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乌干达东部农村地区消化不良患病率及消化不良管理实践的调查

Survey on the prevalence of dyspepsia and practices of dyspepsia management in rural Eastern Uganda.

作者信息

Lee Yang Jae, Adusumilli Gautam, Kyakulaga Francis, Muwereza Peter, Kazungu Rauben, Blackwell Timothy Scott, Saenz Jose, Schubert Moonkyung Cho

机构信息

Washington University School of Medicine, USA.

Empower Through Health, USA.

出版信息

Heliyon. 2019 Jun 13;5(6):e01644. doi: 10.1016/j.heliyon.2019.e01644. eCollection 2019 Jun.

Abstract

AIM

To investigate the current prevalence and management of dyspepsia in rural Eastern Uganda.

METHODS

Residents older than 18 years of age across 95 study sites in Namutumba District, Eastern Uganda were surveyed. Each respondent was administered a questionnaire about dyspepsia and pertinent health-seeking behaviors. Health workers at 12 different clinics were also assessed on their competence in managing dyspepsia. Proportion-based analysis was used to determine self-reported outcome variables reported in this study, including: prevalence of dyspepsia; breakdown of symptoms; initial diagnosis location; management strategies; and appropriate medication usage.

RESULTS

397 residents (average age of 41.2 years) participated in this study (54.4% males, 45.6% females). 57.9% self-reported currently having dyspepsia, of average duration 4.5 years. Of this subset, 87% reported experiencing epigastric pain, and 42.2% believed that ulcers were "wounds in the stomach." Only 3% of respondents had heard of . Respondents varied in their management of dyspepsia, with frequent eating (39.1%), doing nothing (23.9%), and taking Western medicine (20%) being the most common strategies. The diagnosis of "peptic ulcer disease" was made by a health worker in 64.3% of cases, and 27% of cases were self-diagnosed. Notably, 70.3% of diagnoses at formal health centers were based on clinical symptoms alone and only 22.7% of respondents received treatment according to Ugandan Ministry of Health guidelines. Among the 12 health care workers surveyed, 10 cited epigastric pain as a common symptom of "ulcer," although only two reported having heard of Only two out of 12 clinics had the capability to prescribe the triple therapy as treatment for presumed

CONCLUSION

There is a high incidence of dyspepsia in Eastern Uganda, and current management strategies are poor and inconsistent, and may contribute to antibiotic resistance. Further studies are needed to investigate the causes of dyspepsia to guide appropriate management.

摘要

目的

调查乌干达东部农村地区消化不良的当前患病率及管理情况。

方法

对乌干达东部纳穆通巴区95个研究地点的18岁以上居民进行了调查。每位受访者都接受了一份关于消化不良及相关就医行为的问卷。还评估了12个不同诊所的卫生工作者管理消化不良的能力。采用基于比例的分析方法来确定本研究中自我报告的结果变量,包括:消化不良的患病率;症状分类;初始诊断地点;管理策略;以及适当药物的使用情况。

结果

397名居民(平均年龄41.2岁)参与了本研究(男性占54.4%,女性占45.6%)。57.9%的人自我报告目前患有消化不良,平均病程4.5年。在这个子集中,87%的人报告有上腹部疼痛,42.2%的人认为溃疡是“胃里的伤口”。只有3%的受访者听说过……受访者管理消化不良的方式各不相同,最常见的策略是频繁进食(39.1%)、不采取任何措施(23.9%)和服用西药(20%)。64.3%的病例由卫生工作者诊断为“消化性溃疡病”,27%的病例为自我诊断。值得注意的是,正规卫生中心70.3%的诊断仅基于临床症状,只有22.7%的受访者按照乌干达卫生部的指南接受治疗。在接受调查的12名医护人员中,10人将上腹部疼痛列为“溃疡”的常见症状,尽管只有两人报告听说过……12家诊所中只有两家有能力开出三联疗法作为对疑似病例的治疗方案。

结论

乌干达东部消化不良的发病率很高,目前的管理策略不佳且不一致,可能会导致抗生素耐药性。需要进一步研究来调查消化不良的原因,以指导适当的管理。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fe80/6580192/aeb363589fbb/gr1.jpg

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