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揭示罕见病的挑战:来自阿尔巴尼亚的一项回顾性横断面研究(2005 - 2022年)的见解

Uncovering the Challenges of Rare Diseases: Insights From a Retrospective Cross-Sectional Study in Albania (2005-2022).

作者信息

Perolla Adela, Çalliku Elsuarta, Cili Alma, Caja Tatjana, Pulluqi Polikron, Ivanaj Arben

机构信息

Internal Medicine, Hematology, University Hospital Centre "Mother Teresa", Tirana, ALB.

出版信息

Cureus. 2024 Jan 11;16(1):e52091. doi: 10.7759/cureus.52091. eCollection 2024 Jan.

DOI:10.7759/cureus.52091
PMID:38222997
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10784772/
Abstract

BACKGROUND

Diagnosing and treating rare diseases pose significant challenges within global healthcare systems due to their low prevalence and varying criteria for defining them. In Albania, the absence of a dedicated registry for rare diseases exacerbates these challenges. Recognising this gap, a retrospective cross-sectional study was conducted from January 2005 to December 2022 to analyse the incidence and prevalence of rare haematologic diseases in the country, diagnosed in the Hematology Service at the University Hospital Centre "Mother Teresa," which is the sole diagnostic center for blood diseases in Albania. This study aims to provide insights into the frequency of these diseases within the adult Albanian population and seeks to underscore the critical need for improved data collection and research in this field of healthcare.

OBJECTIVE

The primary objective of this study is to assess the incidence and prevalence of rare hematologic diseases diagnosed at the Hematology Service of the University Hospital Centre "Mother Teresa" in Albania from January 2005 to December 2022.

MATERIALS AND METHODS

This retrospective cross-sectional study employed a descriptive study design, focusing on the analysis of rare hematologic disease incidence and prevalence. The study was conducted exclusively at the University Hospital Centre "Mother Teresa" in Albania, the primary diagnostic center for blood-related disorders in the country. Data collection spanned a period of 18 years, from January 2005 to December 2022, encompassing patient records. Inclusion criteria encompassed adult patients aged 15 years and older who had received diagnoses of rare hematologic diseases during the specified timeframe, without specific operational definitions applied. Non-probability convenience sampling was used, including all eligible cases identified within the study's timeframe, obviating the need for formal sample size calculation. Data were extracted from the records of the Hematology Service at the University Hospital Centre "Mother Teresa," primarily using medical records containing essential patient information. Data analysis utilised software such as EXCEL 16.0 and SPSS (v. 25.0), applying descriptive statistical methods, including frequencies and percentages, to assess the incidence and prevalence of rare hematologic diseases. The study's findings were summarised and presented in a tabular format to provide a clear and concise overview of the results.

RESULTS

Our study identified 64 cases of rare hematologic diseases among adults. Notably, primary myelofibrosis (MF) exhibited the highest incidence and prevalence rate, followed by Waldenström macroglobulinemia (WM) and Gaucher disease (GD) emerging as the most prevalent diagnoses after MF, with 16 and 10 cases, respectively. Several ultra-rare diseases, such as Fanconi anemia and chronic eosinophilic leukemia, were also detected, indicating a significant disease burden, while diseases such as Factor X deficiency and Niemann-Pick disease type C were exceptionally rare.

CONCLUSION

Diagnosing and treating rare diseases remain formidable challenges in healthcare systems worldwide. This study underscores the need for enhanced awareness, research, and the pressing need for dedicated registries, collaborative research initiatives, and heightened attention to these conditions to enhance our understanding and management of rare hematological diseases, particularly within the Albanian healthcare context.

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5d52/10784772/7896dd071362/cureus-0016-00000052091-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5d52/10784772/7896dd071362/cureus-0016-00000052091-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5d52/10784772/7896dd071362/cureus-0016-00000052091-i01.jpg
摘要

背景

由于罕见病发病率低且定义标准各异,在全球医疗体系中,诊断和治疗罕见病面临重大挑战。在阿尔巴尼亚,缺乏专门的罕见病登记系统使这些挑战更加严峻。认识到这一差距,于2005年1月至2022年12月开展了一项回顾性横断面研究,以分析该国罕见血液疾病的发病率和患病率,这些病例是在“圣德肋撒”大学医院中心血液科确诊的,该中心是阿尔巴尼亚唯一的血液疾病诊断中心。本研究旨在深入了解这些疾病在成年阿尔巴尼亚人群中的发病频率,并强调在这一医疗领域改进数据收集和研究的迫切需求。

目的

本研究的主要目的是评估2005年1月至2022年12月在阿尔巴尼亚“圣德肋撒”大学医院中心血液科确诊的罕见血液疾病的发病率和患病率。

材料与方法

这项回顾性横断面研究采用描述性研究设计,重点分析罕见血液疾病的发病率和患病率。该研究仅在阿尔巴尼亚的“圣德肋撒”大学医院中心进行,该中心是该国主要诊断血液相关疾病的中心。数据收集历时18年,从2005年1月至2022年12月,涵盖患者记录。纳入标准包括15岁及以上的成年患者,他们在特定时间范围内被诊断为患有罕见血液疾病,未应用具体的操作定义。采用非概率便利抽样,纳入研究时间范围内所有符合条件的病例,无需进行正式的样本量计算。数据主要从“圣德肋撒”大学医院中心血液科的记录中提取,主要使用包含患者基本信息的病历。数据分析使用了EXCEL 16.0和SPSS(v. 25.0)等软件,应用描述性统计方法,包括频率和百分比,以评估罕见血液疾病的发病率和患病率。研究结果以表格形式总结呈现,以便清晰简洁地概述结果。

结果

我们的研究在成年人中确定了64例罕见血液疾病病例。值得注意的是,原发性骨髓纤维化(MF)的发病率和患病率最高,其次是华氏巨球蛋白血症(WM)和戈谢病(GD),在MF之后成为最常见的诊断疾病,分别有16例和10例。还检测到几种超罕见疾病,如范可尼贫血和慢性嗜酸性粒细胞白血病,表明疾病负担较重,而X因子缺乏症和尼曼-皮克病C型等疾病极为罕见。

结论

在全球医疗系统中,诊断和治疗罕见病仍然是艰巨的挑战。本研究强调需要提高认识、加强研究,迫切需要建立专门的登记系统、开展合作研究倡议,并更加关注这些疾病,以增进我们对罕见血液疾病的理解和管理,特别是在阿尔巴尼亚的医疗环境中。

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