孟加拉国、日本和全球视角下 COVID-19 对乙型和丙型肝炎病毒预防、诊断和治疗的影响。
The impact of COVID-19 on hepatitis B and C virus prevention, diagnosis, and treatment in Bangladesh compared with Japan and the global perspective.
机构信息
Department of Epidemiology, Infectious Disease Control and Prevention, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3, Kasumi, Minami-Ku, Hiroshima-Shi, 734-8551, Japan.
Department of Hepato-Biliary-Pancreatic Surgery & Liver Transplant, BIRDEM General Hospital, Dhaka, Bangladesh.
出版信息
BMC Health Serv Res. 2023 Oct 23;23(1):1137. doi: 10.1186/s12913-023-10138-x.
AIM
This study aimed to assess the effect of COVID-19 on hepatitis-related services in Bangladesh and compared the situation with same study conducted in Japan and globally.
METHODS
We conducted an online cross-sectional questionnaire survey among the clinicians of four societies associated with liver disease in Bangladesh from October to December 2022. The questionnaire included the same questions as a survey conducted in Japan and globally.
RESULTS
A total of 83 clinicians from 8 divisions in Bangladesh participated; 66.3% were heads of departments/institutions. Except for HCV treatment initiation, more than 30% of clinicians reported a 76-99% decline in all services. Compared to Japan and the global survey, there was a significantly higher decline in all HBV and HCV services in Bangladesh. To resume services back to pre-COVID-19 levels, Patient anxiety and fear (Bangladesh Survey: 80.7% vs Japan Survey: 67.4% vs Global Survey: 37.9%, p < 0.0001), loss of space due to COVID-19 (Bangladesh Survey: 63.9% vs Japan Survey: 34.7% vs Global Survey: 19.4%, p < 0.0001) were the main challenges. As part of the mitigation strategy, usage of telemedicine (Bangladesh Survey: 83.1% vs. Japan Survey: 67.3% vs Global Survey: 78.6% p < 0.0001), COVID-19 benefits, such as increased laboratory testing platforms (Bangladesh Survey: 77.1% vs Japan Survey: 17.9% vs Global Survey: 41.8%, p < 0.0001) was reported significantly higher in Bangladesh than in Japan and global survey.
CONCLUSION
All the services-related to HBV and HCV were highly affected during greatest impact month of COVID-19 in Bangladesh and the decline level was higher than Japan and global survey. Repeated countermeasures of COVID-19 and constrained healthcare-system were the probable reasons in Bangladesh. Positive impact resulting from COVID-19 countermeasures should be utilized in the national hepatitis program in Bangladesh.
目的
本研究旨在评估 COVID-19 对孟加拉国肝炎相关服务的影响，并将其与在日本和全球开展的同类研究进行比较。
方法
我们于 2022 年 10 月至 12 月期间，对与肝病相关的四个协会的临床医生在孟加拉国进行了在线横断面问卷调查。问卷包含与日本和全球调查相同的问题。
结果
共有来自孟加拉国 8 个行政区的 83 名临床医生参与；其中 66.3%为部门/机构负责人。除 HCV 治疗启动外，超过 30%的临床医生报告所有服务下降了 76%-99%。与日本和全球调查相比，孟加拉国所有乙型肝炎和丙型肝炎服务的下降幅度明显更高。为使服务恢复到 COVID-19 前水平，患者的焦虑和恐惧（孟加拉国调查：80.7%比日本调查：67.4%比全球调查：37.9%，p<0.0001）、因 COVID-19 而导致的空间损失（孟加拉国调查：63.9%比日本调查：34.7%比全球调查：19.4%，p<0.0001）是主要挑战。作为缓解策略的一部分，远程医疗的使用（孟加拉国调查：83.1%比日本调查：67.3%比全球调查：78.6%，p<0.0001），以及 COVID-19 带来的益处，如增加实验室检测平台（孟加拉国调查：77.1%比日本调查：17.9%比全球调查：41.8%，p<0.0001）在孟加拉国的报告比例明显高于日本和全球调查。
结论
在 COVID-19 对孟加拉国影响最大的一个月，所有与乙型肝炎和丙型肝炎相关的服务都受到了严重影响，下降幅度高于日本和全球调查。在孟加拉国，可能是由于 COVID-19 反复采取的应对措施和受限的医疗保健系统导致了这种情况。应在孟加拉国国家肝炎计划中利用 COVID-19 应对措施带来的积极影响。
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