How many patients with a sexually transmitted infection are cured by health services?: A Study from Mwanza region, Tanzania
How many patients with a sexually transmitted infection are cured by health services?: A Study from Mwanza region, Tanzania
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DOI：
10.1046/j.1365-3156.2001.00809.x
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发表时间：
2001-12-01
影响因子：
3.3
通讯作者：
Hayes, RJ
中科院分区：
文献类型：
--
作者：
Buvé, A;Changalucha, J;Hayes, RJ
目的：估计有症状的患者的比例与细菌性性传播感染（STI）治愈的初级卫生保健服务在姆万扎地区，坦桑尼亚，并比较治愈率的卫生中心之前和之后引进改进的STI治疗services.METHODS模型，描述了不同的障碍与STI患者采取之前，他们可以被认为是治愈的卫生服务。模型的输入参数值取自不同的研究。来自一项干预试验以及一项基于人群的男性尿道炎研究的数据被用来估计有症状的性病患者向卫生中心寻求护理的比例。在四个卫生中心进行的一项观察性研究提供了对性传播感染得到正确诊断和治疗的患者比例的估计数，这些卫生中心已改进性传播感染治疗服务。对1周后返回保健中心的患者进行了关于依从性的访谈。生殖器分泌物综合征（GDS）和生殖器溃疡病（GUD）的处方模式的研究中获得了一个估计的疗效，在卫生中心的治疗性传播感染的改进的STI服务推出之前，生殖器分泌物综合征（GDS）和生殖器溃疡病（GUD）。据估计，在卫生中心提供改进的STI服务的集水区，51-72%的STI症状的患者寻求这些卫生中心的照顾。约76-85%的病例得到正确诊断，其中69-80%得到有效治疗。完全治疗的依从性估计为84%。提供经改进的性传播感染服务的保健中心实现的总体治愈率估计在23%至41%之间。在改进性传播感染服务之前，有症状的性传播感染患者到保健中心就诊的比例估计为39%。处方治疗的估计疗效为28%。这些卫生中心实现的总体治愈率不到10%.CONCLUSIONS当评估STI病例发现和管理的性能时，必须考虑到STI患者在被认为是由卫生服务治愈之前所采取的所有步骤。在姆万扎地区，为改善性传播感染服务而采取的干预措施提高了初级保健中心的性传播感染治愈率。
OBJECTIVES To estimate the proportion of symptomatic patients with a bacterial sexually transmitted infection (STI) cured by primary health care services in Mwanza Region, Tanzania, and to compare the cure rate achieved by health centres before and after the introduction of improved STI treatment services.METHODS A model was used that describes the different hurdles patients with an STI take before they can be considered cured by the health services. The values for the input parameters for the model were taken from different studies. Data from an intervention trial as well as from a population-based study on male urethritis were used to estimate the proportion of symptomatic patients with an STI who seek care from a health centre. An observational study in four health centres where improved STI treatment services had been introduced provided estimates of the proportions of patients with an STI correctly diagnosed and treated. Patients who returned to the health centres after 1 week were interviewed about compliance. An estimate of the efficacy of treatments prescribed for STIs in health centres before the introduction of improved STI services was obtained from a study on prescription patterns for genital discharge syndrome (GDS) and genital ulcer disease (GUD).RESULTS It was estimated that in the catchment area of health centres offering improved STI services, 51-72% of patients with STI symptoms sought care from those health centres. About 76-85% of cases were correctly diagnosed, and of these 69-80% received efficacious treatment. Compliance with full treatment was estimated at 84%. The estimated overall cure rate achieved by the health centres offering improved STI services ranged between 23 and 41%. The proportion of symptomatic STI patients who attended a health centre before improved STI services were introduced was estimated at 39%. The estimated efficacy of the treatments prescribed was 28%. The overall cure rate achieved by these health centres was less than 10%.CONCLUSIONS When assessing the performance of STI case detection and management all steps have to be taken into account that are taken by patients with an STI before they can be considered cured by the health services. The intervention to improve STI services in Mwanza Region has resulted in an improvement of the cure rate of STIs achieved by primary health care centres.