Tonelli Marcello, Wiebe Natasha, Nadler Brian, Darzi Ara, Rasheed Shahnawaz
Department of Medicine, University of Calgary, Calgary, Alberta, Canada.
Department of Medicine, University of Alberta, Edmonton, Alberta, Canada.
BMJ Glob Health. 2016 Oct 20;1(3):e000128. doi: 10.1136/bmjgh-2016-000128. eCollection 2016.
The Interagency Emergency Health Kit (IEHK) provides a standard package of medicines and simple medical devices for aid agencies to use in emergencies such as disasters and armed conflicts. Despite the increasing burden of non-communicable diseases (NCDs) in such settings, the IEHK includes few drugs and devices for management of NCDs. Using published data to model the population burden of acute and chronic presentations of NCDs in emergency-prone regions, we estimated the quantity of medications and devices that should be included in the IEHK. NCDs considered were cardiovascular diseases, diabetes, hypertension and chronic respiratory disease. In scenario 1 (the primary scenario), we assumed that resources in the IEHK would only include those needed to manage acute life-threatening conditions. In scenario 2, we included resources required to manage both acute and chronic presentations of NCDs. Drugs and devices that might be required included amlodipine, aspirin, atenolol, beclomethasone, dextrose 50%, enalapril, furosemide, glibenclamide, glyceryl trinitrate, heparin, hydralazine, hydrochlorothiazide, insulin, metformin, prednisone, salbutamol and simvastatin. For scenario 1, the number of units required ranged from 12 (phials of hydralazine) to ∼15 000 (tablets of enalapril). Space and weight requirements were modest and total cost for all drugs and devices was approximately US$2078. As expected, resources required for scenario 2 were much greater. Space and cost requirements increased proportionately: estimated total cost of scenario 2 was $22 208. The resources required to treat acute NCD presentations appear modest, and their inclusion in the IEHK seems feasible.
跨部门应急健康包（IEHK）为援助机构提供了一套标准的药品和简单医疗设备，用于应对灾害和武装冲突等紧急情况。尽管在这些情况下非传染性疾病（NCDs）的负担日益加重，但IEHK中用于管理非传染性疾病的药品和设备却很少。利用已发表的数据对易发生紧急情况地区的非传染性疾病急性和慢性症状的人群负担进行建模，我们估计了IEHK应包含的药品和设备数量。所考虑的非传染性疾病包括心血管疾病、糖尿病、高血压和慢性呼吸道疾病。在情景1（主要情景）中，我们假设IEHK中的资源仅包括管理急性危及生命状况所需的资源。在情景2中，我们纳入了管理非传染性疾病急性和慢性症状所需的资源。可能需要的药品和设备包括氨氯地平、阿司匹林、阿替洛尔、倍氯米松、50%葡萄糖、依那普利、呋塞米、格列本脲、硝酸甘油、肝素、肼屈嗪、氢氯噻嗪、胰岛素、二甲双胍、泼尼松、沙丁胺醇和辛伐他汀。对于情景1，所需单位数量从12（肼屈嗪瓶）到约15000（依那普利片）不等。空间和重量要求适中，所有药品和设备的总成本约为2078美元。正如预期的那样，情景2所需的资源要多得多。空间和成本要求成比例增加：情景2的估计总成本为22208美元。治疗非传染性疾病急性症状所需的资源似乎较少，将其纳入IEHK似乎是可行的。
