ネパールのクラスターベースの世帯調査
Barclay T Stewart1, Even Wong2, Shailvi Gupta3
1Department of Surgery, University of Washington, Seattle, Washington DC, USA.
Lancet (London, England)
|August 28, 2015
まとめ
ネパール で は 手術 の 必要 が 満たさ れ て い ない
科学分野:
- 世界保健
- 外科 疫学
- 高齢者医療
背景:
- 世界の人口の高齢化により,非伝染性疾患の負担が増加し,特に低所得国や中所得国で増加しています.
- この重荷の大部分は 手術で治療したり緩和したりできます
- ネパールの高齢者の間での手術需要の規模は 計り知れないままです
研究 の 目的:
- ネパールで50歳以上で 手術で治療可能な疾患の有病率を推定する.
- この集団で手術を受けるための障壁を特定する.
- 高齢者のための手術のアクセスを改善するための公衆衛生戦略を伝える.
主な方法:
- 認定された外科医の海外手術必要性評価 (SOSAS) ツールを利用したコミュニティベースの調査が行われました.
- この研究は30世帯のサンプル戦略による2段階のランダム化クラスターを用いた.
- 口頭での知見による同意が得られ,その後,世帯の人口統計の収集,口頭による解剖,および外科的条件の頭から足まで検査が行われました.
主要な成果:
- ネパールでは約125万人の高齢者が 手術で治療可能な状態です
- 最も一般的な症状には,腫れ/腫れ (25%),傷害/骨折,既得変形 (13%),および失禁 (11%) が含まれていた.
- 識字率と医療施設への距離が重要な障害となり,手術で予防可能な死亡率は19%でした.
結論:
- ネパールでは高齢者の間では 手術の必要性が十分に満たされていない.
- 手術サービスへのアクセスを改善するには 識字率や地理的な距離などの障壁を克服する必要があります
- 医療制度の強化は 世界の人口の高齢化による 増大する外科的需要に対応するために 極めて重要です
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