Traore Bangaly, Kourouma Mamady, Bah Malick, Keita Mamady
Surgical Oncology Unit of Donka National Hospital, Faculty of Health Sciences and Technics, University of Conakry (Guinea), Conakry, Guinea.
JCO Glob Oncol. 2020 Jun;6:913-918. doi: 10.1200/GO.20.00101.
To assess the impact of the Ebola virus disease outbreak (EVDO) on cancer management at the surgical oncology unit of Donka National Hospital.
This was a retrospective and comparative analysis of cancer consultation and care data before (2012-2013), during (2014-2015), and after (2016-2017) the EVDO. The number of cancer occurrences, referral mode, origin, main activities (consultations, surgery, chemotherapy), and access of radiotherapy were analyzed. The Mann-Whitney test with independent samples used was considered as significant if was ≤ .05.
From 2012 to 2017, 4,977 patients were admitted, including 2,254 with cancer. The variations observed were a decrease in consultations by 2.3% during the EVDO versus an increase by 46.9% after the outbreak ( < .001). We found decreases of 0.7% and 12.5% during and increases of 253.8% and 15.4% after the EVDO from level 1 and 2 and from level 3 health facilities, respectively ( < .001). A total of 251 surgeries were performed, and 1,463 received chemotherapy. There was 5.2% more chemotherapy use during and 33.7% more after the EVDO ( < .001). The number of surgeries increased by 35.8% and decreased by 40.0% during and after the EVDO, respectively ( < .001). We evacuated 36 patients for radiotherapy, which reflected a decrease of 42.1% and 45.5% during and after the EVDO ( < .001).
Cancer management slowed down during the EVDO. This change requires organization of the fight against cancer through the institutionalization and decentralization of its management.
评估埃博拉病毒病疫情（EVDO）对东卡国家医院外科肿瘤病房癌症治疗的影响。
这是一项对EVDO之前（2012 - 2013年）、期间（2014 - 2015年）和之后（2016 - 2017年）癌症会诊和护理数据的回顾性对比分析。分析了癌症发病数量、转诊方式、来源、主要活动（会诊、手术、化疗）以及放疗的可及性。使用独立样本的曼 - 惠特尼检验，若P≤0.05则认为差异具有统计学意义。
2012年至2017年，共收治4977例患者，其中2254例为癌症患者。观察到的变化包括，EVDO期间会诊减少2.3%，疫情爆发后增加46.9%（P<0.001）。我们发现，来自一级和二级以及三级医疗机构的患者，在EVDO期间分别减少了0.7%和12.5%，在疫情爆发后分别增加了253.8%和15.4%（P<0.001）。共进行了251台手术，1463例接受了化疗。EVDO期间化疗使用增加5.2%，之后增加33.7%（P<0.001）。手术数量在EVDO期间增加了35.8%，之后减少了40.0%（P<0.001）。我们将36例患者转诊接受放疗，这反映出EVDO期间和之后分别减少了42.1%和45.5%（P<0.001）。
EVDO期间癌症治疗放缓。这种变化需要通过癌症管理的制度化和去中心化来组织抗癌斗争。
