Cohort monitoring of persons with NCD in UNRWA: A. Seita ([email protected]) 1 Tropical Medicine and InternaBonal Health Volume 17 No 9 PP 11631170 September 2012 1, 2 UNRWA (HQ & Jordan) 3 Tokyo University (Tokyo) 4 InternaBonal Union Against Tuberculosis and Lung Disease (Paris) 5 London School of Hygiene and Tropical Medicine (London) 6 Medicine san FronBers (Luxemburg) 7 World Diabetes FoundaBon (Denmark)
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Cohort monitoring of persons with NCD in UNRWA: A. Seita ([email protected])
1
Tropical Medicine and InternaBonal Health
Volume 17 No 9 PP 1163-‐1170 September 2012
1, 2 UNRWA (HQ & Jordan) 3 Tokyo University (Tokyo) 4 InternaBonal Union Against Tuberculosis and Lung Disease (Paris) 5 London School of Hygiene and Tropical Medicine (London) 6 Medicine san FronBers (Luxemburg) 7 World Diabetes FoundaBon (Denmark)
Care for persons with diabetes (DM) and hypertension (HTN) in UNRWA
• Two decepBvely simple quesBons – ①How many paBents have been diagnosed?
– ②What happens to them?
• Can we answer them? 0
50,000
100,000
150,000
200,000
250,000
2007 2008 2009 2010 2011
No. of Pales/ne refugees with DM / HTN in UNRWA
Others (Lebanon, Syria, Jordan)
Gaza + West Bank 2
Care for persons with diabetes (DM) and hypertension (HTN) in UNRWA
0
50,000
100,000
150,000
200,000
250,000
2007 2008 2009 2010 2011
No. of Pales/ne refugees with DM / HTN in UNRWA
Others (Lebanon, Syria, Jordan)
Gaza + West Bank
à Largely Yes. -‐ But not in full details (>10,000 new paBents a year)
à Largely No. -‐ 10% sample survey (1/yr) -‐ Not in details in compliance “Regularly come/examined?” -‐ Not fully reliable control mix of new & old paBents (>200,000 paBents in total)
3
• Two decepBvely simple quesBons – ①How many paBents have been diagnosed?
– ②What happens to them?
• What should we do?
Cohort monitoring: started in TB • Started with DOTS in 1990s
– Cohort: Group of people treated as a group • Quarterly cohort with two key analysis
4
Pa/ents registered in 2011 Q1
2012 Q1 2011 Q4 2011 Q3 2011 Q2 2011 Q1
Pa/ents registered in 2011 Q2
Pa/ents registered in 2011 Q3
in 2001 Q4 in 2011 Q4
in 2012 Q1
Now
①“How many new pa5ents?” à Count No. of paBents
registered in Jan-‐Mar 2012.
②“What happens to them?” à Assess treatment outcomes
of paBents registered in Jan-‐Mar 2011.
Cohort monitoring: NCD in UNRWA • Nuzha health center (Jordan)
– 55,000 pop. E-‐health from 2009.
• Quarterly cohort with four key analysis
5
Pa/ents registered in 2011 Q1
2012 Q1 2011 Q4 2011 Q3 2011 Q2 2011 Q1
Pa/ents registered in 2011 Q2
Pa/ents registered in 2011 Q3
in 2001 Q4 in 2011 Q4
in 2012 Q1
Now
①“How many new pa5ents?” à Count new paBents à Count all paBents