ネパールにおける糖尿病性網膜症のケアとサービス利用の障壁
Raba Thapa1, Sanjita Sharma2, Sunil Thakali2
1Tilganga Institute of Ophthalmology, Kathmandu, Nepal. rabathapa@live.com.
BMC ophthalmology
|September 1, 2025
まとめ
ネパールでは糖尿病性網膜症 (DR) の治療への従順性が低く,患者の半数未満が治療を受けています. 意識の欠如とコストが大きな障壁であり, 盲目症を予防するために地域社会への支援とケアへのアクセスを改善する必要性を強調しています.
科学分野:
- 眼科について
- 公衆衛生
- 内分泌学
背景:
- 糖尿病 は 低 所得 国 や 中 所得 国 で 増大 し て いる 健康 課題 です.
- 糖尿病性網膜症 (DR) は,ネパールで予防可能な失明の主な原因です.
- 早期の介入と一貫したフォローアップは DRの管理と視力喪失の予防に不可欠です.
研究 の 目的:
- 糖尿病性レチノパシー (DR) の治療プロトコルに対する患者の遵守を評価する.
- 患者のDRケアサービスの利用に影響を与える障壁を特定する.
- 医療従事者の医療従事率を向上させるための 潜在的要因と解決策を探る
主な方法:
- 過去と将来のデータ収集を組み合わせた混合手法です.
- 140人のDR患者の1年間の追跡データを定量的に分析した.
- ネパール全土のフォーカスグループでの議論や 情報提供者のインタビューを通じて 質的データが収集されました
主要な成果:
- 臨床的に有意な黄斑腫 (CSME) のない軽度の非増殖性DR (NPDR) と増殖性DR (PDR) の割合は高かった.
- 有給の雇用はDRのケア遵守と有意な正の関連を示した (p=0.011).
- 主な障壁は,知識不足 (62.8%),伴侶の不在 (28.2%),時間制約 (21.8%),財政上の困難 (15.4%) でした.
結論:
- 治療における大きなギャップを示しています.
- 患者さんの意識向上や サポートシステムへのアクセシビリティや 治療費の改善は不可欠です
- DRに関連する失明を軽減するために,コミュニティの啓発キャンペーンや治療アクセシビリティの改善など,公衆衛生上の取り組みが推奨されています.
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