Enumah Zachary Obinna, Manyama Frank, Yenokyan Gayane, Ngude Hilary, Rafiq Mohamed Yunus, Juma Omar, Stevens Kent, Sakran Joseph V
Department of Surgery, Johns Hopkins Global Surgery Initiative (JHGSI), Johns Hopkins Hospital, Tower 110 Doctor's Lounge, 600 N. Wolfe Street, Baltimore, MD, 21287, USA.
Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
World J Surg. 2022 Jun;46(6):1278-1287. doi: 10.1007/s00268-022-06505-0. Epub 2022 Mar 6.
The goal of this study was to estimate the prevalence of surgical conditions among refugees in East Africa.
Surgery is a foundational aspect to high functioning health care systems. In the wake of the Lancet Commission on Global Surgery, previous research has focused on defining the burden of surgical conditions in low- and middle-income countries. Despite numbering over 80 million people globally, forced migrant populations have often been neglected from this body of research.
We administered a validated survey using random cluster sampling to determine surgical need among refugees in western Tanzania. Primary outcome was history or presence of a surgical problem. Analysis included descriptive and multivariable logistic regression including an average marginal effects model.
We analyzed data from 3,574 refugee participants in East Africa. A total of 1,654 participants (46.3%) reported a history or presence of at least one problem that may be surgical in nature. Of those 1,654 participants who did report a problem 1,022 participants (61.8%) reported the problem was still ongoing. Multivariable analysis revealed several factors associated with having a surgical problem (increasing age, occupation, illness within past year).
To our knowledge, this is the first and largest population-based survey in estimating the prevalence of surgical disease among refugees in sub-Saharan Africa. Our results imply that more than one-in-four refugees has an ongoing surgical problem, suggesting over double the burden of surgical need in refugee populations compared to non-refugee settings.
本研究的目的是估计东非难民中外科疾病的患病率。
外科手术是高效医疗保健系统的一个基础方面。在《柳叶刀》全球外科委员会之后，先前的研究集中于确定低收入和中等收入国家外科疾病的负担。尽管全球被迫移民人口超过8000万，但这一研究领域常常忽视了他们。
我们采用随机整群抽样进行了一项经过验证的调查，以确定坦桑尼亚西部难民的手术需求。主要结果是外科问题的病史或存在情况。分析包括描述性和多变量逻辑回归，包括平均边际效应模型。
我们分析了来自东非3574名难民参与者的数据。共有1654名参与者（46.3%）报告有至少一个可能本质上是外科问题的病史或存在此类问题。在这1654名确实报告有问题的参与者中，1022名参与者（61.8%）报告问题仍在持续。多变量分析揭示了与有外科问题相关的几个因素（年龄增长、职业、过去一年患病）。
据我们所知，这是撒哈拉以南非洲地区首次也是规模最大的一项基于人群的调查，旨在估计难民中外科疾病的患病率。我们的结果表明，超过四分之一的难民有持续的外科问题，这表明难民人群中的手术需求负担是非难民人群的两倍多。
