在乌干达，获得药品和诊断检测对于糖尿病和心血管疾病的管理至关重要：ACCODAD 研究的见解。
Access to medicines and diagnostic tests integral in the management of diabetes mellitus and cardiovascular diseases in Uganda: insights from the ACCODAD study.
机构信息
Department of Medicine, Uganda Martyrs Hospital Lubaga, P.O.BOX 7146, Kampala, Uganda.
Department of Medicine, Case Hospital Kampala, Kampala, Uganda.
出版信息
Int J Equity Health. 2017 Aug 24;16(1):154. doi: 10.1186/s12939-017-0651-6.
BACKGROUND
Despite the burgeoning burden of diabetes mellitus (DM) and cardiovascular diseases (CVD) in low and middle income countries (LMIC), access to affordable essential medicines and diagnostic tests for DM and CVD still remain a challenge in clinical practice. The Access to Cardiovascular diseases, Chronic Obstructive pulmonary disease, Diabetes mellitus and Asthma Drugs and diagnostics (ACCODAD) study aimed at providing contemporary information about the availability, cost and affordability of medicines and diagnostic tests integral in the management of DM and CVD in Uganda.
METHODS
The study assessed the availability, cost and affordability of 37 medicines and 19 diagnostic tests in 22 public hospitals, 23 private hospitals and 100 private pharmacies in Uganda. Availability expressed as a percentage, median cost of the available lowest priced generic medicine and the diagnostic tests and affordability in terms of the number of days' wages it would cost the least paid public servant to pay for one month of treatment and the diagnostic tests were calculated.
RESULTS
The availability of the medicines and diagnostic tests in all the study sites ranged from 20.1% for unfractionated heparin (UFH) to 100% for oral hypoglycaemic agents (OHA) and from 6.8% for microalbuminuria to 100% for urinalysis respectively. The only affordable tests were blood glucose, urinalysis and serum ketone, urea, creatinine and uric acid. Parenteral benzathine penicillin, oral furosemide, glibenclamide, bendrofluazide, atenolol, cardiac aspirin, digoxin, metformin, captopril and nifedipine were the only affordable drugs.
CONCLUSION
This study demonstrates that the majority of medicines and diagnostic tests essential in the management of DM and CVD are generally unavailable and unaffordable in Uganda. National strategies promoting improved access to affordable medicines and diagnostic tests and primary prevention measures of DM and CVD should be prioritised in Uganda.
背景
尽管在中低收入国家（LMIC），糖尿病（DM）和心血管疾病（CVD）的负担不断增加，但获得负担得起的 DM 和 CVD 基本药物和诊断检测仍然是临床实践中的一个挑战。“获取心血管疾病、慢性阻塞性肺疾病、糖尿病和哮喘药物和诊断检测（ACCODAD）”研究旨在提供有关乌干达 DM 和 CVD 管理中不可或缺的药物和诊断检测的可及性、成本和负担能力的最新信息。
方法
该研究评估了乌干达 22 家公立医院、23 家私立医院和 100 家私人药店中 37 种药物和 19 种诊断检测的可及性、成本和负担能力。可及性用百分比表示，可用的最便宜的通用药物和诊断检测的中位数成本，以及最廉价的公务员支付一个月治疗和诊断检测费用所需的工资天数来衡量负担能力。
结果
所有研究地点的药物和诊断检测的可及性范围从未分级肝素（UFH）的 20.1%到口服降血糖药（OHA）的 100%，从微量白蛋白尿的 6.8%到尿液分析的 100%。唯一负担得起的检测是血糖、尿液分析和血清酮、尿素、肌酐和尿酸。苄星青霉素、口服呋塞米、格列本脲、盐酸贝那普利、阿替洛尔、心脏阿司匹林、地高辛、二甲双胍、卡托普利和硝苯地平是唯一负担得起的药物。
结论
本研究表明，乌干达在管理 DM 和 CVD 中必不可少的大多数药物和诊断检测通常无法获得且负担不起。乌干达应优先制定促进获得负担得起的药物和诊断检测的国家战略，并采取 DM 和 CVD 的初级预防措施。
Zotero 插件