Resumé
Background: Due to rapid socio-economic transition and demographic aging, the number of older persons living with chronic diseases is set to increase in low and middle income countries (LMICs). The identification of conditions that may be associated with greater disability burden may help in the prioritization of health policies and allocation of limited resources. However, existing information about the contributions of chronic diseases to disability in older persons living in many LMICs is based on projections from studies conducted in mostly higher income countries. The present systematic review aims to determine the relative contribution of chronic diseases to directly-measured disability in older persons living in LMICs.
Methods: The present systematic review used a simple methodology to estimate the proportions of community-dwelling older persons with a specific chronic disease-disability among all persons with the relevant disease who were participants in studies drawn across LMICs wherein disability was directly measured, rather than implied. Records in the African Journals Online, Medline, EMBASE, PsychINFO, and the Cumulative Index to Nursing and Allied health Literature were searched for relevant citations, and the Pubmed for in-process articles.
Results: Seven cross-sectional surveys including a total of 42,581 community-dwelling older persons met criteria for syntheses. None of the identified studies was based on samples derived from countries in subSaharan Africa. Observations are made suggesting that implicit data derived from a global pool of studies may have the potential to mask the true state of the experience of older persons living with chronic diseases in countries with lower research mileages.
Conclusion: Recommendations are made for future designs of studies investigating the impact of chronic diseases on directly-measured disability in LMICs, especially those in sub-Saharan Africa.
Keywords: Global burden of disease; Population attributable prevalence fractions; Disability adjusted life years; Developing countries
Résumé
Contexte: En raison de la transition socioéconomique rapide et du vieillissement démographique, le nombre de personnes âgées vivant avec des maladies chroniques devrait augmenter dans les pays à revenu faible ou intermédiaire (PRFI). L’identification des conditions qui peuvent être associées à une plus grande charge d’infirmité peut aider à établir des priorités dans les politiques de santé et à allouer des ressources limitées. Cependant, les informations existantes sur les contributions des maladies chroniques aux handicaps chez les personnes âgées vivant dans de nombreux pays à revenu faible sont basées sur des projections d’études menées dans des pays à revenu plus élevé. La présente étude systématique vise à déterminer la contribution relative des maladies chroniques au handicap mesuré directement chez les personnes âgées vivant dans des pays à faible revenu.
Méthodes: La présente revue systématique a utilisé une méthodologie simple pour estimer les proportions de personnes âgées vivant dans la communauté atteintes d’une maladie-handicap chronique spécifique parmi toutes les personnes atteintes de la maladie concernée qui ont participé aux études menées dans les pays à faible revenu où l’incapacité était mesurée directement plutôt que implicite. Les registres des Revues Africaines en Ligne, Medline, EMBASE, PsychINFO et l’Index Cumulatif de la Littérature sur les soins Infirmiers et connexes ont été recherché pour des citations pertinentes et le Pubmed pour les articles en cours.
Résultats: Sept sondages transversaux, dont un total de 42.581 personnes âgées vivant en communauté, ont satisfait aux critères de synthèse. Aucune des études identifiées n’a été basée sur des échantillons provenant de pays d’Afrique subsaharienne. Des observations font ressortir que les données implicites tirées d’une série d’études mondiales risquent de masquer l’état réel de l’expérience des personnes âgées vivant avec des maladies chroniques dans les pays à moindres cadences de recherche.
Conclusion: Des recommandations sont formulées pour la conception future d’études sur l’impact des maladies chroniques sur la déficience mesurée directement dans les pays à faible revenu, en particulier en Afrique subsaharienne.
Mots-clés: Charge mondiale de maladie; Fractions de prévalence attribuables à la population; Années de vie ajustées d’handicap; Pays en voie de développement
Correspondence: Dr. Akin Ojagbemi, Department of Psychiatry, College of Medicine, University of Ibadan, Ibadan Nigeria. E-mail: akin.ojagbemi@kelalumni.net.
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