模拟疟疾在线工具:用于评估医疗服务提供者的做法并为认证消除疟疾和防止疟疾复发的证据基础做出贡献的工具。

IF 2.4 3区 医学 Q3 INFECTIOUS DISEASES
Reza Majdzadeh, Mohammad Ali Mansournia, Ayat Ahmadi, Ahmad Raeisi, Hosein Azizi
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引用次数: 0

摘要

背景:在处于消灭疟疾阶段的国家,医疗保健提供者(HCPs)的实践和疑似疟疾(CMSM)的正确处理是消灭疟疾和预防疟疾复发(POR)的核心要素。然而,由于疟疾病例数量较少,旨在消除疟疾的国家对疟疾监测系统和卫生保健人员做法的了解往往比较薄弱。方法:使用模拟疟疾在线工具根据四项标准对初级保健人员进行评估,包括提供疑似疟疾病例以检测初级保健人员在识别(a)、诊断(b)、适当治疗(c)和紧急报告(d)方面的失误;并与模拟患者(SP)进行比较。通过多重逻辑回归分析,估算出调整后的人类保健工作者失误风险的几率比(ORs):总体失败比例为 237(83%),大多数失败是在识别(a)方面。根据所有失败标准,SMOT 和 SP 之间没有明显差异(P > 0.05)。私立诊所(93%)和公立专科诊所(70%)的失败比例最高和最低。在通过识别阶段(a)后,全体保健医生和传染病专科医生的总体不及格比例分别降至 47.8%和 25.0%。在最终分析中,私营部门(AOR = 4.36:1.25-15.2)、非专科医生(AOR = 2.84:1.29-6.25)和工作经验≥5 年的保健医生(AOR = 2.03:1.01-6.25)增加了失败的风险:研究结果证实,在疟疾传播率较低或传播中断的环境中可以使用 SMOT 工具。该工具能够识别出需要加强的医疗服务提供者子群体,并有助于预防疟疾再次发生。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Simulated Malaria Online Tool: an instrument for evaluating healthcare providers' practices and contributing to the evidence base for certifying malaria elimination and preventing its re-establishment.

Background: Healthcare providers (HCPs) practice and correct management of suspected malaria (CMSM) are central components of malaria elimination and prevention of re-establishment (POR) in countries in the elimination phase. However, knowledge of malaria surveillance systems and HCPs practices often wanes in countries aiming to eliminate malaria due to the low numbers of cases. The study aimed to implement a valid Simulated Malaria Online Tool (SMOT) for assessment HCP performance in CMSM and POR in a malaria-free area.

Methods: HCPs were evaluated using SMOT tool based on four criteria including presenting a suspected malaria case for detection of HCPs' failures in recognition (a), diagnosis (b), appropriate treatment (c), and urgent reporting (d); and compared with simulated patients (SP). Multiple logistic regression analysis was carried out to estimate adjusted odds ratios (ORs) for the risk of HCPs failures.

Results: The overall failure proportion was 237 (83%), and the majority of failures were in recognition (a). There was no significant difference between the SMOT and SP based on all failure criteria (P > 0.05). The private clinic (93%) and the public specialized clinic (70%) had the highest and lowest failure proportions. After passing the recognition stage (a), the overall failure proportions decreased to 47.8% and 25.0% for total HCPs and infectious disease specialists, respectively. In the final analysis, private sector (AOR = 4.36: 1.25-15.2), not-specialist providers (AOR = 2.84: 1.29-6.25) and HCPs with ≥ 5 years' experience (AOR = 2.03: 1.01-6.25) increased the risk of failure.

Conclusion: Findings confirmed the implementation of SMOT tool in settings where malaria transmission is low or interrupted. The tool is able to identify sub-groups of providers needing strengthening, and contributes to the prevention of malaria re-establishment.

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来源期刊
Malaria Journal
Malaria Journal 医学-寄生虫学
CiteScore
5.10
自引率
23.30%
发文量
334
审稿时长
2-4 weeks
期刊介绍: Malaria Journal is aimed at the scientific community interested in malaria in its broadest sense. It is the only journal that publishes exclusively articles on malaria and, as such, it aims to bring together knowledge from the different specialities involved in this very broad discipline, from the bench to the bedside and to the field.
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