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新冠疫情对肯尼亚全国主要转诊医院癌症化疗相关医疗救助利用情况的颠覆性影响。

The Disruptive Impact of COVID-19 on the Utilization of Cancer Chemotherapy-Related Healthcare Assistance at the Principal Nationwide Referral Hospital in Kenya.

作者信息

Njunge Irene Mumbi, Okalebo Faith, Kurdi Amanj, Kumar Santosh, Sinha Susmita, Haque Mainul, Adnan Nihad, Meyer Johanna C, Godman Brian, Opanga Sylvia

机构信息

Pharmacology, Clinical Pharmacy and Pharmacy Practice, University of Nairobi, Nairobi, KEN.

Therapeutics, Strathclyde Institute of Pharmacy & Biomedical Sciences, University of Strathclyde, Glasgow, GBR.

出版信息

Cureus. 2023 Dec 11;15(12):e50320. doi: 10.7759/cureus.50320. eCollection 2023 Dec.

Abstract

Background Lockdown measures to reduce the outbreak of COVID-19 negatively impacted the administration of cancer chemotherapy globally; however, data from Kenya are limited. Researchers strove to address this information gap and assess chemotherapy trends before and during the pandemic at Kenyatta National Hospital (KNH), the most wide-ranging referral infirmary in Kenya, along with associated factors to provide future guidance. Methods Time series analyses and patient interviews were undertaken at the KNH Cancer Treatment Centre. Patient data were analyzed descriptively and inferentially. The average quarterly scores of chemotherapy-related patients from January 2019 to December 2020 were computed for the time series analysis. Results A total of 241 participants were recruited. Of the participants, 164 (68%) were female, and the mean age was 55. Breast cancer was the most typical cancer type. Independent risk factors for missed chemotherapy sessions were a considerable increase in travel costs, rescheduled appointments alongside difficulties in securing an appointment, comorbidities, and marital status. There was a decline in chemotherapy utilization before COVID-19, with a sharp drop at the pandemic's peak. Conclusion COVID-19 and associated measures did appreciably affect the treatment of cancer patients with chemotherapy in this developing country, with several factors contributing to this. Efforts should be geared toward continuity of services during future pandemics in developing countries to improve patient outcomes.

摘要

背景 为减少新冠病毒病(COVID-19)传播而采取的封锁措施对全球癌症化疗的实施产生了负面影响;然而,肯尼亚的数据有限。研究人员努力填补这一信息空白,并评估肯尼亚范围最广的转诊医院——肯雅塔国家医院(KNH)在疫情之前和期间的化疗趋势,以及相关因素,以便提供未来指导。方法 在KNH癌症治疗中心进行时间序列分析和患者访谈。对患者数据进行描述性和推断性分析。计算2019年1月至2020年12月化疗相关患者的季度平均得分用于时间序列分析。结果 共招募了241名参与者。其中,164名(68%)为女性,平均年龄为55岁。乳腺癌是最常见的癌症类型。错过化疗疗程的独立危险因素包括交通费用大幅增加、预约重新安排以及难以预约、合并症和婚姻状况。在COVID-19之前化疗利用率有所下降,在疫情高峰期急剧下降。结论 COVID-19及相关措施确实对这个发展中国家癌症患者的化疗治疗产生了明显影响,有几个因素导致了这种情况。发展中国家在未来疫情期间应努力实现服务的连续性,以改善患者预后。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/37fb/10712275/e2598f6fb99a/cureus-0015-00000050320-i01.jpg

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