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2019年冠状病毒病对非洲癌症护理服务的影响:非洲肿瘤学服务提供者的横断面调查

Impact of COVID-19 on Cancer Care Delivery in Africa: A Cross-Sectional Survey of Oncology Providers in Africa.

作者信息

Martei Yehoda M, Rick Tara J, Fadelu Temidayo, Ezzi Mohammed S, Hammad Nazik, Quadri Nasreen S, Rodrigues Belmira, Simonds Hannah, Grover Surbhi, Incrocci Luca, Vanderpuye Verna

机构信息

Department of Medicine (Hematology-Oncology), University of Pennsylvania, Philadelphia, PA.

Department of Radiation Oncology, Erasmus Medical Center, Rotterdam, the Netherlands.

出版信息

JCO Glob Oncol. 2021 Mar;7:368-377. doi: 10.1200/GO.20.00569.

Abstract

PURPOSE

The COVID-19 pandemic has disrupted cancer care globally. There are limited data of its impact in Africa. This study aims to characterize COVID-19 response strategies and impact of COVID-19 on cancer care and explore misconceptions in Africa.

METHODS

We conducted a web-based cross-sectional survey of oncology providers in Africa between June and August 2020. Descriptive statistics and comparative analysis by income groups were performed.

RESULTS

One hundred twenty-two participants initiated the survey, of which 79 respondents from 18 African countries contributed data. Ninety-four percent (66 of 70) reported country mitigation and suppression strategies, similar across income groups. Unique strategies included courier service and drones for delivery of cancer medications (9 of 70 and 6 of 70, respectively). Most cancer centers remained open, but > 75% providers reported a decrease in patient volume. Not previously reported is the fear of infectivity leading to staff shortages and decrease in patient volumes. Approximately one third reported modifications of all cancer treatment modalities, resulting in treatment delays. A majority of participants reported ≤ 25 confirmed cases (44 of 68, 64%) and ≤ 5 deaths because of COVID-19 (26 of 45, 58%) among patients with cancer. Common misconceptions were that Africans were less susceptible to the virus (53 of 70, 75.7%) and decreased transmission of the virus in the African heat (44 of 70, 62.9%).

CONCLUSION

Few COVID-19 cases and deaths were reported among patients with cancer. However, disruptions and delays in cancer care because of the pandemic were noted. The pandemic has inspired tailored innovative solutions in clinical care delivery for patients with cancer, which may serve as a blueprint for expanding care and preparing for future pandemics. Ongoing public education should address COVID-19 misconceptions. The results may not be generalizable to the entire African continent because of the small sample size.

摘要

目的

新型冠状病毒肺炎(COVID-19)大流行已扰乱全球癌症护理。关于其在非洲影响的数据有限。本研究旨在描述COVID-19应对策略及其对癌症护理的影响,并探讨非洲地区存在的误解。

方法

2020年6月至8月期间,我们对非洲肿瘤医疗服务提供者开展了一项基于网络的横断面调查。进行了描述性统计以及按收入组的比较分析。

结果

122名参与者发起了调查,其中来自18个非洲国家的79名受访者提供了数据。94%(70名中的66名)报告了国家缓解和抑制策略,各收入组情况相似。独特策略包括使用快递服务和无人机运送癌症药物(分别为70名中的9名和70名中的6名)。大多数癌症中心仍在营业,但超过75%的医疗服务提供者报告患者数量减少。此前未报告的是对感染的恐惧导致工作人员短缺和患者数量减少。约三分之一的人报告所有癌症治疗方式都有调整,导致治疗延迟。大多数参与者报告癌症患者中因COVID-19确诊病例≤25例(68名中的44名,64%),死亡≤5例(45名中的26名,58%)。常见误解是非洲人对该病毒不易感(70名中的53名,75.7%)以及在非洲炎热天气下病毒传播减少(70名中的44名,62.9%)。

结论

癌症患者中报告的COVID-19病例和死亡较少。然而,注意到疫情导致癌症护理出现中断和延迟。疫情激发了针对癌症患者临床护理提供的定制创新解决方案,这可能成为扩大护理范围和为未来大流行做准备的蓝图。持续的公众教育应消除对COVID-19的误解。由于样本量小,结果可能不适用于整个非洲大陆。

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