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干部在社区糖尿病视网膜病变管理中的作用及其在中低收入国家面临的挑战:范围综述。

The role of cadre in the community on diabetic retinopathy management and its challenges in low-middle income countries: a scoping review.

机构信息

Residency Program in Ophthalmology, Faculty of Medicine Universitas Indonesia, Cipto Mangunkusumo General Hospital, Jakarta, Indonesia.

Ophthalmology Department, Faculty of Medicine Universitas Indonesia, Cipto Mangunkusumo General Hospital, Jakarta, Indonesia.

出版信息

BMC Public Health. 2024 Jan 15;24(1):177. doi: 10.1186/s12889-024-17652-5.

Abstract

INTRODUCTION

Diabetes is a serious public health problem, with low- and middle-income countries (LMICs) bearing over 80% of the burden. Diabetic retinopathy (DR) is one of the most prevalent diabetic microvascular problems, and early diagnosis through eye screening programs for people with diabetes is critical to prevent vision impairment and blindness. Community-based treatments, including non-physician cadres have been recommended to enhance DR care.

METHODS

The review protocol was determined and scoping review was conducted.The population, concept, and context were "cadre", "role of cadre in the management of DR", and LMICs". Data were collected from databases and searches, including grey literature.

RESULTS

Cadre can motivate people to attend a diabetic eye screening event when the rate of eye examinations is about six times higher than before the start of the intervention. Health education is a possible area for task sharing, and the cadre reported could also perform the task of vision testing. The cadre could be a good supporter and a good reminder for society. However, several challenges have been faced in this study and inadequate infrastructure is the foremost challenge found in this study. Other challenges encountered in the studies include poverty, lack of community awareness, trust issues, and low education levels contributing to poor health.

CONCLUSION

The current study highlighted significant gaps in the literature, which focus on the role of cadre as a community-based intervention in managing DR in LMICs. Further research is needed to develop evidence to support cost-effective screening services and cadre-related policy development in LMICs.

摘要

介绍

糖尿病是一个严重的公共卫生问题,中低收入国家(LMICs)承担着超过 80%的负担。糖尿病视网膜病变(DR)是最常见的糖尿病微血管问题之一,通过糖尿病患者的眼部筛查计划早期诊断对于预防视力损害和失明至关重要。已经推荐了以社区为基础的治疗方法,包括非医师干部,以加强 DR 的护理。

方法

确定了审查方案并进行了范围审查。人群、概念和背景是“干部”、“干部在 DR 管理中的作用”和“LMICs”。数据来自数据库和搜索,包括灰色文献。

结果

当眼部检查率比干预前高约六倍时,干部可以促使人们参加糖尿病眼部筛查活动。健康教育是任务分担的一个可能领域,报告的干部也可以执行视力测试任务。干部可以成为社会的良好支持者和良好提醒者。然而,本研究中遇到了一些挑战,基础设施不足是本研究发现的最主要挑战。在研究中遇到的其他挑战包括贫困、社区意识缺乏、信任问题和低教育水平,这些问题导致健康状况不佳。

结论

本研究强调了文献中的重大差距,这些差距集中在干部作为一种以社区为基础的干预措施在管理 LMICs 中的 DR 方面的作用。需要进一步研究来为支持成本效益高的筛查服务和 LMICs 中的干部相关政策制定提供证据。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4599/10789068/102c9815100d/12889_2024_17652_Fig1_HTML.jpg

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