加纳威尔姆斯瘤负担和治疗的现实情况
Nelly-Ange T Kontchou1, Emmanuel Amankwah2, Issah Seidu3
1Department of Surgery, Vanderbilt University Medical Center, Nashville, TN, USA.
Journal of pediatric surgery
|April 8, 2024
概括
非正式就业和离医院的距离是影响加纳威尔姆斯瘤存活率的关键社会决定因素. 解决这些因素可以改善儿童癌症患者的治疗结果.
科学领域:
- 儿科瘤学 儿科瘤学
- 全球健康 全球健康
- 健康的社会决定因素
背景情况:
- 加纳的威尔姆斯瘤 (WT) 存活率在历史上落后于高收入国家.
- 在2005年至2014年期间,在两年无病生存期中发现了显著的差异.
- 这项研究调查了加纳导致可预防的WT死亡的社会决定因素.
研究的目的:
- 确定影响加纳威尔姆斯瘤结果的健康社会决定因素.
- 了解导致诊断和治疗延迟的因素.
- 在资源有限的环境中,为改善儿科癌症生存率的策略提供信息.
主要方法:
- 在2014-2022年期间,对来自科尔勒-布教学医院 (KBTH) 的127名威尔姆斯瘤患者记录进行了回顾性审查.
- 对人口统计,临床过程,瘤特征和生存数据的分析.
- 使用t测试,皮尔森奇平方和多变量考克斯逻辑回归的统计评估.
主要成果:
- 呈现时的远程转移 (38%的患者) 与低albuminemia,非正式的护理人员就业和更大的瘤大小有关.
- 尽管进行了新辅助化疗,但较大的初始瘤大小与不完全切除相关.
- 放弃治疗和失去随访是重大问题,影响了67%的整体存活率和60%的无事件存活率.
结论:
- 加纳的威尔姆斯瘤存活率有所改善,但仍未达到最佳水平.
- 非正规就业和与KBTH的地理距离与推迟转诊,增加瘤负担和较差的生存率有关.
- 解决这些社会决定因素对于加强加纳儿童癌症护理至关重要.
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