Kabakambira Jean Damascene, Shumbusho Patrick, Mujawamariya Gisele, Rutagengwa William, Twagirumukiza Marc
Department of Internal Medicine, University Teaching Hospital of Kigali, Kigali, Rwanda.
College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda.
Diabetes Metab Syndr Obes. 2022 Jul 20;15:2107-2115. doi: 10.2147/DMSO.S348031. eCollection 2022.
Noncommunicable diseases (NCDs), remain the leading cause of death worldwide and represent an emerging global health threat. In Rwanda and elsewhere, the prevalence of cardiovascular diseases is increasing. To address this global health threat, Rwanda launched integrated nurse-led NCD clinics in all the forty-five District Hospitals across the country in 2006, but no evaluation study has been conducted so far for the added value of this program. The main goal of this study was to assess the impact of NCD clinics on disease control in Rwanda.
This was a retrospective ambulatory patient chart review at a rural district hospital and an urban teaching hospital; which enrolled patients with diabetes and/or hypertension who consulted in a period of 1 month with retrospective data of one year.
A total of 199 patients' electronic health records were reviewed from the University Teaching Hospital of Kigali (CHUK) (53%) and Nyamata District Hospital (47%). Among them, 31% had diabetes, 38% had hypertension and 31% had both diseases. The mean age for the total cohort was 60 years and was predominantly female at 70%. Throughout the year, about 59% patients with hypertension had blood pressure control at the district hospital as opposed to 38% at the referral hospital. The rate of diabetes control was 20% at the referral hospital, but no comparison could be established between the two health facilities as the follow up laboratory markers were not available at the district hospital.
There was a consistent blood pressure control at the district hospital. Diabetes control was not optimal at the referral hospital despite the presence of human resources and logistics required for diabetes care. The situation was even worse at the district hospital where the follow up markers were rarely available.
非传染性疾病仍然是全球主要死因，是一种新出现的全球健康威胁。在卢旺达和其他地方，心血管疾病的患病率正在上升。为应对这一全球健康威胁，卢旺达于2006年在全国45家区级医院设立了由护士主导的综合非传染性疾病诊所，但迄今为止尚未对该项目的附加价值进行评估研究。本研究的主要目的是评估卢旺达非传染性疾病诊所对疾病控制的影响。
这是一项在一家农村区级医院和一家城市教学医院进行的回顾性门诊患者病历审查；纳入了在1个月内就诊的糖尿病和/或高血压患者，并回顾了一年的回顾性数据。
共审查了基加利大学教学医院（CHUK）（53%）和尼亚马塔区医院（47%）的199份患者电子健康记录。其中，31%患有糖尿病，38%患有高血压，31%同时患有这两种疾病。整个队列的平均年龄为60岁，女性占主导，为70%。全年来看，区级医院约59%的高血压患者血压得到控制，而转诊医院为38%。转诊医院的糖尿病控制率为20%，但由于区级医院没有后续实验室指标，无法在两家医疗机构之间进行比较。
区级医院的血压控制情况较为稳定。尽管转诊医院具备糖尿病护理所需的人力资源和后勤保障，但糖尿病控制并不理想。区级医院的情况更糟，那里很少有后续指标。
