Impact of the COVID-19 pandemic on pediatricians' clinical activity in Cameroon.
Impact of the COVID-19 pandemic on pediatricians' clinical activity in Cameroon.
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DOI：
10.1016/j.arcped.2020.09.004
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发表时间：
2020-11
期刊：
影响因子：
--
通讯作者：
Tetanye E
中科院分区：
文献类型：
--
作者：
Enyama D;Chelo D;Noukeu Njinkui D;Mayouego Kouam J;Fokam Djike Puepi Y;Mekone Nkwele I;Ndenbe P;Nguefack S;Nguefack F;Kedy Koum D;Tetanye E
新冠肺炎的爆发给卫生系统带来了许多挑战。本研究的目的是描述新冠肺炎大流行对儿科医生临床活动的影响。我们对在喀麦隆执业的儿科医生进行了一项横断面和描述性在线调查。数据是通过匿名的预先测试的Google Form®收集的。在118名有资格参加调查的儿科医生中，101名(85.6%)做出了回应，其中61.2%是女性。儿科门诊就诊率从大流行前的60.4%的儿科医生每周看30个以上的病人大幅下降到大流行期间的9.9%(P<；0.000)。根据住院床位的占有率，45.5%的儿科医生报告在大流行前每周有76-100%的儿科住院床位被占用，但没有儿科医生报告在大流行期间有类似的比率(P<；0.000)。远程保健的使用显著增加，从大流行前没有儿科医生“非常频繁地”使用远程保健，到大流行期间23.8%的儿科医生使用远程保健(P<；0.000)。大多数儿科医生有医用口罩(96%)、护理手套(80.2%)、水酒精凝胶(99.0%)、肥皂和水(86.1%)。在儿童管理方面，90.1%和71.3%的儿科医生在使用新冠肺炎聚合酶链式反应和氯喹时遇到困难，74.3%的儿科医生表示难以适当隔离患者。超过半数(65.3%)的受访儿科医生对感染SARS-CoV-2感到“非常害怕”或“极度害怕”，分别为45.5%和19.8%。最常见的原因是害怕感染亲属(85.1%)和发展成严重的疾病(43.6%)。父母表示不愿咨询卫生服务的原因是：害怕在离开家时被感染，特别是在卫生机构(96%)，严格遵守分娩(30.7%)，以及家庭经济困难(13.9%)。这项工作突出了冠状病毒大流行对喀麦隆儿科医生临床活动的影响。自大流行开始以来，卫生设施的使用率大幅下降，这可能对儿童的整体健康水平产生负面影响。尽管预防措施解释了卫生机构就诊率下降的原因，但父母离开家时担心被感染可能是卫生机构就诊率下降的主要原因。这可以构成一个轴心，向父母发出信息，鼓励他们逐步恢复儿童保健服务。
The outbreak of COVID-19 has imposed many challenges on health systems. The purpose of this study was to describe the impact of the COVID-19 pandemic on the clinical activity of pediatricians. We conducted a cross-sectional and descriptive online survey among pediatricians practicing in Cameroon. Data were collected through an anonymous pre-tested Google Form®. Among the 118 pediatricians eligible for the survey, 101 responded (85.6%), of whom 61.2% were women. The pediatric outpatient consultations dropped significantly from 60.4% of pediatricians seeing more than 30 patients per week before the pandemic to 9.9% during the pandemic (P < 0.000). According to the occupancy rate of hospitalisation beds, 45.5% of pediatricians reported having 76–100% of pediatric hospitalisation beds occupied per week before the pandemic but no pediatrician reported a similar rate during the pandemic (P < 0.000). There was a significant increase in the use of telehealth, ranging from no pediatrician using telehealth “very frequently” before the pandemic to 23.8% using it during the pandemic (P < 0.000). Most of the pediatricians had at their disposal surgical masks (96%), care gloves (80.2%), hydroalcoholic gel (99.0%), and soap and water (86.1%). For the management of children, 90.1% and 71.3% of pediatricians experienced difficulties accessing COVID-19 PCR and chloroquine, respectively, and 74.3% declared difficulties for proper isolation of patients. More than half (65.3%) of the pediatricians interviewed were “very afraid” or “extremely afraid” of being infected with SARS-Cov-2, respectively 45.5% and 19.8%. The most frequent reasons included fear of infecting their relatives (85.1%) and of developing a severe form of the disease (43.6%). The reluctance to consult health services expressed by the parents was due to: fear of being infected when leaving their home and especially in the health facility (96%), strict compliance with confinement (30.7%), and financial difficulties of families (13.9%). This work highlights the impact of the coronavirus pandemic on the clinical activity of Cameroonian pediatricians. Since the beginning of the pandemic, there has been a significant drop in the use of health facilities, which probably has a negative impact on children's overall level of health. Although the preventive measures explain this drop in attendance at health facilities, the parents’ fear of being infected when leaving the house was the predominant reason likely to explain this drop in attendance at health facilities. This could constitute an axis for developing messages to parents to encourage a gradual return to child health services.
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