Improved Malaria Case Management after Integrated Team-based Training of Health Care Workers in Uganda
Improved Malaria Case Management after Integrated Team-based Training of Health Care Workers in Uganda
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DOI：
10.4269/ajtmh.2008.79.826
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发表时间：
2008-12-01
影响因子：
3.3
通讯作者：
Dorsey, Grant
中科院分区：
文献类型：
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作者：
Ssekabira, Umaru;Bukirwa, Hasifa;Dorsey, Grant
非洲疟疾病例管理的特点是假定治疗和大量过度治疗。我们评估了所有以团队为基础的疟疾病例管理综合培训计划。在乌干达的八个卫生设施对培训前后120天的监测数据进行了比较。培训后，5岁以下的疑似疟疾患者接受血涂片检查的比例从38.3%增加到54.6%（P = 0.04），5岁以上的患者从34.1%增加到53.4%（P = 0.02）。在5岁以下的人群中，血涂片阴性的患者比例从47.9%降至19.6%（P < 0.001）。培训并没有提高血涂片呈阳性的病人中开抗疟药的比例、开适当抗疟药的病人比例或显微镜诊断的准确性。以团队为基础的综合培训可改善疟疾病例管理，减少不必要的抗疟治疗次数。
Malaria case management in Africa is characterized by presumptive treatment and substantial overtreatment. We evaluated all integrated team-based training program on malaria case management. Surveillance data 120 days before and after training were compared at eight health facilities in Uganda. After training, the proportion of patients with suspected malaria referred for blood smears increased from 38.3%, to 54.6% (P = 0.04) in persons < 5 years of age years and front 34.1% to 53.4% (P = 0.02) in those >= 5 years of age. The proportion of patients with negative blood smears prescribed antimalarial drugs decreased from 47.9% to 19.6% (P < 0.001) in persons = 5 years of age. Training did not improve the proportion of patients with positive blood smears prescribed antimalarial drugs, the proportion of patients prescribed appropriate antimalarial drugs or the diagnostic accuracy of microscopy. Integrated team-based training may improve malaria case management and reduce the number of unnecessary antimalarial treatments.