Peer S, Vial I, Numanoglu A, Fagan J J
Red Cross War Memorial Children's Hospital, Cape Town, South Africa; Division of Otorhinolaryngology, Head & Neck Surgery, University of Cape Town, Cape Town, South Africa.
Red Cross War Memorial Children's Hospital, Cape Town, South Africa; Division of Paediatric Surgery, Erasmus University Medical Centre-Sophia Children's Hospital, Rotterdam, The Netherlands.
Eur Ann Otorhinolaryngol Head Neck Dis. 2018 Sep;135(5S):S79-S83. doi: 10.1016/j.anorl.2018.07.005. Epub 2018 Aug 22.
Children constitute 50% of Africa's population. Sub-Saharan Africa has the highest under-five mortality rates in the world. This study is the first to document the availability of paediatric ENT and paediatric surgery services in Africa.
To determine the availability of paediatric ENT services in Africa, as well as that of paediatric surgery that would complement paediatric ENT.
A descriptive observational study in the form of an online questionnaire was distributed by email to known ENT and paediatric surgeons based in Africa.
Surgeons from twelve of 23 African countries responded to the survey. Seven countries had both ENT and paediatric surgery responses. In 8 of the 11 countries, the number of ENT surgeons per country was<6% of that of the UK, with 1 ENT surgeon per 414,000 people and 1 paediatric surgeon per 1,181,151 people. Ten of 11 countries reported hearing assessments in schools were poor/unavailable. Seventy-three percent responded positively for access to rigid laryngoscopes, bronchoscopes, cameras and fibre optic cables, tracheostomy, anaesthesia and nurse practitioners. Access was reported as poor/unavailable for balloon dilators 73% (8/11 countries); CPAP machines 73% (8/11) and sleep studies 82% (9/11 countries). Flexible endoscopes were available in 50% (4/8 countries), 75% (6/8 countries) had access to a camera, monitor and stack. Thirty-eight percent (3/9 countries) reported no ENT specialists with paediatric training.
There is a great shortage of paediatric ENT and paediatric surgery services in Africa. More regional training opportunities and health infrastructure for these surgical specialties are needed. Collaborative development of paediatric ENT, surgery and anaesthesia should be considered to improve ENT-related child health in Africa.
儿童占非洲人口的50%。撒哈拉以南非洲地区是全球五岁以下儿童死亡率最高的地区。本研究首次记录了非洲儿科耳鼻喉科和儿科外科服务的可及情况。
确定非洲儿科耳鼻喉科服务以及可辅助儿科耳鼻喉科的儿科外科服务的可及情况。
通过电子邮件向非洲已知的耳鼻喉科医生和儿科外科医生发放在线问卷形式的描述性观察性研究。
23个非洲国家中的12个国家的外科医生回复了调查。7个国家既有耳鼻喉科又有儿科外科的回复。在11个国家中的8个国家，每个国家的耳鼻喉科医生数量不到英国的6%，每41.4万人中有1名耳鼻喉科医生，每118.1151万人中有1名儿科外科医生。11个国家中有10个报告称学校的听力评估较差或无法进行。73%的回复表示能够获得硬质喉镜、支气管镜、摄像头和光纤电缆、气管切开术、麻醉和执业护士服务。73%（8/11个国家）报告称球囊扩张器服务较差或无法获得；持续气道正压通气（CPAP）机器服务为73%（8/11），睡眠研究服务为82%（9/11个国家）。50%（4/8个国家）有可弯曲内窥镜，75%（6/8个国家）能够获得摄像头、监视器和设备架。38%（3/9个国家）报告没有接受过儿科培训的耳鼻喉科专家。
非洲儿科耳鼻喉科和儿科外科服务严重短缺。需要为这些外科专科提供更多的区域培训机会和卫生基础设施。应考虑协同发展儿科耳鼻喉科、外科和麻醉，以改善非洲与耳鼻喉科相关的儿童健康状况。
