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撒哈拉以南非洲五个国家中因新冠肺炎住院的医护人员的流行病学概况及结局:一项队列研究

Epidemiological profiles and outcomes of healthcare workers hospitalized for COVID-19 in five Sub-Saharan African countries: a cohort study.

作者信息

Millimouno Tamba Mina, Grovogui Fassou Mathias, Kourouma Karifa, Hassan Shermarke, Kaba Ibrahima, Kamara Ibrahim Franklyn, Mbasha Jerry-Jonas, Collins Timire, Merson Laura, Delamou Alexandre

机构信息

Africa Center of Excellence for Prevention and Control of Communicable Diseases (CEA-PCMT), Gamal Abdel Nasser University of Conakry, Conakry, Guinea.

Centre National de Formation et de Recherche en Santé Rurale de Maferinyah, Forecariah, Guinea.

出版信息

F1000Res. 2024 Jun 18;13:655. doi: 10.12688/f1000research.150775.1. eCollection 2024.

Abstract

BACKGROUND

The COVID-19 pandemic placed immense strain on global health systems and healthcare workers (HCWs). This study aimed to analyze the epidemiological profiles and outcomes of HCWs hospitalized for COVID-19 across five sub-Saharan African countries.

METHODS

This was a cohort study using secondary data collected between January 30, 2020, and December 31, 2022, as part of the International Severe Acute Respiratory and emerging Infection Consortium study. The study population consisted of HCWs who were hospitalized due to clinically suspected or laboratory-confirmed SARS-CoV-2 infection. Demographic and clinical characteristics and case management were summarized using proportions or medians and interquartile ranges. Factors associated with risk of mortality among HCWs were assessed using a Cox proportional hazards model, adjusted for age and sex.

RESULTS

Findings showed that South Africa recorded a lower percentage (2.4%) of patients who were HCWs compared to Gambia, Ghana, Guinea, and Malawi. Overall, many HCWs were aged ≥50 years and the majority were females (66.8%). In three of the five countries, however, the majority of the HCWs were <39 years old and were males. Antibiotics were the most commonly used medical treatments across three countries (Ghana, 67.8%; Guinea, 97.3%; Malawi, 80%), while antimalarials were commonly used in Guinea (87.8%) and Ghana (30.4%). Guinea and South Africa reported deaths with case-fatality rates varying from 22% in March 2020 to 1.4% in February 2022. Risk factors for mortality included age over 50 years, hypertension, diabetes mellitus, and chronic kidney disease.

CONCLUSIONS

Our study underscores the critical need for continuous protection and enhanced readiness for HCWs, particularly during epidemics and pandemics. Strengthening infection prevention and control measures and focusing on vulnerable groups such as older and female HCWs are essential for mitigating the impact of future health crises. Further research is required to fully comprehend the implications of these findings.

摘要

背景

新冠疫情给全球卫生系统和医护人员带来了巨大压力。本研究旨在分析撒哈拉以南非洲五个国家因新冠住院的医护人员的流行病学特征和结局。

方法

这是一项队列研究,使用了2020年1月30日至2022年12月31日期间收集的二手数据,作为国际严重急性呼吸道和新发感染联盟研究的一部分。研究人群包括因临床疑似或实验室确诊的SARS-CoV-2感染而住院的医护人员。人口统计学和临床特征以及病例管理情况用比例、中位数和四分位间距进行总结。使用Cox比例风险模型评估与医护人员死亡风险相关的因素,并对年龄和性别进行了调整。

结果

研究结果显示,与冈比亚、加纳、几内亚和马拉维相比,南非医护人员患者的比例较低(2.4%)。总体而言,许多医护人员年龄≥50岁,大多数为女性(66.8%)。然而,在五个国家中的三个国家,大多数医护人员年龄<39岁且为男性。抗生素是三个国家(加纳,67.8%;几内亚,97.3%;马拉维,80%)最常用的药物治疗,而抗疟药在几内亚(87.8%)和加纳(30.4%)常用。几内亚和南非报告了死亡情况,病死率从2020年3月的22%到2022年2月的1.4%不等。死亡风险因素包括50岁以上、高血压、糖尿病和慢性肾脏病。

结论

我们的研究强调了持续保护医护人员并提高其应对能力的迫切需求,尤其是在流行病和大流行期间。加强感染预防和控制措施,关注老年和女性医护人员等弱势群体,对于减轻未来健康危机的影响至关重要。需要进一步研究以全面理解这些发现的意义。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ea18/12238847/570c4ecebec9/f1000research-13-165373-g0000.jpg

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