战争与慢性病:以保健中心为基础的加沙巴勒斯坦非传染性疾病患者研究。

IF 3.1 2区 医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH
Belal Aldabbour, Yousef Barakat, Samah Elamassie, Fatima Hmeid, Manar Dughmoush, Maha Al-Rantisi, Doaa Abu-Helal, Lina Barakat, Diana Bader, Afnan Kwaik
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引用次数: 0

摘要

背景:加沙地带的战争给基础设施和保健服务带来了巨大压力。因此,人口面临着更大的发病率和死亡率风险,这不仅是因为暴力,还因为缺乏获得保健的机会。这项研究考察了战争如何影响加沙地带患有非传染性疾病的巴勒斯坦人。方法:这项横断面调查采用结构化问卷,于2024年10月至11月期间从加沙北部和南部的七家主要初级保健诊所招募了968名患有六种常见非传染性疾病的患者。调查收集了社会人口统计数据,评估了战争对参与者的直接影响,评估了获得初级保健和药物的情况,并审查了战争期间对参与者的健康影响。根据描述性统计,推断分析调查了参与者对初级保健的看法与其居住或流离失所地区之间的关系。结果:高血压(64.9%)、2型糖尿病(44.4%)和心血管疾病(17.1%)是报告最多的非传染性疾病。98.0%的参与者在战争期间流离失所,68.1%仍然流离失所。29.9%的人失去了一级亲属,大多数人无法获得足够的食物和饮用水,财产和收入损失,睡眠和体育锻炼习惯受到不利影响。92.8%的人认为战前生活质量很好,而81.3%的人认为战争期间生活质量很差。定期随访的依从性从战前的96.7%下降到战争期间的40.7% (p结论:该研究为高强度武装冲突对非传染性疾病患者的影响提供了重要见解。加沙地带的战争对非传染性疾病患者产生了深刻影响,阻碍了他们获得医疗保健,使民众现在和将来都面临更高发病率和过高死亡率的风险。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
War and chronic illness: a health center-based study of Palestinians with non-communicable diseases in Gaza.

Background: The war in the Gaza Strip has put immense strain on the infrastructure and health services. As a consequence, the population faces increased risks of morbidity and mortality, not only from violence but also from lack of access to healthcare. This study examines how the war affected Palestinians with non-communicable diseases (NCDs) in the Strip.

Methods: This cross-sectional survey employed a structured questionnaire to recruit 968 patients with six common NCDs from seven leading PHC clinics located in northern and southern Gaza between October and November 2024. The survey collected sociodemographic data, assessed direct war impacts on participants, evaluated accessibility to PHC and medications, and examined health impacts on participants during the war. Following descriptive statistics, inferential analysis investigated the relationships between participants' perceptions of PHC and their areas of residence or displacement.

Results: Hypertension (64.9%), type II diabetes mellitus (44.4%), and cardiovascular disease (17.1%) were the most frequently reported NCDs. 98.0% of participants were displaced during the war, and 68.1% were still displaced. 29.9% had lost a first-degree relative, and the majority suffered inaccessibility to adequate food and drinking water, lost property and income, and suffered adverse impacts on their sleep and physical exercise habits. 92.8% rated their pre-war quality of life (QoL) as excellent or good, while 81.3% rated their QoL during the war as poor. Adherence to regular follow-ups decreased from 96.7% before the war to 40.7% during the war (p < 0.001). Satisfaction with PHC dropped from 92.9% to 57.33% (p = 0.002). In terms of access to PHC, more than 93% changed their PHC doctor or clinic, and most stated that reaching the clinic was dangerous and necessitated long journeys. Medication unavailability or high cost were the most frequently reported reasons for non-compliance during the war, reported by 42.7% and 18.1%, respectively. Nearly one in five participants spent two or more consecutive months without medication. Participants from the southern enclave were significantly less satisfied with PHC and medications (p = 0.001), and their subjective QoL was significantly worse (p = 0.007).

Conclusions: The study offers important insights into the impacts of high-intensity armed conflicts on people with NCDs. The war in the Gaza Strip has profoundly impacted patients with NCDs and hampered their access to healthcare, leaving the population at risk for higher morbidity and excess mortality rates now and well into the future.

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来源期刊
Conflict and Health
Conflict and Health Medicine-Public Health, Environmental and Occupational Health
CiteScore
6.10
自引率
5.60%
发文量
57
审稿时长
18 weeks
期刊介绍: Conflict and Health is a highly-accessed, open access journal providing a global platform to disseminate insightful and impactful studies documenting the public health impacts and responses related to armed conflict, humanitarian crises, and forced migration.
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