population Surveillance
Prospective Studies
Referral and Consultation
Young Adult
Non-communicable diseases
Health information system
Disease surveillance
Public Health and Health Services
Public Health
Epidemiology
Health services and systems
Public health
Language
Abstract
BackgroundAs Mozambique faces a double burden of diseases, with a rise of Non Communicable Diseases (NCD) superimposed to uncontrolled communicable diseases (CD), routine disease surveillance system does not include NCD. The objectives of our study were to i) upgrade of the current surveillance system by adapting the data collection tools to NCD; ii) describe the occurrence and profile of selected NCD using these data collection tools.MethodsWorkshops were implemented in a first referral urban hospital of Mozambique to train clinical staff, administrative workers and nurses on NCD surveillance, as well as select conditions to be prioritized. Based on the WHO Global Action Plan and Brazaville Declaration for NCD prevention and control, we selected arterial hypertension, diabetes, stroke, chronic respiratory diseases, mental illness and cancers. Data collection tools used for CD were changed to include age, gender, outcome and visit type. Between February/2014 and January/2015 we collected data at an urban hospital in Mozambique's capital.ResultsOver 12 months 92,018 new patients were assisted in this hospital. Data was missing or diagnosis was unreadable in 2637 (2.9%) thus only 89,381 were used for analysis; of these 6423 (median age 27 years; 58.4% female) had at least one selected NCD as their primary diagnosis: arterial hypertension (2397;37.31%), mental illness (1497;23.30%), asthma (1495;23.28%), diabetes (628;9.78%), stroke (299;4.66%), chronic obstructive pulmonary disease 61 (0.95%) and cancers 46 (0.72%). Emergency transfers were needed for 76 patients (1.2%), mainly due to hypertensive emergencies (31; 40.8%) and stroke (18;23.7%). Twenty-four patients died at entry points (0.3%); 10 of them had hypertensive emergencies.ConclusionChanges in existing surveillance tools for communicable diseases provided important data on the burden and outcomes of the selected NCD helping to identify priority areas for training and health care improvement. This information can be used to design the local NCD clinics and to strengthen the health information system in resource-limited settings in a progressive and sustainable way.