15个法语撒哈拉以南非洲国家阻塞性睡眠呼吸暂停诊断和治疗的障碍：一项多国调查

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中文摘要

目的： 阻塞性睡眠呼吸暂停（OSA）在资源匮乏地区诊断不足且治疗不足。本研究旨在全面评估15个法语撒哈拉以南非洲（FSSA）国家OSA诊断和治疗资源的可用性、可及性和可负担性。
方法： 在法语非洲肺科学会（SAPLF）协调下，于2025年10月至12月开展了一项横断面调查。通过SAPLF网络有目的地选取了来自15个国家的国家专家，并完成了一份标准化问卷，内容涵盖基础设施、费用、人力资源、保险覆盖和感知障碍。定量数据进行描述性分析；定性回答进行主题分析。
结果： 多导睡眠监测（PSG）在6/15个国家（40%）可用，呼吸体积描记（RP）在13/15个国家（86.7%）可用，主要集中在首都和私立中心。诊断费用高得令人望而却步：PSG为221-686欧元，RP为69-259欧元，通常超过法定月最低工资（SMW）。持续气道正压通气（CPAP）设备在8/15个国家（53.3%）可用，下颌前移装置（MAD）在5/15个国家（33.3%）可用，费用分别为381-3812欧元和38-305欧元。CPAP的保险覆盖仅为部分覆盖，且仅在三个国家有报告。受过培训的从业人员密度极低，大多数国家报告每百万居民不足两人。
结论： 法语撒哈拉以南非洲的OSA诊疗受到诊断能力集中、费用高昂和训练有素提供者短缺的制约。加强培训、减少经济障碍并将睡眠医学纳入非传染性疾病策略，可能改善获取服务的公平性。

英文摘要

PURPOSE: Obstructive sleep apnoea (OSA) is underdiagnosed and undertreated in low-resource settings. This study aimed to comprehensively assess the availability, accessibility, and affordability of diagnostic and therapeutic resources for OSA across 15 francophone sub-Saharan African (FSSA) countries.
METHODS: A cross-sectional survey was conducted from October to December 2025 under the coordination of the Société Africaine de Pneumologie de Langue Française (SAPLF). National experts from 15 countries were purposefully selected through the SAPLF network and completed a standardized questionnaire covering infrastructure, costs, workforce, insurance coverage, and perceived barriers. Quantitative data were analyzed descriptively; qualitative responses were analyzed thematically.
RESULTS: Polysomnography (PSG) was available in 6/15 countries (40%) and respiratory polygraphy (RP) in 13/15 (86.7%), primarily concentrated in capital cities and private centers. Diagnostic costs were prohibitive: PSG ranged from €221-686 and RP from €69-259, often exceeding the statutory monthly minimum wage (SMW). Continuous positive airway pressure (CPAP) devices were available in 8/15 countries (53.3%) and mandibular advancement devices (MAD) in 5/15 (33.3%), with costs ranging from €381-3,812 and €38-305, respectively. Insurance coverage for CPAP was partial and reported in only three countries. The density of trained practitioners was critically low, with most countries reporting fewer than two per million inhabitants.
CONCLUSION: OSA care in francophone sub-Saharan Africa is constrained by centralised diagnostic capacity, prohibitive costs, and a shortage of trained providers. Strengthening training, reducing financial barriers, and integrating sleep medicine into non-communicable disease strategies may improve equity in access.