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Mdt sd'kS't qua ban dau ve do hiifng ganh nang benh tat d Vifit Nam, 2006
Bui Ngoc Linh (*), Nguyin Thi Trang Nhung (**), Tran Khanh Long(***), Theo Vos (•**•), Ngo Dffc Anh {*****). Nguyin Thanh Hrf(ftig(***"*)
Sdi trinh bdy ndy gidi thieu mgt sdket qud ban ddu cua nghien ciiu "Do ludng gdnh ridng benh tdt tgi Viet Nam " ve gdnh ndng binh tgt (sii dung chi sd DALYs) cua cdc nhom binh/chdn thuang hdng ddu theo gidi vd tudi. Nghien ciiu sd dung phuang phdp cua nghien cihi do ludng gdnh ndng bfnh tdt loan cdu (GBD - Global Burden of Disease study). Vdi phuang phdp ndy. chi so do ludng gdnh ndng benh tdt (DALYs) duac tinh bdng tdng sdndm sdng mdt di do ni vong sdm (YLLs) vd tdn tdt (YLDs) bdi binh/chdn thuang. Kit qud cho thdy tdng gdnh ndng benh idt cda Viet Nam ndm 2006 Id 15,2 trieu DALYs. trong dd gdnh ndng cua cdc benh khdng truyen nhiem ehie'm hOn 2/3 (68%) tdng gdnh ndng benh tdt. Chdn thuang khdng chu dinh Id nguyen nhdn hdng ddu cua gdnh ndng benh tdt d nam gidi, tiep de'n Id cdc benh ve tim mgch,ung ihu vd cdc benh tdm thdn kinh. Nguyen nhdn hdng ddu cua gdnh ndng benh tdt d nd gidi Id cdc benh ve tim mgch, tiip din Id cdc benh tdm than kinh, ung thu vd chdn thuang khdng chu dinh. Dgt quy Id nguyen nhdn hdng ddu cua gdnh ndng binh tdt d Viet Nam ndm 2006, chiim ty le cao nhdi d cd rmm (10%) vd nd (12%). Tuy con mgt sdhgn chi, nghien cdu cdng dd phdn ndo phdn dnh dugc biic tranh lodn cdnh ve gdnh ndng binh tdt d Viit Nam, gdp phdn cung cap cdc bdng chiing khoa hgc cho viec xdc dinh uu tiin vd xdy dUng chinh sdch y le.
THkhda: Gdnh ndng benh tdi. DALYs. YLLs. YLDs. VietNam.
Preliminary findings on burden of disease and injury in Viet Nam, 2006
Bui Ngoc Linh (*), Nguyen Thi Trang Nhung (*), Tran Khanh Long(*), Theo Vos (**), Ngo Due Anh (**), Nguyen Thanh HuongC)
This repon introduces some preliminary findings from "Vietnam Burden of Disease and Injury Study"
with a focus on the disease burden (DALYs) of major disease categories by age and sex in 2006. The studv applies methods developed for the Global Burden of Disease Study (GBD) in which DALYs for a disease or health condition are calculated as the sum of years oflife lost due to premature mortality (YLL) in the population and the equivalent healthy' years gf life lost due to disability (YLD) for incident cases ofthe health condition. Results shoM- that the total burden of disease (BoD) in Viet Nam in 2006 amounted to 15.2 million DALYs. Non-communicable diseases accounted for more than
4 Tap chi Y t^ Cfing cdng, 7.2011, Sd' 20 (20)
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m o thirds (68%) oftotal disease burden. Among men, unintentional injuries were the leading cause of BoD. followed by cardiovascular diseases, cancer and neuropsychialric conditions. The leading cause of BoD among women was cardiovascular disease, followed by neuropsychiatric conditions, cancer and unintentional injuries. Stroke was the leading cause of DALYs in both sexes (accounting for 10% and 12% ofthe total of burden among men and women, respectively). This is the first time
a national burden of disease study is conducted in Viet Nam. Despite of some limitations, its results have provided an overvicH- on burden of disease and injury in VietNam which can be used as scientific evidence for priority selling and health policy making.
Key words: Burden of Disease and Injury, DALYs, YLLs, YLDs, Viet Nam
Tdc gi£:
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CN. Bili Nggc Linh-Cdn bpBo mon Kinh Ie'Yte-Dai hoc Yt^cSngc^ng- 138 Giang V o - Ba Dinh - Hk Npi, E.maU: [email protected]ThS. NguySn Thi Trang Nbung - Giang vien - Bg mon Dich le - Thong ke - Dai hgc Y te'cdng c^ng.
E.maU- [email protected] vn
CN. Tr^n Khdnh Long - da bg Bp m6n Siic khoe m6i mrSng - Dai hoc Y tf cfing c§ng.
E.mail: [email protected],
TS. Ng6 Dtfc Anh - Di^u phoi dil an VINE tai Vi6t Nam - D?i hpe Queensland - iSc.
E.maU: [email protected],edu.3u.
GS. Theo Vos: Gidm S6c Trung tam Ganh nang b^nh t^l va Danh gii chi phi - lii?u qud - D^i hgc Queensland - Uc. E.maU: [email protected]
I TS. Nguyin Thanh HtftJng - Phd tttfdng Khoa cdc Khoa hgc xS hpi - H^nh vi v^ giio due sffc khoe - TnrClng Dai hoc Y te cong c^ng. E.mail: [email protected]
1. D $ t vg'n d d va m u c tifiu
Vific stf dting nhidu chi sd stfe khde khac nhau gay khd k h i n irong viee so s i n h mtfc dp t r i m trpng ctfa c i c va'n de stfc khde va dffa ra eac quye't dinh v l ebinb s i c h y t e ' d h l u het eae qude gia Iren the gldi. Chinh vi vay. Itfdng hda eac ihdng tin ve sffc ichde, cu the hdn Id ganh nang benh t i l (ttf vong vd tdn lat) efla epng ddng la rft can thifi't ebo qua liinh ltfa chpn ean thifip va xay dffng ehinh s i c h . Chi s d DALYs - DisabiUty Adjusted Life Years ( s o ' n a m sd'ng d i l u chinh theo mtfc dd tan tat) da va dang dffde stf dung rgng r i i d e do Iffdng gdnh nang bfinh tft d n h i l u qude gia. Mgt ddn vi DALY la mdi ndm sdng khde manh mdi di vi ttf vong sdm va t i n tft do mpl bfinh hoae tinh trang stfe k h d e n i o dd. Chi sd DALYs cd l a m quan trpng chien Itfdc trong Hnh vtfe ehinh sdch y id bdi nd eho phep ket hdp e i c thdng tin v l tff Vdng va lan tfl d e phan i n h tinh trang sffc
k h d e eua q u a n the' b a n g mdt ddn vi d o Iffdng duy nhft, nhd dd vific d i n h gid, so s i n h cac vfn de stfc k h d e bay chi phi - hifiu qua efla cdc can thifip y le k b i c nbau trd nfin d e d a n g v i khoa hgc hdn.
O Viet N a m . viec d i n h g i i g i n h ndng bfinh lal stfdung chi s d D A L Y s mdi chi dtfdc tiitfc hifin Ufin quy md ddn l e , c a c thdng tin ehffa dfl tinh dai difin d e cung c f p mgt bffe ti-anh loan c a n h v l g i n h nang bfinh if I mang tinh qud'c gia. Nghifin cffu "Do Iffdng gdnh ndng bfinh if t d Vifit N a m " dtfde thffc hifin vdi m u c dich tinh t o i n g a n h nang v l ttf vong va lan lal ctfa bfinh tat, cha'n ihffdng va e i c ydu t d n g u y cd lai Viet Nam n i m 2 0 0 6 . Nghifin ctfU n i y l i mpl trong ba ca'u p h a n ehinh c d a dff an "Cung c a p c i c bf og chtfng khoa hge v e bfinb l i t va tfl'vong cho qud trinh hoach dinh chinh sach y tfi" d Vifit N a m " (dff i n VINE) trong khudn k h d xay dtfng v i p h i l trien quan b e hdp l i e giffa D a i hgc Queensland - Uc va Bp Y
Tap chi Y te C d n g cdng, 7.2011, Sd 20 (20) 5
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id Vifit Nam, Dtf an dffde thtfc hifin vdi sff cdng tic efla nhieu ddn vi, vien nghifin eu^ vi cic trtfdng dai hoc y - dtfde tren ca ntfde, trong dd Trffdng Dai hoc Y te cfing cdng ch|u trich nhifim thtfc hifin cfu phin
"Do Itfdng ginh ndng bfinh tat d Viet Nam". Trong khufin khd bdi vidt nay, chtfng tdi sfi trinh bay mdt sdket qua ban diu eua can phan nghifin ctfU nay vdi mue tifiu: tfdc tinh ginh nang benh tft (stf dung chi sd DALYs) efla cic nhdm bfinb/chan thtfdng hing dau theo gidi va iudi.
2. Phitdng ph^p nghifin citu
DiJa trfin phtfdng phip cua nghifin ctfU do Iffdng ginh ndng benh tft loan clu (GBD - Global Burden of Disease study) [5]. Phtfdng phip niy cho phdp Itfdng boa tinh trang stfc khde ihdng qua ebi sd DALYs.
DALYs eua mpt finh trang sffc khde (bfinh hay chfn thtfdng) dffde tinh bang tong sdnam sdng mfl di do ttf vong sdm (YLLs - Years of Life Lost due lo premature mortaUty) trong quan the va sfi' nam sdng "khde manh" mft di do tdn tat (YLDs- Years Lost due lo DisabiUty) efla cac Irtfdng hdp mdi mac tinh trang sffc khde dd trong nam do Iffdng:
DALYs = YLLs + YLDs Mffe ehiet khfu 3% eho mdi ndm dffde dp dung ddi vdi sd nim sdng mfi di trong tffdng lai dd ffdc tinh gii tri hifin tai efla nd. Vi du, vdi ty lfi chiet khfu ndy, I nam sd'ng khde manh tai nam thtf 10 trong tffdng lai kd iff Ihdi diem hien tai sfi chi Itfdng dtfdng vdi 0,76 nim sd'ng khde manh hien tai [2].
Khdc vdi GBD, nghien ctfU nay khong sff dung trgng sd'mdi (the hien gia tri khic nbau efla 1 nam sdng khde manh d eie dp tuoi khic nhau) khi tinh DALYs do cdn nhilu Iranh eai xung quanh vifie stf dung trpng sdnay [2,3].
Nghien cffu nay stf dung kdt hdp trpng sd' bfinh lai eua GBD [6] va trgng sd'benh tdt ctfa eae nha nghifin etfu Hi Lan [7]). Trpng sd bfinh tft la chi sd eho phfip Itfdng gii "gii tri" cua Ihdi gian sdng trong cic dieu kifin stfc khde (khdng ttf vong) khde nhau, irong dd "gid tri" ctfa thdi gian sd'ng trong cic dieu kifin stfc khde dtfdc xae dinh dtfa trfin
"mtfc dp tfa thicb" (preference) cua xa hdi ddi vdi cic dieu kien sffc khde. Trgng sd'benh tfl ed gii tri trong khoang tff 0 den I, vdi gia tri 0 tffdng dtfdng vdi Iinh trang hodn lodn khde manh vi I ttfdng
dtfdng vdi finh trang ttf vong.
2.1. Do litimg chisd YLL
Sd nam sdng mft di do ttf vong sdm (YLL) ctfa mdt finh trang sffc khde ndo dd d moi nhdm mdi ctia nam hoae ntf dffde tinh bang tich sd' ctfa sd trffdng hdp ttf vong do tinh trang stfc khde d nhdm tudi dd vd ky vpng sdng chuan (Standard life expectancy) stf dung trong GBD tai tudi tmng binh khi iff vong Irong nhdm tudi dd (Ihffdng dtfdc Ify la tudi giffa cua nhdm ludi), Cdng thffc cd ban de tinh YLL nhff sau:
YLL = N X L
vdi N li sd trtfdng hdp ttf vong va L la ky vpng sdng chuan tai tudi trung binh khi tff vong theo nhdm mdi vd gidi.
Sd Ueu vl ttf vong theo nguyfin nban dtfde tbu thfp thong qua dieu tra nguyen nhan ttf vong, sff dung phtfdng phdp phdng van (Verbal autopsy) [7], dtfde thtfe hifin eung vdi dieu tra bidn ddng dan sd 2007. Tdng sdhd gia dinh dtfdc dilu tra la 384.000, chiem khoang 2% dan sd' va dai difin cho 64 tinh thanh Irfin ca ntfde, Dilu ira bien dfing dan sd'ghi nhfn eac trtfdng hdp tff vong Irong thdi gian 01/04/2006 ddn 31/03/2007 tai hp gia dinh. Vdi mdi trtfdng bdp ttf vong, eac thdng tin vl tuoi, gidi, ngay mft efla ngffdi chet va dia chi efla hd gia dinh dtfde tbu thap de Ihuan tifin cho vific dilu tra xae dinh nguyen nhfn ttf vong bdng phdng vfn. Bd cau hdi pbdng van chuan de dilu tra nguyfin nhan ttf vong efla Td chtfc Y td the gidi (WHO) da dtfdc dieu ehinh eho phfl hdp vdi bdi canh va van hda ctfa Vifit Nam,
2.2. Bo litifng chisd YLD
De do Itfdng so' nam sdng khde manh mat di do tan tat (YLD) efla mdt finh trang stfe khde nao dd, chtfng ta cin xdc dinh sd' trtfdng hdp mdi mac tinh trang stfe khde dd trong ndm do Itfdng. Ddi vdi mdi Irtfdng hdp mdi mac, YLD dtfdc tinh bang tich so ctfa thdi gian mac benh (thdi gian sdng tan tft) trung blnb va trpng sd'benh tat efla tinh trang sffc khde dd.
Cdng thtfc ed ban de linh YLD nhtf sau:
YLD = I X DW X L vdi I la sd trtfdng hdp mdi mac trdng nam do Itfdng, DW la trpng sd bfinh tat va L li thdi gian mac bfinh trung binh (do Itfdng bang nam)
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YLD eung dtfdc tinh eho tffng gidi, theo nhdm ludi \a theo nguyfin nhfn. So lieu mdi mac efla benh/ehfn ihtfdng dtfdc lay ttf he thdng ghi nhan bfinh tft, sd lifiu dinh ky efla cac ehtfdng tnnh y id, cic nghien ctfu dich tl hge hodc tinh loan difa trfin cic chi sd dich tfi khic nhtf ty lfi hifin mac, ty Ifi ttf vong va ty Ifi khdi benh.
2.3. Ddn sd:
Dan sd nam 2006 dffde tfdc Itfdng dtfa trfin sd lifiu dan sdcua dilu tra din sdnim 1999.
2.4. Nhom bfnh
DALYs dtfdc linh cho 3 nhdm bfinh Idn (benh truyin nhilm, bfinh khdng tmyln nhiem va chfn thtfdng) vdi 22 phan nhdm bfinh/chfn thtfdng gdm tdng sd 111 bfinh/chfn ihtfdng theo danh sdch benh vi chfn thtfdng cua GBD.
3. K€'t qua
3.1. Gdnh ngng bfnh tqt (svt dtfng chi sd DALYs) cua 3 nhom bfnh ldn (bfnh truyen nhiim, b^nh khdng truyen nhiem vd chdn thuang)
Nim 2006, tdng ganh nf ng bfinh tft efla Viet Nam la 15.2 trifiu DALYs. trong dd ganh ndng efla eac bfinb khdng tmyen nhiem chidm hdn 2/3 (68%) tong gdnh ndng bfinh tat. Gdnh ndng efla chfn thffdng chidm 17% tdng ginh ndng bfinh tdt efla Vifit Nam nim 2006 (xem Bieu do I).
ndng bfinh tat efla cac benh tmyen nhifim la Itfdng dffdng d ea nam va nff, chiem khoang 15%. Ginh ndng bfinh tft efla chfn thtfdng d nam Idn hdn 2 lan so vdi d nff (Bilu do 2).
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Biiu dS 2. DAL Ys theo gidi vd 3 nhdm bfnh ldn, Vift Nam 2006
3.2. Gdnh ngng bfnh tdt (sii dung chi sd DALYs) cua 20phdn nhdm bfnh/chdh thttffng hang ddu theo gidi vd tuoi Cac benh vl tim mach Id nguyen nhfn hing dau ctfa ganh nf ng benh tat d Viet Nam nam 2006, ehiem 17% tdng sd DALYs. Chfn ihtfdng kbdng ehu dinh xdp ihtf 2 vi cic bfinh tam thin kinh xdp Ihtf 3 trong cic nguyfin nhfn hang diu cua gdnh nfng bfinh tft, chiem 15% va 14% tdng sdDALYs (Bieu dd 3).
Bieu do 1. DALYs theo 3 nhdm bfnh ldn, Vift Nam 2006
Tdng DALYs d nam gidi li 8,2 trieu va 6 nff gidl la 6,9 Irifiu. Cac bfinh khdng tmyen nhilm la nguyfin nhfn chinh eua gdnh nang bfinb tft d ea nam (63%) vi nfl (73%). Ty ttpng trong tdng ginh
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Bieu do 3. DALYs cHa 10 phdn nhdm b^nh/chdn thuang kdng ddu, Vi^t Nam 2006 Ganh nfng efla iff vong chidm tJ trpng ldn hdn gdnh nang vl tfn tat d ca 2 gidi. Tuy nhien neu so sdnh giffa hai gidi tfai ty trpng cua gdnh nfng vl ttf vong d nam gidi cao hdn so vdi d nff gidi (Bidu do 4),
Tap chi Yt^ Cfing cdng, 7.2011, Sd 20 (20) 7
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Bieu dd 4. Ty trgng cda YLL vd YLD trong long gdnh ndng b§nh tgt theo gidi
Chfn thtfdng khdng chu dinh la nguyen nhan hdng diu efla gdnh ndng benh tft d nam gidi, chidm 20% tdng sd DALYs. Cae bfinh ve tim mach gfy ra 16% efla tdng ganh nfng bfinh Ifl d nam. Ung thff vi cac bfinh lam than kinh cung chidm ty trgng ldn trong long ginh ndng bfinh lit d nam gidi (Bidu dd 5),
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Bieu do 5. DALYs cua 10 phdn nhdm bfnh/cha'n thuang hdng ddu d nam gidi, Vift Nam 2006
Biiu dd 6. DALYs cua 10 phdn nhom b$nh/chdn tkiAfng hdng ddu d nSgidi, Vift Nam 2006
tfl d nam gidi chfl ydu do eac bfinh ve tim mach va ung thtf. Mpt diem ding chtf ^ la eie bfinh tfm thin kinh chifi'm ty irpng khi Idn trong tdng gdnh ndng bfinh tft d nam gidi dd tuoi 15 dfi'n 49 (Bieu dd 7).
Bieu do 7. DALYs cua 10 phdn nhom bfnh/chdn thuang hdng ddu d nam theo tudi, Vi^t Nam 2006
Nguyfin nhan hang dau ctfa ginh ndng bfinb tft d nff gidi la edc bfinb vl lim mach. lie'p den li cic bfinb tam than kinh, ung thtf va cha'n thtfdng khdng chtf dinh. 4 nhdm nguyfin nhfn oay chidm 2/3 tdng sdDALYs d nff. Trong khi chfn Ihffdng ed chu dinh vd cdc bfinh vl tieu hda la 2 Irong cae nguyen nhdn cliinh efla ginh nang bfinh tft d nam gidi thi d nff gidi la cic benh vl cd xffdng va bfinh ddi thio dffdng (Bieu do 6).
Chfn Ihffdng khdng chfl dinh, cae benh nhifim khuan va ky sinh trtfng nim irong danh sach eac nguyfin nban ehinh efla ganh nang b^nh tat d nam gidi drfdi 30 tudi. Tff 30 tudi ird len. ginh ning bfinh
Md hinh ganh nfng benh tfl efla 10 phfn nhdm benh/ehfn thtfdng hdng dau tbeo tudi khae nhau giffa nam va nff. O Ire em gii, nhifim khuan hd hap, cac bfinh nhifim khuan va ky sinh trung vi ung thff la cdc nguyfin nban ehinb eua ganh nang benh tdt.
O do tudi 15 de'n 45 thi ung thff va eic benh tam thin kinh chidm ty trgng ldn trong tdng ginh ndng benh lit d nff, Ginh ndng benh if t d nfl gidi tudi Iff 45 ddn 70 chu yfi'u do cdc bfinh if m than kinh va cie bfinh dffdng hd bfp. Cac benh vl iim mach ciing chifi'm ty trgng Idn trong ldng ganh nang bfinh tft d nff gidi mdi 45-70 va trd thanh nguyen nhdn hang dau cua ganh nang bfinh tft d ntf gidi Irfin 70 mdi (Bieu dd 8).
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Bieu do 8. DALYs cda 10 phdn nhom bfnh/chdn thuang hdng ddu dnH Iheo tudi, ViftNam 2006
3.3. Gdnh ngng bfnh tgt (si? dung chi sd DALYs) cua 10 nguyen nhdn (binh/chdn thuang cu the) hang dau theo gidi Dot quy la nguyfin nhfn dtfng bang dau gay ra DALYs d ci bai gidi (chiem 10% long DALYs d nam vi 12% tdng DALYs d nfl). Tai nan giao didng la nguyfin nhfn dtfng hing tiiff 2 d nam gidi vdi 9%
tdng ganh ning bfinb tfl vf la nguyfin nhfn dtfng hang thtf 4 d nff gidi vdi 4% tdng ginh nang bfinh tft. Dtf^g hdng thtf 3 trong cac nguyfin nhdn ctfa DALYs d ca nam va nff la benh phdi phe quan tac nghfin man tinh (COPD). Trong khi ung tiitf gan, HIV/AIDS, dudi ntfde, lao va ung thtf phdi Id eae nguyen nban chinh ctfa gdnh nfng bfinb tat d nam gidi Ihi d nff gidi eac nguyfin nbin chinh lai la tram cam. mft tri nhd. mat Ihi Itfc. benh xtfdng khdp man tinh va dii thao dtfdng (Bang 1).
Bdng 1. DALYs cua 10 nguyin nhan hdng ddu theo gidi
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4. Ban luan
Nam 2006, ganh nang efla eic benh khfing tmyen nhifim chiem hdn 2/3 ldng ganh nang bfinh tft ctfa Viet Nam. Dieu nay mpl Ian nffa eho tiiay ein tang ctfdng cac chi'nh sdch cung nhtf cic can tiiiep nang cao stfc khde nhim phdng ngffa va ehffa tri edc bfinh khdng tmyen nhifim d Viet Nam.
Chfn tiitfdng khdng chfl dinh la nguyfin nhin hing dau efla ginh nang bfinh tft d nam gidi trong ndm 2006, tiep den Ui cie bfinh ve tim maeh, ung thtf vd cic bfinh tam than kinh. Nguyfin nhfn hdng dau efla ginh ning benh tft 3 nff gidi la cic bfinh
\ e tim maeh, tifi'p den la eic benh tam than kmh, ung thff vd chfn tiitfdng khdng chfl dinh. Gdnh ning benh lal d nam gidi dtfdi 30 mdi chu yeu do chfn Ihtfdng khdng chu dinh vi cdc bfinh nhifim khuan va ky sinh trung. Tuf 30 moi trd len, cae bfinh ve lim maeh va ung thtf la eic benh ehinh gay ra ginh ndng benh tft d nam gidi. d nfl gidi, ganh oang bfinh tfl d do mdi 15 ddn 44 chfl yen do ung thff va eae benh tfm than kinh. Cic bfinh tim mach, cic bfinh tfm than kinh vi cdc bfinh dffdng ho hfp la nguyfin nhan chinh efla ginh ning bfinb lit d nfl gidi mdi tiJ 45 den 69 trong khi nguyfin nhin hang diu efla gdnh nang bfinb tft d nff gidi Irfin 70 mdi la cdc bfinh vl tim maeh.
Neu xet tbeo eic bfinh/chfn thtfdng cu the Ih) dot quy la nguyfin nhan hang diu dan ddn ganh nang bfinh tat d ca nam gidi va nfl gidi Vifit Nam trong nam 2006. Khae vdi ket qua vl ginh ndng bfinh tft cua Thai Lan nam 1999 [8] va Malaysia nam 2004 [1], nguyfin nhan hang dau cua DALYs d ca 2 gidi l i HIV/AIDS d Thii Lan vd bfinh thidu mdu ed tim d Malaysia. Tai nan giao thdng diu Id nguyfin nban dffng hdng thff 2 giy ra ganh ning benh tat d nam gidi Viet Nam va Thdi Lan va la nguyen nhan dtfng bang thtf 3 ctfa ganh nang bfinh tft d nam gidi Malaysia, Mpl dilu ding Itfu $ la trong khi dot quy la nguyen nhfn dtfng thtf 2 trong danh sach eic nguyfin nhfn hang diu efla DALYs d nff gidi Thai Lan va Malaysia thi d Viet Nam la benh tram cam. Ket qua ndy cung vdi vific eic bfinh tam than kinh nim trong 4 phin nhdm benh/ehan thtfdng hang dau gay ra ginh ndng benh If l d ea 2 gidi btfdc dau gdi S tdi vific ein quan tfm vd dau nf hdn nffa eho van de stfe khde tfm than d Viet Nam.
Dfy Id Iln diu tifin mdt nghifin cd\i vl gdnh nang bfinh tat qudc gia dffde Ihffc bifin d Vi^t Nam.
Tap chi Yt^ Cdng cfing, 7.2011, Sd 20 (20) 9
ITiHGIIUAN&NGHllNCBUI
Bfio e a n h nhffng b a n c h d v l phffdng p h i p tinh t o i n g a n h n a n g bfinh tft sfl'dung ehi s d D A L Y s dang edn nhifiu tranh c i i , e h f t Itfdng efla sd' Ufiu cung la mpt h a n chfi'cua nghifin ctfii nay. Tffdng Iff nhff c i c nffdc d a n g p h i t trien k h a c , s d Ufiu Ihtf ci'p v e b e n h tft va chan thtfdng ctfa V i e t N a m cdn chffa day dfl, loan difin, ihdng nhi't, nhieu ngudn so' Ufiu ed dp tin cfy chtfa eao. Vi vfy kbi khdng cd dtf dff lifiu, n h d m nghifin ctfu p h a i d u n g c a e gia dinh dtfa trfin s d U e u efla e i e qudc gia k h a c d e tinh t o i n D A L Y s cua mpt sd van d l sffc k h d e eho Vifit N a m . Tuy v i n edn mdt s d ban e h e , ket q u a efla nghifin ctfu da p h i n ndo p h a n i n h dtfdc btfc tranh loan canh v l c i c n g u y e n nhfn chinh g i y ra g a n h n f n g bfinh tft d Viet N a m , gdp p h i n cung c f p e a c bang ehffng khoa hge ebo vifie xde dinh tfu tifin v i dinh htfdng ehinh sach y id, C i c kfi't qua cua n g h i e n etfn ed thd dtfdc stf dung cbo c i e nghifin ctfu tidp theo n h a m phfn tich chi phi -
hieu qua ctfa c i c can thifip y te phuc vu cbo vific lap k e hoach v i x a y dtfng chinh sdeh. C i c mfi hinb tinh l o i n efla n g h i e n ctfli d a n g tifi'p luc dtfdc a p dung dd d o Itfdng g i n h n i n g bfinh t i t cho n a m 2008 vdi cdc sd Ufiu cdp n h f t hdn v e bfinh tf t vd ttf vong ctfa Vifit N a m v i bdo e a o se dtfdc cdng b d v i o d i u n a m 2 0 1 1 .
L d i c a m d n :
Nhdm nghifin cuU trtfdng Dai hpe Y t d c d n g cdng xin chfn Ihdnh c a m dn Bd Y id. Trtfdng Dai hpe Queensland - U e , td chtfc Atiantic Philanthropies - M y va Trtfdng Dai hpe Y tfi' Cdng edng da bd trd chtfng Idi ve ky thuft v i ngudn Itfc. Chtfng tdi cung xin cam dn cac mrdng dai hgc y - dtfde, c i c bfinh vifin, e i c vifin nghifin ctfM v i edc ciic, vu eua Bd Y l e d a tao d i l u kifin thuan Idi vd eung c f p sfi'Iifiu cho n h d m tiitfc hifin nghien cffu nay.
T i i li^u tham khao
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Division of Burden of Disease, Institute for Public Health, Ministry of Health, Malaysia,
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3, Barendregt J, J.„ Bonoeux L, Van der Maas PJ (1996).
DALYs: the age-weights on balance. Bulletin of the World Healtii Organization. 74-439-43.
4. Mathers CD VT, Lopez AD, Salomon J, Ezzati M (ed.) (2001). National Burden of Disease Studies: A Practical Guide. Edition 2 ed. Geneva: World Health Organization.
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A Compendium of Incidence , Prevalence and Mortality Estimates for Over 200 Conditions. Cambrigde: Havard Unuversity Press.
6. Munray CJL, Lopez (1996); A.D, The Global Burden of Disease World Health Organiation.
7. Stouihard ME. Essink-Bol M-L, Bonsel GJ, Barendregt JJ, Kramer PGN. Water HPAvd, et al (1997), Disabihty weights for diseases in The Netherlands. In: Department of Health, editor. Rotterdam: Erasmus University Rotterdam 8. The Thai working group on burden of disease and injury (2002). Burden of Disease and Injury in Thailan: Bureau of Health Policy and Planning.
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Geneva.
10 T a p chi Y tfi' Cfing cdng, 7.2011, Sd 20 (20)
