Impact of socioeconomic and geographical factors on clinical care of biliary atresia patients: a cross-sectional study.

IF 1.5 3区医学 Q2 PEDIATRICS

Pediatric Surgery International Pub Date : 2024-12-30 DOI:10.1007/s00383-024-05949-w

Palak Singhai, Shailesh Solanki, Ravi P Kanojia, Nitin James Peters, Chimmani Sai Kiran, Pramod Kumar Gupta, Sadhna B Lal, Jai Kumar Mahajan

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引用次数: 0

Abstract

Purpose: Biliary atresia (BA) is a critical pediatric condition requiring timely intervention through Kasai portoenterostomy (KPE), and up to two-thirds of patients need liver transplantation (LT). The outcomes for BA patients still need improvement in low- and middle-income countries. This study aims to assess the socioeconomic and geographical profile of BA patients in India, focusing on their compliance with follow-up care, treatment-seeking behaviour, and acceptability of LT in addition, it provides recommendations to overcome identified challenges.

Methods: A retrospective observational study was conducted in a tertiary care centre in India, including 48 patients who underwent KPE between 2018 and 2022. SES was assessed using the modified Kuppuswamy scale, and geographical areas were classified as per the criteria of the Indian Census 2011. Compliance with follow-up, treatment-seeking behaviour, and LT acceptability were evaluated.

Results: The majority of patients belonged to rural areas and lower middle SES. Compliance with follow-up decreased over time, with financial and geographical barriers being significant challenges. Only one patient underwent LT due to prohibitive costs and limited accessibility.

Conclusion: Socioeconomic and geographical factors significantly impact the clinical outcomes of BA patients in India. Improving education, healthcare infrastructure, and financial support is crucial for enhancing patient compliance and access to necessary treatments.

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社会经济和地理因素对胆道闭锁患者临床护理的影响：一项横断面研究。

目的：胆道闭锁（BA）是一种严重的儿童疾病，需要通过Kasai门肠造口术（KPE）及时干预，高达三分之二的患者需要肝移植（LT）。在低收入和中等收入国家，BA患者的预后仍需改善。本研究旨在评估印度BA患者的社会经济和地理概况，重点关注他们对随访护理的依从性、寻求治疗的行为和LT的可接受性，此外，它还提供了克服已确定挑战的建议。方法：在印度的一家三级医疗中心进行了一项回顾性观察研究，包括48名在2018年至2022年期间接受KPE的患者。使用改进的Kuppuswamy量表对SES进行评估，并根据2011年印度人口普查的标准对地理区域进行分类。评估随访依从性、寻求治疗行为和LT可接受性。结果：患者以农村和中下社会经济阶层居多。随着时间的推移，后续行动的依从性下降，财政和地理障碍是重大挑战。由于高昂的费用和有限的可及性，只有一名患者接受了肝移植。结论：社会经济和地理因素显著影响印度BA患者的临床预后。改善教育、医疗基础设施和财政支持对于提高患者依从性和获得必要治疗至关重要。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Pediatric Surgery International 医学-外科

CiteScore

3.00

自引率

5.60%

发文量

215

审稿时长

3-6 weeks

期刊介绍： Pediatric Surgery International is a journal devoted to the publication of new and important information from the entire spectrum of pediatric surgery. The major purpose of the journal is to promote postgraduate training and further education in the surgery of infants and children. The contents will include articles in clinical and experimental surgery, as well as related fields. One section of each issue is devoted to a special topic, with invited contributions from recognized authorities. Other sections will include: -Review articles- Original articles- Technical innovations- Letters to the editor