Nono Denis, Ssemata Andrew S, Bannink Mbazzi Femke, Seeley Janet
Department of Global Health and Development, Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, United Kingdom.
Medical Research Council (MRC), Uganda Virus Research Institute (UVRI) and London School of Hygiene and Tropical Medicine (LSHTM) Uganda Research Unit, Entebbe, Uganda.
Afr J Disabil. 2024 Nov 22;13:1473. doi: 10.4102/ajod.v13i0.1473. eCollection 2024.
Spina bifida is a congenital neural tube defect, where there is incomplete formation of the spinal cord and vertebrae, resulting in abnormal development of the neural tube. This affects bladder function and urinary incontinence. Clean Intermittent Catheterization (CIC) is used to manage bladder and bowel management.
This study aims to scope evidence on the facilitators and barriers to usage and practice of CIC in children with spina bifida in low-income countries.
We searched databases including PubMed, Web of Science and SCOPUS, and screened articles for inclusion following the PRISMA-ScR guidelines. The search terms included 'Spina Bifida ([continence management] AND [clean intermittent catheterisation]) AND ([barriers to Clean Intermittent Catheterisation] OR [Low Income Countries]) OR (myelomeningocele)'. Full-text assessment for eligibility excluded 202 articles. Twenty-two articles were reviewed and twelve full-text articles were excluded because of limited content. Ten articles published in English between 2004 and 2023 were selected for review.
Barriers in practicing CIC include pain and discomfort in catheter insertion, stigma and fears; inaccessibility of public toilets, unavailability of appropriate catheters, difficulty in positioning, limited quality of teaching and challenges with accessing supplies. Facilitators include starting CIC in infancy, follow-up by healthcare providers, support from family and community members, quality of training, continuous practice of CIC, utilisation of lubricants, reuse of catheters and other low-cost materials.
Our review summarises facilitators and barriers to CIC and provides recommendations for further research, which includes the involvement of family members and community-based rehabilitation workers.
This article contributes to a better understanding of CIC use in low-income countries.
脊柱裂是一种先天性神经管缺陷，脊髓和椎骨形成不完全，导致神经管发育异常。这会影响膀胱功能和尿失禁。清洁间歇性导尿（CIC）用于管理膀胱和肠道。
本研究旨在梳理低收入国家脊柱裂儿童使用和实施CIC的促进因素和障碍方面的证据。
我们检索了包括PubMed、科学网和Scopus在内的数据库，并按照PRISMA-ScR指南筛选纳入的文章。检索词包括“脊柱裂（[控尿管理]和[清洁间歇性导尿]）以及（[清洁间歇性导尿的障碍]或[低收入国家]）或（脊髓脊膜膨出）”。对符合资格的全文评估排除了202篇文章。对22篇文章进行了审查，12篇全文文章因内容有限被排除。选择了2004年至2023年期间发表的10篇英文文章进行审查。
实施CIC的障碍包括导尿插入时的疼痛和不适、耻辱感和恐惧；公共厕所无法使用、合适的导管无法获得、定位困难、教学质量有限以及获取用品方面的挑战。促进因素包括在婴儿期开始CIC、医护人员的随访跟进、家人和社区成员的支持、培训质量、CIC的持续实践、润滑剂的使用、导管和其他低成本材料的重复使用。
我们的综述总结了CIC的促进因素和障碍，并为进一步研究提供了建议，其中包括家庭成员和社区康复工作者的参与。
本文有助于更好地了解低收入国家对CIC的使用情况。
