関連する実験動画
バングラデシュの重症肺炎を患っている子供たちのための第一レベルの施設でのケア:コホート研究
Enayet K Chowdhury1, Shams El Arifeen, Muntasirur Rahman
1International Centre for Diarrhoeal Disease Research, Bangladesh (ICDDR,B) Dhaka, Bangladesh.
Lancet (London, England)
|August 22, 2008
まとめ
重度の肺炎に対する修正ガイドライン 安全な治療と効果的な治療を現地で行い,バングラデシュの農村部でケアへのアクセスと治療結果を改善しました. このアプローチは,正しい管理率を高め,病院への紹介を減らしました.
科学分野:
- 小児科は小児科です.
- 公衆衛生は公衆衛生である.
- 感染症 感染症は感染症です.
背景:
- 子どもの病気の統合管理 (IMCI) のガイドラインは,重度の肺炎の場合は病院への紹介を推奨しています.
- 低水準の入院率は,推薦による介護の効果を制限する.
- 修正されたガイドラインは,第一レベルの施設での局所的治療を可能にすることを目的としています.
研究 の 目的:
- 重度の肺炎に対するIMCIガイドラインの安全性と有効性を評価する.
- 地方の管理とバングラデシュの田舎の病院への紹介を評価する.
- 介護へのアクセスと幼児死亡率への影響を決定する.
主な方法:
- バングラデシュの10の田舎の保健施設での観察コホート研究.
- ガイドラインの修正前 (n=261) と後 (n=1271) の重症肺炎を患った子供の比較.
- 施設記録と家庭訪問から収集されたデータ,結果を含む.
主要な成果:
- 重度の肺炎の病院紹介は94%から8%に減少した (p<0.0001).
- 正確な管理は36%から90% (p<0.0001) に増加した.
- 症例死亡率は有意な違いを示さなかった (1.1%対0.6%,p=0.39).
結論:
- IMCIのガイドラインの局所的な適応は,重度の肺炎では安全で有効です.
- 実施に成功するためには,トレーニングと監督が不可欠です.
- このアプローチは,病院への紹介の障壁を克服し,介護の提供を改善します.
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