Department of Anesthesiology, Maharajgunj Medical Campus, Institute of Medicine, Tribhuvan University Teaching Hospital, Kathmandu, Nepal.
Research Center for Community Health, Minamisoma Municipal General Hospital, Minamisoma, Fukushima, Japan.
BMJ Open. 2019 Jun 28;9(6):e026746. doi: 10.1136/bmjopen-2018-026746.
Little is known regarding how natural disasters affect patients with cancer in low-income and middle-income countries. The objective of the present study was to assess the impact of the 2015 Nepal earthquake on the admission of patients with cancer at a core medical institution in Kathmandu.
DESIGN, SETTING AND PARTICIPANTS: We considered all 3520 cancer patient admissions to Tribhuvan University Teaching Hospital, from 25 April 2013 to 24 April 2017 (2 years before and 2 years after the earthquake).
The number of cancer patient admissions was calculated for each month. Using a negative binomial model, we estimated the incidence rate ratio (IRR) for admission numbers each month after the earthquake compared with the pre-earthquake baseline and investigated chronological change.
The total admission number in the first month after the earthquake was decreased compared with that of the predisaster baseline (IRR=0.66, 95% CI 0.43 to 1.00), which largely reflected decreased admissions of patients from outside of the most disaster-affected districts. From the second month, the admission number consistently exceeded the predisaster baseline for the remaining postdisaster period. In contrast to the month of the disaster, the continuation of increased admissions was most prominent among those from outside of the most affected districts.
After a transient decrease immediately following the 2015 Nepal earthquake, there was a long-term increase in cancer patient admissions in a core hospital in Kathmandu. These changes were seen most prominently in patients from outside the most disaster affected areas.
关于自然灾害如何影响低收入和中等收入国家的癌症患者,人们知之甚少。本研究的目的是评估 2015 年尼泊尔地震对加德满都一家核心医疗机构癌症患者入院的影响。
设计、地点和参与者:我们考虑了 2013 年 4 月 25 日至 2017 年 4 月 24 日期间(地震前 2 年和地震后 2 年)共有 3520 名癌症患者入住特里布万大学教学医院的情况。
我们逐月计算癌症患者入院人数。使用负二项模型,我们估计了地震后每个月与震前基线相比的入院人数的发病率比(IRR),并调查了时间变化。
与灾害前基线相比,地震后第一个月的总入院人数减少(IRR=0.66,95%CI 0.43 至 1.00),这主要反映了受灾最严重地区以外的患者入院人数减少。从第二个月开始,在剩余的灾后时期,入院人数一直超过灾害前基线。与灾害当月相比,受灾最严重地区以外的患者入院人数持续增加的情况最为明显。
在 2015 年尼泊尔地震后短暂下降之后,加德满都一家核心医院的癌症患者入院人数长期增加。这些变化在最受灾地区以外的患者中最为明显。