Cardiac Surgery Capacity in Sub-Saharan Africa: Quo Vadis?
Cardiac Surgery Capacity in Sub-Saharan Africa: Quo Vadis?
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DOI：
10.1055/s-0034-1383723
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发表时间：
2014-08-01
影响因子：
1.5
通讯作者：
Bolman, Ralph, III
中科院分区：
文献类型：
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作者：
Yankah, Charles;Fynn-Thompson, Francis;Bolman, Ralph, III
背景 目前关于非洲心脏外科能力的数据缺乏或质量低下，而这些数据是非洲制定可持续心脏外科项目的有效概念的基础。方法向 16 个国家的 29 名同事（26 名心脏外科医生和 3 名心脏病专家）发送了一份有关非洲心脏外科手术的调查问卷。此外，从心胸外科网络 (CTSNet) 检索了非洲执业外科医生数量的数据。 结果 有 25 名受访者，答复率为 86.2%。出现了三种模式： 加纳/德国模式，配备当地高级顾问外科医生（模式 1）；短期来访进行人道主义手术的外科医生（模型 2）；和外籍外科医生签订合同开发心脏项目（模型 3）。 CTSNet 列出的 933 名心胸外科医生相当于每 130 万人中就有一名外科医生。在北非，这一数字是每 100 万人拥有 3 名外科医生，而在撒哈拉以南非洲 (SSA)，这一数字是每 330 万人拥有 1 名外科医生。确定的 156 名心脏外科医生代表外科医生与人口的比例为 1:590 万人。在 SSA，这一比例为每 1430 万人中就有一名外科医生。在北非，每 110 万人中就有一名外科医生。非洲的心脏直视手术约为每百万人 12 例，撒哈拉以南非洲的每百万人有 2 例，北非的每百万人有 92 例。结论 如果没有人道主义手术的支持，撒哈拉以南非洲的心胸保健服务将会恶化。尽管这三种模式都有成功的潜力，但加纳/德国模式已被证明从长远来看是成功的，并且可以激励医疗保健政策制定者和计划在非洲建立心脏项目的高级同事。
Background Current data on cardiac surgery capacity on which to base effective concepts for developing sustainable cardiac surgical programs in Africa are lacking or of low quality.Methods A questionnaire concerning cardiac surgery in Africa was sent to 29 colleagues-26 cardiac surgeons and 3 cardiologists in 16 countries. Further, data on numbers of surgeons practicing in Africa were retrieved from the Cardiothoracic Surgery Network (CTSNet).Results There were 25 respondents, yielding a response rate of 86.2%. Three models emerged: the Ghanaian/German model with a senior local consultant surgeon (Model 1); surgeons visiting for a short period to perform humanitarian surgery (Model 2); and expatriate surgeons on contract to develop cardiac programs (Model 3). The 933 cardiothoracic surgeons listed by CTSNet translated into one surgeon per 1.3 million people. In North Africa, the figure was three surgeons per 1 million and in sub-Saharan Africa (SSA), one surgeon per 3.3 million people. The identified 156 cardiac surgeons represented a surgeon to population ratio of 1:5.9 million people. In SSA, the ratio was one surgeon per 14.3 million. In North Africa, it was one surgeon per 1.1 million people. Open heart operations were approximately 12 per million in Africa, 2 per million in SSA, and 92 per million people in North Africa.Conclusion Cardiothoracic health care delivery would worsen in SSA without the support of humanitarian surgery. Although all three models have potential for success, the Ghanaian/German model has proved to be successful in the long term and could inspire health care policy makers and senior colleagues planning to establish cardiac programs in Africa.