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心脏病患者的风湿性心脏病负担及决定因素:埃塞俄比亚的后续护理问题

Rheumatic heart disease burden and determinants in cardiac patients: A follow up care concern in Ethiopia.

作者信息

Berhanu Hiwot, Tegene Elsah, Sudhakar Morankar, Gemechu Tadesse Dukessa, Mossie Andualem

机构信息

Department of Biomedical Sciences, Faculty of Medical Science, Jimma Institute of Health, Jimma University, Jimma, Ethiopia.

Department of Internal Medicine, Institute of Health, Jimma University, Jimma, Ethiopia.

出版信息

Int J Cardiol Cardiovasc Risk Prev. 2024 Nov 21;24:200352. doi: 10.1016/j.ijcrp.2024.200352. eCollection 2025 Mar.

Abstract

Rheumatic heart disease (RHD) is a neglected tropical disease and remains one of the leading causes of cardiovascular-related deaths in Ethiopia. This study aims to assess the burden of RHD and identify its determinants in the country. A hospital-based cross-sectional study was employed from January 5 to April 15, 2023, among cardiac patients attending Jimma Medical Center. Socio-demographic data were collected using a structured interviewer-administered questionnaire and echocardiographic patterns were taken by senior cardiologists. Data were entered into Epidata Version 4.6 and exported to SPSS version 25.0 for analysis. Bivariable and multivariable logistic regressions were performed. A p value < 0.05 was considered statistically significant. Accordingly, the most frequent morbidities were RHD (n = 95, 27.9 %), hypertensive heart disease (n = 92, 27.1 %), ischemic heart disease (n = 54, 15.9 %), and dilated cardiomyopathies (n = 54, 15.9 %). Further, female sex [AOR = 3.06: 95 % CI 1.73-5.47], using wood (biomass fuel) for cooking [AOR = 1.94: 95 % CI 1.10-3.42], history of malnutrition with follow-up at a health facility [AOR = 3.90: 95 % CI 2.22-6.86], dental caries [AOR = 2.09: 95 % CI 1.12-3.87], and living in crowded households [AOR = 2.02: 95 % CI 1.15-3.52] were identified as the determinants of RHD. This finding suggests that focusing on female healthcare, reducing biomass fuel exposure, improving nutritional status, providing regular dental care, and improving living conditions could help reduce the impacts of the disease. Moreover, conducting further research regularly will also benefit the community at large.

摘要

风湿性心脏病(RHD)是一种被忽视的热带疾病,在埃塞俄比亚仍然是心血管相关死亡的主要原因之一。本研究旨在评估该国RHD的负担并确定其决定因素。2023年1月5日至4月15日,在吉姆马医疗中心就诊的心脏病患者中开展了一项基于医院的横断面研究。使用结构化的访谈问卷收集社会人口统计学数据,并由资深心脏病专家进行超声心动图检查。数据录入Epidata 4.6版本,并导出到SPSS 25.0版本进行分析。进行了双变量和多变量逻辑回归分析。p值<0.05被认为具有统计学意义。因此,最常见的疾病是RHD(n = 95,27.9%)、高血压性心脏病(n = 92,27.1%)、缺血性心脏病(n = 54,15.9%)和扩张型心肌病(n = 54,15.9%)。此外,女性[AOR = 3.06:95%CI 1.73 - 5.47]、使用木材(生物质燃料)做饭[AOR = 1.94:95%CI 1.10 - 3.42]、在医疗机构随访时有营养不良史[AOR = 3.90:95%CI 2.22 - 6.86]、龋齿[AOR = 2.09:95%CI 1.12 - 3.87]以及居住在拥挤的家庭中[AOR = 2.02:95%CI 1.15 - 3.52]被确定为RHD的决定因素。这一发现表明,关注女性医疗保健、减少生物质燃料暴露、改善营养状况、提供定期牙科护理以及改善生活条件有助于减轻该疾病的影响。此外,定期开展进一步研究也将使整个社区受益。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5996/11647114/d303932b3315/gr1.jpg

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