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伊拉克人口在约旦和叙利亚流离失所者中的慢性疾病和残疾。

Chronic disease and disability among Iraqi populations displaced in Jordan and Syria.

机构信息

Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA.

出版信息

Int J Health Plann Manage. 2013 Jan-Mar;28(1):e1-e12. doi: 10.1002/hpm.2119. Epub 2012 Jun 8.

Abstract

The Iraq conflict resulted in the largest displacement in the Middle East since the Palestinian crisis, and provision of health services to the displaced population presents a critical challenge. The study aimed to provide information on chronic medical conditions and disability to inform humanitarian assistance planning. Nationally representative cross-sectional surveys of Iraqi populations displaced in Jordan and Syria were conducted in late 2008 and early 2009. Clusters of 10 household were randomly selected using probability-based sampling; a total of 1200 and 813 Iraqi households in Jordan and Syria, respectively, were interviewed. The majority of respondents in both countries perceived healthcare as unaffordable but accessible; cost was an important barrier to care. In Jordan, most routine health expenditures were for medications where in Syria, expenses were divided between medical consultations and medication. Chronic disease prevalence among adults was 51.5% (confidence interval (CI): 49.4-53.5) in Syria and 41.0% (CI: 39.4-42.7) in Jordan, most common were hypertension and musculoskeletal problems. Overall disability rates were 7.1% (CI: 6.3-8.0) in Syria and 3.4% (CI: 3.0-3.9) in Jordan. In both countries, the majority of disability was attributed to conflict, prevalence was higher in men than women, and depression was the leading cause of mental health disability. Chronic illnesses, disabilities and psychological health are key challenges for the Iraqi population and the health systems in Jordan and Syria. Continued attention to the development of systems to manage conditions that require secondary and tertiary care is essential, particularly given reported difficulties in accessing care and the anticipated prolonged displacement.

摘要

伊拉克冲突导致了自巴勒斯坦危机以来中东地区最大规模的人口流离失所,为流离失所人口提供医疗服务是一项重大挑战。本研究旨在提供有关慢性病和残疾的信息,以为人道主义援助规划提供信息。2008 年末和 2009 年初,在约旦和叙利亚对流离失所的伊拉克人口进行了全国代表性的横断面调查。使用基于概率的抽样方法随机选择 10 户家庭的集群;分别在约旦和叙利亚采访了 1200 户和 813 户伊拉克家庭。两国的大多数受访者都认为医疗保健负担不起但可获得;费用是获得护理的重要障碍。在约旦,大多数常规医疗支出用于药物,而在叙利亚,支出则在医疗咨询和药物之间分配。叙利亚成年人慢性病患病率为 51.5%(置信区间(CI):49.4-53.5),约旦为 41.0%(CI:39.4-42.7),最常见的是高血压和肌肉骨骼问题。叙利亚的总残疾率为 7.1%(CI:6.3-8.0),约旦为 3.4%(CI:3.0-3.9)。在这两个国家,大多数残疾归因于冲突,男性的患病率高于女性,抑郁症是精神健康残疾的主要原因。慢性病、残疾和心理健康是伊拉克人口以及约旦和叙利亚卫生系统面临的关键挑战。继续关注管理需要二级和三级护理的疾病的系统的发展至关重要,特别是考虑到报告的获得护理的困难以及预计的长期流离失所。

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