Estimates of number of children and adolescents without access to surgical care
Estimates of number of children and adolescents without access to surgical care
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DOI：
10.2471/blt.18.216028
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发表时间：
2019-04-01
影响因子：
11.1
通讯作者：
Bickler, Stephen
中科院分区：
文献类型：
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作者：
Mullapudi, Bhargava;Grabski, David;Bickler, Stephen
目的估计全世界有多少儿童和青少年无法获得外科治疗。方法：通过使用联合国2017年的人口数据和2015年的国际手术获取数据，我们估计了全球19岁以下儿童和青少年无法获得安全、负担得起和及时的手术护理的数量。我们根据世界银行的国家收入分组对国家进行了分类，并从Lancer全球外科委员会的一项研究中获得了无法获得外科护理的人口比例。2017年，全球估计有17亿（95%可信区间：1.6-1.8）儿童和青少年无法获得手术护理。在儿童和青少年在人口中所占比例过大的低收入和中等收入国家，缺乏获得医疗服务的机会尤为严重。此外，4.53亿5岁以下儿童无法获得基本的挽救生命的手术护理。根据Lancer全球外科标准委员会，低收入国家不到3%的儿科人口和中低收入国家不到8%的儿科人口能够获得外科护理。结论：在世界范围内，特别是中低收入国家，儿童手术服务的可获得性存在很大差距。今后的研究应侧重于制定具体措施，评估儿科手术的可及性、分娩和结果，并澄清世界最贫穷地区有限的手术可及性如何影响儿童健康，特别是5岁以下儿童的死亡率。
Objective To estimate how many children and adolescent worldwide do not have access to surgical care.Methods We estimated the number of children and adolescents younger than 19 years worldwide without access to safe, affordable and timely surgical care, by using population data for 2017 from the United Nations and international data on surgical access in 2015. We categorized countries by World Bank country income group and obtained the proportion of the population with no access to surgical care from a study by the Lancer Commission on Global Surgery.Findings An estimated 1.7 billion (95% credible interval: 1.6-1.8) children and adolescents worldwide did not have access to surgical care in 2017. Lack of access occurred overwhelmingly in low- and middle-income countries where children and adolescents make up a disproportionately large fraction of the population. Moreover, 453 million children younger than 5 years did not have access to basic life-saving surgical care. According to Lancer Commission on Global Surgery criteria, less than 3% of the paediatric population in low-income countries and less than 8% in lower-middle-income countries had access to surgical care.Conclusion There were substantial gaps in the availability of surgical services for children worldwide, particularly in low- and middle-income countries. Future research should focus on developing specific measures for assessing paediatric surgical access, delivery and outcomes and on clarifying how limited surgical access in the poorest parts of the world affects child health, especially mortality in children younger than 5 years.