低收入和中等收入国家的严重儿童喘
Jose A Castro-Rodriguez1, Manuel E Soto-Martínez2, Carlos E Rodriguez-Martinez3
1Department of Pediatric Pulmonology, Division of Pediatrics, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile.
Paediatric respiratory reviews
|July 30, 2025
概括
尽管发病率较低,但在低收入和中等收入国家的严重喘存在重大挑战. 改善对负担得起的治疗方法的获取和解决环境因素对于更好的儿童喘管理至关重要.
科学领域:
- 公共卫生 公共卫生
- 儿科呼吸系统医学 儿科呼吸系统医学
- 全球卫生平等全球卫生平等
背景情况:
- 严重的喘影响低收入和中等收入国家 (LMICs) 的儿童和青少年,导致严重的发病率和管理挑战.
- 患病率受到社会经济不平等和环境风险因素 (如污染和过敏原) 的影响,处境不利的儿童面临更高的风险.
- 不充分的治疗是常见的,吸入性皮质类固醇和间隔剂的使用较低,在某些地区的药物选择过时.
研究的目的:
- 分析LMIC中严重喘的挑战和成本有效的管理策略.
- 在这些环境中确定足够的喘护理和随访的关键障碍.
- 提出公共卫生优先事项,以改善LMICs中的喘结果.
主要方法:
- 审查当前的喘患病率,风险因素和治疗模式在LMICs.
- 分析各种喘管理疗法的成本效益,包括生物药物.
- 识别医疗保健准入和患者合规方面的障碍.
主要成果:
- 尽管发病率较低,但严重的喘在LMICs中造成了显著的发病率和管理问题.
- 许多患者接受低于最佳的治疗,对吸入性皮质类固醇和间隔剂等推治疗的坚持较低.
- 具有成本效益的治疗方法包括维持和缓解疗法 (MART) 和三重疗法;生物药物在LMICs中没有成本效益.
- 组织不良的卫生服务,有限的诊断和患者的不遵守是足够的随访的主要障碍.
结论:
- 需要紧急的公共卫生干预措施,以改善LMICs的严重喘护理.
- 优先事项包括提高获得负担得起的药物的机会,提高诊断能力,减轻环境风险因素.
- 解决社会经济差异和医疗保健系统的弱点对于减少弱势群体的喘负担至关重要.
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