Amsterdam UMC Location Vrije Universiteit, Department of Surgery, De Boelelaan 1117, 1081 HV, Amsterdam, The Netherlands.
Global Surgery Amsterdam, Amsterdam, The Netherlands.
World J Surg. 2022 Nov;46(11):2585-2594. doi: 10.1007/s00268-022-06695-7. Epub 2022 Sep 6.
Understanding the burden of diseases requiring surgical care at national levels is essential to advance universal health coverage. The PREvalence Study on Surgical COnditions (PRESSCO) 2020 is a cross-sectional household survey to estimate the prevalence of physical conditions needing surgical consultation, to investigate healthcare-seeking behavior, and to assess changes from before the West African Ebola epidemic.
This study (ISRCTN: 12353489) was built upon the Surgeons Overseas Surgical Needs Assessment (SOSAS) tool, including expansions. Seventy-five enumeration areas from 9671 nationwide clusters were sampled proportional to population size. In each cluster, 25 households were randomly assigned and visited. Need for surgical consultations was based on verbal responses and physical examination of selected household members.
A total of 3,618 individuals from 1,854 households were surveyed. Compared to 2012, the prevalence of individuals reporting one or more relevant physical conditions was reduced from 25 to 6.2% (95% CI 5.4-7.0%) of the population. One-in-five conditions rendered respondents unemployed, disabled, or stigmatized. Adult males were predominantly prone to untreated surgical conditions (9.7 vs. 5.9% women; p < 0.001). Financial constraints were the predominant reason for not seeking care. Among those seeking professional health care, 86.7% underwent surgery.
PRESSCO 2020 is the first surgical needs household survey which compares against earlier study data. Despite the 2013-2016 Ebola outbreak, which profoundly disrupted the national healthcare system, a substantial reduction in reported surgical conditions was observed. Compared to one-time measurements, repeated household surveys yield finer granular data on the characteristics and situations of populations in need of surgical treatment.
了解国家层面需要手术治疗的疾病负担对于推进全民健康覆盖至关重要。2020 年外科状况患病率研究（PRESSCO）是一项横断面家庭调查，旨在估计需要外科咨询的身体状况的患病率，调查卫生保健寻求行为，并评估西非埃博拉疫情前的变化。
本研究（ISRCTN：12353489）基于外科医生海外手术需求评估（SOSAS）工具，包括扩展。从全国 9671 个集群中按人口规模比例抽取了 75 个计数区。在每个集群中，随机分配并访问了 25 户家庭。手术咨询的需求是基于对选定家庭成员的口头回答和体格检查。
共有来自 1854 户家庭的 3618 人接受了调查。与 2012 年相比，报告有一个或多个相关身体状况的人数从人群的 25%减少到 6.2%（95%CI 5.4-7.0%）。每五分之一的情况使受访者失业、残疾或受到歧视。成年男性主要容易出现未治疗的外科状况（男性为 9.7%，女性为 5.9%；p<0.001）。经济拮据是不寻求治疗的主要原因。在寻求专业医疗保健的人群中，86.7%接受了手术。
PRESSCO 2020 是第一次进行外科需求家庭调查，与早期研究数据进行了比较。尽管 2013-2016 年埃博拉疫情严重扰乱了国家卫生保健系统，但报告的外科状况显著减少。与一次性测量相比，重复的家庭调查可提供更精细的有关需要外科治疗的人群特征和情况的数据。
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