南アフリカにおける非伝染性疾患の負担
Bongani M Mayosi1, Alan J Flisher, Umesh G Lalloo
1Department of Medicine, Groote Schuur Hospital and University of Cape Town, Cape Town, South Africa. bongani.mayosi@uct.ac.za
Lancet (London, England)
|August 28, 2009
まとめ
南アフリカは,非伝染性疾患 (NCD) の増加により,医療の負担が大きくなり,病重が4倍に増加しています. これに対処するには,初等医療の強化と慢性疾患とHIV/エイズに対するサービスの統合が必要です.
科学分野:
- 公衆衛生は公衆衛生である.
- エピデミオロジー エピデミオロジー
- 医療システム研究 医療システム研究
背景:
- 南アフリカは,民主化後15年,健康面での大きな変化を経験しています.
- 病気の4倍の負担 (伝染性,非伝染性,生前/産後,傷害) が,この移行を特徴としています.
- 非伝染性疾患 (NCD) は,都市部と農村部の両方でますます蔓延しており,特に貧しい都市部の人々に影響を及ぼしています.
研究 の 目的:
- 南アフリカにおける病重の4倍化という,増大する課題を強調するためです.
- NCDによる医療サービスに対する圧力の増大を強調する.
- HIV/AIDSとNCDの共同負担を管理するための包括的な国家対応を呼びかけること.
主な方法:
- 人口の変化と,HIV/AIDSが平均寿命に与える影響の分析.
- 抗レトロウイルス治療の導入による疾病負担の予測増加の評価.
- 病気の初次および二次予防のための必要な介入のレビュー.
主要な成果:
- 人口の高齢化を含む人口動態の変化は,NCDの増加に寄与しています.
- HIV/AIDSの死亡率を低減する抗レトロウイルス治療の有効性は,NCDの負担を増やすことが期待されています.
- 既存の医療制度は,伝染性疾患と非伝染性疾患の両方からの圧力の増大に直面しています.
結論:
- 南アフリカの保健システムは,複雑で増大する病気の負担に適応しなければなりません.
- 地域ベースの初等保健医療の強化は,統合的な慢性疾患管理に不可欠です.
- 感染症および非伝染病の統合ケアのための卓越センターを設立するために,全国的なイニシアチブが必要である.
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