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2019年冠状病毒病大流行期间的癌症护理:非洲的情况与前景

Cancer Care During the COVID-19 Pandemic: The African Narrative and Prospects.

作者信息

Ojo Charles, Orji Chijioke, Adedeji Ayodeji, Nwachukwu Chibuike, Fagbemi Ona

机构信息

Emergency Department, United Lincolnshire Hospitals NHS Trust, Boston, GBR.

Trauma and Orthopaedics, Betsi Cadwaladr University Health Board, Wrexham, GBR.

出版信息

Cureus. 2023 Aug 20;15(8):e43803. doi: 10.7759/cureus.43803. eCollection 2023 Aug.

Abstract

The COVID-19 pandemic has had a significant impact on healthcare services globally. Whilst it has been particularly disruptive for cancer care in low-resource settings, a few African countries have been able to adapt strategies to enable continued delivery of medical care to persons with cancer. This study seeks to highlight how much effect the coronavirus pandemic has had on oncological care in Africa and to indicate the way forward. For this narrative review, PubMed and Google Scholar were used to search for literature addressing the effect of the coronavirus pandemic on the care of patients with cancer in Africa with ensuing coping strategies. Selection criteria were manuscripts published since the onset of the pandemic in 2019 and written in the English language with Africa being the focus. In total, 52 research papers involving up to 21 African nations were found and reviewed. Across the board, the COVID-19 pandemic resulted in the deferral of oncological screening programs and a halt in immunization activities routinely scheduled for preventable cancers. It caused a colossal shortage in the availability of appropriately trained medical personnel, reduced frequency and duration of outpatient consultations, and a delay in cancer investigations and diagnosis. It also stirred up the substandard modification of chemotherapy regimens and radiotherapy due to the scarcity of anticancer medications and radioisotopes and engendered the cancellation of cancer surgical procedures. Palliative care for patients with locally advanced and metastatic disease was in many cases interrupted and cancer research activities were abruptly deferred. Ultimately, these led to poor patient outcomes and increased cancer-related fatalities. However, a few African countries - Rwanda, Ghana, and Tunisia - have continued to adapt telemedicine, small unmanned aircraft systems (sUAS), and home therapy to facilitate cancer care. To date, there is a paucity of data concerning the successes and cost-effectiveness of these relatively new methods recently adapted to cater to the medical needs of cancer patients in Africa. The pandemic has presented the African community an opportunity to advance her healthcare systems, especially as it pertains to the delivery of medical care to persons with cancer. The need of the hour is to study further the alternative cancer care delivery systems initiated during the pandemic in order to determine their sustainability in Africa at large.

摘要

2019年冠状病毒病疫情对全球医疗服务产生了重大影响。虽然它对资源匮乏地区的癌症护理造成了特别大的破坏,但一些非洲国家已经能够调整策略,以便继续为癌症患者提供医疗服务。本研究旨在强调冠状病毒疫情对非洲肿瘤护理产生了多大影响,并指明前进的方向。对于本叙述性综述,使用了PubMed和谷歌学术搜索关于冠状病毒疫情对非洲癌症患者护理的影响及随之而来的应对策略的文献。选择标准是自2019年疫情爆发以来发表的、以英语撰写且聚焦于非洲的手稿。总共找到了52篇涉及多达21个非洲国家的研究论文并进行了综述。总体而言,2019年冠状病毒病疫情导致肿瘤筛查项目推迟,为可预防性癌症定期安排的免疫活动暂停。它造成了经过适当培训的医务人员严重短缺,门诊咨询的频率和时长降低,癌症检查和诊断延迟。由于抗癌药物和放射性同位素短缺,它还引发了化疗方案和放疗的不合标准的调整,并导致癌症手术取消。局部晚期和转移性疾病患者的姑息治疗在许多情况下被中断,癌症研究活动也突然推迟。最终,这些导致了患者预后不良和癌症相关死亡人数增加。然而,一些非洲国家——卢旺达、加纳和突尼斯——继续采用远程医疗、小型无人机系统和家庭治疗来促进癌症护理。迄今为止,关于这些最近为满足非洲癌症患者医疗需求而采用的相对新方法的成功情况和成本效益的数据很少。疫情为非洲社会提供了一个推进其医疗系统的机会,特别是在为癌症患者提供医疗服务方面。当务之急是进一步研究疫情期间启动的替代癌症护理提供系统,以确定它们在整个非洲的可持续性。

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