Endoscopic Findings and Associated Risk Factors in Primary Health Care Settings in Havana, Cuba.
INTRODUCTION Upper gastrointestinal endoscopy, traditionally performed in Cuba in specialized hospitals, was decentralized to the primary health care level in 2004 to make it more patient-accessible. OBJECTIVES Describe frequency and distribution of the principal symptomatic diseases of the upper ga...
| Publicado en: | MEDICC Review Vol. 14; no. 1; pp. 30 - 38 |
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| Autores principales: | , , |
| Formato: | research tables/charts Journal Article |
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Medical Education Cooperation with Cuba
Jan2012
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=104513985&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 104513985 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 15273172 903V jtl: MEDICC Review issn: 15273172 maglogo: N pubinfo: dt: Jan2012 vid: 14 iid: 1 pid: 54282 pub: Medical Education Cooperation with Cuba place: Oakland, California artinfo: ui: 104513985 71255293 10.37757/mr2012v14.n1.7 NLM22334110 104513985 ppf: 30 ppct: 8 formats: fmt: @attributes: type: P tig: atl: Endoscopic Findings and Associated Risk Factors in Primary Health Care Settings in Havana, Cuba. aug: au: Galbán, Enrique Arús, Enrique Periles, Ulises affil: Chief of epidemiology, National Gastroenterology Institute (IGE), Havana, Cuba sug: subj: Endoscopy Primary Health Care Cuba Cuba Human Endoscopy, Gastrointestinal Multicenter Studies Cross Sectional Studies Gastrointestinal Diseases Diagnosis Odds Ratio Confidence Intervals Helicobacter Infections Epidemiology Prevalence Adolescence Adult Middle Age Aged Aged, 80 and Over Male Female Adolescent: 13-18 years Adult: 19-44 years Middle Aged: 45-64 years Aged: 65+ years Aged, 80 & over Male Female ab: INTRODUCTION Upper gastrointestinal endoscopy, traditionally performed in Cuba in specialized hospitals, was decentralized to the primary health care level in 2004 to make it more patient-accessible. OBJECTIVES Describe frequency and distribution of the principal symptomatic diseases of the upper gastrointestinal tract and their relation to the main risk factors associated with each in a sample of urban adults who underwent upper gastrointestinal endoscopy in primary care facilities in Havana in selected months of 2007. METHODS A multicenter cross-sectional study was conducted, including 3556 patients seen in the primary health care network of Havana from May through November 2007. The endoscopies were performed at the 22 polyclinics (community health centers) providing this service. Diagnostic quality and accuracy were assessed by experienced gastroenterologists using a validated tool. Patients responded to a questionnaire with clinical, epidemiologic, and sociodemographic variables. Univariate and multivariate analyses (unconditional logistical regression) were used to identify associated risk factors. The significance level was set at p < 0.05 (or confidence interval excluding 1.0). RESULTS The diagnoses were: gastritis (91.6%), duodenitis (57.8%), hiatal hernia (46.5%), esophagitis (25.2%), duodenal ulcer (15.8%), gastric ulcer (6.2%) and malignant-appearing lesions (0.4%). Overall prevalence of Helicobacter pylori infection was 58.4%. The main risk factors for duodenal ulcer were H. pylori infection (OR 2.70, CI 2.17.3.36) and smoking (OR 2.08, CI 1.68.2.58); and for gastric ulcer, H. pylori (OR 1.58, CI 1.17.2.15) and age .60 years (OR 1.78, CI 1.28.2.47). H.pylori infection was the main risk factor for gastritis (OR 2.29, CI 1.79.2.95) and duodenitis (OR 1.58, CI 1.38.1.82); and age .40 years for hiatal hernia (OR 1.57, CI 1.33.1.84). External evaluation was "very good" or "good" for 99.3% of endoscopic procedures and 97.9% of reports issued. CONCLUSIONS Gastrointestinal endoscopy performed in primary care yielded high quality results and important information about prevalence of the most common diseases of the upper GI tract and associated risk factors. This study provides a reference for new research and can inform objective recommendations for community-based interventions to prevent and control these diseases. The existence of a network of universally accessible diagnostic endoscopy services at the primary care level, will contribute to conducting further research. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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