紧急呼吁在中低收入国家扩大胃动力障碍方面的举措:以胃痉挛为例

H. Bharadwaj, Priyal Dalal, M. D. Marsool, Priyadarshi Prajjwal, Simran Karkhanis, Omniat Amir
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摘要

本文全面探讨了中低收入国家(LMICs)胃瘫管理的现状,强调了最近的创新、持续存在的挑战以及未来的前景。胃瘫是一种以胃排空延迟为特征的疾病,会出现使人衰弱的症状,与包括糖尿病在内的神经性疾病有显著关联。尽管低收入和中等收入国家的发病率明显高于全球平均水平,但流行病学数据仍然很少。本文重点介绍了巴基斯坦、巴西和中国的开创性研究,展示了向全面研究的转变,这些研究深入探讨了胃痉挛流行病学的细微之处、性别特异性模式以及创新治疗方法(如针灸)。然而,在低收入和中等收入国家,阻碍临床管理和研究的挑战依然存在,包括缺乏广泛的流行病学研究、缺乏治疗指南以及缺乏针对医疗保健专业人员的专门培训计划。这些挑战与更广泛的问题交织在一起,如有限的医疗保健基础设施、资源差异和医疗保健人员短缺。本文提出了应对这些挑战的多层面方法,包括国际合作、能力建设以及将胃痉挛管理纳入初级医疗保健服务。本文还提倡采取类似于英国-南非谅解备忘录的合作协议等策略来防止人才流失。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Urgent appeal for expanded initiatives in gastric motility disorders across low and middle-income countries: Illustrating the example of gastroparesis
This paper provides a comprehensive exploration of the current state of gastroparesis management in low and middle-income countries (LMICs), emphasising recent innovations, persistent challenges, and future prospects. Gastroparesis, a condition characterised by delayed stomach emptying, presents debilitating symptoms and is notably linked to neuropathic disorders, including diabetes mellitus. Despite an apparent higher prevalence in LMICs compared to the global average, epidemiological data remains scarce. The paper highlights pioneering research in Pakistan, Brazil, and China, showcasing a transformative shift toward comprehensive studies that delve into nuanced aspects of gastroparesis epidemiology, gender-specific patterns, and innovative therapeutic approaches such as acupuncture. However, challenges impeding clinical management and research in LMICs are identified, encompassing the absence of extensive epidemiological studies, lack of treatment guidelines, and the scarcity of specialised training programs for healthcare professionals. These challenges are intertwined with broader issues such as limited healthcare infrastructure, resource disparities, and healthcare workforce shortages. The paper proposes a multifaceted approach for addressing these challenges, involving international collaboration, capacity building, and the integration of gastroparesis management into primary healthcare services. Strategies to combat brain drain, such as collaborative agreements akin to the UK-South Africa Memorandum of Understanding, are advocated.
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