Aga Khan University, Karachi, Pakistan.
Bolan University of Medical and Health Sciences, Quetta, Pakistan.
J Neurol Sci. 2021 Jun 15;425:117462. doi: 10.1016/j.jns.2021.117462. Epub 2021 Apr 17.
We aimed to assess the response and impact of covid 19 pandemic at tertiary care centers in Pakistan especially pertaining to neurological care, facilities and training.
A pre-tested survey form was sent to 40 neurology tertiary care centers in all the provinces in the country in the first week of July 2020. 33 filled forms were received, out of which 18 were public (government) and 15 were private hospitals.
Estimated 1300 HCW (faculty, medical officers, trainees and nurses) work at these 33 participating centers. There were 17 deaths among HCW (1.3%) at ten centers. Sufficient personal protective equipment (PPE) were provided to 158 HCW (12%). 129 (10%)HCW tested positive for COVID 19 at 31 centers including trainees/medical officers (39), consultants (29) and nursing and other staff (61). Due to low neurology admissions, 23/33 hospitals (70%) posted neurology trainees in COVID 19 units to contribute to covid care. Less than 50% hospitals did covid screening PCR before admission to neurology wards. Only 10% hospitals provide training and regular update to HCW. Neurology tele-health services were started for clinically stable patients at 15 (45%) centers. Only 60% neurology training programs were able to start online training. Ongoing research studies and trials focusing neurological manifestations of COVID-19 were done at 10 (30%) centers. Modification of facilities for COVID patients showed that 24(72%) hospitals strictly reduced the number of attendants accompanying patients. Only 10 (30%) centers had neurophysiological tests being conducted on COVID-19 patients. Mental health support services to HCW were provided at 12 (36%) centers.
Among HCW 10% tested positive for covid and 1.3% died. Mental health support services offered for HCW were available in 36% institutions. Neurology training was substantially affected due to low admissions, limited ward rounds and limited availability of online training.
本研究旨在评估新冠疫情对巴基斯坦三级医疗中心的影响，特别是对神经科护理、设施和培训的影响。
我们于 2020 年 7 月的第一周向全国所有省份的 40 个神经科三级医疗中心发送了一份预先测试的调查问卷。共收到 33 份有效问卷，其中 18 家为公立医院，15 家为私立医院。
这 33 家参与调查的中心共有 1300 名医护人员（包括教员、医师、住院医师和护士）。在 10 家中心，有 17 名医护人员（1.3%）死亡。158 名医护人员（12%）获得了充足的个人防护设备（PPE）。在 31 家中心，包括住院医师/医师（39 人）、顾问（29 人）和护理及其他工作人员（61 人）在内的 129 名（10%）医护人员新冠病毒检测呈阳性。由于神经科收治患者较少，23/33 家（70%）医院将神经科住院医师派往新冠病房参与新冠救治。不到 50%的医院在将患者收入神经科病房前进行新冠核酸 PCR 检测。只有 10%的医院对医护人员进行培训和定期更新。15 家（45%）中心为病情稳定的患者启动了神经科远程医疗服务。只有 60%的神经科培训项目能够开始在线培训。10 家（30%）中心正在进行针对新冠病毒感染的神经科表现的研究。为新冠患者改造设施的情况显示，24 家（72%）医院严格限制了陪伴患者的家属人数。只有 10 家（30%）中心对新冠患者进行神经生理学检查。12 家（36%）中心向医护人员提供心理健康支持服务。
在医护人员中，10%的人新冠病毒检测呈阳性，1.3%的人死亡。36%的机构为医护人员提供心理健康支持服务。由于收治患者较少、查房受限以及在线培训机会有限，神经科培训受到了严重影响。
