Standard case management of asthma in Sudan: a pilot project
Standard case management of asthma in Sudan: a pilot project
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DOI：
10.5588/pha.13.0019
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发表时间：
2013-09-21
影响因子：
1.4
通讯作者：
Enarson, D. A.
中科院分区：
文献类型：
--
作者：
El Sony, A. I.;Chiang, C-Y.;Enarson, D. A.
单位：在苏丹喀土穆和杰兹拉州选定的医院开展哮喘管理试点项目。目的：评估2007-2008年间哮喘的标准病例管理。设计：在当地调整指南，然后进行情况分析、干预前研究、培训和实施。在患者登记一年后评估治疗结果。结果：情况分析显示吸入性倍氯米松在公共部门不可用。入选患者2068例，其中重度间歇性哮喘185例(9.0%)，轻度持续性哮喘231例(11.2%)，中度持续性哮喘640例(31.0%)，重度持续性哮喘812例(39.3%)，未分类哮喘200例(9.7%)。在接受吸入皮质类固醇治疗的1654名持续性哮喘患者中，1157名(70.0%)拥有可用于结果评估的治疗卡。其中652例(56.4%)未参加年度评估，其中死亡1例(0.1%)，失访651例(56.3%)。在参加年度评估的505例患者中，进步417例(82.6%)，稳定32例(6.3%)，恶化56例(11.1%)。接受1年随访的患者急诊和住院次数显著减少。结论：哮喘标准病例管理的结果是令人鼓舞的，但仍有很高比例的患者没有回来接受长期治疗。
Setting: A pilot project for asthma management in selected hospitals in Khartoum and Gezira States, Sudan.Objective: To assess standard case management of asthma in 2007-2008.Design: Local adaptation of guidelines, followed by situational analysis, pre-intervention study, training and implementation. Treatment outcome was assessed 1 year after patient enrolment.Results: Situational analysis revealed that inhaled beclometasone was not available in the public sector. During the project, 2068 patients were enrolled: severity of asthma was intermittent in 185 (9.0%), mild persistent in 231 (11.2%), moderate persistent in 640 (31.0%), severe persistent in 812 (39.3%) and unclassified in 200 (9.7%). Of the 1654 patients with persistent asthma who were treated with inhaled corticosteroids, 1157 (70.0%) had treatment cards available for outcome assessment. Of these, 652 (56.4%) did not attend their annual evaluation, among whom 1 (0.1%) died and 651 (56.3%) were lost to followup. Of the 505 patients who attended their annual evaluation, 417 (82.6%) improved, 32 (6.3%) were stable and 56 (11.1%) were worse. The frequency of emergency visits and hospitalisation decreased substantially among those who presented for the 1 year follow-up assessment.Conclusion: The results of standard case management of asthma were encouraging; however, a high proportion of patients did not return for long-term management.