Endoscopic Findings and Associated Risk Factors in Primary Health Care Settings in Havana, Cuba
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Redalyc
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| Formato: | Artículo científico |
| Lenguaje: | en |
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Medical Education Cooperation with Cuba
2012
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| _version_ | 1876466642394808320 |
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| author | Enrique Galban |
| author_facet | Enrique Galban |
| contents | Endoscopic Findings and Associated Risk Factors in Primary Health Care Settings in Havana, Cuba Enrique Galban Enrique Arús Ulises Periles Medicina Cuba Endoscopy prevalence risk factors primary care INTRODUCTION Upper gastrointestinal endoscopy, traditionally per- formed in Cuba in specialized hospitals, was decentralized to the pri- mary 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 pri- mary care facilities in Havana in selected months of 2007. METHODS A multicenter cross-sectional study was conducted, includ- ing 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 gas- troenterologists using a validated tool. Patients responded to a ques- tionnaire with clinical, epidemiologic, and sociodemographic variables. Univariate and multivariate analyses (unconditional logistical regres- sion) were used to identify associated risk factors. The signi Þ cance level was set at p < 0.05 (or con Þ dence 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 infec- tion was 58.4%. The main risk factors for duodenal ulcer were H. pylori infection (OR 2.70, CI 2.173.36) and sm oking (OR 2.08, CI 1.682.58); and for gastric ulcer, H. pylori (OR 1.58, CI 1.172.15) and age 60 years (OR 1.78, CI 1.282.47). H. pylori infection was the main risk factor for gastritis (OR 2.29, CI 1.792.95) and duodenitis (OR 1.58, CI 1.381.82); and age 40 years for hia- tal hernia (OR 1.57, CI 1.331.84). 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 communi- ty-based interventions to prevent and control these diseases. The existence of a network of universally accessible diagnostic endos- copy services at the primary care level, will contribute to conducting further research. 2012 artículo científico 1555-7960 https://www.redalyc.org/articulo.oa?id=437542161007 en http://www.redalyc.org/revista.oa?id=4375 MEDICC Review application/pdf Medical Education Cooperation with Cuba MEDICC Review (Estados Unidos de América) Num.1 Vol.14 |
| format | Artículo científico |
| id | redalyc_437542161007 |
| institution | Redalyc |
| language | en |
| publishDate | 2012 |
| publisher | Medical Education Cooperation with Cuba |
| spellingShingle | Endoscopic Findings and Associated Risk Factors in Primary Health Care Settings in Havana, Cuba Enrique Galban Medicina Cuba Endoscopy prevalence risk factors primary care Endoscopic Findings and Associated Risk Factors in Primary Health Care Settings in Havana, Cuba Enrique Galban Enrique Arús Ulises Periles Medicina Cuba Endoscopy prevalence risk factors primary care INTRODUCTION Upper gastrointestinal endoscopy, traditionally per- formed in Cuba in specialized hospitals, was decentralized to the pri- mary 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 pri- mary care facilities in Havana in selected months of 2007. METHODS A multicenter cross-sectional study was conducted, includ- ing 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 gas- troenterologists using a validated tool. Patients responded to a ques- tionnaire with clinical, epidemiologic, and sociodemographic variables. Univariate and multivariate analyses (unconditional logistical regres- sion) were used to identify associated risk factors. The signi Þ cance level was set at p < 0.05 (or con Þ dence 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 infec- tion was 58.4%. The main risk factors for duodenal ulcer were H. pylori infection (OR 2.70, CI 2.173.36) and sm oking (OR 2.08, CI 1.682.58); and for gastric ulcer, H. pylori (OR 1.58, CI 1.172.15) and age 60 years (OR 1.78, CI 1.282.47). H. pylori infection was the main risk factor for gastritis (OR 2.29, CI 1.792.95) and duodenitis (OR 1.58, CI 1.381.82); and age 40 years for hia- tal hernia (OR 1.57, CI 1.331.84). 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 communi- ty-based interventions to prevent and control these diseases. The existence of a network of universally accessible diagnostic endos- copy services at the primary care level, will contribute to conducting further research. 2012 artículo científico 1555-7960 https://www.redalyc.org/articulo.oa?id=437542161007 en http://www.redalyc.org/revista.oa?id=4375 MEDICC Review application/pdf Medical Education Cooperation with Cuba MEDICC Review (Estados Unidos de América) Num.1 Vol.14 |
| title | Endoscopic Findings and Associated Risk Factors in Primary Health Care Settings in Havana, Cuba |
| topic | Medicina Cuba Endoscopy prevalence risk factors primary care |
| url | https://www.redalyc.org/articulo.oa?id=437542161007 |