社会环境是否决定了肛门直肠畸形门诊设置的改变？

Do social circumstances dictate a change in the setup of an anorectal malformation clinic?

机构信息

Department of Paediatric Surgery, Chris Hani Baragwanath Academic Hospital, University of the Witwatersrand, Johannesburg, South Africa; Paediatric Colorectal and Pelvic Reconstruction Centre, Chris Hani Baragwanath Academic Hospital, Chris Hani Road, Diepkloof, Soweto, Johannesburg, South Africa.

Department of Paediatric Surgery, Chris Hani Baragwanath Academic Hospital, University of the Witwatersrand, Johannesburg, South Africa.

出版信息

J Pediatr Surg. 2020 Dec;55(12):2820-2823. doi: 10.1016/j.jpedsurg.2020.03.012. Epub 2020 Mar 24.

DOI:10.1016/j.jpedsurg.2020.03.012

PMID:32273115

Abstract

BACKGROUND/PURPOSE: To assess the number of patients seen at the colorectal clinic of a low-to-middle income-country with emphasis on their social circumstances.

METHODS

Between January 2013 and December 2018 we recorded the number of visits to colorectal clinic. From February 2019 prospective data on patients with anorectal malformations (ARMs) focusing on their social conditions (type of housing and sanitation) and HIV-exposure were collected.

RESULTS

At the clinic 452 visits were recorded in 2013, 608 in 2014, 904 in 2016, 1392 in 2017, and 1968 in 2018. The ARM cohort included 100 patients: at the time of delivery the HIV status of 74 mothers was negative, positive in 21, and unknown in 5. None of the HIV-exposed patients seroconverted to HIV positive (average follow-up:39 months). Seventy-four patients live in formal settlements, 23 in informal, and 3 in unknown type. Forty-six patients have inside toilets, 39 outside flushing toilets, 10 outside pit latrines, 2 community toilets, and 3 an unknown sanitation.

CONCLUSIONS

The clinic work-load has increased during the past years. A significant proportion of our patients are HIV-exposed, do not live in formal houses and do not have inside toilets. Tailored strategies for a successful surgical plan and bowel management need to be implemented.

LEVEL OF EVIDENCE

II.

摘要

背景/目的：评估中低收入国家结直肠诊所的就诊患者数量，并重点关注其社会环境。

方法

我们记录了 2013 年 1 月至 2018 年 12 月期间结直肠诊所的就诊次数。自 2019 年 2 月起，我们开始前瞻性收集肛肠畸形（ARM）患者的数据，重点关注其社会状况（住房和卫生类型）和 HIV 暴露情况。

结果

该诊所 2013 年记录了 452 次就诊，2014 年 608 次，2016 年 904 次，2017 年 1392 次，2018 年 1968 次。ARM 队列包括 100 名患者：在分娩时，74 名母亲的 HIV 检测结果为阴性，21 名阳性，5 名未知。无 HIV 暴露患者出现 HIV 阳性血清转化（平均随访时间：39 个月）。74 名患者居住在正规住区，23 名居住在非正规住区，3 名居住在未知类型住区。46 名患者拥有室内厕所，39 名拥有冲水式室外厕所，10 名拥有坑式厕所，2 名拥有社区厕所，3 名拥有未知卫生设施。