Davé Dattesh R, Nagarjan Neeraja, Canner Joseph K, Kushner Adam L, Stewart Barclay T
Department of Surgery, University of California San Diego, San Diego, CA, USA.
Department of General Surgery, Brigham and Women's Boston Hospital and Medical Center, Boston, MA, USA.
Burns. 2018 Aug;44(5):1228-1234. doi: 10.1016/j.burns.2018.01.015. Epub 2018 Feb 21.
Low-and middle-income (LMIC) countries account for 90% of all reported burns, nevertheless there is a paucity of providers to treat burns. Current studies on burns in LMICs have not evaluated the gap between care seeking and receiving. This study explores this gap across socioeconomically similar populations in a multi-country population based assessment to inform burn care strategies.
The Surgeons OverSeas Assessment of Surgical Need (SOSAS) instrument is a cross sectional national, cluster random sampling survey administered in Nepal, Rwanda, Sierra Leone, and Uganda from 2011 to 2014. The survey identifies burn etiology, demographics, timing, disability, and barriers to receiving care.
Among 13,763 individuals surveyed, 896 burns were identified. Rwanda had the highest proportion of individuals seeking and receiving care (91.6% vs 88.5%) while Sierra Leone reported the fewest (79.3% vs 70.3%). Rwanda reported the largest disability while Nepal reported the highest proportion with no disability (47.5% vs 76.2%). Lack of money, healthcare providers, and rural living reduce the odds of receiving care by 68% and 85% respectively.
Despite similar country socioeconomic characteristics there was significant variability in burn demographics, timing, and disability. Nevertheless, being geographically and economically disadvantaged predict lack of access to burn care.
低收入和中等收入国家（LMIC）报告的烧伤病例占全球总数的90%，然而治疗烧伤的医疗服务提供者却很匮乏。目前关于低收入和中等收入国家烧伤情况的研究尚未评估寻求治疗与接受治疗之间的差距。本研究在一项基于多国人群的评估中，探索了社会经济背景相似人群中的这一差距，以为烧伤护理策略提供依据。
海外外科医生手术需求评估（SOSAS）工具是一项横断面的全国性整群随机抽样调查，于2011年至2014年在尼泊尔、卢旺达、塞拉利昂和乌干达开展。该调查确定了烧伤的病因、人口统计学特征、时间、残疾情况以及接受治疗的障碍。
在接受调查的13763人中，发现了896例烧伤病例。卢旺达寻求治疗和接受治疗的人数比例最高（分别为91.6%和88.5%），而塞拉利昂报告的人数最少（分别为79.3%和70.3%）。卢旺达报告的残疾情况最为严重，而尼泊尔报告的无残疾比例最高（分别为47.5%和76.2%）。缺钱、缺乏医疗服务提供者以及居住在农村分别使接受治疗的几率降低了68%和85%。
尽管这些国家的社会经济特征相似，但烧伤的人口统计学特征、时间和残疾情况仍存在显著差异。然而，地理位置和经济上的劣势预示着难以获得烧伤护理。
