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乌干达内科医生和牙科医生的概况和死因:1986 年至 2016 年。

The profile and causes of death among medical doctors and dental surgeons in Uganda: 1986 to 2016.

机构信息

Ministry of Health.

Uganda Cancer Institute.

出版信息

Afr Health Sci. 2022 Sep;22(3):656-665. doi: 10.4314/ahs.v22i3.70.

Abstract

BACKGROUND

The loss of health workers through death is of great importance and interest to the public, media and the medical profession as it has very profound social and professional consequences on the delivery of health services.

OBJECTIVE

To describe the profile, causes and patterns of death among medical doctors and dental surgeons in Uganda between 1986 and 2016.

METHODS

We conducted a retrospective descriptive study of mortality among registered medical doctors and dental surgeons. Information on each case was collected using a standard questionnaire and analysed. Cause of death was determined using pathology reports, and if unavailable, verbal autopsies. We summarized our findings across decades using means and standard deviations, proportions and line graphs as appropriate. Cuzick's test for trend was used to assess crude change in characteristics across the three decades. To estimate the change in deaths across decades adjusted for age and sex, we fit a logistic regression model, and used the margins command with a dy/dx option. All analyses were done in Stata version 14.0 (Stata Corp, College Station, TX).

RESULTS

There were 489 deaths registered between 1986 and 2016. Of these, 59 (12.1%) were female. The mean age at death was 48.8 years (Standard Deviation (SD) 15.1) among male and 40.1 years (SD 12.8) among females. We ascertained the cause of death for 468/489 (95.7%). The most common causes of death were HIV/AIDS (218/468, 46.6%), cancer (68/468, 14.5%), non-communicable diseases (62/48, 13.3%), alcohol related deaths (36, 7.7%), road traffic accidents (34, 7.3%), gunshots (11, 2.4%), among others. After adjusting for age and sex, HIV/AIDs attributable deaths decreased by 33 percentage points between the decade of 1986 to1995 and that of 2006 to 2016 -0.33 (-0.44, -0.21. During the same period, cancer attributable deaths increased by 13 percentage periods 0.13 (0.05,0.20).

CONCLUSION

The main causes of death were HIV/AIDS, cancer, non-communicable diseases, alcohol-related diseases and road traffic accidents. There was a general downward trend in the HIV/AIDS related deaths and a general upward trend in cancer related deaths. Doctors should be targeted for preventive and support services especially for both communicable and non-communicable diseases.

摘要

背景

卫生工作者的死亡对公众、媒体和医学界来说非常重要和关注,因为这对卫生服务的提供有非常深远的社会和专业影响。

目的

描述 1986 年至 2016 年间乌干达注册医生和牙医的死亡情况、原因和模式。

方法

我们对注册医生和牙医的死亡率进行了回顾性描述性研究。使用标准问卷收集了每个病例的信息,并进行了分析。通过病理报告确定死因,如果没有病理报告,则进行口头尸检。我们使用平均值和标准差、比例和线图等方法,在不同的十年间进行总结。Cuzick 趋势检验用于评估三个十年间特征的粗变化。为了估计调整年龄和性别后几十年间死亡人数的变化,我们拟合了一个逻辑回归模型,并使用 margins 命令和 dy/dx 选项。所有分析均在 Stata 版本 14.0(StataCorp,德克萨斯州学院站)中进行。

结果

在 1986 年至 2016 年期间,共登记了 489 例死亡。其中,59 例(12.1%)为女性。男性死亡时的平均年龄为 48.8 岁(标准差(SD)为 15.1),女性为 40.1 岁(SD 为 12.8)。我们确定了 468/489(95.7%)例死亡原因。最常见的死因是艾滋病毒/艾滋病(218/468,46.6%)、癌症(68/468,14.5%)、非传染性疾病(62/48,13.3%)、酒精相关死亡(36 例,7.7%)、道路交通碰撞(34 例,7.3%)、枪伤(11 例,2.4%)等。调整年龄和性别后,1986 年至 1995 年和 2006 年至 2016 年期间,艾滋病毒/艾滋病导致的死亡人数减少了 33 个百分点,即 0.33(0.44,0.21)。在此期间,癌症导致的死亡人数增加了 13 个百分点,即 0.13(0.05,0.20)。

结论

主要死因是艾滋病毒/艾滋病、癌症、非传染性疾病、酒精相关疾病和道路交通碰撞。与艾滋病毒/艾滋病相关的死亡人数呈总体下降趋势,与癌症相关的死亡人数呈总体上升趋势。应针对医生开展预防和支持服务,特别是针对传染病和非传染病。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6c53/9993294/0a1f46ae911a/AFHS2203-0656Fig1.jpg

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