Health system factors that influence diagnostic and treatment intervals in women with breast cancer in sub-Saharan Africa: a systematic review.
Health system factors that influence diagnostic and treatment intervals in women with breast cancer in sub-Saharan Africa: a systematic review.
复制标题
影响撒哈拉以南非洲女性乳腺癌诊断和治疗间隔的卫生系统因素：系统评价。
DOI：
10.1186/s12889-021-11296-5
复制
发表时间：
2021-07-06
影响因子：
4.5
通讯作者：
Khalis M
中科院分区：
文献类型：
--
作者：
Gbenonsi G;Boucham M;Belrhiti Z;Nejjari C;Huybrechts I;Khalis M
撒哈拉以南非洲地区的乳腺癌患者从第一次到卫生保健机构就诊到开始癌症治疗间隔时间较长。卫生系统在增加治疗时间间隔中的作用尚未得到广泛调查。本综述旨在确定影响撒哈拉以南非洲乳腺癌妇女诊断和治疗间隔的卫生系统因素的现有信息，以促进该区域卫生政策的重新定位。检索了PubMed、ScienceDirect、African Journals Online、Mendeley、ResearchGate和谷歌Scholar，以确定2010年至2020年7月之间发表的相关研究。我们按照系统评价和荟萃分析的首选报告项目（PRISMA）声明进行了定性综合。根据世界卫生组织的六个卫生系统构建模块提取相关卫生系统因素并进行分类。定性和定量研究的质量分别通过使用关键评估技能项目质量评估工具和国家卫生质量评估工具进行评估。此外，我们使用了定性研究综述证据的置信度工具来评估每个定性发现的证据。从14184项确定的研究中，本系统综述包括28篇文章。我们确定了可能影响乳腺癌妇女诊断和治疗间隔的总共36个障碍和8个促进因素。确定的主要卫生系统因素主要与人力资源和服务提供有关，特别是难以获得卫生保健、诊断错误、管理不善和治疗费用。本综述显示，撒哈拉以南非洲地区乳腺癌妇女的诊断和治疗间隔受到许多相关卫生系统因素的影响。撒哈拉以南非洲的决策者需要通过充分的全民健康覆盖政策解决乳腺癌治疗的经济可及性问题，并加强卫生工作者的临床能力，以确保该地区乳腺癌妇女的及时诊断和适当护理。在线版本包含补充材料，可在10.1186/s12889-021-11296-5获得。
Breast cancer patients in sub-Saharan Africa experience long time intervals between their first presentation to a health care facility and the start of cancer treatment. The role of the health system in the increasing treatment time intervals has not been widely investigated. This review aimed to identify existing information on health system factors that influence diagnostic and treatment intervals in women with breast cancer in sub-Saharan Africa to contribute to the reorientation of health policies in the region. PubMed, ScienceDirect, African Journals Online, Mendeley, ResearchGate and Google Scholar were searched to identify relevant studies published between 2010 and July 2020. We performed a qualitative synthesis in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. Related health system factors were extracted and classified according to the World Health Organization’s six health system building blocks. The quality of qualitative and quantitative studies was assessed by using the Critical Appraisal Skills Program Quality-Assessment Tool and the National Institute of Health Quality Assessment Tool, respectively. In addition, we used the Confidence in the Evidence from Reviews of Qualitative Research tool to assess the evidence for each qualitative finding. From 14,184 identified studies, this systematic review included 28 articles. We identified a total of 36 barriers and 8 facilitators that may influence diagnostic and treatment intervals in women with breast cancer. The principal health system factors identified were mainly related to human resources and service delivery, particularly difficulty accessing health care, diagnostic errors, poor management, and treatment cost. The present review shows that diagnostic and treatment intervals among women with breast cancer in sub-Saharan Africa are influenced by many related health system factors. Policy makers in sub-Saharan Africa need to tackle the financial accessibility to breast cancer treatment by adequate universal health coverage policies and reinforce the clinical competencies for health workers to ensure timely diagnosis and appropriate care for women with breast cancer in this region. The online version contains supplementary material available at 10.1186/s12889-021-11296-5.
登录
查看更多内容
影响因子：
1.4
作者：
Aziato, Lydia;Clegg-Lamptey, Joe Nat A.
通讯作者：
Clegg-Lamptey, Joe Nat A.
影响因子：
6.2
作者：
Harford, Joe;Azavedo, Edward;Fischietto, Mary
通讯作者：
Fischietto, Mary
影响因子：
3.7
作者：
Grosse Frie K;Kamaté B;Traoré CB;Ly M;Mallé B;Coulibaly B;Wienke A;Kantelhardt EJ
通讯作者：
Kantelhardt EJ
影响因子：
2.9
作者：
Gebremariam, Alem;Addissie, Adamu;Jemal, Ahmedin
通讯作者：
Jemal, Ahmedin
影响因子：
7.4
作者：
Foerster, Milena;Anderson, Benjamin O.;McCormack, Valerie
通讯作者：
McCormack, Valerie