拉丁美洲和加勒比地区医院自身免疫性脑炎诊断和治疗可及性的挑战

IF 2.7 3区 医学 Q2 CLINICAL NEUROLOGY
Miguel A. Vences, Julián A. Rivillas, Rocío N. Campos-Gamarra, Virgilio E. Failoc-Rojas, Daniel A. Godoy
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引用次数: 0

摘要

本研究旨在确定拉丁美洲和加勒比地区医院自身免疫性脑炎(AE)的诊断和治疗可及性特点。描述性、前瞻性、多中心研究于2023年10月至11月进行。分类变量在描述性分析中以频率和百分比表示,而在定量数据中以集中趋势和离散度表示。根据参与国的数量绘制了分布图。共有来自19个拉丁美洲和加勒比地区的108名医生参加,参与者的年龄中位数和行医年数分别为40岁和13岁。在专科方面,回答最多的是普通重症医师(31.5%)、神经科医师(28.7%)和神经重症医师(17.6%)。在获得诊断方法(共振、抗体检测和脑电图)方面存在重大限制,缺乏机构协议,为抗体检测提供资金的潜在高额自付费用,以及患者随访率低。在评估的国家中发现了不同的诊断策略和治疗方法,并且一线免疫治疗和抗危机治疗的可接受性。这是首个针对拉丁美洲和加勒比地区治疗AE患者的局限性的跨国研究,揭示了巨大的困难和可能的不公平。重要的是开展多学科合作,提高决策者、临床医生和投资者对这种疾病的认识,以减少其对受影响人群的福祉和生产力的负面影响。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Challenges in Access to Diagnosis and Treatment of Autoimmune Encephalitis in Hospitals in Latin America and the Caribbean

Challenges in Access to Diagnosis and Treatment of Autoimmune Encephalitis in Hospitals in Latin America and the Caribbean

This study is aimed at determining the characteristics of access to diagnosis and treatment of autoimmune encephalitis (AE) in hospitals in Latin America and the Caribbean. The descriptive, prospective, and multicenter study was conducted from October to November 2023. Categorical variables were presented as frequencies and percentages in the descriptive analysis, whereas measures of central tendency and dispersion were shown for quantitative data. A distribution map was created based on the number of participating countries. A total of 108 doctors from 19 Latin America and the Caribbean participated, and participants’ median age and years of medical practice were 40 and 13 years, respectively. Regarding specialties, individuals who responded the most to the survey were general intensivists (31.5%), neurologists (28.7%), and neurointensivists (17.6%). There were significant limitations in access to diagnostic methods (resonance, antibody testing, and electroencephalogram), absence of institutional protocols, potential high out-of-pocket costs in financing antibody tests, and low patient follow-up. Heterogeneous diagnostic strategies and therapeutic approaches were found in the countries evaluated, and there was acceptable access to first-line immunotherapy and anticrisis. This first multinational study addressing the existing limitations in Latin America and the Caribbean for treating patients with AE revealed great difficulties and possible inequities. It is important to conduct multidisciplinary collaborations to increase awareness of this disease among decision-makers, clinicians, and investors to reduce its negative impact on the well-being and productivity of affected populations.

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来源期刊
Acta Neurologica Scandinavica
Acta Neurologica Scandinavica 医学-临床神经学
CiteScore
6.70
自引率
2.90%
发文量
161
审稿时长
4-8 weeks
期刊介绍: Acta Neurologica Scandinavica aims to publish manuscripts of a high scientific quality representing original clinical, diagnostic or experimental work in neuroscience. The journal''s scope is to act as an international forum for the dissemination of information advancing the science or practice of this subject area. Papers in English will be welcomed, especially those which bring new knowledge and observations from the application of therapies or techniques in the combating of a broad spectrum of neurological disease and neurodegenerative disorders. Relevant articles on the basic neurosciences will be published where they extend present understanding of such disorders. Priority will be given to review of topical subjects. Papers requiring rapid publication because of their significance and timeliness will be included as ''Clinical commentaries'' not exceeding two printed pages, as will ''Clinical commentaries'' of sufficient general interest. Debate within the speciality is encouraged in the form of ''Letters to the editor''. All submitted manuscripts falling within the overall scope of the journal will be assessed by suitably qualified referees.
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