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新冠疫情对撒哈拉以南非洲地区慢性非传染性疾病管理的影响:慢性病护理模式的应用。

Implications of COVID-19 for the management of chronic non-communicable diseases in sub-Saharan Africa: application of the chronic care model.

机构信息

Department of Population and Behavioural Sciences, School of Public Health, University of Health and Allied Science, Hohoe, Ghana.

Department of Epidemiology and Biostatistics, School of Public Health, University of Health and Allied Science, Hohoe, Ghana.

出版信息

Pan Afr Med J. 2020 Jun 29;35(Suppl 2):94. doi: 10.11604/pamj.supp.2020.35.24047. eCollection 2020.

Abstract

About 41 million people die of chronic non-communicable diseases (CNCDs) each year, accounting for 71% of all global deaths. The high prevalence of CNCDs is particularly problematic for sub-Saharan Africa (SSA) since CNCDs are already a major cause of mortality in the sub-region. While the case fatality rate of COVID-19 is quite low, it is worth noting that people with underlying CNCDs constitute the majority of those who die from this virus. Underpinned by the chronic care model (CCM), we present a commentary on the implications of COVID-19 for the management of CNCDs in SSA. We realized that despite the World Health Organisation's guidelines for countries to maintain essential services while putting necessary measures in place to prevent and control the spread of COVID-19, myriad of health systems and community-level factors militate against effective management of the CNCDs in SSA. This results in disruptions in management of the conditions as well as possible long-term effects such as the deterioration of the health status of CNCD patients and even deaths. Without immediate interventions to salvage the status quo, SSA countries may not be able to achieve the Sustainable Development Goal 3.4 target of reducing by one-third, premature mortality from CNCDs by the year 2030. We recommend that financial constraints could be ameliorated through short- and long-term loan facilities from the International Monetary Fund and the World Bank to augment national efforts at strengthening health systems while combating COVID-19. We also recommend increased community engagement and public education by COVID-19 response teams to enhance community support for persons living with CNCDs and to reduce social stigmatization.

摘要

每年约有 4100 万人死于慢性非传染性疾病(CNCDs),占全球死亡人数的 71%。慢性非传染性疾病在撒哈拉以南非洲(SSA)的高发率尤其成问题,因为这些疾病已经是该地区死亡的主要原因。虽然 COVID-19 的病死率相当低,但值得注意的是,患有潜在 CNCD 的人是死于该病毒的大多数人。我们以慢性病护理模式(CCM)为基础,对 COVID-19 对 SSA 中 CNCD 管理的影响进行了评论。我们意识到,尽管世界卫生组织为各国制定了在采取必要措施预防和控制 COVID-19 传播的同时维持基本服务的指导方针,但无数的卫生系统和社区层面的因素阻碍了 SSA 有效管理 CNCD。这导致了对这些疾病的管理中断,以及可能出现的长期影响,如 CNCD 患者健康状况恶化甚至死亡。如果不立即采取干预措施来挽救现状,SSA 国家可能无法实现到 2030 年将慢性非传染性疾病过早死亡率减少三分之一的可持续发展目标 3.4 目标。我们建议,可以通过国际货币基金组织和世界银行的短期和长期贷款来缓解财政限制,以加强国家努力,加强卫生系统,同时抗击 COVID-19。我们还建议,由 COVID-19 应对小组加强社区参与和公众教育,以增强社区对患有 CNCD 的人的支持,并减少社会污名化。

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