Sickle cell disease has a growing global burden falling primarily on low-income countries (LICs) and lower-middle-income countries (LMICs) where comprehensive care is often insufficient, particularly in rural areas. Integrated care models might be beneficial for improving access to care in areas with human resource and infrastructure constraints. As part of the Centre for Integration Science's ongoing efforts to define, systematise, and implement integrated care delivery models for non-communicable diseases (NCDs), this Review explores models of care for sickle cell disease in LICs and LMICs. We identified 99 models from 136 studies, primarily done in tertiary, urban facilities in LMICs. Except for two models of integrated care for concurrent treatment of other conditions, sickle cell disease care was mostly provided in specialised clinics, which are low in number and accessibility. The scarcity of published evidence of models of care for sickle cell disease and integrated care in rural settings of LICs and LMICs shows a need to implement more integrated models to improve access, particularly in rural areas. PEN-Plus, a model of decentralised, integrated care for severe chronic non-communicable diseases, provides an approach to service integration that could fill gaps in access to comprehensive sickle cell disease care in LICs and LMICs.

中文翻译：

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低收入和中低收入国家镰状细胞病的护理模式：范围界定审查

镰状细胞病的全球负担日益沉重，主要落在低收入国家 (LIC) 和中低收入国家 (LMIC) 上，这些国家的综合护理往往不足，特别是在农村地区。综合护理模式可能有利于改善人力资源和基础设施有限地区获得护理的机会。作为整合科学中心持续努力定义、系统化和实施非传染性疾病 (NCD) 综合护理服务模式的一部分，本综述探讨了低收入国家和中低收入国家镰状细胞病的护理模式。我们从 136 项研究中确定了 99 个模型，这些研究主要是在中低收入国家的高等教育城市设施中进行的。除了同时治疗其他疾病的两种综合护理模式外，镰状细胞病护理大多在专科诊所提供，但数量少且可及性低。镰状细胞病护理模式和低收入国家和中低收入国家农村地区综合护理模式的已发表证据的缺乏表明，需要实施更加综合的模式来改善获取服务的机会，特别是在农村地区。 PEN-Plus 是一种针对严重慢性非传染性疾病的分散综合护理模式，提供了一种服务整合方法，可以填补低收入国家和中低收入国家获得全面镰状细胞病护理的空白。