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在低收入和中等收入国家(LMICs)实现对儿科内分泌疾病的有效治疗:一项范围综述

Achieving impactful treatment for paediatric endocrine disorders in low- to middle-income countries (LMICs): a scoping review.

作者信息

Olson Hannah Elise, Dolan Carrie

机构信息

Health Sciences, William and Mary, Williamsburg, Virginia, USA

Health Sciences, William and Mary, Williamsburg, Virginia, USA.

出版信息

BMJ Open. 2025 Jul 1;15(7):e090745. doi: 10.1136/bmjopen-2024-090745.

Abstract

OBJECTIVES

Endocrine disorders, such as hypo/hyperthyroidism and diabetes, affect over 5% of the world's population, with an additional 5% of cases remaining undiagnosed. Despite the increasing prevalence of endocrine disorders, especially in low- to middle-income countries (LMICs), limited research offers comprehensive guidance on treating this complex medical field. This scoping review aims to provide evidence-based recommendations for efficient, effective and accessible treatment of paediatric thyroid conditions and diabetes in LMICs.

DESIGN

Scoping review guidelines outlined by the Preferred Reporting Items for Systematic and Meta-Analysis Extension for Scoping Reviews, using the Joanna Briggs Institute (JBI) methodology to analyse healthcare administration approaches in LMICs.

DATA SOURCES

PubMed, Google Scholar, MEDLINE, EconLit, Science Direct and Scopus were searched using a set of search terms from 19 December 2023 to 16 January 2024. An additional high-level search was performed in May 2025.

ELIGIBILITY CRITERIA

Selection of a variety of peer-reviewed publications with a setting in LMICs. Articles were included if they described an intervention strategy related to select paediatric chronic diseases, endocrine conditions or non-communicable diseases. The treatment strategies in question were government initiatives, mobile health, specialised programmes and primary care.

DATA EXTRACTION AND SYNTHESIS

One reviewer manually reviewed articles and documented findings on Microsoft Excel. In accordance with JBI methodological guidelines, no risk of bias assessment or quality appraisal of included studies was conducted.

RESULTS

After reviewing primary care, specialised care, government intervention programmes and mobile care initiatives within developing countries, primary care with an emphasis on task shifting emerged as the best approach for treating paediatric endocrine disorders.

CONCLUSION

Despite recommendations favouring specialised care or government interventions, primary care proves to be the optimal method for treating endocrine conditions. Given limited healthcare funding in LMICs, implementing primary care initiatives can achieve significant health outcomes while maximising resources.

摘要

目标

内分泌失调,如甲状腺功能减退/亢进和糖尿病,影响着全球超过5%的人口,另有5%的病例尚未得到诊断。尽管内分泌失调的患病率不断上升,尤其是在低收入和中等收入国家(LMICs),但针对这一复杂医学领域的治疗,相关研究有限,缺乏全面的指导。本综述旨在为低收入和中等收入国家高效、有效且可及地治疗儿童甲状腺疾病和糖尿病提供循证建议。

设计

采用系统评价与Meta分析扩展的首选报告项目(PRISMA-ScR)概述的综述指南,运用乔安娜·布里格斯研究所(JBI)的方法分析低收入和中等收入国家的医疗管理方法。

数据来源

于2023年12月19日至2024年1月16日使用一组检索词对PubMed、谷歌学术、MEDLINE、EconLit、科学Direct和Scopus进行检索。2025年5月进行了一次额外的高级检索。

纳入标准

选择在低收入和中等收入国家开展的各类同行评议出版物。如果文章描述了与选定的儿童慢性病、内分泌疾病或非传染性疾病相关的干预策略,则纳入其中。所讨论的治疗策略包括政府举措、移动医疗、专门项目和初级保健。

数据提取与综合

一名评审员人工审阅文章,并在Microsoft Excel上记录研究结果。根据JBI方法指南,未对纳入研究进行偏倚风险评估或质量评价。

结果

在对发展中国家的初级保健、专科护理、政府干预项目和移动护理举措进行审查后,强调任务转移的初级保健成为治疗儿童内分泌失调的最佳方法。

结论

尽管有建议倾向于专科护理或政府干预,但初级保健被证明是治疗内分泌疾病的最佳方法。鉴于低收入和中等收入国家的医疗资金有限,实施初级保健举措可以在最大限度利用资源的同时取得显著的健康成果。

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