The coronavirus disease 2019(COVID-19)global public health emergency,has exposed the fragility of health systems.Access to healthcare became a scarce commodity as healthcare providers and resource-poor populatio...The coronavirus disease 2019(COVID-19)global public health emergency,has exposed the fragility of health systems.Access to healthcare became a scarce commodity as healthcare providers and resource-poor populations became victims of the novel corona virus.Therefore,this study focuses on Africa’s readiness to integrate telemedicine into the weak health systems and its adoption may help alleviate poor healthcare and poverty after COVID-19.We conducted a narrative review through different search strategies in Scopus on January 20,2021,to identify available literature reporting implementation of various telemedicine modes in Africa from January 1,2011 to December 31,2020.We summarized 54 studies according to geographies,field,and implementation methods.The results show a willingness to adopt telemedicine in the resource-poor settings and hard-to-reach populations,which will bring relief to the inadequate healthcare systems and alleviate poverty of those who feel the burden of healthcare cost the most.With adequate government financing,telemedicine promises to enhance the treating of communicable and non-communicable diseases as well as support health infrastructure.It can also alleviate poverty among vulnerable groups and hard-to-reach communities in Africa with adequate government financing.However,given the lack of funding in Africa,the challenges in implementing telemedicine require global and national strategies before it can yield promising results.This is especially true in regards to alleviating the multidimensionality of poverty in post-COVID-19 Africa.展开更多
目的:探讨甲壳质酶蛋白40(YKL-40)水平以及CXC趋化因子配体9(CXCL9)水平预测慢性阻塞性肺疾病(COPD)急性加重风险的意义。方法:2019年10月至2021年10月,选择本院呼吸与危重症医学科150例COPD患者(女性38例,男性112例)和150例正常人作为...目的:探讨甲壳质酶蛋白40(YKL-40)水平以及CXC趋化因子配体9(CXCL9)水平预测慢性阻塞性肺疾病(COPD)急性加重风险的意义。方法:2019年10月至2021年10月,选择本院呼吸与危重症医学科150例COPD患者(女性38例,男性112例)和150例正常人作为研究对象。ELISA法测定血清YKL-40、CXCL9水平,计算住院时间。本次住院治疗后1年内追踪COPD急性加重次数。结果:与对照组相比,在COPD病例中血清YKL-40水平显著升高(22.23±15.35ng/mL vs 63.96±13.66ng/mL,t=24.79,P<0.0001),而CXCL9水平无显著变化(17.92±9.01ng/mL vs 19.29±9.84ng/mL,t=1.26,P=0.210)。血清YKL-40随着COPD病例的GOLD分级升高而升高(1-2级:51.82±12.82ng/mL;3级:63.26±4.59ng/mL;4级:76.86±7.59ng/mL,F=96.92,P<0.0001)。与mMRC评分≤2的COPD患者相比,mMRC评分为2~3或≥3的COPD患者的血清YKL-40水平上调(58.35±15.37ng/mL vs 64.55±10.60ng/mL、68.79±12.66ng/mL,P<0.05)。在COPD患者中,血清YKL-40与FEV1(r=-0.668,P<0.001)和FEV1/FVC(r=-0.167,P=0.041)之间存在显著的负相关,以及血清YKL-40与IL-6(r=0.257,P=0.002)、TNF-α(r=0.522,P<0.001)和CRP(r=0.231,P=0.006)呈正相关。与住院时间≤8d的COPD患者相比,住院时间8~13d和≥13d的COPD患者血清YKL-40水平上调(57.31±15.82ng/mL vs 64.96±9.98ng/mL、69.79±11.58ng/mL,P<0.05)。急性加重次数≤2次患者入院时血清YKL-40水平显著低于急性加重次数>2次患者(58.77±15.66ng/mL vs 69.58±9.08ng/mL,t=5.17,P<0.001)。多元线性回归显示血清YKL-40与FEV1%呈负相关(OR=0.700,95%CI=-0.958,-0.272),和与住院时间≥13d呈正相关(OR=1.125,95%CI=1.007,1.472)。结论:入院时血清YKL-40水平与COPD患者的严重程度和不良预后呈正相关。展开更多
文摘The coronavirus disease 2019(COVID-19)global public health emergency,has exposed the fragility of health systems.Access to healthcare became a scarce commodity as healthcare providers and resource-poor populations became victims of the novel corona virus.Therefore,this study focuses on Africa’s readiness to integrate telemedicine into the weak health systems and its adoption may help alleviate poor healthcare and poverty after COVID-19.We conducted a narrative review through different search strategies in Scopus on January 20,2021,to identify available literature reporting implementation of various telemedicine modes in Africa from January 1,2011 to December 31,2020.We summarized 54 studies according to geographies,field,and implementation methods.The results show a willingness to adopt telemedicine in the resource-poor settings and hard-to-reach populations,which will bring relief to the inadequate healthcare systems and alleviate poverty of those who feel the burden of healthcare cost the most.With adequate government financing,telemedicine promises to enhance the treating of communicable and non-communicable diseases as well as support health infrastructure.It can also alleviate poverty among vulnerable groups and hard-to-reach communities in Africa with adequate government financing.However,given the lack of funding in Africa,the challenges in implementing telemedicine require global and national strategies before it can yield promising results.This is especially true in regards to alleviating the multidimensionality of poverty in post-COVID-19 Africa.
文摘目的:探讨甲壳质酶蛋白40(YKL-40)水平以及CXC趋化因子配体9(CXCL9)水平预测慢性阻塞性肺疾病(COPD)急性加重风险的意义。方法:2019年10月至2021年10月,选择本院呼吸与危重症医学科150例COPD患者(女性38例,男性112例)和150例正常人作为研究对象。ELISA法测定血清YKL-40、CXCL9水平,计算住院时间。本次住院治疗后1年内追踪COPD急性加重次数。结果:与对照组相比,在COPD病例中血清YKL-40水平显著升高(22.23±15.35ng/mL vs 63.96±13.66ng/mL,t=24.79,P<0.0001),而CXCL9水平无显著变化(17.92±9.01ng/mL vs 19.29±9.84ng/mL,t=1.26,P=0.210)。血清YKL-40随着COPD病例的GOLD分级升高而升高(1-2级:51.82±12.82ng/mL;3级:63.26±4.59ng/mL;4级:76.86±7.59ng/mL,F=96.92,P<0.0001)。与mMRC评分≤2的COPD患者相比,mMRC评分为2~3或≥3的COPD患者的血清YKL-40水平上调(58.35±15.37ng/mL vs 64.55±10.60ng/mL、68.79±12.66ng/mL,P<0.05)。在COPD患者中,血清YKL-40与FEV1(r=-0.668,P<0.001)和FEV1/FVC(r=-0.167,P=0.041)之间存在显著的负相关,以及血清YKL-40与IL-6(r=0.257,P=0.002)、TNF-α(r=0.522,P<0.001)和CRP(r=0.231,P=0.006)呈正相关。与住院时间≤8d的COPD患者相比,住院时间8~13d和≥13d的COPD患者血清YKL-40水平上调(57.31±15.82ng/mL vs 64.96±9.98ng/mL、69.79±11.58ng/mL,P<0.05)。急性加重次数≤2次患者入院时血清YKL-40水平显著低于急性加重次数>2次患者(58.77±15.66ng/mL vs 69.58±9.08ng/mL,t=5.17,P<0.001)。多元线性回归显示血清YKL-40与FEV1%呈负相关(OR=0.700,95%CI=-0.958,-0.272),和与住院时间≥13d呈正相关(OR=1.125,95%CI=1.007,1.472)。结论:入院时血清YKL-40水平与COPD患者的严重程度和不良预后呈正相关。
