PDF(Pubmed)
Abstract：
BACKGROUND: The World Health Organisation Essential Medicines List (WHO EML) guides National Essential Medicines Lists and Standard Treatment Guidelines for clearly identified disease priorities especially in low- and middle-income countries. This study compares the degree to which the basket of medicines recommended for rheumatic diseases in children and young people in National Essential Medicines Lists of countries in the WHO Africa region, corresponds to the 2021 WHO EML and WHO EML for children, as a proxy of availability.
METHODS: An online search of the WHO medicines and health technology portal, the Health Ministry websites of the 54 African countries, PUBMED and Google Scholar, with search terms for \'National Essential Medicines List\', AND/OR \'standard treatment guidelines\' AND/OR \'Lista Nacional de Medicamentos Essenciais\' AND/ OR \'Liste Nationale de Medicaments Essentiels\' AND Africa AND/OR < Name of African country > was conducted. The number of medicines on the national lists were compared according to a predefined template of medicines; and the percentage similarity calculated. Descriptive statistics were derived using STATA.
RESULTS: Forty-seven countries in the WHO Africa region have developed a National Essential Medicines List. Eleven countries do not have any medicines listed for rheumatic diseases. The majority of countries had less than or equal to 50% similarity with the WHO EML for rheumatic disease in children and young people, median 3 medicines (IQR 1- 4). The most common medicines on the national lists from Africa were methotrexate, sulfasalazine and azathioprine, with etanercept available in 6 countries. Seven countries had only one medicine, acetylsalicylic acid listed in the section \'Juvenile Joint diseases\'. A multiple linear regression model for the predictors of the number of medicines on the national lists established that 20% of the variability was predicted by health expenditure per capita, socio-demographic index and the availability of rheumatology services (adult and/or paediatric) p = 0.006, with socio-demographic index (p = 0.035, 95% CI 0.64-16.16) and the availability of rheumatology services (p = 0.033, 95% CI 0.13 - 2.90) significant.
CONCLUSIONS: Four countries (8.5%) in Africa have updated their National Essential Medicines Lists to reflect adequate care for children and young people with rheumatic diseases. Moving forward, efforts should focus on aligning available medicines with the WHO EML, and strengthening healthcare policy for rheumatology and pharmaceutical services, for affordable access to care and medicines.
METHODS: An online search of the WHO medicines and health technology portal, the Health Ministry websites of the 54 African countries, PUBMED and Google Scholar, with search terms for \'National Essential Medicines List\', AND/OR \'standard treatment guidelines\' AND/OR \'Lista Nacional de Medicamentos Essenciais\' AND/ OR \'Liste Nationale de Medicaments Essentiels\' AND Africa AND/OR < Name of African country > was conducted. The number of medicines on the national lists were compared according to a predefined template of medicines; and the percentage similarity calculated. Descriptive statistics were derived using STATA.
RESULTS: Forty-seven countries in the WHO Africa region have developed a National Essential Medicines List. Eleven countries do not have any medicines listed for rheumatic diseases. The majority of countries had less than or equal to 50% similarity with the WHO EML for rheumatic disease in children and young people, median 3 medicines (IQR 1- 4). The most common medicines on the national lists from Africa were methotrexate, sulfasalazine and azathioprine, with etanercept available in 6 countries. Seven countries had only one medicine, acetylsalicylic acid listed in the section \'Juvenile Joint diseases\'. A multiple linear regression model for the predictors of the number of medicines on the national lists established that 20% of the variability was predicted by health expenditure per capita, socio-demographic index and the availability of rheumatology services (adult and/or paediatric) p = 0.006, with socio-demographic index (p = 0.035, 95% CI 0.64-16.16) and the availability of rheumatology services (p = 0.033, 95% CI 0.13 - 2.90) significant.
CONCLUSIONS: Four countries (8.5%) in Africa have updated their National Essential Medicines Lists to reflect adequate care for children and young people with rheumatic diseases. Moving forward, efforts should focus on aligning available medicines with the WHO EML, and strengthening healthcare policy for rheumatology and pharmaceutical services, for affordable access to care and medicines.
摘要：
背景：世界卫生组织基本药物清单（WHOEML）指导国家基本药物清单和标准治疗指南，以明确确定疾病优先事项，特别是在低收入和中等收入国家。这项研究比较了世卫组织非洲区域国家国家基本药物清单中推荐用于儿童和年轻人风湿性疾病的药物篮子的程度，对应于2021年世卫组织EML和世卫组织儿童EML，作为可用性的代理。
方法：对WHO药品和卫生技术门户网站的在线搜索，卫生部54个非洲国家的网站，pubmed和谷歌学者，带有“国家基本药物清单”的搜索词，和/或\'标准治疗指南\'和\''和\'列塔国家医疗要点\'和/或\'列塔国家医疗要点\'和非洲和/或<非洲国家名称>进行。根据预定义的药物模板比较了国家清单上的药物数量；并计算了相似度百分比。描述性统计数据是使用STATA得出的。
结果：世卫组织非洲地区的47个国家制定了国家基本药物清单。11个国家没有列出任何治疗风湿性疾病的药物。大多数国家与世卫组织EML在儿童和青少年风湿性疾病方面的相似性小于或等于50%，中位数3种药物（IQR1-4）。非洲国家名单上最常见的药物是甲氨蝶呤，柳氮磺吡啶和硫唑嘌呤，在6个国家/地区使用etanercept。七个国家只有一种药物，乙酰水杨酸列在“青少年关节疾病”一节中。国家清单上药品数量的预测因素的多元线性回归模型建立了20％的变异性是由人均卫生支出预测的，社会人口统计学指数和风湿病服务(成人和/或儿科)的可获得性p=0.006,社会人口统计学指数(p=0.035,95%CI0.64-16.16)和风湿病服务的可获得性(p=0.033,95%CI0.13-2.90)显著.
结论：非洲有四个国家（8.5%）更新了国家基本药物清单，以反映对患有风湿性疾病的儿童和年轻人的适当护理。往前走,努力应侧重于使现有药物与世卫组织EML保持一致，加强风湿病和药学服务的医疗保健政策，获得负担得起的护理和药品。
方法：对WHO药品和卫生技术门户网站的在线搜索，卫生部54个非洲国家的网站，pubmed和谷歌学者，带有“国家基本药物清单”的搜索词，和/或\'标准治疗指南\'和\''和\'列塔国家医疗要点\'和/或\'列塔国家医疗要点\'和非洲和/或<非洲国家名称>进行。根据预定义的药物模板比较了国家清单上的药物数量；并计算了相似度百分比。描述性统计数据是使用STATA得出的。
结果：世卫组织非洲地区的47个国家制定了国家基本药物清单。11个国家没有列出任何治疗风湿性疾病的药物。大多数国家与世卫组织EML在儿童和青少年风湿性疾病方面的相似性小于或等于50%，中位数3种药物（IQR1-4）。非洲国家名单上最常见的药物是甲氨蝶呤，柳氮磺吡啶和硫唑嘌呤，在6个国家/地区使用etanercept。七个国家只有一种药物，乙酰水杨酸列在“青少年关节疾病”一节中。国家清单上药品数量的预测因素的多元线性回归模型建立了20％的变异性是由人均卫生支出预测的，社会人口统计学指数和风湿病服务(成人和/或儿科)的可获得性p=0.006,社会人口统计学指数(p=0.035,95%CI0.64-16.16)和风湿病服务的可获得性(p=0.033,95%CI0.13-2.90)显著.
结论：非洲有四个国家（8.5%）更新了国家基本药物清单，以反映对患有风湿性疾病的儿童和年轻人的适当护理。往前走,努力应侧重于使现有药物与世卫组织EML保持一致，加强风湿病和药学服务的医疗保健政策，获得负担得起的护理和药品。
