Ebola and indirect effects on health service function in sierra leone.
Ebola and indirect effects on health service function in sierra leone.
复制标题
DOI：
10.1371/currents.outbreaks.0307d588df619f9c9447f8ead5b72b2d
复制
发表时间：
2014-12-19
期刊：
影响因子：
--
通讯作者：
von Schreeb, Johan
中科院分区：
文献类型：
--
作者：
Bolkan, Hakon Angell;Bash-Taqi, Donald Alpha;von Schreeb, Johan
背景：埃博拉疫情对卫生服务功能的间接影响可能是显著的，但尚不清楚。本研究的目的是量化在埃博拉疫情期间塞拉利昂提供此类护理的卫生机构的入院率和手术发生了多大程度的变化。方法：回顾性检索9月和10月住院和外科手术室登记簿中每周住院病人和手术的数据。21名参加外科任务转移计划的社区卫生官员亲自访问了这些设施。研究时间为2014年1月6日（第2周）至10月12日（第41周）。结果：从55个机构中的40个机构中检索到数据。在研究期间，总共登记了62,257例入院病例和12,124例大手术。在第一例埃博拉病例发生的一周内，总入院人数为2006人，中位数为40人（IQR 20-76），而在研究的最后一周为883人，中位数为12人（IQR 4-30）。这相当于5月至10月期间入学人数中位数下降了70% （p=0.005）。同期总大手术数由342例，中位数6例（IQR 2 ~ 14）降至231例，中位数3例（IQR 0 ~ 6），大手术数中位数减少50% （p=0.014）。结论：埃博拉疫情严重影响了住院卫生服务。记录在案的住院病人和大手术的急剧下降可能被低估了。重建这种护理是紧迫的，必须成为优先事项。
BACKGROUND: The indirect effects of the Ebola epidemic on health service function may be significant but is not known. The aim of this study was to quantify to what extent admission rates and surgery has changed at health facilities providing such care in Sierra Leone during the time of the Ebola epidemic.METHODS: Weekly data on facility inpatient admissions and surgery from admission and surgical theatre register books were retrospectively retrieved during September and October. 21 Community Health Officers enrolled in a surgical task-shifting program personally visited the facilities. The study period was January 6 (week 2) to October 12, (week 41) 2014.RESULTS: Data was retrieved from 40 out of 55 facilities. A total of 62,257 admissions and 12,124 major surgeries were registered for the study period. Total admissions in the week of the first Ebola case were 2,006, median 40 (IQR 20-76) compared to 883, median 12 (IQR 4-30) on the last week of the study. This equals a 70% drop in median number of admissions (p=0.005) between May and October. Total number of major surgeries fell from 342, median 6 (IQR 2-14) to 231, median 3 (IQR 0-6) in the same period, equal 50% reduction in median number of major surgeries (p=0.014).CONCLUSIONS: Inpatient health services have been severely affected by the Ebola outbreak. The dramatic documented decline in facility inpatient admissions and major surgery is likely to be an underestimation. Reestablishing such care is urgent and must be a priority.