WHO

WHO
  • 文章类型: Journal Article
    背景:世界卫生组织(WHO)对泌尿系和男性生殖器肿瘤的分类最近已更新为第5版。新版本提出了一种全面的方法来分类泌尿和男性生殖器肿瘤,并结合了形态学,临床,和基因组数据。
    目的:这篇综述旨在更新第5版膀胱癌的新分类,并强调命名法的重要变化,诊断标准,和分子表征,与第四版相比。
    方法:将第5版《WHO泌尿和男性生殖器肿瘤分类》中膀胱癌的病理分类与第4版进行了比较。PubMed是用关键词搜索的,包括膀胱癌,WHO1973,WHO1998,WHO2004,WHO2016,组织学,病理学,基因组学,以及1973年至2022年8月的分子分类。还查阅了其他相关文件,结果选择了81篇论文作为参考文献。
    结果:乳头状尿路上皮癌(UC)的二元分级是实用的,但它可能过于简化,并有助于近年来的“等级迁移”。对于混合等级的膀胱癌,已提出了任意截止值(5%)。近年来,由于重叠的形态学和低度乳头状UC的治疗,具有低恶性潜能的乳头状尿路上皮肿瘤的诊断已大大减少。倒置的生长模式应与乳头状UC的真实(或破坏性)基质侵袭区分开。已经提出了几种方法用于pT1肿瘤子状态分析,但在小活检标本中对pT1肿瘤进行亚组治疗通常是具有挑战性的。膀胱UC显示出较高的分化倾向,导致与侵袭性临床行为相关的几种不同的组织学亚型。基于基因组分析的分子分类可能是对患者进行分层以进行最佳治疗的有用工具。
    结论:第5版《WHO泌尿系和男性生殖器肿瘤分类》在膀胱癌的分类中做出了一些重大改变。重要的是要意识到这些变化并将其纳入常规临床实践。
    BACKGROUND: The World Health Organization Classification (WHO) of Urinary and Male Genital Tumors has recently been updated to its 5th edition. The new edition presents a comprehensive approach to the classification of urinary and male genital tumors with an incorporation of morphologic, clinical, and genomic data.
    OBJECTIVE: This review aims to update the new classification of bladder cancer in the 5th edition and to highlight important changes in nomenclatures, diagnostic criteria, and molecular characterization, as compared to the 4th edition.
    METHODS: The pathologic classification of bladder cancer in the 5th edition of WHO Classification of Urinary and Male Genital Tumours was compared to that in the 4th edition. PubMed was searched using key words, including bladder cancer, WHO 1973, WHO 1998, WHO 2004, WHO 2016, histology, pathology, genomics, and molecular classification in the time frame from 1973 to August of 2022. Other relevant papers were also consulted, resulting in the selection of 81 papers as references.
    RESULTS: The binary grading of papillary urothelial carcinoma (UC) is practical, but it may be oversimplified and contribute to \"grade migration\" in recent years. An arbitrary cutoff (5%) has been proposed for bladder cancers with mixed grades. The diagnosis of papillary urothelial neoplasm with low malignant potential has been dramatically reduced in recent years because of overlapping morphology and treatment with low-grade papillary UC. An inverted growth pattern should be distinguished from true (or destructive) stromal invasion in papillary UC. Several methods have been proposed for pT1 tumor substaging, but it is often challenging to substage pT1 tumors in small biopsy specimens. Bladder UC shows a high tendency for divergent differentiation, leading to several distinct histologic subtypes associated with an aggressive clinical behavior. Molecular classification based on the genomic analysis may be a useful tool in the stratification of patients for optimal treatment.
    CONCLUSIONS: The 5th edition of WHO Classification of Urinary and Male Genital Tumours has made several significant changes in the classification of bladder cancer. It is important to be aware of these changes and to incorporate them into routine clinical practice.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Pubmed)

  • 文章类型: Journal Article
    背景:鉴于近年来作为主要人口发展的全球生育率空前下降,本研究是为了确定家庭健康之间的因果关系,感知关系质量成分,伊朗妇女对生育的态度:世界卫生组织模型分析方法:2023年,这项描述性研究招募了400名已婚妇女,这些妇女前往Alborz医科大学附属的选定综合卫生中心,卡拉杰,伊朗。通过多阶段分层整群抽样并使用社会经济状况问卷(Ghodratnama)收集数据,感知关系质量成分(PRQC)量表,原产地家庭量表(FOS),在SPSS25和LISREL8.8中分析了对生育和生育量表(AFCS)的态度和人口统计检查表.
    结果:根据路径分析,家庭健康直接通过一条途径(B=0.334),关系质量(B=0.698)和婚姻生活持续时间(B=0.387)直接和间接地对生育态度产生了最显著和积极的因果关系。儿童人数(B=-0.057),然而,通过这两种途径对生育态度产生了最显著和最负面的因果效应。
    结论:本研究结果表明,家庭健康和关系质量对生育态度有显著影响。因此建议在综合保健中心对这些变量进行筛选,确定相关的限制和问题,并由健康专家提供适当的培训和咨询解决方案。
    BACKGROUND: Given the unprecedented global decline in fertility as a major demographic development in recent years, the present study was conducted to determine Causal association Between Family Health, Perceived Relationship Quality Components, and Attitudes toward Childbearing in Iranian Women: A WHO Model Analysis METHODS: In 2023, this descriptive study recruited 400 married women presenting to selected comprehensive health centers affiliated to Alborz University of Medical Sciences, Karaj, Iran. The data were collected through multistage stratified cluster sampling and using a socioeconomic status questionnaire (Ghodratnama), the Perceived Relationship Quality Components (PRQC) scale, the family-of-origin scale (FOS), the attitudes toward fertility and childbearing scale (AFCS) and a demographic checklist were analyzed in SPSS 25 and LISREL 8.8.
    RESULTS: According to the path analysis, family health exerted the most significant and positive causal effect on attitudes to childbearing directly through one path (B = 0.334) and relationship quality (B = 0.698) and duration of married life (B = 0.387) both directly and indirectly. The number of children (B = -0.057), however, exerted the most significant and negative causal effect on attitudes to childbearing through both paths.
    CONCLUSIONS: The present findings suggested the significant effects of family health and relationship quality on attitudes toward childbearing. It is therefore recommended that these variables be screened in comprehensive health centers, the associated limitations and problems be identified and appropriate training and counseling solutions be provided by health specialists.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Pubmed)

  • 文章类型: Editorial
    暂无摘要。
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

    求助全文

  • 文章类型: Journal Article
    WHO对内分泌和神经内分泌肿瘤的最新分类使这些病变的诊断和分级发生了重大变化。例如,病理学家现在能够使用各种组织学特征和复合风险评估模型对甲状腺和肾上腺肿瘤的亚群进行分层.此外,关于如何治疗内分泌肿瘤的新建议涉及额外的免疫组织化学分析,识别和实施这些关键标记对于现代化诊断能力至关重要。此外,对肿瘤起源的理解的提高导致了几个实体的重命名,导致尚未得到普遍认可的术语的出现。术语和预后的调整可能对临床团队构成挑战,护理提供者可能渴望与诊断病理学家进行对话,因为治疗指南还没有完全赶上这些最近的变化。因此,对于外科病理学家来说,了解实施WHO分类方案变化背后的知识至关重要.这篇综述文章将探讨与甲状旁腺病变相关的最重要的诊断和预后变化,甲状腺,肾上腺和胃肠胰腺神经内分泌系统。此外,作者将简要分享他对临床实施的个人思考,从这些新算法的几年经验中汲取。
    The most recent WHO classification of endocrine and neuroendocrine tumours has brought about significant changes in the diagnosis and grading of these lesions. For instance, pathologists now have the ability to stratify subsets of thyroid and adrenal neoplasms using various histological features and composite risk assessment models. Moreover, novel recommendations on how to approach endocrine neoplasia involve additional immunohistochemical analyses, and the recognition and implementation of these key markers is essential for modernising diagnostic capabilities. Additionally, an improved understanding of tumour origin has led to the renaming of several entities, resulting in the emergence of terminology not yet universally recognised. The adjustments in nomenclature and prognostication may pose a challenge for the clinical team, and care providers might be eager to engage in a dialogue with the diagnosing pathologist, as treatment guidelines have not fully caught up with these recent changes. Therefore, it is crucial for a surgical pathologist to be aware of the knowledge behind the implementation of changes in the WHO classification scheme. This review article will delve into the most significant diagnostic and prognostic changes related to lesions in the parathyroid, thyroid, adrenal glands and the gastroenteropancreatic neuroendocrine system. Additionally, the author will briefly share his personal reflections on the clinical implementation, drawing from a couple of years of experience with these new algorithms.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

    求助全文

  • 文章类型: Journal Article
    我们审查了几个系统评价中的第一个发表的一个,这是世卫组织新倡议的一部分,旨在评估人造射频电磁辐射(RF-EMF)与人类不良健康影响之间的关联。审查的审查涉及非人类哺乳动物的怀孕和出生结果的实验研究。该评论声称,分析的数据没有提供足够的结论来为监管层面的决策提供信息。我们的目的是评估此系统评价的质量,并评估其结论与孕妇及其后代的相关性。质量和相关性在审查本身的前提下进行了检查:例如,我们没有质疑论文的选择,也不是选择的统计方法。虽然世卫组织的系统审查表明自己是彻底的,科学,与人类健康相关,我们发现了许多问题,这些问题使得世卫组织的审查无关紧要且存在严重缺陷.发现的所有缺陷都扭曲了结果,以支持审查的结论,即没有确凿的非热效应证据。我们证明了底层数据,当相关研究被正确引用时,支持相反的结论:有明显的迹象表明RF-EMF暴露会产生有害的非热效应。许多已发现的缺陷揭示了系统偏斜的模式,旨在隐藏在复杂的科学严谨性背后的不确定性。这篇综述的方法偏差和质量低下令人高度关注,因为它有可能破坏世卫组织在人为RF-EMF危害人类健康方面的可信度和专业性。
    We examined one of the first published of the several systematic reviews being part of WHO\'s renewed initiative to assess the evidence of associations between man-made radiofrequency electromagnetic radiation (RF-EMF) and adverse health effects in humans. The examined review addresses experimental studies of pregnancy and birth outcomes in non-human mammals. The review claims that the analyzed data did not provide conclusions certain enough to inform decisions at a regulatory level. Our objective was to assess the quality of this systematic review and evaluate the relevance of its conclusions to pregnant women and their offspring. The quality and relevance were checked on the review\'s own premises: e.g., we did not question the selection of papers, nor the chosen statistical methods. While the WHO systematic review presents itself as thorough, scientific, and relevant to human health, we identified numerous issues rendering the WHO review irrelevant and severely flawed. All flaws found skew the results in support of the review\'s conclusion that there is no conclusive evidence for nonthermal effects. We show that the underlying data, when relevant studies are cited correctly, support the opposite conclusion: There are clear indications of detrimental nonthermal effects from RF-EMF exposure. The many identified flaws uncover a pattern of systematic skewedness aiming for uncertainty hidden behind complex scientific rigor. The skewed methodology and low quality of this review is highly concerning, as it threatens to undermine the trustworthiness and professionalism of the WHO in the area of human health hazards from man-made RF-EMF.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

    求助全文

  • 文章类型: Journal Article
    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。
    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.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Pubmed)

  • 文章类型: Journal Article
    目的:我们的目的是对国际护理教科书中包含的手卫生信息和斯洛文尼亚护理教科书中与护理程序相关的等效内容进行彻底比较。
    背景:手卫生习惯对于预防医疗保健相关感染至关重要,每年影响数百万患者。“手部卫生的五个时刻”背后的想法是鼓励评估成功并提高自我效能。
    方法:比较国际护理教科书中的手卫生内容与斯洛文尼亚护理教科书中的内容。
    方法:在2023年3月至2024年3月之间进行了一项研究,以比较国际护理教科书中的手卫生内容。这项研究包括来自美国和英国的教科书,以及斯洛文尼亚(SI)教科书。最后阶段涉及将手卫生绩效实践与世卫组织“手卫生五个时刻”进行比较。
    结果:该研究回顾了三本教科书中的470个护理程序,确定四个常见的:女性留置导尿,小口径饲管插入,灌肠给药和皮下注射。美国教科书的步数最高,而英国的教科书是最低的。不建议在所有护理程序中使用清洁防护手套,仅适用于小口径饲管插入和灌肠给药。美国教科书省略了女性留置导尿管程序的12个步骤,而英国的教科书包括10个步骤。SI教科书省略了8个步骤。
    结论:手卫生对于预防和控制医疗保健感染至关重要。研究发现,在这些护理程序中,手卫生的频率存在差异。世卫组织的“手部卫生五个时刻”指南并未得到普遍接受,在患者接触之前经常观察到卫生不足。未来的研究应该回顾国外的教科书并更新现有的教科书。
    OBJECTIVE: Our aim was to conduct a thorough comparison between the hand hygiene information included in international nursing textbooks and the Slovenian nursing textbook\'s equivalent content as it relates to nursing procedures.
    BACKGROUND: Hand hygiene practices are crucial in preventing healthcare-associated infections, which affect millions of patients annually. The idea behind \"Five Moments for Hand Hygiene\" is to encourage assessing success and boosting self-efficacy.
    METHODS: Comparison of hand hygiene content in international nursing textbooks with the content in a Slovenian nursing textbook.
    METHODS: A study was conducted between March 2023 and March 2024 to compare hand hygiene content in international nursing textbooks. The study included textbooks from the USA and UK, as well as Slovenian (SI) textbooks. The final phase involved comparing hand hygiene performance practices against the WHO Five Moments for Hand Hygiene.
    RESULTS: The study reviewed 470 nursing procedures across three textbooks, identifying four common ones: female indwelling urinary catheterisation, small-bore feeding tube insertion, enema administration and subcutaneous injections. The USA textbook had the highest number of steps, while the UK textbook had the lowest. Clean protective gloves are not recommended for all nursing procedures, only for small-bore feeding tube insertion and enema administration. The US textbook omitted 12 steps for the female indwelling urinary catheter procedure, while the UK textbook included 10 steps. The SI textbook omitted 8 steps.
    CONCLUSIONS: Hand hygiene is crucial for healthcare infections prevention and control. The study found differences in the frequency of hand hygiene in these nursing procedures. WHO\'s Five Moments for Hand Hygiene guidelines are not universally accepted, with inadequate hygiene often observed before patient contact. Future research should review foreign textbooks and update existing ones.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

    求助全文

  • 文章类型: Journal Article
    我们评估了使用世界卫生组织(WHO)AirQ和AirQ+工具进行空气污染(AP)健康风险评估(HRA)的研究,并为未来评估提供了最佳实践建议。
    我们使用WHO的AirQ和AirQ+工具对研究进行了全面审查,在几个数据库中搜索相关文章,reports,和论文从成立到2022年12月31日。
    我们确定了286项符合我们标准的研究。这些研究在69个国家进行,大多数(57%)在伊朗,其次是意大利和印度(各8%)。我们发现许多研究报告空气污染暴露数据不足,其质量,和有效性。关于分析人口规模的决定,感兴趣的健康结果,基线发病率,浓度-响应函数,相对风险值,反事实价值观往往是不合理的,足够。许多研究缺乏不确定性评估。
    我们的审查发现了已发布的评估中的一些常见缺陷。我们建议更好的做法,并敦促未来的研究关注输入数据的质量,其报告,和相关的不确定性。
    UNASSIGNED: We evaluated studies that used the World Health Organization\'s (WHO) AirQ and AirQ+ tools for air pollution (AP) health risk assessment (HRA) and provided best practice suggestions for future assessments.
    UNASSIGNED: We performed a comprehensive review of studies using WHO\'s AirQ and AirQ+ tools, searching several databases for relevant articles, reports, and theses from inception to Dec 31, 2022.
    UNASSIGNED: We identified 286 studies that met our criteria. The studies were conducted in 69 countries, with most (57%) in Iran, followed by Italy and India (∼8% each). We found that many studies inadequately report air pollution exposure data, its quality, and validity. The decisions concerning the analysed population size, health outcomes of interest, baseline incidence, concentration-response functions, relative risk values, and counterfactual values are often not justified, sufficiently. Many studies lack an uncertainty assessment.
    UNASSIGNED: Our review found a number of common shortcomings in the published assessments. We suggest better practices and urge future studies to focus on the quality of input data, its reporting, and associated uncertainties.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Pubmed)

  • DOI:
    文章类型: Journal Article
    静脉内给药的人免疫球蛋白产品(IVIG)中抗D抗体的水平由欧洲药典规定的直接血凝方法控制(Ph。欧尔.)需要2种对照参考试剂。世界卫生组织(WHO)阳性对照国际参考试剂(IRR;02/228)的标称滴度为8,定义了最高可接受滴度,而阴性对照制剂(02/226)的标称滴度<2。工作参考制剂(04/132和04/140)随后被确立为用于Ph的生物参考制剂(BRP)。欧尔.,并由美国食品和药物管理局(USFDA)和国家生物标准与控制研究所(NIBSC)分发。由于3家机构的这些工作参考准备工作的库存减少,组织了一项联合国际研究,以建立统一的替代批次。16个实验室为研究提供了数据,以评估阳性和阴性候选替代批次(分别为13/148和12/300)与WHO阳性和阴性对照IRR以及当前的工作参考制剂(BRP)。结果表明,候选参考制剂(13/148和12/300)与相应的IRR和当前的BRP没有区别。候选制剂13/148和12/300由博士通过。欧尔.作为免疫球蛋白(抗D抗体测试)BRP批次2和免疫球蛋白(抗D抗体测试阴性对照)BRP批次2,标称血凝滴度分别为8和<2。同样的材料也被采用作为NIBSC和美国FDA的参考制剂,从而确保全面协调。
    The level of anti-D antibodies in human immunoglobulin products for intravenous administration (IVIG) is controlled by the direct haemagglutination method prescribed by the European Pharmacopoeia (Ph. Eur.) that requires 2 control reference reagents. The World Health Organization (WHO) positive control International Reference Reagent (IRR; 02/228) with a nominal titre of 8 defines the highest acceptable titre, while the negative control preparation (02/226) has a nominal titre of <2. Working reference preparations (04/132 and 04/140) were subsequently established as Biological Reference Preparations (BRPs) for the Ph. Eur., and for distribution by the United States Food and Drug Administration (US FDA) and the National Institute for Biological Standards and Control (NIBSC). Due to diminishing stocks of these working reference preparations across the 3 institutions, a joint international study was organised to establish harmonised replacement batches. Sixteen laboratories contributed data to the study to evaluate positive and negative candidate replacement batches (13/148 and 12/300, respectively) against the WHO positive and negative control IRRs and the current working reference preparations (BRPs). The results show that the candidate reference preparations (13/148 and 12/300) are indistinguishable from the corresponding IRRs and current BRPs. The candidate preparations 13/148 and 12/300 were adopted by the Ph. Eur. Commission as Immunoglobulin (anti-D antibodies test) BRP batch 2 and Immunoglobulin (anti-D antibodies test negative control) BRP batch 2 with nominal haemagglutination titres of 8 and <2, respectively. The same materials were also adopted as NIBSC and US FDA reference preparations, thus ensuring full harmonisation.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

    求助全文

  • 文章类型: Journal Article
    背景:世界卫生组织的全球卫生观察站将孕产妇死亡率定义为每年女性死亡人数,无论怀孕的时期或地点,在妊娠和分娩期间或终止妊娠后42天内,与妊娠或其管理相关或由妊娠或其管理引起的任何原因(意外或偶然原因除外),在2016年至2020年期间,全球估计有287,000名妇女因孕产妇原因去世,每天约800例死亡或每两分钟约1例。
    方法:使用了14个SSA国家的最新2018-2023年DHS数据集,总共89,489名加权母亲在调查前3年出生,进行了多层次分析。在多变量分析中包括p值≤0.20的双变量分析变量,在多变量分析中,p值小于≤0.05的变量被认为是与8次及以上ANC访视相关的显著因素.
    结果:在14个撒哈拉以南非洲国家进行8次及以上ANC访问的幅度为8.9%(95%CI:8.76-9.13),范围从加蓬的3.66%(95%CI:3.54-3.79)到尼日利亚的18.92%(95%CI:18.67-19.17)。多水平分析表明,孕产妇年龄(40-44,AOR;2.09,95CI:1.75-2.53),产妇职业状况(AOR;1.14,95CI;1.07-1.22),孕产妇教育水平(中等及以上,AOR;1.26,95CI;1.16-1.38),财富状况(AOR;1.65,95CI;1.50-1.82),媒体暴露(AOR;1.20,95CI;1.11-1.31),妊娠意向(AOR;1.12,95CI;1.05-1.20),曾经终止妊娠(AOR;1.1695CI;1.07-1.25),及时开始第一次ANC访问(AOR;4.79,95CI;4.49-5.10),对受访者医疗保健的赋权(AOR;1.43,95CI;1.30-1.56),城市居住地(AOR;1.33,95CI;1.22-1.44)是严重影响AN利用的因素。另一方面,较高的出生顺序(AOR;0.54,95CI;0.53-0.66),不使用避孕药(AOR;0.80,95CI;0.75-0.86)和调查年份(AOR;0.47,95CI;0.34-0.65)是与8次或更多ANC就诊呈负相关的因素.
    结论:在本研究纳入的14个SSA中,8次和更多的ANC访问对世卫组织准则的遵守程度较低。受过教育,有工作,从农村居民和富裕财富群体获得媒体的访问有助于八次或更多的非国大访问,因此,我们强烈建议政策实施者倡导这种做法。
    BACKGROUND: The world health organization\'s global health observatory defines maternal mortality as annual number of female deaths, regardless of the period or location of the pregnancy, from any cause related to or caused by pregnancy or its management (aside from accidental or incidental causes) during pregnancy and childbirth or within 42 days of termination of pregnancy and an estimated 287 000 women worldwide passed away from maternal causes between 2016 and 2020, that works out to be about 800 deaths per day or about one every two minutes.
    METHODS: The most recent 2018-2023 DHS data set of 14 SSA countries was used a total of 89,489 weighted mothers who gave at list one live birth 3 years preceding the survey were included, a multilevel analysis was conducted. In the bi-variable analysis variables with p-value ≤ 0.20 were included in the multivariable analysis, and in the multivariable analysis, variables with p-value less than ≤ 0.05 were considered to be significant factors associated with having eight and more ANC visits.
    RESULTS: The magnitude of having eight and more ANC visits in 14 sub-Saharan African countries was 8.9% (95% CI: 8.76-9.13) ranging from 3.66% (95% CI: 3.54-3.79) in Gabon to 18.92% (95% CI: 18.67-19.17) in Nigeria. The multilevel analysis shows that maternal age (40-44, AOR;2.09, 95%CI: 1.75-2.53), maternal occupational status (AOR;1.14, 95%CI; 1.07-1.22), maternal educational level (secondary and above, AOR;1.26, 95%CI; 1.16-1.38), wealth status(AOR;1.65, 95%CI; 1.50-1.82), media exposure (AOR;1.20, 95%CI; 1.11-1.31), pregnancy intention (AOR;1.12, 95%CI; 1.05-1.20), ever had terminated pregnancy (AOR;1.16 95%CI; 1.07-1.25), timely initiation of first ANC visit (AOR;4.79, 95%CI; 4.49-5.10), empowerment on respondents health care (AOR;1.43, 95%CI; 1.30-1.56), urban place of residence (AOR;1.33, 95%CI; 1.22-1.44) were factors highly influencing the utilization of AN. On the other hand higher birth order (AOR;0.54, 95%CI; 0.53-0.66), not using contraceptive (AOR;0.80, 95%CI; 0.75-0.86) and survey year (AOR;0.47, 95%CI; 0.34-0.65) were factors negatively associated with having eight and more ANC visits.
    CONCLUSIONS: In the 14 SSA included in this study, there is low adherence to WHO guidelines of eight and more ANC visits. Being educated, having jobs, getting access to media being from rural residence and rich wealth group contribute to having eight and more ANC visits, so we highly recommend policy implementers to advocate this practices.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Pubmed)

公众号