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非洲管理先天性心脏缺陷的心脏外科手术能力的反映:一种观点。

A reflection of Africa's cardiac surgery capacity to manage congenital heart defects: a perspective.

作者信息

Awuah Wireko A, Adebusoye Favour T, Wellington Jack, Ghosh Shankhaneel, Tenkorang Pearl O, Machai Paciencia N M, Abdul-Rahman Toufik, Mani Shyamal, Salam Abdus, Papadakis Marios

机构信息

Sumy State University, Sumy, Ukraine.

Cardiff University School of Medicine, Cardiff University, Wales, UK.

出版信息

Ann Med Surg (Lond). 2023 Jul 8;85(8):4174-4181. doi: 10.1097/MS9.0000000000001054. eCollection 2023 Aug.

Abstract

Congenital heart defects (CHDs) are birth abnormalities that may drastically alter the structure and functionality of the heart. For 70% of infants with congenital disorders to survive or maintain a better quality of life, surgery is necessary. Over 500 000 of the 1.5 million CHD cases reported annually, or 1% of all live births, occur in Africa, according to the WHO. A surmounted 90% of these patients are from Africa, and as a consequence, 300 000 infants die annually as a result of poor care or difficulty accessing adequate healthcare. However, the high prevalence of CHDs, precipitated by a plethora of aetiologies worldwide, is particularly pronounced in Africa due to maternal infectious diseases like syphilis and rubella amongst the pregnant populace. In low- and middle-income countries, especially in Africa, where foreign missions and organizations care for the majority of complicated cardiac surgical patients, access to secure and affordable cardiac surgical therapy is a substantial issue. Interventions for CHDs are very expensive in Africa as many of the continent's domiciles possess low expenditures and funding, thereby cannot afford the costs indicated by associated surgical treatments. Access to management and healthcare for CHDs is further hampered by a lack of trained surgical personnel, specialized tools, infrastructure, and diagnostic facilities in Africa.

摘要

先天性心脏缺陷(CHDs)是出生时就存在的异常情况,可能会极大地改变心脏的结构和功能。对于70%患有先天性疾病的婴儿来说,为了存活或维持更好的生活质量,手术是必要的。根据世界卫生组织的数据,在每年报告的150万例先天性心脏病病例中,超过50万例(占所有活产婴儿的1%)发生在非洲。其中超过90%的患者来自非洲,因此,每年有30万婴儿因护理不善或难以获得足够的医疗保健而死亡。然而,由于全球范围内众多病因导致先天性心脏病的高发病率,在非洲尤其明显,这是因为孕妇群体中存在梅毒和风疹等母体传染病。在低收入和中等收入国家,特别是在非洲,外国使团和组织照顾着大多数复杂心脏手术患者,获得安全且负担得起的心脏手术治疗是一个重大问题。在非洲,先天性心脏病的干预措施非常昂贵,因为该大陆许多地区的支出和资金水平较低,因此无法承担相关手术治疗所需的费用。非洲缺乏训练有素的外科人员、专业工具、基础设施和诊断设施,这进一步阻碍了先天性心脏病的管理和医疗服务的获取。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a15e/10406072/4d238a9e6c19/ms9-85-4174-g001.jpg

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