Ngaruiya Christine, Kawira Annrita, Mali Florence, Kambua Faith, Mwangi Beatrice, Wambua Mbatha, Hersey Denise, Obare Laventa, Leff Rebecca, Wachira Benjamin
Department of Emergency Medicine, Yale University, New Haven, CT, USA.
Department of Surgery, Mwingi Level 4 Hospital, Kitui County, Kenya.
Afr J Emerg Med. 2021 Jun;11(2):264-276. doi: 10.1016/j.afjem.2021.02.005. Epub 2021 Apr 5.
Mortality and morbidity from Non-Communicable Diseases (NCDs) in Africa are expected to worsen if the status quo is maintained. Emergency care settings act as a primary point of entry into the health system for a spectrum of NCD-related illnesses, however, there is a dearth of literature on this population. We conducted a systematic review assessing available evidence on epidemiology, interventions and management of NCDs in acute and emergency care settings in Kenya, the largest economy in East Africa and a medical hub for the continent.
All searches were run on July 15, 2015 and updated on December 11, 2020, capturing concepts of NCDs, and acute and emergency care. The study is registered at PROSPERO (CRD42018088621).
We retrieved a total of 461 references, and an additional 23 articles in grey literature. 391 studies were excluded by title or abstract, and 93 articles read in full. We included 10 articles in final thematic analysis. The majority of studies were conducted in tertiary referral or private/mission hospitals. Cancer, diabetes, cardiovascular disease and renal disease were addressed. Majority of the studies were retrospective, cross-sectional in design; no interventions or clinical trials were identified. There was a lack of access to basic diagnostic tools, and management of NCDs and their complications was limited.
There is a paucity of literature on NCDs in Kenyan emergency care settings, with particular gaps on interventions and management. Opportunities include nationally representative, longitudinal research such as surveillance and registries, as well as clinical trials and implementation science to advance evidence-based, context-specific care.
如果维持现状，非洲非传染性疾病（NCDs）的死亡率和发病率预计将恶化。急诊护理机构是一系列与非传染性疾病相关疾病进入卫生系统的主要入口点，然而，关于这一人群的文献却很匮乏。我们进行了一项系统综述，评估肯尼亚急性和急诊护理机构中有关非传染性疾病的流行病学、干预措施和管理的现有证据。肯尼亚是东非最大的经济体和非洲大陆的医疗中心。
所有检索于2015年7月15日进行，并于2020年12月11日更新，涵盖非传染性疾病以及急性和急诊护理的概念。该研究已在国际系统评价注册库（PROSPERO，注册号：CRD42018088621）登记。
我们共检索到461篇参考文献，另外在灰色文献中找到23篇文章。通过标题或摘要排除了391项研究，对93篇文章进行了全文阅读。我们将10篇文章纳入最终的主题分析。大多数研究是在三级转诊医院或私立/教会医院进行的。涉及了癌症、糖尿病、心血管疾病和肾脏疾病。大多数研究为回顾性、横断面设计；未发现干预措施或临床试验。缺乏基本诊断工具，非传染性疾病及其并发症的管理有限。
肯尼亚急诊护理机构中关于非传染性疾病的文献匮乏，在干预措施和管理方面存在特别的差距。机会包括开展具有全国代表性的纵向研究，如监测和登记，以及进行临床试验和实施科学研究，以推进基于证据的、因地制宜的护理。
