Introducing malaria rapid diagnostic tests at registered drug shops in Uganda: limitations of diagnostic testing in the reality of diagnosis.
Introducing malaria rapid diagnostic tests at registered drug shops in Uganda: limitations of diagnostic testing in the reality of diagnosis.
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DOI：
10.1016/j.socscimed.2011.01.009
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发表时间：
2011-03
影响因子：
5.4
通讯作者：
Mbonye, Anthony K.
中科院分区：
文献类型：
--
作者：
Chandler, Clare I. R.;Hall-Clifford, Rachel;Asaph, Turinde;Pascal, Magnussen;Clarke, Sian;Mbonye, Anthony K.
关键词：
在乌干达，大约三分之二的药品是从私营部门采购的，大多数是从药店采购的。因此，在药店采用疟疾快速诊断测试有可能对针对疟疾寄生虫感染者的抗疟药物作出重大贡献。我们在乌干达的一个地区进行了形成性研究，为在药店进行RDT的随机试验做准备。2009年5月至7月，我们采访了9名药店工作人员、5名卫生工作者和4名地区卫生官员，并与75名社区成员进行了10次焦点小组讨论，以调查药店的作用和在这些卫生保健网点实施RDT的潜力。药店被视为向社区成员提供重要服务，其性质取决于对客户需求的反应。然而，药店的地位是有限的：在不同的行为者眼中，这些药店既是商店又是诊所;既合法又不合法;既值得信任又不值得信任。疟疾治疗被认为是诊断的同义词。诊断测试在理论上被认为是有用的，社区成员对结果感到好奇，期望测试能够减少不确定性，并有助于结束疾病。然而，在实践中，是否会寻求测试作为治疗决定的常规步骤是不确定的，因为测试的吸引力减弱，鉴于其成本和潜在的结果与假定的诊断相冲突。需要采取干预措施，提高对疟疾样疾病的多种原因和管理的认识，以支持以寄生虫学诊断为代表的疟疾治疗的新合理化。
In Uganda, around two thirds of medicines are procured from the private sector, mostly from drug shops. The introduction of malaria rapid diagnostic tests (RDTs) at drug shops therefore has the potential to make a significant contribution to targeting antimalarial drugs to those with malaria parasites. We undertook formative research in a district in Uganda in preparation for a randomised trial of RDTs in drug shops. In May to July 2009, we interviewed 9 drug shop workers, 5 health workers and 4 district health officials and carried out 10 focus group discussions with a total of 75 community members to investigate the role of drug shops and the potential for implementation of RDTs at these health care outlets. Drug shops were seen to provide an important service to community members, the nature of which is determined by responsiveness to client demands. However, drug shops hold a liminal status: in the eyes of different actors, these outlets are at once a shop and clinic; legitimate and illegitimate; and trusted and distrusted. Malaria treatment was found to be synonymous with diagnosis. Diagnostic testing was deemed useful in theory, and community members were curious about the results, with the expectation that a test would decrease uncertainty and help secure an end to illness. However, whether testing would be sought as a routine step in treatment decisions in practice is uncertain, since the appeal of the tests waned in light of their costs and potential for results to conflict with presumed diagnosis. Interventions that increase awareness of multiple causes and management of malaria-like illness will be needed to support the new rationalisation for malaria treatment represented by parasitological diagnosis.
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影响因子：
1.5
作者：
Mbonye, AK;Neema, S;Magnussen, P
通讯作者：
Magnussen, P
影响因子：
3
作者：
Chandler, Clare I. R.;Jones, Caroline;Whitty, Christopher J. M.
通讯作者：
Whitty, Christopher J. M.
影响因子：
3
作者：
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影响因子：
3
作者：
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通讯作者：
Bjorkman A
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影响因子：
15.8
作者：
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通讯作者：
Björkman A