Cherewick Megan L, Cherewick Steven D, Kushner Adam L
Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD.
Johns Hopkins University Carey Business School, Baltimore, MD.
Surgery. 2017 May;161(5):1436-1443. doi: 10.1016/j.surg.2016.11.030. Epub 2016 Dec 30.
In 2015, it was estimated that approximately 36.7 million people were living with HIV globally and approximately 25.5 million of those people were living in sub-Saharan Africa. Limitations in the availability and access to adequate operative care require policy and planning to enhance operative capacity.
Data estimating the total number of persons living with HIV by country, sex, and age group were obtained from the Joint United Nations Programme on HIV/AIDS (UNAIDS) in 2015. Using minimum proposed surgical rates per 100,000 for 4, defined, sub-Saharan regions of Africa, country-specific and regional estimates were calculated. The total need and unmet need for operative procedures were estimated.
A minimum of 1,539,138 operative procedures were needed in 2015 for the 25.5 million persons living with HIV in sub-Saharan Africa. In 2015, there was an unmet need of 908,513 operative cases in sub-Saharan Africa with the greatest unmet need in eastern sub-Saharan Africa (427,820) and western sub-Saharan Africa (325,026). Approximately 55.6% of the total need for operative cases is adult women, 38.4% are adult men, and 6.0% are among children under the age of 15.
A minimum of 1.5 million operative procedures annually are required to meet the needs of persons living with HIV in sub-Saharan Africa. The unmet need for operative care is greatest in eastern and western sub-Saharan Africa and will require investments in personnel, infrastructure, facilities, supplies, and equipment. We highlight the need for global planning and investment in resources to meet targets of operative capacity.
2015年估计全球约有3670万人感染艾滋病毒,其中约2550万人生活在撒哈拉以南非洲地区。获得充分手术治疗的机会和可及性存在限制,这需要制定政策和规划以提高手术能力。
2015年从联合国艾滋病规划署(UNAIDS)获取了按国家、性别和年龄组估计的艾滋病毒感染者总数数据。利用非洲撒哈拉以南4个特定区域每10万人的最低建议手术率,计算了各国和各区域的估计数。估计了手术程序的总需求和未满足的需求。
2015年,撒哈拉以南非洲地区2550万艾滋病毒感染者至少需要1539138例手术。2015年,撒哈拉以南非洲地区有908513例手术需求未得到满足,其中撒哈拉以南非洲东部(427820例)和撒哈拉以南非洲西部(325026例)未满足的需求最大。手术病例总需求中约55.6%为成年女性,38.4%为成年男性,6.0%为15岁以下儿童。
每年至少需要150万例手术才能满足撒哈拉以南非洲地区艾滋病毒感染者的需求。撒哈拉以南非洲东部和西部手术治疗的未满足需求最大,这需要在人员、基础设施、设施、用品和设备方面进行投资。我们强调需要进行全球规划并对资源进行投资,以实现手术能力目标。