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Non-Communicable Disease and the Need to Strengthen Prehospital Care: Experience from Kigali, Rwanda

Article scientifique 2020 Anglais

Résumé

Abstract Background Non-communicable diseases (NCDs) are increasing in incidence in low-and middle-income countries (LMICs). Many NCDs present as emergencies which require emergency response. We aimed to review NCDs transported by Service d’Aide Medicale Urgente (SAMU), the public ambulance service in Rwanda.Methods Descriptive analysis of a REDCap database was performed for medical cases between December 2012 to May 2016 and compared to non-medical cases. Student’s t-test, ANOVA, and chi square test were run with p < 0.05 considered significant.Results A total of 832 patients were seen. 51% were female, and the average age was 57 years old + 22. Cardiac indications were most common (52%) followed by diabetic complications (22%), cancer (16%) and stroke (10%). Patients with NCDs were more likely to be tachycardic, HR>100 bpm (OR 2.61 [P<0.001]), hypoxic with SPO2 <90% (OR 3.28 [P<0.0001]), hypotensive with blood pressure <100 mmHg (OR 2.65 [P<0.0001]), and tachypneic with respiratory rate >20 breaths per minute (OR 2.06 [P<0.0001]).Conclusions Access to emergency services is essential for NCD management. Compared to other emergencies treated by SAMU in Kigali, Rwanda, the NCD cohort had a higher acuity despite being a smaller proportion. As NCDs increase, investment in robust prehospital care will have substantial value in LMICs.

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Rosenberg, A., Mukagasasira, J., Turikumana, V., Dworkin, M., Nsengimana, V., Bailey, P., Kankindi, E., Niyonsaba, M., Nkeshimana, M., Uwitonze, J., Kabagema, I., Dushime, T., Jayaraman, S. (2020). Non-Communicable Disease and the Need to Strengthen Prehospital Care: Experience from Kigali, Rwanda. https://doi.org/10.21203/rs.3.rs-15646/v1

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Auteur(s)

Ashley Rosenberg Jacqueline Mukagasasira Verene Turikumana Myles Dworkin Vizir Jean Paul Nsengimana Pamela Bailey E. Kankindi Mediatrice Niyonsaba Menelas Nkeshimana Jean Marie Uwitonze Igance Kabagema Theophile Dushime Sudha Jayaraman

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