在埃塞俄比亚西南部消除疟疾的抗疟疾治疗的评估:一个快速决策的并行三角设计。

IF 3 3区 医学 Q3 INFECTIOUS DISEASES
Mathewos Alemu Gebremichael, Tadesse Gebremedhin, Wondwossen Niguse, Girma Mamo, Bezuayehu Alemayehu, Ephrem Negeri, Ibrahim Temam, Haile Zewude, Tamerat Bogale, Endale Sahile, Erkyihun Pawlos
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引用次数: 0

摘要

背景:疟疾病例管理是确保消除疟疾规划战略的重要组成部分。尽管实施了持续的预防战略,但在资源有限的国家,特别是在埃塞俄比亚,由于与治疗有关的问题,疟疾仍然是一个主要的公共卫生问题。因此,本研究旨在确定在埃塞俄比亚西南人民地区州(SWEPRS)公共卫生机构工作的卫生保健提供者对疟疾诊断和治疗指南的遵守程度。方法:从2024年3月至2024年7月,采用以设施为基础的横断面研究与定性调查相结合。采用多阶段分层有目的抽样技术分别进行定量和定性研究。通过记录审查、焦点小组讨论(fgd)和深度访谈(IDIs)收集数据。根据现行疟疾诊断和治疗指南的建议,对保健提供者的依从性进行了评估。定性分析的结果在专题分析中呈现,并与定量分析结果进行三角测量。结果:共审核患者卡1684张。患者平均年龄20.99(±15.61)岁。通过显微镜和/或多物种快速诊断试验(RDT)筛选了1,616例(95.96%)患者。卫生保健提供者对最新疟疾治疗标准的总体依从性为36.99% (95%CI: 33.93-38.52%),其中大多数(982人)(58.31%)被诊断为恶性疟原虫,其次是间日疟原虫和混合感染。据报告,抗疟疾药物短缺是最主要的障碍,其次是缺乏关于最新疟疾病例管理指南的培训、卫生专业人员短缺和缺乏实验室材料。此外,电力供应短缺、计算机短缺、门诊部(OPD)房间短缺、交通不便、距离卫生设施较远、社区耐药性、处方抗疟疾药物使用不当、认为药物无效、无法负担抗疟疾药物、缺乏新的疟疾病例管理指南、缺乏私人药房、语言障碍和吉姆萨质量差,这些都是确定的障碍。结论:卫生保健提供者的依从性水平较低。因此,建议确保提供所有国家推荐的抗疟疾药物和用品、合格的保健专业人员、提供持续培训、加强公共保健设施的持续后续行动和监督,以提高保健专业人员对国家疟疾治疗指南的遵守程度。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Evaluation of anti-malarial treatment for elimination of malaria in South West Ethiopia: a concurrent triangulation design for prompt decision.

Background: Malaria case management is a vital component of strategies to ensure malaria elimination programme. Despite continuous preventive strategies in place, malaria remains a major public health problem in resource-limited countries particularly in Ethiopia due to treatment-related problems. Hence, this study aimed to determine the level of adherence to malaria diagnosis and treatment guidelines among healthcare providers working in the public health facilities in Southwest Ethiopian Peoples Regional State (SWEPRS).

Methods: A facility-based cross-sectional study triangulated with qualitative inquiry was applied from March 2024 and July 2024. A multi-stage stratified and purposive sampling technique was used for the quantitative and qualitative study, respectively. Data were collected by the records review, Focus Group Discussions (FGDs), and In-depth Interviews (IDIs). The adherence of healthcare providers was evaluated according to recommendations of the current malaria diagnosis and treatment guidelines. The findings in the qualitative analysis were presented in the thematic analysis and triangulated with the quantitative findings.

Results: 1,684 patient cards were reviewed. The mean age of patients was 20.99 (± 15.61) years. 1,616 (95.96%) patients were screened through microscopy and/or multispecies rapid diagnostic tests (RDT). The overall adherence of healthcare providers to the updated malaria treatment standards was 36.99% (95%CI: 33.93-38.52%) and the majority, 982 (58.31%) were diagnosed with Plasmodium falciparum followed by Plasmodium vivax, and mixed infections. Shortage of anti-malarial drugs was reported as the foremost barrier followed by lack of training on the updated malaria case management guideline, shortage of health professionals, and lack of laboratory materials. In addition, shortage of electric supply, shortage of computers, shortage of outpatient department (OPD) rooms, lack of transport, distance from a health facility, community resistance, improper use of prescribed anti-malarial drugs, perceived inefficacy of drugs, inability to afford the anti-malarial drugs, lack of new malaria case management guideline, lack of private pharmacy, language barriers, and poor quality of Giemsa, were identified barriers.

Conclusions: The adherence level of healthcare providers was found to be low. Hence, ensuring the availability of all nationally recommended anti-malarial drugs and supplies, qualified health professionals, providing continuous training, strengthening continuous follow-up and supervision in the public health facilities are recommended to improve the adherence level of health professionals to national malaria treatment guideline.

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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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