Community Health Workers Use Malaria Rapid Diagnostic Tests (RDTs) Safely and Accurately: Results of a Longitudinal Study in Zambia
Community Health Workers Use Malaria Rapid Diagnostic Tests (RDTs) Safely and Accurately: Results of a Longitudinal Study in Zambia
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DOI：
10.4269/ajtmh.2012.11-0800
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发表时间：
2012-07-01
影响因子：
3.3
通讯作者：
Bell, David
中科院分区：
文献类型：
--
作者：
Counihan, Helen;Harvey, Steven A.;Bell, David
疟疾快速诊断测试（RDT）可以从根本上改善偏远和资源匮乏人群的发热性疾病管理。然而，由于对血液安全和青蒿素联合疗法的适当使用的担忧，对社区卫生工作者（CHW）的依赖仍然存在争议。这项研究评估了 CHW 在培训后 12 个月内安全、准确地使用 RDT 的能力。我们培训了 65 名赞比亚社区卫生工作者，然后提供 RDT、工作辅助工具和其他必要的用品供村庄使用。观察员在培训后 3、6 和 12 个月评估 CHW 的表现。正确执行关键步骤的比例从 3 个月时的 87.5% 增加到随后的 100%。然而，一些社区卫生工作者错误地将微弱的阳性或无效结果解读为阴性。尽管大多数指标随着时间的推移有所改善或保持稳定，但对微弱阳性的解释在 12 个月时正确率下降至 76.7%。我们的结论是，经过适当培训和监督的社区卫生工作者可以在培训后长达 12 个月的时间内在社区实践中安全、准确地使用 RDT。
Malaria rapid diagnostic tests (RDTs) could radically improve febrile illness management in remote and low-resource populations. However, reliance upon community health workers (CHWs) remains controversial because of concerns about blood safety and appropriate use of artemisinin combination therapy. This study assessed CHW ability to use RDTs safely and accurately up to 12 months post-training. We trained 65 Zambian CHWs, and then provided RDTs, job-aids, and other necessary supplies for village use. Observers assessed CHW performance at 3, 6, and 12 months post-training. Critical steps performed correctly increased from 87.5% at 3 months to 100% subsequently. However, a few CHWs incorrectly read faint positive or invalid results as negative. Although most indicators improved or remained stable over time, interpretation of faint positives fell to 76.7% correct at 12 months. We conclude that appropriately trained and supervised CHWs can use RDTs safely and accurately in community practice for up to 12 months post-training.